Moon of Alabama Brecht quote
October 21, 2013

Obamacare Meets Brooks' Law

Obama is making a big mistake by continuing the Affordable Care Act (Obamacare) enrollment while the main software this enrollment depends on, the healthcare.gov website, is buggy:
“There’s no excuse for the problems,” he added, “and they are being fixed.” He said the government is “doing everything we can possibly do” to repair the site, including 24-hour work from “some of the best IT talent in the country.”

Ahh -- the "best and the brightest" will now "surge" to win this decisive battle. Haven't those concepts failed before?

Throwing more resources onto a broken mammoth software project is likely to increase the problems and to delay a bug free version. Software engineers and IT managers have known this law for decades:

"adding manpower to a late software project makes it later"
Engineers who have not been involved with this software so far will now have to be trained by the people who know it. Total productivity will therefore sink. Discussions about design issues that had been held and decided months or years ago will start anew. Bugs that had already been cleared will be reintroduced. Communication within a 24 hour team will be very difficult, lead to miscommunications and further delays.

If this report about the site's problems is halfway correct the troubles will not end within a month or two:

In interviews, experts said the technological problems of the site went far beyond the roadblocks to creating accounts that continue to prevent legions of users from even registering. Indeed, several said, the login problems, though vexing to consumers, may be the easiest to solve. One specialist said that as many as five million lines of software code may need to be rewritten before the Web site runs properly.

“The account creation and registration problems are masking the problems that will happen later,” said one person involved in the repair effort.

The website's task is to mask the very complicate process that is demanded by the law with an easy user interface. Currently parts of the user interface are in trouble and will be fixed but the real problems are more likely in the various back end connections to other databases and the complicate rule base that transfers the letters of the laws into a product choice decision.

The reasons for this failure are the usual ones and were foreseeable at the project's start. An inexperienced integration management team, ever changing requirements and a lack of testing:

One major problem slowing repairs, people close to the program say, is that the Centers for Medicare and Medicaid Services, the federal agency in charge of the exchange, is responsible for making sure that the separately designed databases and pieces of software from 55 contractors work together. It is not common for a federal agency to assume that role, and numerous people involved in the project said the agency did not have the expertise to do the job and did not fully understand what it entailed.
...
In the last 10 months alone, government documents show, officials modified hardware and software requirements for the exchange seven times. It went live on Oct. 1 before the government and contractors had fully tested the complete system. Delays by the government in issuing specifications for the system reduced the time available for testing.
Throughout my IT managing career I have seen dozens of such project disasters. They are quite normal. About every second big IT project fails to reach its intended usefulness. Most of the projects will not meet the proposed timeline. But those projects were not about political legacy and most of the processes they covered had some alternatives that, though more costly and time consuming, could replace them.

So what should Obama do? He should stop the current enrollment process and push all relevant dates at least six month out. Stop the customers from coming, repair the shop and only open anew when you are sure that you can serve everyone. By sticking to the current process and the buggy software Obama will only increase the mess and the political damage.

All these problems were of course unnecessary and Obama can only blame himself for them. Medicare is a quite well run system that already does for some parts of the U.S. population what the new law wants to achieve: Provide some reasonably prized health insurance. Expanding medicare, an established system, would have been much easier than this new process which is more about shuffling money to insurers, and now also software developers, than about getting healthcare for everyone.

Posted by b on October 21, 2013 at 02:11 PM | Permalink

Comments

Any comment has to include the recognition that many of the criticisms of this ridiculous compendium of legislation have always been correct. One doesn't have to support the Tea Party to realise that "Obamacare" exemplifies all of the faults traditionally attributed to committee compromises.
I know nothing about IT systems but it seems obvious to me that legislation that sets out to achieve what this does: to dampen calls for medicare while picking pockets for the insurance companies (and dozens of other mutually inimical if not downright contradictory objects) is going to be as complex and unwieldy in software as it is in reality.
When faced with a Gordian Knot, sensible politicians do not pass the problem over to programmers to unravel.
Obamacare is a perfect symbol of the man's presidency: it is designed to fail but not until he has left the scene and the victims are too poor and sick to make a fuss.
(Did anyone else catch the news item at RT to the effect that the NHS in Britain is paying doctors fifty pound bonuses for categorizing their patients as bound to die, thus saving hospital beds?)

