Archive for November, 2013

What’s Next for Obama “I Lied, Period” Care

WhatsNextforObama_ILied_Period_Care   <– PDF version

President Barack “I Lied, Period” Obama has suffered some bad press recently owing to the disastrous rollout of the website.  Enrollment rates are far below what is required to make the system work, and at this writing about 5 million Americans have had their health insurance cancelled.  It is expected that ultimately 90 million people will have their health care interfered with by government regulations and the enforcement bureaucrats run amok. Of course, the good news is that Barack “I Lied, Period” Obama, his family, Joe Biden, his family, administration officials, their families, the members of Congress, their families, Congressional staffs, their families, the wealthy, their families, the politically well-connected, and their families will be unaffected by the “Affordable Care Act” (ACA).  Therefore, there is no problem for the “people who matter”, if you know what I mean.

The website is supposed to re-launch tomorrow, and the administration will regard it as a big success if only 20% of the people who attempt to access it are unable to do so.  The good news is that the technical problems with the web site will ultimately be engineered out; and eventually it will work almost as well as any of the other 100 million websites offering products to the consumer.

The website is not the real problem.  The real problem is that the algorithm underpinning it must coded by software engineers, who are eminently logical people.  They are faced with coding a law written by bureaucrats and self-serving insurance industry operatives, put into legalese by Congressional staffers who are immune from it, passed by members of Congress who did not read it, and signed by a President who lied about it.  It was then transmogrified into incoherent bureaucratic “regulatoryspeak” by employees of the Department of Health and Human Services, all of whom are also immune from it.  The political part was about what we expect from the political elite.  But the software coders still must implement the bureaucratic maze.  With 25 years of experience writing software, I can tell you that there are four possible types of answers in the course of integrating any software process:

a)  The answer is correct, and is verifiably correct

b)  The answer is incorrect, and is obviously incorrect

c)  The answer is incorrect, but cannot be verified

d)  The answer is correct, but cannot be verified

Before one can declare success by achieving option a), he must first verify that none of the other possibilities occur.  The second item b) is the easiest to deal with: if the power company sends you a residential electric bill for $25,852,902.45 for the month of October, there is clearly an obvious problem, and correcting it is a matter of investigation and correction of some erroneous input somewhere.  Those types of problems with the implementation of the ACA will all be tracked down sooner or later.

The last two are the real problems, and are likely to be widespread in a system as complex as the ACA.  We are likely to see in the next year or two, many cases where the premiums and subsidies as quoted appear to be consistent with expectations (higher cost, lower access to care) but are actually wrong, and will have to be revised (another increment of higher cost and lowered access).  Or, we may see cases where the quoted values are actually correct, but there is confusion within the health insurance industry because the result of the government’s implementation is different from what the insurance companies expected (or were lied to about); again requiring an eventual re-adjustment (higher cost, lowered access to care, in addition to lower profits for the insurance companies).  Both of these are very bad insofar as instilling public confidence, and from a software standpoint, are the most difficult and time-consuming to correct.  But, given the inept nature of oversized government in general and this administration in particular, what else should we expect?

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