I don’t find this stuff amusing anymore

Updated 11.20.2013

“I think we probably underestimated the complexities of building out a website that needed to work the way it should,” [President Obama] told the annual meeting of the Wall Street Journal CEO Council.

The [security] experts said the site needed to be completely rebuilt to run more efficiently, making it easier to protect. They said HealthCare.gov runs on 500 million lines of code, or 25 times the size of Facebook, one of the world’s busiest sites.

One of the most important repairs remaining deals with the information pages that the system provides to insurers about coverage applicants. These so-called “834s” have been riddled with erroneous information and, despite weeks of repairs, they continue to spit out incorrect data.

The enrollment, to give you a general sense of what’s happening, for a health plan that might have to sign-up 100,000 people in order to get their share of the 7 million Obama administration’s national enrollment objective, has grown from perhaps 10-15 enrollments a day a few weeks ago to 40-50 a day now … Backroom error rates being committed by Healthcare.gov, when enrollment data are transmitted to the health plans, are still far too high to transition to high volume processing without serious customer service issues.

The last quote is from an insurance industry insider, so take that into account in whatever fashion you think appropriate. I was too lazy to google the security experts cited in the bit about that aspect of the site, but 500 million lines of code? Holy crap. Can that be true?

I don’t know what to say about that first quote. Here you have a web site meant to accommodate tens of thousands of simultaneous visitors whose activities would result in information moving to and from a slew of massive federal databases as well as a credit agency (which still strikes me as bizarre) and a legion of insurance companies. And you didn’t know it would be a hideously complex venture?

500 million lines of code. Yes, there might be a vulnerability in there somewhere. Surely that includes some of the systems the site draws on?

The bit about the continuing errors in the forms sent to insurers seems particularly fraught. The administration say that four of five users should have no problem accessing the site by the end of this month, but users on the front end will have no way of knowing about any errors being transmitted on the back end until the insurance company tells them. That’s a particularly insidious situation for people who have to buy by December 15 in order to be insured on January 1st of next year. Insurance companies are still processing applications by hand because of the form errors, so buyers will be in trouble if the errors continue and the companies get inundated.

In addition to that issue, customers will probably have to make payment at least a few days before December 15 to make sure the companies post it in time because they can’t pay via the site. That compresses the window even further.

Years and years and years ago a customer at the bar where I worked told me that in his work as a therapist, he sometimes had clients who couldn’t assimilate the possibility that their relationships might be beyond repair. With 26 days (or fewer) before it’s too late for several million people to replace the coverage they’re losing on January 1st, along with who knows how many who don’t have coverage now but would like to start on January 1st, it’s time for Obamacare optimists to consider the idea that this may not work out.

A week ago I was telling some folks that the administration needed a Plan B, which turned out to be the sleight-of-hand extension of cancelled policies. Now it’s time for Plan C. Maybe the gremlins will all be run out of Dodge in the next ten days but one can’t dismiss the possibility that they won’t.

UPDATE: Along the lines of what the family therapist told me at the bar whilst deep in his cups … “Failure is Always an Option,” from found-materials playwright, former Electronic Freedom Foundation executive and current guy who does TED talks, Clay Shirky.

20 thoughts on “I don’t find this stuff amusing anymore”

  1. As I was trying to say earlier (about five hours ahead of Krugman) Obamacare is here to stay. It doesn’t matter if it stumbles across the finish line (Krugman’s allusion) its the only horse in the race. For all their breast-beating the Republicans have nothing to offer as a substitute and The People ain’t going back to no coverage for people with pre-existing conditions or being left with ever escalating premiums and no help in sight. The state exchanges are signing people up at a fair clip and Healthcare.gov is improving with every passing hour. It ain’t gonna be repealed and it ain’t gonna be rolled back.

    1. That’s a line from Paul Simon, but there were several weeks there when I found it darkly comical if not necessarily amusing.

      I think it’ll take at least three years, but eventually it’ll get repealed or terminally amended. Certainly before 2020 when the last of the measures are implemented.

  2. You think we are going to revert to no program or are you envisioning single payer rising from the ashes?

    1. I think Mike’s beloved “robust public option” is a good bet. A voluntary Medicare or Medicaid buy-in, or resuscitating the cooperatives that somehow got defunded twixt cup and lip, or something of that sort. Depends on how badly Democrats are willing to treat Medicare between now and then, but both Medicare and Medicaid each have a large enough risk pool already to be fatally competitive with private insurers. And if they were merged, boy howdy.