Posted by: bevin | Oct 21, 2013 3:06:04 PM | 1

Shuffling money to insurance corporations is the main goal. The insurance 'industry' wrote this legislation so that millions of younger healthy people would be coerced into buying their shitty product.

Posted by: par4 | Oct 21, 2013 3:09:22 PM | 2

The reason why Obama will not declare an enrollment freeze and put everything off for another six months, as b suggests, is that it would validate criticisms the Tea Party Republicans, who are currently reeling from their failed government shutdown and hollow default threats, have made of the Affordable Care Act.

Obama will engage in his usual duplicity to justify the shortcomings of the online insurance exchanges. And most of the public, captive of the "lesser of two evils" mindset, will support him because the Republicans are truly horrible.

Posted by: Mike Maloney | Oct 21, 2013 4:11:09 PM | 3

@ bevin...50 pounds? They are being robbed. That's like 3 pieces of silver. They are supposed to get 30 and if I were a UK physician I wouldn't catagorize a single patient until I got it.

Posted by: Lysander | Oct 21, 2013 4:20:56 PM | 4

Regarding the suggestion that the current enrollment and processing should stop for a period of six months until necessary fixes can be implemented: Does anyone really think there won't be additional absolutely essential changes to the requirements during the extension? Too many cooks, the broth is spoiled. Only the second suggestion holds out any chance for success. Further extend the already reasonably well working Medicare system. Although even that would undoubtedly prove challenging.

Posted by: MDBill | Oct 21, 2013 4:36:44 PM | 5

Sounds to me much like the UK attempt to install a united NHS database, to which every medic would have access. National catastrophe.

Much the same thing. Sounds to me like there are problems in installing such massive databases which have not been resolved.

Posted by: alexno | Oct 21, 2013 5:00:55 PM | 6

Bring Edward Snowden back to work on the O-care website. He'll fix all the bugs and glitches and get it up and running in no time.

Posted by: Cynthia | Oct 21, 2013 5:22:28 PM | 7

and now also software developers

If the "software developers" include IBM, SAP, Accenture ... they will be grinning ear-to-ear. The more incompetent they are, the more money they make.

Posted by: DM | Oct 21, 2013 5:23:12 PM | 8

Glad somebody else threw a flag on the Brooks's Law violation :-)

http://www.nakedcapitalism.com/2013/10/links-102113.html

The disaster in the making was visible as far back as July for careful readers of the news, and insiders doubtless knew earlier. See here and and here.

Posted by: lambert strether | Oct 21, 2013 6:30:16 PM | 9

Ah, this is what happens when a running dog Corporatist lackey has charge of a program which should have been solely for the protection of the public.

Obama had promised and did indeed set up a Profit Protection Plan for the big medical industry players. This was obvious from the first little nuggets the administration and its corporate sponsors let things out to the public.

The running dog Corporatist lackey press never reported accurately on what was going on with the ACA.

Alas.

Shoulda, coulda done Medicare for All Improved. But that wouldn't have protected the Big Insurers' profits.

Posted by: jawbone | Oct 21, 2013 8:23:06 PM | 10

Hey, why not give this job to the NSA?

They know a thing or three about setting up massive databases, though I have to admit they don't have a track-record for designing easy-to-use data-entry forms.

But maybe that's not necessary; the NSA may already have enough information about every single US citizen that it can fill in those enrollment forms without any member of the public having to bother with all that "login 'n' enroll" nonsense.

Your government, hard at work so you don't have to work hard.....

Posted by: Johnboy | Oct 21, 2013 8:31:48 PM | 11

Posted by: Cynthia | Oct 21, 2013 5:22:28 PM | 6

Thanks for this evenings LOL


aca is just another way to transfer the last bit wealth from Main Street to the puppet masters or known as 1% the ones that run Amerika for the time being.

Posted by: jo6pac | Oct 21, 2013 8:39:28 PM | 12

"Sounds to me much like the UK attempt to install a united NHS database, to which every medic would have access. National catastrophe."

Same thing in Ontario.
Of course by "national catastrophe" we do not include the contractors who inevitably, in accordance with free market traditions, walk away with billions, muttering "sorry for our crass incompetence but thanks for the cheque" as they depart. For them, at least, the cloud is lined with silver. (See 3 above)

Posted by: bevin | Oct 21, 2013 9:35:23 PM | 13

Perhaps things are working according to plan. I heard callers on a NPR radio program who had been Obama supporters dissing Obama's AHC and calling for Universal health coverage. Obama has a couple years left. He could go for single payer coverage. Sooo much easier than that boondoggle Obama care. He could bravely admit his plan did not work but universal care is the answer. Who would oppose it, Boehner?

