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A Disaster, Not A Glitch

Posted Oct 13 2013 7:45pm


Stanley Feld M.D.,FACP,MACE


There is an important lesson in the recent Healthcare Insurance Exchange computer program “glitches”.

Once more the Obama administration only presents a fragment of the truth. Unfortunately, the traditional media accepts President Obama’s explanation and that is the news.

The online health insurance exchange program should be very easy to execute. All of the major healthcare insurance companies have an online presence. People can go online, put in simple demographics, and in a matter of seconds they can have at least 100 healthcare insurance products to choose from. 

The Obama administration told the media that the software developed for the web site, by CGI a Canadian company with offices in Washington D.C., had an estimated cost of $93 million. said it cost the government $634 million dollars. The site calculated the cost from grants paid to CGI. This is seven times the estimate published by the administration.

“Not only was the site still experiencing substantial problems a week after launching, but the White House had reportedly been aware for months that the website had flaws and might not be ready to launch. Yet officials insisted on the Oct. 1 roll out anyway.”

The problems experienced by people trying to use the user interface was something that was tested least or not done right -- or both.'

- James Turner, a member of the technical staff at software firm Beeonics, Inc.

The healthcare industry, participating in the new exchange, complained “loudly” that the site had experienced problems before the launch.  

Speaker of the House John Boehner asked, "How can we tax people for not buying a product from a website that doesn't work?"

The front end user experience is only a fraction of the problem with the federal health insurance exchange site. A front end user’s experience typically means there is something wrong with the basic construction of the software.

The monumental issue of the site involves interfacing seamlessly the multiple government agencies (IRS, HSS, CMS, Welfare, Food Stamps and others) and private insurers legacy’ computer networks. Each agency and organization has a myriad of computer networks that must interface with the health insurance exchange web site.

It is reality easy to have a pretty front end interface with the user. If the software program is poor the interface is a disaster.

These computer networks must be integrated into what appears to be a fancy front end. It looks as if this software is incapable of this very complex integration.

It is one of the reasons that verifying patient for subsides has been dropped and the government is going to take the patient’s word.

These problems were published in blogs for months. The software  failed initial testing.

The Obama administration did not delay the launch despite these warnings.

Now President Obama has told us that this is a small “glitch.” He compare it a glitch Apple had with its launch and it did not put them out of business.

"Take away the volume and it works," President Barack Obama's chief technology adviser, Todd Park,  told USA Today. 

Either President Obama does not know what is going on or he is not telling the truth to the American people.

The administration has blamed the glitch on the high volume of people trying to access the site. This is partially true.  

The prediction by experts is it will likely take months to get it running properly. The rollout was disastrous.  There were 8.6 million unique visitors in the first 3 days hoping to apply and enroll in a healthcare insurance plan.  Instead they experienced an online nightmare, with websites crashing, refusing to load, and failing to offer comprehensive choices.

 The demographics of the 8.6 million are unknown. They may all have been high risk uninsured people.

The Daily Mail  is reporting that sources within HHS are saying only 51,000 people signed up for insurance via the government run website in the first 12 days, 

Two HHS career civil servants told the Daily Mail that only 6200 people signed up on the first day. “

White House and administration officials continue to insist they have no idea how many people have signed up but will release the numbers monthly after November 1.

Is the administration trying to hide something?

“If the state-run exchanges were to have a similar response rate for six months, the national enrollment total would be approximately 2 million in six months."

That number is less than 29 per cent of the 7 million the Obama administration would need, according to the nonpartisan Congressional Budget Office, in order to balance the new health insurance system's books and keep it from financial collapse.”

The White House’s published goal is to enroll at least 2.7 million young, healthy people between the ages of 18 and 35 in 6 months.

The monthly premiums of healthy, low risk people are needed to offset the cost of health care for older, sicker Americans who will certainly try enroll.

“Exchanges must provide many different functions, the soundest approaches bring together expertise and best practices in federal and state health programs, commercial insurance, data exchange, portals, e-commerce over the cloud, and financial management.”

“ CGI brings all of this expertise to the table, along with direct experience in developing sustainable HIX programs. We also have a dedicated group of subject matter experts tracking best practices for state HIX and integrated eligibility systems across the United States.”

CGI knows what to say. It has not shown that they know what to do.

The Obama administration may have wasted $634 million taxpayer dollars on software that does not work.

This is more than a glitch. This is a disaster.

Just wait and see the prices for a Bronze level healthcare insurance plan once people can negotiate the site.

No one is going to be able to afford the insurance in the Affordable Care Act (Obamacare).

Another disaster will be coming your way complements of Obamacare.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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