September 26, 2013
The ObamaCare Implosion
An established political idea is like a vampire. Facts, opinions, votes, garlic: Nothing can make it die.
But there is one thing that can kill an established political idea. It will die if the public that embraced it abandons it.
Six months ago, that didn't seem likely. Now it does.
The public's dislike of ObamaCare isn't growing with every new poll for reasons of philosophical attachment to notions of liberty and choice. Fear of ObamaCare is growing because a cascade of news suggests that ObamaCare is an impending catastrophe.
Big labor unions and smaller franchise restaurant owners want out. UPS dropped coverage for employed spouses. Corporations such as Walgreens and IBM IBM +0.45% are transferring employees or retirees into private insurance exchanges. Because of ObamaCare, the Cleveland Clinic has announced early retirements for staff and possible layoffs. The federal government this week made public its estimate of premium costs for the federal health-care exchanges. It is a morass, revealing the law's underappreciated operational complexity.
But ObamaCare's Achilles' heel is technology. The software glitches are going to drive people insane.
Creating really large software for institutions is hard. Creating big software that can communicate across unrelated institutions is unimaginably hard. ObamaCare's software has to communicate—accurately—across a mind-boggling array of institutions: HHS, the IRS, Medicare, the state-run exchanges, and a whole galaxy of private insurers' and employers' software systems.
Recalling Rep. Thomas's 1999 remark about Medicare setting prices for 3,000 counties, there is already mispricing of ObamaCare's insurance policies inside the exchanges set up in the states.
The odds of ObamaCare's eventual self-collapse look stronger every day. After that happens, then what? Try truly universal health insurance? Not bloody likely if the aghast U.S. public has any say.
The observation about the software couldn't possibly be more apt. Great essay - read the whole thing.
Posted by Cassandra at September 26, 2013 06:13 AM
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It is a good essay. Eric Blair will be insufferable after this, though. :)
Posted by: Grim at September 26, 2013 12:06 PM
"ObamaCare's Achilles' heel is technology"
For which the medicament would be arterial bureaucracies and ministries to which the sequela is presently clinically unknown but thought fatal. I would find all this amusing if I weren't just now feeling pekid from exposure to Obama – a little of which can contaminate a whole lot.
Posted by: George Pal at September 26, 2013 02:31 PM
I think McArdle is better on this, less politics, more analysis: IT Is One of Obamacare’s Weakest Links
I've only skimmed about a dozen comments but the IT guys are really piling on. I did application programming for about 20 years and I can only imagine what a nightmare this has been for the programmers. One of the commenters at McArdle's place says to get the real story, interview three of the grunts working on this - that would be a story I'd love to read. Another one is wondering about DOS attacks - I hadn't even thought of that.
All that said, though, I'm starting to get a really bad feeling in the pit of my stomach. Those who oppose Obamacare are telling each other way too often and way too definitely that "of course" this isn't going to work, it isn't going to be ready, everyone's going to hate it, prices are going to go up, access/quality are going to go down. Since if all that is the case, we'll know within a few months, I'm starting to get nervous at how insistent everyone is being now, right on the threshold. It reminds me of all the people who were sure, certain, absolutely Romney was going to win.
Posted by: Elise at September 26, 2013 03:56 PM
The 1980s FAA/IBM project known as the Advanced Automation System has been called, doubtless with some hyperbole, The Greatest Debacle in the History of Organized Work. After a few more months of the Obamacare IT efforts, there may be a new candidate for that title.
Robert Britcher, who was involved with the AAS project, has written about it extensively. I excerpted some of his thoughts in my post The Story of a Software Failure:
Posted by: david foster at September 26, 2013 05:07 PM
I haven't had time to read McArdle's piece yet (didn't even know about it until Elise posted the link - thanks!), but analyzing software project data is what I do in meat space.
This is a huge, mega sized, ultra complex job and there's no way they allowed enough time for it to be done right.
Size alone is an enormous risk factor for software projects. So is throwing a gazillion people on the project in the vain hope that you'll finish faster. It doesn't work, and we've seen that over and over an over again.
Just getting the requirements adequately defined is a huge project all by itself. It's hard to understand how anyone would expect the code to work if the developers don't really understand everything the system needs to do? In this case, the requirements aren't nice-to-have features dreamed up by some client.
