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posted by girlwhowaspluggedout on Friday March 14 2014, @01:30AM   Printer-friendly
from the lowest-bidders-all-the-way-down dept.

skullz writes:

"I've watched the Affordable Care Act's federal and state website roll-outs with trepidation as one botched IT project crashes and burns after another. As more information is coming out about Minnesota's health insurance exchange, lo and behold, poor communication, lack of fundamentals, and bureaucracy seem to be contributing factors.

From NPR's How A Series Of Mistakes Hobbled Minnesota's Health Exchange we learn that the users were the first to actually test the website:

What Minnesotans did not know is they were testing the site. There wasn't time for consumer testing before the site went live. Michael Krigsman, a consultant who specializes in diagnosing and preventing IT project failures, says testing is key. 'That is so screwed up. You can quote me on that,' he says. 'This is one of these things that's so foundational. It's like why do we need to breathe the air?"

Propublica has another article which covers the health insurance exchanges of Minnesota, Massachusetts, Oregon and Maryland - blue states that support the Affordable Care Act.

Having been on projects with shifting scope, compressed timeframes, and arbitrary milestones I feel for the developers who worked on these websites and am a little depressed that we are still doing this in 2014. When will the managers learn? Or at least listen?"

 
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  • (Score: 4, Insightful) by Blackmoore on Friday March 14 2014, @01:36AM

    by Blackmoore (57) on Friday March 14 2014, @01:36AM (#16145) Journal

    Does this surprise anyone in tech? they wanted a professional level software doing 400 billion things, built by the lowest bidder.

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  • (Score: 3, Insightful) by GungnirSniper on Friday March 14 2014, @01:53AM

    by GungnirSniper (1671) on Friday March 14 2014, @01:53AM (#16147) Journal

    Often by law, they have to choose the lowest bidder. In some cases, the second lowest bidder may be an option.

    • (Score: 5, Insightful) by clone141166 on Friday March 14 2014, @02:04AM

      by clone141166 (59) on Friday March 14 2014, @02:04AM (#16150)

      Then the government should write better, more detailed contracts to ensure that either a) budget IT companies that can't meet the requirements don't bid or b) when the company that wins the contract fails to deliver, the expenses can be recouped from said company.

      Maybe if more IT sweatshops started being sued for failing to deliver on these big, juicy government contracts they might stop bidding on contracts that they can't fulfill. It seems to be becoming like the banking industry where it doesn't matter how badly you screw up, just because you employ a few hundred people you become immune to any kind of serious financial penalties. Bad companies should fail.

  • (Score: 4, Interesting) by PapayaSF on Friday March 14 2014, @02:03AM

    by PapayaSF (1183) on Friday March 14 2014, @02:03AM (#16149)

    But it's more than that. These exchanges are built for political purposes, so you have political meddling in design and function, such as Healthcare.gov forcing people through a complex registration process, because they didn't want to scare people away with prices before the subsidies could be calculated. Or the fact that they held back requirements until after the 2012 election, because they didn't want political opponents to use the details against the administration.

    Semi-off-topic: Is the back end of Healthcare.gov fully functional yet? I'm waiting for a follow-up to this story from January. [slashdot.org]

    • (Score: -1, Offtopic) by Anonymous Coward on Friday March 14 2014, @02:20AM

      by Anonymous Coward on Friday March 14 2014, @02:20AM (#16154)

      Im not sure that has much to do with site functionality.

    • (Score: 5, Insightful) by TheLink on Friday March 14 2014, @03:42AM

      by TheLink (332) on Friday March 14 2014, @03:42AM (#16170) Journal

      These exchanges are built for political purposes

      Yeah, they shouldn't even exist! Everyone should be AUTOMATICALLY covered at minimum by ONE base plan that's good enough for common reasonable scenarios. There should be no need to choose anything or even register! If you want anything fancier/extra, you should be free to do it with your own $$$ (or $$$ provided by others voluntarily).

      But because of the greed, selfishness and stupidity[1] of too many in the USA you end up with this Frankenstein monster of ObamaCare.

      [1] I hear too many stupid US people fighting healthcare reform who say "Why should I pay for some idiot who didn't insure or take care of himself?". But guess who is paying when that idiot goes to ER or even prison for his healthcare? Not that idiot. People going to ER or prison for healthcare is a stupidly inefficient way of using public money to provide healthcare. Not everyone rolls over and dies quietly. So unless you want to euthanize the poor and sick, you are going to have to pay for their healthcare. Please do it in better ways.