  3. I’m not sure how merging Medicaid would help since that is paid for out of general revenues.

    1. A good chunk of Medicare is funded out of general revenues as well — remember all the brouhaha about that when Part D was unleashed? — but I really didn’t intend a partial sentence to serve as a detailed policy prescription. Even the Medicare for All bill runs to 15 pages or so. They’re the two largest government-funded health care plans and they’re run out of the same shop, so I expect a relatively painless way to combine them could be devised. And who knows, by then maybe Democrats would be prepared to use budget reconciliation from the get-go.

  4. If you are saying ACA will ultimately morph into an expansion of Medicare/Medicaid and conceivably into single payer, I say not only wasn’t Obamacare rolled back or repealed but the system of universal healthcare will forever be referred to as Obamacare. I say ACA will never be repealed nor rolled-back and so, apparently, do you. We Agree!

    1. No, I’m saying it will be dismantled and replaced with something else because it will have become unworkable. I suppose you could credit Obama with the foresight to realize that people would grow to loathe his creation so much that they demand better, just as JP Morgan created the depression so that FDR would reign in Morgan and his pirate friends.

    1. Of course it is. It’s what I’ve been saying all along. The primary sin of the bill is cementing private insurers as gatekeepers. That’s its raison d’etre. That’s what Nixon’s goal was when he outlined the basics of it, that’s what the Heritage Foundation’s goal was when they refined it, that’s what Baucus and the Obama administration wanted when they passed it and that’s what makes it unsustainable. It’s a “market” “solution.” Enlisting everybody in single-payer or (in the instance of Medicaid) dual-government payers is exactly the opposite of what the law does. You can call whatever replaces it whatever you want, but it will an entirely different animal. If it had initially included a Medicare buy-in, or even adequately funded those doomed cooperatives, then you could call what’s going to happen “morphing.” But it didn’t include those and it won’t morph: it’ll collapse.

  5. Don’t get your panties in a tangle, I thought it would be hilarious to contradict you as to what you were saying. But we agree, it’s just semantics from here on out. I increasingly find myself in this position withy you, Weldon. You must get your way and have things framed in exactly the way you’ve stated them. I do not agree with your characterization. We are not going backwards from what Obamacare delivers (however flawed it may be) and unless the result of its morphing is to return people with pre-existing conditions to a state of uninsurability, then it is an evolution which had as its first step this piece of shit we’ve had to settle for. The insurance lobby will fight tooth and nail against any move toward single payer or Medicare expansion or my beloved robust public option and you can’t blame them. For them these are the harbingers of doom, the death knell. And good riddance. But right now we’ve got Obamacare and like it or lump it, for a lot of people it’s going to work.

  6. Then there’s the unemployment problem. A lot of people work for those insurance companies.

  7. meh. (the single most dismissive word I could come up with) and, funny thing about the potential of job losses for the insurance industry, Jack, I can’t imagine an argument for sustaining the 19th century freebooter model of healthcare because healthcare buccaneers might lose their ships. A sizable part of recently terminated healthcare ‘professionals’ would be absorbed by the emerging public programs. Look at Great Britain in 1947.

  8. Mike, I was sort of cracking wise although it might not seem so funny to those in the insurance business. There is a reason that Lieberman was such a pain about single payer and the public option. Not unlike protests from coal producing states about clean air proposals. To Weldon’s point about the proposal to retrain “clerical” insurance employees, considering the economy, retrain them for what? Then, of course, there are a lot of people in the business who are not “clerical”. As to buccaneers losing their ships, that brings to mind those defending African pirates today who point out that there are no jobs and “them folks gotta eat too”.
    All of which brings to mind the national and worldwide problem of the lack of meaningful employment for the increasing populace. Ooops, we were just talking about health care, weren’t we?

    1. I haven’t seen anybody argue that Medicare for all wouldn’t save a ton of money, which means making a ton of money available for other stuff. Most of the arguments are SOCIALISM! and related issues. Companies would no longer have to chip in for health care for current employees or retirees, health care for individuals would no longer be a cost taken out of net income, and the government saves a whole bunch too. It would be great news for the economy even without using some portion of the savings for stimulus. It wouldn’t just be plunked down onto the current landscape with no transformative effects. And, as everybody keeps telling me about the current situation, you deal with other issues as they arise.

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