The Healthcare Tech Hearings

Friday, October 25, 2013

Problems continue to plague the online healthcare exchanges set up under Obamacare, from slow access to corrupt data being sent to insurance companies. NPR congressional reporter Ailsa Chang talks about the Congressional hearings on the troubles, and what comes next.


Ailsa Chang

Comments [26]

Martin Chuzzlewit from Manhattan

Pallone is a pandering, lying Left Wing hack .... just like his party leader, who will slither out of the White House in 1182 days and 18 hours.
The road to serfdom leads through these two phonies.

Listen carefully to the full audio of Pallone's statement .... was he slurring his words?

Oct. 25 2013 06:15 PM
keira from Manhattan

Monkey court brilliantly defines the moment and is vastly better than kangaroo court. Shakespeare isn't the only one allowed to coin words—kudos to Rep. Pallone!

Oct. 25 2013 03:27 PM
Edward from Washington Heights AKA pretentious Hudson Heights

REGISTERING for Obamacare should be the easy part.

The hard part is handling the claims.

And the spin by RUCB and others claiming nefarious DDOS and sabaotge is ludicrous. If there was a DDOS, why wasn't it mentioned at the hearing?

RUCB, are you a 9/11 Troofer too?

Oct. 25 2013 11:30 AM
Amy from Manhattan

Joyce: No, nobody has PPACA insurance yet. The insurance doesn't go into effect until Jan. 1, 2014. No one in the gov't. has claimed that anyone will actually have the insurance before then.

Oct. 25 2013 11:16 AM
Martin Chuzzlewit from Manhattan


Good points, all.

Oct. 25 2013 11:07 AM
thatgirl from manhattan

Joyce - I don't know--why don't you ask them? You said you're "hearing" from everyone.

And calm down on those screaming caps. I'm not sure you have the coverage to effectively manage your aneurysm.

Oct. 25 2013 10:59 AM
Joyce from NYC

thatgirl writes:

I didn't know you were gathering data from applicants. Seems over 40,000 people in New York State have registered. So much for your record keeping.


Oct. 25 2013 10:54 AM
RUCB_Alum from Central New Jersey

@Ben from here in town

"When the ACA was enacted, the President said it was paid for..."

Do the numbers. Healthcare today is covered by private insurance, MediCare, Medicaid and charity care and is costing us 17% of GDP. PPACA *requires* all of the currently uninsureds now buy insurance. For all of the hyperbole that is all it does. The costs for the health care for the uninsureds are currently carried by that other 85%. How can a system that collects more money for healthcare increase the debt?

The GOP contention is that only the old and sick will sign up for PPACA and the young will deny/delay/avoid joining up. That is an imbalance in the risk pool that could bankrupt some insurers. This is why they fought the 'individual mandate' so hard. Odd, that a system that they cooked up by the GOP to respond to Hillary's managed healthcare plans and put in place in Massachusetts is now subject to so much rock-throwing. Believe me, the insurance companies will tighten control of what is and what is not covered long before they let their continued existence be challenged.

In this instance trust the insurance companies to know their business better than Democrats or Republicans.

Does ObamaCare blunt (and eventually bend down) the cost curve for American healthcare such that it matches that of other developed nations? That is 11.5-14% (rather than 17%). [Keep up the daily cardio and watch what you put in your mouth!] and what do we do with the 'health care dividend'? [Also, whose income goes DOWN because the nation's health costs are more in line.]

Oct. 25 2013 10:46 AM
M.J. Wilken from Wilton CT

I wonder if Rep. Pallone is subconsciously conflating “kangaroo court” with this singsong put-down we used as kids: Order in the courtroom, the monkey wants to speak. Speak, monkey, speak!
It gives an appropriate flavor to these ACA hearings, don’t you think?

Oct. 25 2013 10:43 AM
thatgirl from manhattan

Joyce - You talk about this being a "product." Wrong. It's a huge swath of products that vary by age, state and other criteria, and depend upon the policy agreements entered into with the hundreds of insurance companies on the Federal and State exchanges. It's a huge opportunity for the insurance companies, with nothing but upside potential.

I didn't know you were gathering data from applicants. Seems over 40,000 people in New York State have registered. So much for your record keeping.

