from the did-you-dot-your-eyes-and-cross-your-teas? dept.
The Government Accountability Office released a report Thursday on the security of the Federal Health Care website, through which millions of Americans bought coverage under the health law last year and which millions more will be urged to use. [Summary, highlights (pdf), full report (pdf), full report (text-only).]
The GAO said the Centers for Medicare & Medicaid Services (CMS) failed to ensure system-security plans were complete and was relying on a draft data-use agreement with a contractor tasked with verifying users' identities.
Moreover, the CMS skipped some assessments of privacy risks and didn't perform comprehensive security testing of the Healthcare.gov system that used all of the security controls specified by the government ahead of the site's launch. Testing remained incomplete as of June 2014, GAO said.
As a freelancer, Obamacare is literally the best thing the federal government has done for me in ages. I will be signing up for coverage this fall. But the system's security has always been a big concern for me, particularly since I "know how the sausage is made" in the industry. I hope this publicity will lead to significant improvements. I think their system may be one of the most attractive targets for identity thieves on the internet. They won't get credit-card numbers, but there is so much personal information that goes into those systems that they are practically the keys to kingdom. So attractive that I find it hard to believe that the systems aren't already fully compromised and we are just waiting for the other shoe to drop.
Kaiser Health News provides, for each of several publications, a summary paragraph and a link to the full article. It is quite interesting to see how each publication puts a different spin on the same material.
On the technical side, are there any Soylents with first-hand information on the site's development they'd like to share, or, in developing software for a major bureaucracy, in general? What are the greatest impediments you've found to "getting it right?"
(Score: 0) by Anonymous Coward on Friday September 19 2014, @02:45AM
on Obamacare, after the Tea Party declared war on the GOP establishment during primary season and (mostly) got their butts handed to them. Now we're getting back to politics as usual in Washington, where "as usual" means before 2009 - a lot of wheeling and dealing between the two parties on Capitol Hill.
I just checked - nothing on ObamaCare in the front page of foxnews.com. One item (positive, about bipartisan cooperation) on drudgereport.com.
Now, the web site and IT stuff is another matter. Maybe Larry decided he could live without the continued abuse he's scheduled to get over badly executed ObamaCare implementations.
(Score: 3, Interesting) by khallow on Friday September 19 2014, @12:46PM
The Republicans and their allies overplayed the website issues. The thing that's going to matter in the long run are the huge problems with cost control, perhaps with a contribution from more modest problems like the incentives for perverse behavior (like employing a bunch of people less than 30 hours a week or only getting insurance when you think you will need it in the near future), the various unconstitutional aspects of the law, and the neutering of Medicaid (the public single payer insurance for the poor). But that won't destroy the Obamacare system before the 2014 election and probably not before the 2016 election either. However, I do think the system will require a major fix by 2020 in order to keep from self-destructing.
(Score: 0) by Anonymous Coward on Friday September 19 2014, @05:32PM
Your post is so full of wrong, that even I, someone with no more than a passing familiarity with obamacare can recognize the BS:
> only getting insurance when you think you will need it in the near future),
You can only sign up for insurance once a year.
There are substantial penalties for people who do not purchase coverage, that is what the entire supreme court fight about the individual mandate was about
> problems with cost control
> the neutering of Medicaid
You mean that bogus $700B [politifact.com] claim? You can't have it both ways - cuts in future medicaid increases were in order to control costs
(Score: 2) by khallow on Saturday September 20 2014, @01:14AM
The most expensive health care problems aren't unexpected. Your diabetes has been getting worse or you're starting to show the symptoms of heart and circulation problems? Planning to get pregnant? Better stock up on insurance before the next check up. Besides, substantial penalties have to be pretty substantial, on the order of thousands of dollars or more per year in order to discourage this sort of game playing.
Given the claim was a real thing, Medicaid is being cut at the same time as a bunch of new people are being put on the program, it's not bogus by definition. Let's stop being an ignorant, partisan fuck for a moment and consider the following.
The law creates subsidies and penalties to encourage people to buy insurance - that is an increase in the demand for health insurance and subsequently for health care. Similarly, the subsidies leave a large portion of the US population with fixed, fairly low caps on cost no matter how much health care they consume beyond their deductible. That isolates a lot of the demand for health insurance from the cost of their health insurance. We also have the insurers being forced to expand the services provided under their coverage which again increases demand.
That right there is going to increase health care costs substantially. You put a system in place which encourages people to consume lots of health care regardless of the cost and the cost will go up on a regular basis.
Then on the insurer side, we have the Temporary Risks Corridors program. While it can easily be expanded to become a bailout program for insurers that take bad risks, the real problem is that it transfers wealth from the more prudent insurers to the less prudent. It is a short term gimmick to lower the price of health care insurance now at the expense of a bunch of failing insurance companies later.
These are large systematic issues with Obamacare that make the real issue, high health care costs worse. In exchange, the only two parts that can be considered deflationary are the cuts to Medicaid and the market competition. I don't think the combination will succeed - especially once the price difference between what Medicaid offers and what the health care actually is priced for get large enough that Medicaid can no longer act as insurance.
There are several failure modes to consider here. First, as I just noted that Medicaid fails to act as insurance. If everyone refuses to serve Medicaid patients, then it's not insurance. We're getting to that point. Another failure mode is growing subsidy costs to the US federal budget and some state budgets. Recall that the subsidies cap costs but not cost growth. So they'll have to cut back on what the insurance pays for, cut back on the subsidy, (these former two options include inflating the currency, cutting back on everything that the dollar pays for), or increase the lower side thresholds and push people off of the subsidy into Medicaid (which shifts the failure mode back to Medicaid). Or they can attempt to control health care costs directly by interfering with the markets.
So what happens when Medicaid becomes the new uninsured? Or spending on this program increases the US's budget deficit? Or people can't afford health insurance or health care? Something has to give again. I think it'll happen pretty fast, within six years. It's a terrible, ill-planned system and we have the opportunity to learn from it, should we choose to do so.
(Score: 0) by Anonymous Coward on Friday September 26 2014, @04:56AM
The most expensive health care problems aren't unexpected. Your diabetes has been getting worse or you're starting to show the symptoms of heart and circulation problems? Planning to get pregnant? Better stock up on insurance before the next check up.
Diabetes and heart problems are chronic you can't "stock up" on treatments for chronic conditions by definition. And clearly you've never had a kid because (a) pregnancy requires regular medical exams during practically the entire term and (b) newborns go to the doctor on a regular basis both for checkups and vaccinations as well as all the ways kids get sick. You simply don't have fucking clue what you are talking about.
Let's stop being an ignorant, partisan fuck for a moment
Yes, lets stop. You let me know when you've done that.
(Score: 2) by khallow on Saturday September 20 2014, @01:20AM
Also, note that the only people happy with Obamacare are those bouncing around with pricy "pre-existing" conditions. That's what Medicaid and Medicare were supposed to be for, I might add. But I think it's interesting that the only real advocates for the system are the ones who benefit right now from it.