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It Is Just The Beginning Of The Problems

Stanley Feld M.D.,FACP,MACE

The recent problems with www.HealthCare.gov are just the beginning of President Obama’s problems with Obamacare.

CMS has tried every public relations trick in the book to restore public confidence in Obamacare. The web site is failing. The cost of healthcare insurance is rising above affordability for everyone except people who qualify for government subsidies.

The deficit is going to skyrocket because the young healthy people are not going to sign up unless they receive a subsidy. Even with a subsidy, the price of insurance through the health insurance exchanges is too high to afford.

President Obama has even tried to rebrand Obamacare. The new name is the Affordable Care Act. The ACA is the wrong name. Maybe it should be called the Unaffordable Care Act (UCA)? 

The health insurance exchange policies are unaffordable because of government mandates for required care. This unaffordability will result in an increase in uninsured.

At the beginning of October, President Obama placed a November 30,2013 date for the web site being fully operational after the glitches were fixed.

It turns out that the problems are much worse than a few glitches.

“Despite recent progress at HealthCare.gov, a raft of problems will remain beyond the Obama administration's Saturday deadline to make the troubled federal insurance website work.”

The November 30th deadline will be missed. President Obama has revised his declaration. Now the web site will be partially operational.

Once again President Obama’s original promise does not ring true. President Obama announced web site would be 80% operational. What does that mean?

Americans were warned by Henry Chao, the top IT official at the Centers for Medicare and Medicaid Services, who testified on Capitol Hill Tuesday on November 19th   2013 that more than 30% of the "back end" infrastructure still remains to be built in the federally-run marketplace.

The front end looks better according to recent users. The pages load faster. More people are getting through to sign up for health plans.

However the devil is in the details of the “back end.”

As of December 1,2013 healthcare.gov is missing the following,

  1. The ability to verify users’ identities.
  2. The ability to verify income for the purpose of subsidies.
  3. The ability to transmit accurate enrollment data to insurers.
  4. The tools for processing payments by insurers haven't been built.
  5. The data centers ability to support the various site functions has been inconsistent causing the site to crash often.
  6. The ability to supply adequate security for personal information.
  7. Total disregard for HIPPA privacy.
  8. Adequate security on every level.

 

http://youtu.be/uOk0vOup4yA

 

Problems with the performance of the site's databases, storage and servers and their interaction with each other continue to slow the site or make it unavailable for short periods, as of December 1,2013, according to government officials and contractors working on the project.

There are many problems. Forty-eight dollar an hour navigators, CMS spokespersons, and other government official are all rationalizing about the problems.

No one in the Obama administration comes out and tells the public the real problems. They just say it will be fixed.

The comment sections of online articles are many times more truthful than the media fed “facts” by the Obama administration.

One comment appearing in the article, “Health Site Is Improving But Likely to Miss Saturday Deadline.” Said the headline should have been written as  “Health Site Is Improving But CERTAINLY to Miss Saturday Deadline.” 

Richard Sullivan wrote,

“Our father, whose art be in heaven, Hollywood be thy name…………”

  John Rogitz wrote;“The web site will be fixed. Eventually. What won't be so easily fixed is a culture that has relinquished its medical care to government overseers.”

Teresa Rich replied; We haven't relinquished our "care," Mr. Rogitz. We have relinquished our "freedom" — all for the promise of "free" health insurance for "the COLLECTIVE." 

 Charles Whitlach wrote the most educational comment of all.

"We programmers are laughing at the incompetence of this administration. I write in the very same server code as this website developer.”

 “I am a Microsoft Certified Solutions Developer [MCSD]. I have been certified by Microsoft as an expert in this language.

Although I haven't written in ASP.net 2.0 since 2005. We use 5.0 now.”

The primitive program is a result of giving a non-bid contract to Michelle Obama’s friend rather than going through a competitive bidding process. 

“The Javascript & CSS files are uncompressed. Programming 101 says compress them before release. Why are there so many JavaScript files? I have never seen so many JavaScript files on a page, even with sites like Google.” 

“What happened to Unit Testing Mr. President? 

Didn't anyone test this web site for load capacity? That is why people can never get to the "Select State Page". No one tested for load capacity.

 Didn't anyone put in redundancy and fall back servers? These are the basic questions/steps every good IT person checks off before release.” 

“Every good programmer knows that ASP.net 2.0 is "Leak-o-Matic". Who uses 2.0 anymore? This goes beyond legacy issues. What possible justification could anyone have in creating a website today in 2.0? There are none. 

Obama calling in the best and brightest to fix the problem? Why didn't he call us in, in the first place?” 

Lastly, "YOU CANNOT FIX BAD CODE, YOU CAN ONLY REPLACE IT." 

The website written in 10 yr old code cannot be tweaked. There have been too many API changes since 2005. The code must be rewritten.

 The client-side and server side code of this website must be redone. 5 million lines of code need to be rewritten? In my field that is an epic failure.”

“Who ever created this website should return the money. This was utter incompetence. 

The $684 million was wasted."

President Obama has been modifying his statements about the web site being completely fixed by November 30th for the last two weeks.

“It will work for 80% of the people who try to enroll.“

 Officials mixed optimism with caution. "November 30th does not represent a relaunch of HealthCare.gov," said Julie Bataille, a spokeswoman for the government's Centers for Medicare and Medicaid Services, which operates the site.

 "It (November 30,2013) is not a magical date. There will be times after November 30th when the site, like any website, does not perform optimally."

The administration said plans are in place to replace the Verizon unit with H-P this spring.

Someone should tell the administration they need to rewrite the program. Switching database vendors is not going to fix the program.

HHS also didn't initially contract for a backup website or monitoring tools like those used by sophisticated consumer sites, according to people familiar with the matter.”

 Patrick Reikofski might be right when he said.  “Ladies and gentlemen, your Federal Government in action…”

I have not covered the problems Obamacare will have with physicians, insurance companies or hospitals. Obamacare’s implementation will be a nightmare.

If we wasted $684 billion dollars so far on broken web site, how much more will we waste until Obamacare fails completely?

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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