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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: 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
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  • (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 ;).