      • (Score: 3, Funny) by Vanderhoth on Friday March 14 2014, @11:18AM

        by Vanderhoth (61) on Friday March 14 2014, @11:18AM (#16277)

        Everyone should be AUTOMATICALLY covered at minimum by ONE base plan that's good enough for common reasonable scenarios. There should be no need to choose anything or even register! If you want anything fancier/extra, you should be free to do it with your own $$$ (or $$$ provided by others voluntarily).

        You mean like every other first world country in the world? HERESY!!!!

        In all seriousness though, I'm Canadian, but have lived in several states (NC, SC, ME, NH) from '94 to '99 when I was old enough to leave home and decided I'd seen enough of the great land of 'merica. My mother's still a nurse currently working in SC.

        Sorry to say, but you guys are screwed, you need a system exactly as you described it, which is pretty much what we have here in Canada. Most basic stuff is covered, but you can still get insurance from blue cross or other insurers for extra, if you think you need it.

        You're biggest problem right now is your government, mainly congress, is so fixated on making they other guy look bad, mainly your president. So you have one side that's not willing to actually fix the problem and part of that side is hell bent on making it as bad as possible. Not to boost their approvals, but to make the president look as bad as possible, talk about petty. And the other side's unable to fix anything because their cock-blocked and castrated at every turn.

        I know fist hand most Americans are pretty awesome, I made a lot of American friends, but you guys seriously need to keep the tea baggers off TV, they're really hurting your image on the international stage. It's like when there's a hurricane and the news reporter go out and finds the dumbest looking and sounding most stereotypical redneck hick to give their assessment of the damage, "Ah, yeah ma' Pa was in the trail'r when it done roll'd over the moonshine still. Ta hur'can wan't so bad but the still done blowed up an fired the trail'r off in't that swamp or'younder and da gators got him. Not left by his drink'n jar".

        As someone who's lived in the mid south and has actually heard people talk like that, it's not meant to be funny. I dated a girl from Georgia and the accent when used right can sound very intellectual and sexy, when used by a hillbilly to string a bunch of barely coherent words together it makes the rest of the world wonder how you breath.

        Republicans in general are ok, it's just the extremist faction that's bad and is seriously holding you guys back.

        Sorry, just my opinion eh.

        --
        "Now we know", "And knowing is half the battle". -G.I. Joooooe
        • (Score: 3, Insightful) by Thexalon on Friday March 14 2014, @02:42PM

          by Thexalon (636) on Friday March 14 2014, @02:42PM (#16402)

          You're biggest problem right now is your government, mainly Congress, is so fixated on making they other guy look bad, mainly your president. So you have one side that's not willing to actually fix the problem and part of that side is hell bent on making it as bad as possible.

          There's also a significant faction among Americans that doesn't view the American health care hodgepodge (it's not anything close to a coherent "system") as a problem. There are 4 basic reasons for that:
          1. Rich Americans don't experience any kind of problems, and probably get better service than their rich Canadian counterparts. This is because they don't have to deal with all the problems the masses encounter every day with insurance companies not paying or medical bankruptcy or waiting 5 hours while you're bleeding internally at the ER. If you're rich, this really is the best health care system in the world - the entire apparatus will snap to attention and deliver you exactly what you want very quickly, because they look at you and see dollar signs.

          2. Free market ideology says that free markets will always provide what should exist, and that doing anything at all to try to control markets will create inefficiencies that will reduce GDP growth. And no, egghead economists presenting evidence that sometimes markets and particularly health care markets don't actually work that way will have no effect on that belief.

          3. The current situation benefits businesses by making employees more reluctant to quit or risk being fired. That's because losing health insurance is often a greater calamity than leaving a job. That allows businesses to demand overtime, keep wages or salaries down, bust unions, prevent experienced hands from retiring early even if they can otherwise afford to, etc.

          4. Some Americans believe that if you don't earn a certain amount of money, you don't deserve to live. In other words, they believe that your net worth and/or credit score is in fact an accurate measurement of your worth as a human being. This is the sort that cheered during a Republican primary debate the idea that an uninsured person should be left to die.

          These politicians who are doing their best to keep the system a complete mess are indeed reflecting the opinions of both their campaign donors and their base.