Posted by: therevolutionwas | Oct 21, 2013 11:32:24 PM | 14

from twitter, and only slightly off topic:

@HelloCullen
On your first day in the hospital kick the ass of the sickest motherfucker in there

Posted by: biklett | Oct 22, 2013 12:16:53 AM | 15

I agree that expanding Medicare would have been a better option. Instead, they create a health insurance marketplace where those who cannot afford it will be fined when they file their tax returns. What a shameful disgrace Obama is.

Posted by: Hilmihakim | Oct 22, 2013 12:52:20 AM | 16

You're a smart dude, b (whoever you are). You know whereof you speak. This is a major clusterfuck which will likely take months to correct.

When laws are passed often not much thought is given to the difficulty of implementation. Defense contractors get a bye for projects that are years late and billions over estimate, but the same slack is not extended to civil projects. (This one must have been particularly tough, with the Republicans biting and scratching to keep the system from becoming reality).

As an IT contractor who has worked with CMS and health insurance companies in the past, I have sympathy for CMS's predicament. CMS actually has many skilled and highly dedicated personnel. If a system has difficulties the inefficiency of the insurers never gets attention - it's always "those damn government employees". Dealing with hundreds of insurers and thousands of plans is unbelievably complex (and brings no real benefit to the public).

Patience is called for all around. If Obamacare is to fail, let it fail on its own terms, which can't be realized until the system is fixed. (I'm a single payer supporter myself). That should be doable.

Posted by: talus | Oct 22, 2013 9:34:10 AM | 17

So nice of you to ask for patience whilst tens of millions go without basic care at all or are either at serious risk of going bankrupt for being patient, playing by the rules. Sorry, combine the two and we are definitely well over a hundred million people.

If you are really for single payer then you should quit negotiating and apologizing for the antithesis of single payer.

Posted by: Eureka Springs | Oct 22, 2013 11:08:06 AM | 18

Medicare for all would instantly fix our budget issues on the entitlement side, after all the "privatize" all the profitable young. But, that would hurt the wealthy insurance companies, and some of the top paid doctors, and they lobby hard and have much more money than the masses; so politically, that bit of sense is a dead letter.

Also, "complicate" is a verb, "complicated" is the adjective, and the word you needed. Your English is quite good, but you seem to make a few small errors that are a funny, considering how well you write.

Posted by: scottindallas | Oct 22, 2013 11:42:23 AM | 19

If you are really for single payer then you should quit negotiating and apologizing for the antithesis of single payer.

Posted by: Eureka Springs | Oct 22, 2013 11:08:06 AM |


Exactly. The entire privatized health insurance regime is a travesty. And to listen to many people in USA, Obamacare equals socialized medicine.

And they are blazing mad about this.

Closer to topic, I wonder why anyone is surprised that the Obamacare website is a disaster. It is 500 million lines of code. Yes, you read that right.

Here's a pretty decent piece deciphering some of the political language being used right now about the software problems they are dealing with.

Posted by: [Name Redacted] | Oct 22, 2013 12:00:05 PM | 20

All these problems were of course unnecessary and Obama can only blame himself for them. Medicare is a quite well run system that already does for some parts of the U.S. population what the new law wants to achieve: Provide some reasonably prized health insurance. Expanding medicare, an established system, would have been much easier than this new process which is more about shuffling money to insurers, and now also software developers, than about getting healthcare for everyone.

HELLO!!! This is the 11ty dimensional chess that Obama's so good at in action. ACA is destined to fail because - wait, for it - Obama secretly wants it to fail and then we'll all get an expansion of Medicare!! Huzzah!!

More seriously, though, everyone - elite included - knows that there's a medical care catastrophe in the US and sooner or later it's going to reach a crisis point. TPTB just bought themselves at least a decade with ACA before they are going to have to revisit the issue. That's all the ACA was: a play for time.

Posted by: JSorrentine | Oct 22, 2013 12:07:59 PM | 21

Excellent coverage of this issue and excellent comments. The most honest I've seen anywhere on the web.

Posted by: Exactly | Oct 22, 2013 1:52:21 PM | 22

it is physically impossible for a project of that size to work so quickly. someone will make lots of money.
I wonder why the insurance companies were not asked to help out, since it is really their job to sell policies... why didn't they set up something more like regular insurance brokers' offices (which already exist) and transition to online services gradually over time?
somebody must have friends in Washington. at least they're not building nukes.