Oct. 25 2013 10:34 AM
thatgirl from manhattan

Margaret - Excellent point. The insurance industry was yet another huge stakeholder in this project. If anyone here had any idea how to make these disparate sites work together seamlessly, they wouldn't be so freaked out. It's a challenge.

Nick - This isn't Amazon, and everyone needs to stop comparing it to the ACA site. Amazon has a uniform way of transacting purchases--it isn't a state-by-state prospect (save for the zip code lookups for shipping and taxation--the latter of which freaked Bezos out when it was proposed these purchases be taxed in that manner). The Federal Government has never had the reason to hire personnel who have this kind of advanced, transactional know-how--count up the state exchanges, insurance companies, thousands of "rules" by state, powerful verification capabilities, security and the need for dozens of contractors to speak the same language, and you have something the size and nature of the Iraq and Afghanistan war quagmires. No one's talking about lost suitcases of cash yet, so this still has more merit.

Scort - "Non-working?" Tell that to the estimated 476,000 who've put in their applications and paid. This doesn't comprise "failure" in the world of a rollout of this scale.

Too right, Becky--people could call, go in to speak to someone in some states. But many states did add exchanges at various points, some very late--they were but one source that held this up.

Oct. 25 2013 10:29 AM
Truth & Beauty from Brooklyn

It sounds like every one is playing "Pass the Buck."

Anyway, it could very well be that this was too last minute a project to have been done so quickly, but any software engineer who rolls out software or websites without testing them first is the equivalent of people who represent themselves in court - i.e., FOOLS. All software and websites must be tested first (note Windows ME and VISTA), and any software engineer who doesn't insist on testing should find something else to do for a living.

The upshot of all this is: 1. Obamacare is a good first try for providing health care coverage for as many US citizens as possible; 2. the software should have been tested before it was put on line; 3. we still need the healthcare coverage, so let's stop playing the blame game, find people who can fix the software and associated websites, and let's get this show on the road.

Attn: Republicans: complaining about the software/website issues won't get you off the hook for shutting down the government!

Oct. 25 2013 10:27 AM
Joyce from NYC

I continue to be amazed at these WNYC listeners who live in a world of wishful thinking.

It's slow -- no, its not slow, it does not work -- I have yet to hear from on person who now has insurance from the site.

The states work. Not all of them, I have yet to hear from on person who now has insurance from the a state site.

It's the Republicans fault. Are some people infantile or what ?????

Use the phone. Becky, when you use the phone, the call-center operator takes your info and puts it into the web site -- WHICH DOES NOT WORK.

Yes, they could have built a site that works, but then people would have info like HOW MUCH THERE DEDUCTEBLE IS, LIKE $5,000 PER PERSON, OR $20,000 FOR A FAMILY OF 4.

One of the reasons for it not to work is so that we don't know the truth about the product.

Oct. 25 2013 10:25 AM
Amy from Manhattan

Part of the problem in how this is treated is that so much attention is given to the "monkey court" remark & so little to what Rep. Pallone actually said after he didn't yield his time. Even on WNYC, I haven't heard what his response to the "incompetent or lying" (rhetorical) question was.

Oct. 25 2013 10:25 AM
Mike from Long Island

What is interesting in this story with this last systemic failure is who in this administration is going to cash in and get work in one of those corporations.
You know, this is what Obama’s administration is all about, to cash in their ‘public’ service in corporate world.

Oct. 25 2013 10:20 AM
thatgirl from manhattan

No one who's ever worked on a web destination rollout can tell you: These projects of tremendous scale do take multiple contractors who have very specific roles in said rollout. As long as the revenue stream isn't interrupted (and it can be, often), and everyone up the approval chain agrees completely on the progress and results of the labor, it rarely launches when predicted. It's kind of surprising that someone like Bezos hasn't stepped up and explained what goes into a huge transactional site that links to the many state exchanges (with all associated communications to said exchanges). This isn't a wiki--it uses qualification/verification, which takes quite a lot of pipeline space and energy. And no one within the Federal government has the know-how to do it single-handedly--nor are there contractors who can do it all.

The other thing no one talks about is that the U.S. is number 26 in the country in internet infrastructure. Municipalities who've tried to develop universal access have been quashed by the TWCs, Verizons and Comcasts, worried they'd miss out on their precious, per-person revenue. Up to 50% of Americans can't enjoy a mean standard of internet access because of this lack of universal infrastructure, its affordability, and the affordability of the right hardware to make a transactional experience go smoothly; hence the time-outs and frustration people with sub-standard access have in engaging a site being accessed by millions of others at once. Ask the Bush Administration about their disastrous launch of the Medicare Part D site about that one (knowing it's nowhere near the scale of the ACA site).

