Kathleen Sebelius: Good Luck In Your Future Endeavors

[flabbybody]

Obama needed to recruit a super geek from Amazon or Facebook in order to create a website that would accomplish the enormously complex task of signing people up for Obamacare. Instead he treated the job as patronage and hired a person with zero tech background. The poor woman was doomed from the very start. The prez has been very bad at getting really smart competent people from the private sector for important government jobs.

[Stavros]

Another way of looking at this might be to ask why Governments seem to find creating integrated IT systems for its departments so difficult, not least because this doesn't seem to happen in the military and intelligence services (as far as I know), and because global corporations don't have this problem, and although starting from zero, Facebook and Twitter have been able to create a global network which fits all.

In the UK it was estimated that under the last Labour govt the equivalent of £26 billion was lost on failed schemes, here are some extracts from a report in The Independent in 2010 which indicate the problems -

"Further evidence has emerged over the failings of Labour's most costly programme, the mammoth £12.7bn IT scheme to revolutionise the NHS. The Independent has learnt that just 160 health organisations out of about 9,000 are using electronic patient records delivered under the scheme. The vast majority of those were GP practices. New figures have also revealed that millions of pounds have been paid out in legal fees. The taxpayer has footed a £39.2m bill for "legal and commercial support" for the National Programme for IT (NPfIT).

Government departments right across Whitehall have been guilty of overseeing embarrassing IT failures. A project that was meant to save the Department for Transport (DfT) about £57m eventually cost £81m, and workers at the Driver and Vehicle Licensing Agency (DVLA) were forced to brush up on their language skills when computer systems gave them messages in German."

http://www.independent.co.uk/news/uk...n-1871967.html

[trish]

The IT system for ACA has to integrate with all the systems of private insurance agencies. This requires the coordinated efforts on each of the thousands of ends of the connection. In the case of the ACA there wasn't adequate time spent on testing for bugs, largely because of delays due to obstructionism and foot dragging. One also has to remember that the IT-interface was only one part of the overall project. Lot's of people signed up in person at the offices of private insurers, on the phone etc. That required yet another kind of organization. Making sure that all the different policies offered by all the different private insurers were compatible with law was yet another part of the project.

If you ever bought a simple app for your iPhone, or a word processor for your laptop, you know how many different bug fixes and re-installations come after initial purchase. IT-systems come with bugs, in the military, in government and in business. There's no getting around it. That's why there's are always IT guys around to fix 'em.

What makes the ACA network complicated is that the act did not establish a real government healthcare system. It's a private system that's government coordinated. It's not single payer. Private insurers still insist on their own forms. There is very little uniformity. Single payer would have greatly simplified all the paperwork and data processing required.

[Stavros]

Trish, eloquently put...but: "Single payer would have greatly simplified all the paperwork and data processing required."
Is not the problem that a Federal programme would need to inherit and integrate data from 50 states many of which will have gathered the data using different, and incompatible software? Isn't this always the problem with new IT systems that attempt to integrate pre-existing one's? That is why, I think, by starting at zero, Facebook and twitter can have a global membership all using the same template.

[buttslinger]

On one level, the USA is all about competition and money.

Insurance companies compete with each other.
Even if Obamacare was carved on stone tablets by God, you would have republicans, insurance companies, doctors, big pharma, ...you'd have everybody disagreeing and fighting, that's the way we do it.

[flabbybody]

trish, Richard Nixon knew single payer was DOA 40 years ago when he tested the waters with his own version of it. The insurance lobby in the US will never let the government take away their precious revenue base so Obama needed to come up with something that kept them in the game. I suppose ACA was the best we could have hoped for. But to pick a person like Sebelius to try to make it work was just unforgivably stupid. When you need a code writer don't hire a politician

[trish]

Secretary of Health and Human Services is not a programming job. If one were to seeking to appoint someone to that position, one might look for...oh, I don’t know...maybe someone who served as an Insurance Commissioner for eight years. No doubt, Sebellius was a political appointee. But I think she did a good job. Yes, there was a glitch in the software. Are you saying Microsoft never had any bugs and glitches in any of the rollouts of its software? ‘Cause if you are, I’d like to know what product that was. I’m sorry she had to resign. But it was inevitable that she would draw fire. Anyone in that post at that time would have drawn fire and eventually have to resign.