Posted by: anon | Oct 22, 2013 5:23:59 PM | 23

Other than (allegedly)whacking OBL,has this totally novice and unprepared marionette done any thing right?And the only reason he was reelected was because his opponent ran the absolutely most ludicrous campaign in American history,kow towing to dual citizen traitors and declaring 47 % of the nation deadbeats.Sheesh.
Affordable Care Act;Just like the stinkin' patriot act,the exact opposite of its moniker.

Posted by: dahoit | Oct 22, 2013 7:01:00 PM | 24

As usual b hits it pretty well.

However, I think his guesstimate of 6 months is a) well below what's realistic for that situation (from what we know) and b) theoretical. For a simple reason: obama is a politician.

So they will shift functionalities around, focus on making it *look* less troubled, pin guilt on diverse parties and paint some parties as evil working against the miraculous, wonderful thing.

Simple rule: When politcians are involved about the only things that are made to work and do work are those for the politicians. Anything for the people is but something to play political games.

Posted by: Mr. Pragma | Oct 22, 2013 9:04:04 PM | 25

well, I wonder WHY "exchanges" had to be coded into software to be sold to the public AT ALL.
it's a racket.
we buy insurance already. employers do it, individuals do it, and social workers help enroll people on Medicaid, the AARP does it, and there are insurance brokers that do it for the individual market. then there are HMOs...
why the need for a big software project?

Posted by: anon | Oct 23, 2013 2:53:59 PM | 26

Regarding the TP defeat or perception;This is all MSM poppycock made large,because as usual,they own the pulpit,and as the TP are against our overseas Israeli(and oligarchal) securitization and expansion scheme,aka the War of Terror,anything they pronounce about the TPs standing or morale should be taken with the same grain of salt as the Baghdad defense minister in 03.
And I'm not a TP true believer,as Ayn Rand might be one of hells most destructive emissaries sent to bedevil humanity,although Henry Kissinger gives her a run,but their fiscal stance should be explained better than the current demonization by the MSM.But of course it's all about the do re mi they can steal from America,and the ACA does it very,very well,and Medicare for all,or single payer,which I'm for, does not quite fill their overflowing coffers well enough.And aint this Obomba guy a hoot,and an empty suit,or what?sheesh.

Posted by: dahoit | Oct 23, 2013 3:00:50 PM | 27

Back when ACA was proposed I read about 350 pages of it. Appalling. How it ever could be organised in one “Gov” agency seemed impossible. (Has to be tied to States / citizen check such as Social Security / Medicare, Medicaid / the IRS (income, taxes, subsidies..) / a plethora of Insurance cos. / Hospitals / and more.

First off, management should have been given over to States (with Gov help in financing if needed), 2) it is not up to the Gov to sell private insurance, that is the insurers job, see e.g. anon above - oh I could go on but what use it was probably doomed anyway.

Pausing for 6 months will probably wreck it as well. All is on a tight staggered schedule.

However, it is typical of Obama, or, yes, a brand of what one may call State Socialism, which integrates ‘the market place’ (ha ha) and has an over-reaching mega hierarchical organisation, with one echelon at the top (State), and only confused levels below it, that are supposed to collaborate and/or compete in schemas that are incomprehensible. Obama is doing this in Education as well. These are sort of State-Corporate partnerships, peculiarly meddlesome, inefficient, and unstable in time. With the inefficiency costing mega bucks and inappropriate or ‘bad’ care (it is decided on the finances and not on the benefit to the patient) to the ‘consumer’ as Obama calls ppl who are dying of cancer.

It is quite possible that a purely libertarian system (no price controls or Gvmt. regs or anything, with insurers, docs and hospitals competing, etc. Price on the door, like the nail salon...) might have a better health outcome. It would have lead to a several-tier med system but some heath care is better than none. (Personally I’m for some form of universal care paid for by taxes and I’m not advocating for such an arrangement, as, for one, it leaves too much room for scammers and hacks.)

ACA is the worst of all worlds, full stop.

Posted by: Noirette | Oct 26, 2013 10:27:12 AM | 28

It sounds like they are administrating to themselves the same poison they have sold their liberal allies in the Middle East!

Posted by: Mina | Oct 26, 2013 11:10:10 AM | 29

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