          --
          The only thing that stops a bad guy with a compiler is a good guy with a compiler.
          • (Score: 2) by Vanderhoth on Friday March 14 2014, @03:34PM

            by Vanderhoth (61) on Friday March 14 2014, @03:34PM (#16445)

            I agree with everything you said, but I'm compelled to comment on this statement because of how often my American friends bring it up. Usually as "Our system is so much better, people die in Canada all the time from waiting for treatment". It's a myth that it's common for people to die while waiting to get healthcare.

            waiting 5 hours while you're bleeding internally at the ER

            People do wait sometimes, I waited four hours in outpatients once myself, but the reason you wait is because the most important cases, or biggest emergencies, go first. If you're bleeding, that's a pass, you go in a head of someone complaining about a sore back.

            I personally have only heard of one case [huffingtonpost.ca] where someone died waiting to get treatment and it's special circumstances. This particular case was a homeless man who frequented outpatients as a place to sleep for the night. He'd come in and complain of something minor, knowing that would have him waiting the longest, and would have a warm place to sleep. In this case he did actually have something wrong, but everyone thought he was just there to "sleep it off" so none of the medical staff bothered checking on him after he checked in and he died. There are a lot of factors in this case, but to me it's a case of crying wolf, not a case of the system was too burdened to handle him.

            Far more people die in the states from not being able to afford treatment than people dying in Canada waiting for it.

            --
            "Now we know", "And knowing is half the battle". -G.I. Joooooe
            • (Score: 2) by Thexalon on Friday March 14 2014, @04:08PM

              by Thexalon (636) on Friday March 14 2014, @04:08PM (#16476)

              To be clear, I was describing the reality of uninsured people at American hospitals, not Canadian NHS.

              Another way of looking at that issue is that in Canada, patients are ranked and treated based on their genuine medical needs. In the US, patients are ranked and treated based on their wealth. The reason wealthy Americans can't stand the idea of a Canadian-style system is that any area where money doesn't put them at the top of the heap is something they hate.

              This phenomenon also shows up when rich people are complaining about the US Postal Service: If you walk into a post office here, you'll notice that the employees serve people in the order they enter the queue, and provide more-or-less identical service to everybody. This is profoundly democratic if you think about it. If, on the other hand, you're used to being treated as a VIP and never wait in line and get fantastic service just for you (at the expense of everyone around you, but you probably don't notice that after a while), you think that the post office is unfair in treating you just like everyone else.

              --
              The only thing that stops a bad guy with a compiler is a good guy with a compiler.
              • (Score: 2) by Vanderhoth on Friday March 14 2014, @05:14PM

                by Vanderhoth (61) on Friday March 14 2014, @05:14PM (#16517)

                To be clear, I was describing the reality of uninsured people at American hospitals, not Canadian NHS.

                Sorry, I should have been more clear that I understood that, but felt it was necessary to say anyway because of how often I hear that myth from Americans who've never used the Canadian health system, but use that as a way to defend letting people die because they're poor. I completely understand what you're saying.

                What I find very ironic is, watching Fox News (I know, I know, but my dad has it running 24/7 at his place whenever I visit him), it appears that the "regular" Americans arguing against healthcare changes are not well-to-do and would be the people most likely to benefit from affordable health insurance and regulations preventing insurance companies denying a claim based on preexisting conditions or other technicalities. If it was just Fox News I'd ignore it, but couple that with comments on any news site talking about the ACA (a.k.a Obamacare) and it paints a very bleak picture of American intellect concerning their own well being and personifies the negative stereotype Americans have of being ignorant, greedy and self-centered around the world.

                I've said a couple of times now, I have quite a few American friends and have lived in a few different states, I still have family living in SC, so I know the stereotype is a very small minority. But this issue and the way the states are being run at the moment has serious implication for the world. Talk about too big to fail, if the states goes under, like it almost did when the Republicans (tea party specifically) shutdown the government, they're throwing the world back into another economic collapse.

                Get your shit together 'merica! Don't let the back water yokels drag the rest of you, and us, down!

                --
                "Now we know", "And knowing is half the battle". -G.I. Joooooe
            • (Score: 1) by HiThere on Friday March 14 2014, @07:07PM

              by HiThere (866) Subscriber Badge on Friday March 14 2014, @07:07PM (#16573) Journal

              It's not just the uninsured. Because the US emergency room is used for so many non-emergency cases, it has trouble with genuine emergencies...unless they are quite obvious.