And the media, including NPR, is making snippy comments about this project, not knowing jack about what this takes. It's a monstrous project. Having the whole thing threatened by zealots in the GOP hasn't helped it. Guess what happens when the money's threatened every few weeks? Work shuts down.

And please stop the panic about "the young people" who we "need" to sign up--no one's offered any metrics on the age breakdown of those who've successfully signed up, which does include families with young people. It's clear this isn't be helped by all the "hair on fire" types.

Digital rollouts can be painful. They always have multiple contractors and approval people. Get a grip.

Oct. 25 2013 10:20 AM
Margaret from Brooklyn

The portrayal of the healthcare role out problems being a factor of government failure. Personally, I blame insurance. Has ANYONE in these discussions tried to sign up for their corporate healthcare plan when it's got 4 different layers of sub-contracting. They're totally disjointed, require multiple calls to clarify how to use the numerous portals, and more often than not... each portal has different logins. Yeah, there are significant issues with the role out. But, these issues are inherent of insurance and any new software role out. Rather than finger pointing, let's highlight WHY the insurance companies aren't receiving the right information. It's most likely because they each have different and totally tangled means of taking in data.

Oct. 25 2013 10:19 AM
Nick from UWS

Why didn't they hire a contractor highly experienced in designing massive e-commerce sites, like the guys who design and operate Amazon? What kind of imbeciles are these? What the fuck is the matter with the US Government?

Oct. 25 2013 10:14 AM

Thanks for the "monkey court "information. That is much more important than discussing what the $600,000,000.00+ in taxpayer money went to create a non working website. Its just a half a billion dollars or so. I guess its ok to let this little mishap slide.

I can't wait for Brian to start bashing those crazy people who think the governement is wasting taxpaye money.

Oct. 25 2013 10:14 AM
The Truth from Becky

There is and always has been help available by phone. This is not a big deal.

Oct. 25 2013 10:13 AM
antonio from baySide

What an irony, CMS in the web world means "content management system.."

Oct. 25 2013 10:12 AM
Scott from Lower Manhattan

Any possibility that Republican refusals to allocate funds to implement Obamacare could have contributed to the difficulties in getting up?

Oct. 25 2013 10:11 AM
Ben from here in town

When the ACA was enacted, the President said it was paid for, and would not increase the US debt. Yet the Republicans say it will bankrupt our economy. I'd love it if you would address this question, Brian.

Oct. 25 2013 10:10 AM
John A

Integration test is very important in gvt contracts. Finding the person who requested that registration was required for browsing, changed in the last minute, that will be the smoking gun here.

Oct. 25 2013 10:07 AM
Cory from NYC

The states that acted responsibly and set up their own exchanges are not experiencing problems. The states that have acted irresponsibly and did not set up exchanges for their citizens have thrown them into the federal exchange. So why should anybody care about the federal exchange glitches? If you don't like it, complain to your irresponsible governor and legislature.

Oct. 25 2013 10:03 AM
RUCB_Alum from Central New Jersey

Is there any chance for ObamaCare to sign up the young (and presumably healthier) participants that it needs to survive? I think yes but this stumble out of the gate makes it tougher than it would otherwise have been.

Certainly, the website launch could have been better but developing a website to handle the traffic of a possible 45 million people (and probably four times that many looky-loos) is hard enough. Doing it when half your Congress are against you and will roadblock attempts to make it work is maddening. The reality of DDOS and other hacking attempts can also impact the final service delivery.

Knocking ObamaCare because the website is slow and ineffective is like knocking because you had trouble finalizing your e-book purchase. In the end you got the e-book and in the end the 15% of us who were previously excluded from buying insurance will be able to do so and by the March 15, 2014 deadline. [Congressional hearing on 'the problem' is premature and not going to get anything substantial done. Why doesn't Congress folks on the creating a program to stimulate the JOBS that would right the country's deficit!]

Did anyone else hear the IT analyst who said that he saw a working ACA website (based on open source software) in JUNE. This was scrapped and re-coded on private software. Have to wonder why was that...

Oct. 25 2013 09:44 AM

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