15-Oct-13 World View-Aetna CEO predicts Obamacare IT failure

[John]

15-Oct-13 World View -- Aetna CEO predicts Obamacare IT failures until 2017


Assad says loss of chemical weapons a blow to Syria's morale

** 15-Oct-13 World View -- Aetna CEO predicts Obamacare IT failures until 2017
** http://www.generationaldynamics.com/pg/ ... tm#e131015



Contents:
Aetna CEO predicts Obamacare IT failures until 2017
Assad says loss of chemical weapons a blow to Syria's morale
EU officials demand more privatization from Greece


Keys:
Generational Dynamics, Aetna, Mark Bertolini, Obamacare,
Syria, Bashar al-Assad, Israel, Greece

[gerald]

IT failure --
http://healthpolicyandmarket.blogspot.c ... p-for.html

How Many People Have Signed Up For Health Insurance on the Federal Health Insurance Exchanges?

"For some reason the system is enrolling, unenrolling, enrolling again, and so forth the same person. This has been going on for a few days for many of the enrollments being sent to the health plans. It has got on to the point that the health plans worry some of these very few enrollments really don't exist."

[NoOneImportant]

Suggest everyone reread John's post... especially the bridge analogy. In large system development where development is rushed to meet unrealistic roll-out dates, internal development discipline disappears... what you end up with is this undocumented monster where nothing appears to work as planned. As the roll-out date approaches ever closer, everyone feels the pressure, and panic sets in; developers begin doing whatever they think they need to do, wear-ever they want to do it, and abandon all development discipline. The result: errors to appear to happen "at random" and leave no, or little trail as to who the offending party - software module - was who caused the problem - thus, as Gerald noted above, nothing appears to be certain, and thus every one becomes gun shy of using any output of any sort, as nothing can be relied upon.

Scalability alone is an enormous issue, what may work for 4,5, 10, 100, or ever a thousand users may not work when you have 10, 20, or 30 thousand users banging away on it. Time per user becomes super critical. If each user requires .3 seconds to do something, that's not an issue for a single user, but start stacking up individual users and it very quickly, with a relatively small number of users, becomes an enormous problem as the time may be cumulative. Yes it only takes .3 seconds for any given user but if you have 10 users that 3 seconds, 100 users that's 30 seconds and so on. As noted in John's article inexperienced programmers often don't understand the physical ramifications of what appears to them to be a simple programming request. All of these things come out in testing, and are addressed, if sufficient time is allowed to test things.

But again, this is simply yet another area of which the President is just grossly ignorant. He uses his PC, he surfs the Internet, and believes that he can command his heart's desire - after all, Microsoft can make Windows work, can't they? He has no memory of the early versions of Windows that were simply awful. He routinely cruses the Internet, he sees that it works, he can view Fox News any time he desires, right? He has no memory of the Internet's development period from the mid 70s to the mid 90s, times when maybe the Internet worked, and maybe it didn't. So, he rationalizes, why shouldn't Obamacare be used to orchestrate 300 million people into nationalized healthcare? So he gives the developers a couple of years - ... anybody should be able to write whatever software they need in a couple of years, right? Sorry, that's just not how it works - you design big, start small, then scale it up; fix the problems; then scale it up; fix the problems then scale it up. No one in their right mind goes from zero to 300 million users in one fell swoop - with the possible exception of Obama. The problem is much akin to fusion power generation. We know that it works; we arise daily to view a clear example in the sky; we know that it works in large bombs, yet getting it to work on a contained manageable scale isn't all that easy - perhaps Obama should simply command that controlled fusion simply work, because he knows just about as much about fusion as he does about large system software development.

[shoshin]

To all the doom-sayers on the Affordable Care Act ("it will destroy America" "the end of the United States" etc), I ask you to look back in history, for which many seem sot extend no further than 2 weeks. First, all the same arguments were made by Reagan et al about Medicare and Medicaid. Now, you can argue that, given time, those predictions will come true. But both programs have done enormous good and and are embraced by the citizenry. Second, try to recall when Bush II railroaded through the changes to Part D of Medicare (oddly, enough, no government shutdown threatened, no impeachment imminent). Seniors had to go online and sign up and there were monumental glitches. It took at least 2 months to sort things out, and for a program tiny compared to AFA. Once again, no government shutdown threatened, no impeachment imminent. Just sayin'.

And for a very effective demonstration of the differences between signing up for Obamacare versus a "traditional" health insurance plan, I hope you can spare the time (6 minutes) for this short video, in which a nice young man attempts to do both, It vividly demonstrates:
(1)why Obamacare is better for the health and happiness of the citizenry,
(2) why insurance companies hate it, and,
(3) why Congress, which is effectively owned by the insurance industry, will fight it tooth and nail.

http://www.youtube.com/watch?v=ql9RVy6F ... _Kl06ApH54

And as for those dire predictions that AFA will "destroy small businesses." I hope you can access this New Yorker piece, which effectively destroys that argument.
http://www.newyorker.com/talk/financial ... surowiecki

Finally, the AFA is NOT a great piece of legislation and needs multiple alterations, BUT it is far better than what we had before, and still a pale shadow of what other developed countries supply to their citizens.

[at99sy]

ACA is not in any way affordable for many working families. I checked what my premiums would likely be in NH and they are at least 50% more than what I pay right now. So if my employer drops our plan and we get slammed into this I would be financially devastated. The cap on wage/premium clause is ineffectual in many cases due to all the loopholes in the policy.

Medicare and Medicaid make up about 1 trillion in annual expenses, of which about 40% are paid out of general funds and 38% through taxpayer "contributions."

http://kff.org/medicaid/state-indicator ... -spending/

http://kaiserfamilyfoundation.files.wor ... icare1.png

It may not be a complete disaster but it certainly has the potential to be at least a disaster of grand proportions. I see insurance companies making additional fortunes under this policy. Everyone is required to get insurance from somewhere, they will logically find the least expensive method of keeping the "man" off their backs. As obamacare's exorbitant prices become more understood, other options will be more palatable. Still illegals will not get any insurance, still a huge drain of resources around the country. Working people will pay more and the poor will get more free stuff while the uber wealthy maintain status quo.

cheers
sy

[gerald]

And as for those dire predictions that AFA will "destroy small businesses." I hope you can access this New Yorker piece, which effectively destroys that argument.
http://www.newyorker.com/talk/financial ... surowiecki

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http://www.nola.com/business/index.ssf/ ... dly_o.html
Part-time job growth rapidly outpacing full-time opportunities, statistics show
Part-time work has particularly picked up lately. From January through July, the number of working Americans grew by 960,000, according to Labor Department surveys. The number of those who have full-time jobs is up 172,000. The ranks of part-time workers? Up 766,000.

and from comments --

Well what would you expect employers to do when facing a mandatory requirement by Washington that they pay for the health care of workers. They are going to stop hiring full time worker and worse, put many full time workers on part time employment.

The hitch is the part time employees have to buy Obamacare for themselves and family and they can hardly afford to do that working only part time.

So what comes next? The IRS can not jail all part time workers who can not afford the affordable care act. The answer then put them on Medicare so all workers who have jobs will pay.

Why work when you can go on welfare?

If you want to turn a growth economy with full employment into a recessive socialist economy with no future for American kids this is how you do it.