              I remember one time I waited in the ER 8-12 hours to be seen by a doctor. I was in extreme pain, throwing up, passing out, etc. I'm sure the infection got worse while I was waiting, but no doctor was available, and the nurses couldn't do much before I was seen by a doctor. That I had health insurance wasn't even something that they bothered to find out until much later. I'll grant you that this was an unusually bad time, but people with obvious emergencies (gun shot, etc.) were being seen.

              --
              Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
              • (Score: 2) by TheLink on Saturday March 15 2014, @05:46AM

                by TheLink (332) on Saturday March 15 2014, @05:46AM (#16764) Journal

                That's the other cost I didn't mention in my original post for brevity - ERs getting overloaded AND more hospitals closing down ERs: http://www.nytimes.com/2011/05/18/health/18hospita l.html?_r=0 [nytimes.com]

                This hurts most in the USA - only the really wealthy have their own medical staff. Healthcare reform won't really hurt most of these super rich (unless they're one of those sucking blood from US healthcare). Hence the other 99.9% should push for a more civilized, effective and efficient healthcare with none of this "health exchange"/obamacare nonsense that adds little but more costs and redtape.

                It'll still be expensive, but you'll get more bang for the buck.

                Lastly I'm also one of those who believe that there should be rationed health care - it's going to be rationed anyway! For example, till the technology becomes cheaper and better you're not going to be able to 3D-print kidneys etc for everyone who needs them - maybe only the billionaires can afford the advanced stuff at first. One way of rationing is everyone when born gets to use a few hundred kilobux worth of healthcare (which replenishes at say 100k per year, capped at a max- all depending on how rich the country is), once you run out, you're on your own unless you can get others to transfer some of their quota to you (limited to a max of a certain percentage), or get direct donations. Sounds harsh but there are limits to resources. Plus it might encourage people to not be assholes, make more friends and fewer enemies ;).
                 

  • (Score: 3, Interesting) by SuggestiveLanguage on Friday March 14 2014, @12:49PM

    by SuggestiveLanguage (1313) on Friday March 14 2014, @12:49PM (#16317)

    I have yet in my career to see even on large-scale forklift government IT project achieve its objectives within budge--whether its the revenue, DMV, military, state, federal whatever--they all have a terrible record of running off the rails and exploding into expensive fail rather quickly.

    The core problem is that the business logic is thousands of pages of byzantine rules layered on top of another ten-thousand pages of byzantine rules. That's a project-management nightmare right from the start. Now, an intelligent, experienced and honest vendor might be able to achieve the business case if the bids submitted were honestly construed and realistic but that not often the case. I'll leave the reader to explore why this happens, but I will provide a small clue: The project vendors are often selected based on political or personal connections to legislators (read kickbacks) rather than proven capabilities.

    The liberal *American technocrat's answer to the failed project is to throw more money or bodies at the project if available then ask for more money from the next appropriation. The conservative *American technocrat's answer is to scrap and surplus the entire project--baby, bathwater and all--then outsource (inexplicably on a cost-plus contract) the entire implementation, as if turning over a government mandated diktat entirely to a for-profit entity will not be squeezed for every dime its worth. Streamlining or simplifying the project never seems to enter their minds. It's either "double-down and spend" or "cancel and spend."

    Simplifying the law or streamlining the off-track project to execute a subset of the business logic doesn't even enter the picture. Gee, i wonder why?

    *I'm not terrilby impressed with the intellectual capability of American technocrats as their vitas are heavily embellished cheating and legacy benefits and political skills.

    • (Score: 3, Interesting) by Thexalon on Friday March 14 2014, @03:03PM

      by Thexalon (636) on Friday March 14 2014, @03:03PM (#16416)

      then outsource (inexplicably on a cost-plus contract) the entire implementation, as if turning over a government mandated diktat entirely to a for-profit entity will not be squeezed for every dime its worth

      Whaddaya mean, "inexplicably"? The explanation is clear: The point of the exercise is to transfer as much government money as possible to certain favored businesses. The more that politicians or bureaucrats can do that, the more valuable it is to bribe them, which means they can demand larger bribes.

      That's why I'm thoroughly opposed to the concept of government contracts: They are inevitably and almost invariably corrupt. I'd rather have our government just hire people directly to do the jobs that the government has decided it needs to do. There's no real reason to hire a business - all that does is creates at least one more management team and a batch of middlemen that get paid handsomely while contributing more-or-less nothing of value.

      --
      The only thing that stops a bad guy with a compiler is a good guy with a compiler.