They're laws. This has all the hallmarks of a disaster.
Posted by: Cass at September 26, 2013 06:07 PM
I disagree with Henninger (say what?!), but only regarding what happens after Obamacare is taken off life-support. Henninger believes that, having been given a taste of socialized medicine,and finding it tastes like creamed bullshit, the American Public will rise up and demand a return to the Good Old Way rather than be led further down the path towards the Progressive Utopia of Single-Payor Universal Healthcare. Henninger thinks too much of the American Public, less than half of whom are above-average, and most of whom would know the difference between Universal Healthcare and Universal Studios.
Maybe I'm jaded, but it would not surprise me one bit if every hard-core Progressive in this country wasn't hoping that Obamacare falls flat on its ass so that it can be "fixed" with 100% government paid cradle-to-grave medical coverage. And, to be perfectly insane about it, I think that they've got a better shot of driving us all over the cliff than "we" have of backing the train down. It's a different world, folks.
Posted by: spd rdr at September 26, 2013 06:18 PM
In this case, the requirements aren't nice-to-have features dreamed up by some client.
They're laws. This has all the hallmarks of a disaster.
Yes but as someone was arguing early on in the McArdle comments, the Executive Branch will simply deep-six, delay, or re-interpret any parts of the law that the software can't handle.
Which led, distressingly, to an insistence by the same commenter that the job of the Executive Branch is to not execute parts of laws if the President thinks those parts are a bad idea. It really is a different world.
Posted by: Elise at September 26, 2013 07:10 PM
Look on the bright side, folks. Shortly after the Spousal Unit was finally "allowed" to work a full work week (and get the whole paycheck!), we're about to turn around and shut the federal government down :p
What's that lovely acronym I dimly recall from the 70s? BOHICA?
Posted by: Cass at September 26, 2013 07:18 PM
I'm no code monkey, but I have seen what happens when someone tries to roll out software too quickly. Without proper testing, the software blows up when users (in today's point & click environment) don't point & click in exactly the right order.
Also, I've seen what happens - as an end user - when someone is writing (and selling) software to help met requirements of portions of Obamacare. My employer is now required by law to report certain information to the government, along with every other company in our industry. Software outfits are writing and selling software purporting to help companies meet these reporting requirements. The law included a now past date for the beginning of the first reporting period, but this deadline was pushed back because the rules from HHS weren't published on time. How can you write software when you don't have all the functional requirements? A software vendor was engaged and then we discover it didn't work like what they said it would. Now we are looking at other vendors to replace the first vendor. My boss, in speaking to references from the "finalist" software vendors says they are both crap, but at least this time, whichever vendor is chosen, we'll know it and be better prepared to work with it. And what we are trying to do with the reporting - though very complicated - won't be nearly as complicated as the exchanges.
I've been in Boston this week for work. At dinner this evening (on our free night), four of us (me & another lady from the home office and the two ladies from our UK office) were out to dinner and the subject of insurance and going to the doctor (and dentist) came up. The one lady said the NHS is just fine if all you need to do is see your primary care physician. However, if you need to see a specialist (even if you have private insurance to see a private HCP, which our employer does offer to it's UK employees), you must get a referral from your NHS physician to see a specialist, and if you don't have private insurance, you must wait to see the government specialist. We really don't want to go down that road...
Posted by: Miss Ladybug at September 27, 2013 12:20 AM
It's my fond hope that this will blow up, fall down, and/or implode sufficiently by Summer of 2014 to translate into a GOP takeover of the Senate.
Some may be RINO's, but they won't have any 'loyalty' oaths to Obama, and that will end funding of the mess. Fiscal votes are straight majority, w/ no filibuster allowed.
*IF,* (and will admit it's a huge 'if') we wind up w/ a reasonable POTUS, 2016 will finally see some sort of real repeal & replace.
Posted by: CAPT Mike at September 27, 2013 12:46 AM
When I first came here, this was all a swamp of data. Everyone said I was daft to build universal healthcare on a swamp of data, but I built it all the same, just to show them. It sank into the swamp of data. So I built a second one. That sank into the swamp of data. So I built a third. That burned down, fell over, then sank into the swamp of data.
Patience my liberal friends. I'm sure it eventually it will work.
Posted by: President of Obamacare Swamp at September 27, 2013 11:09 AM
OK, that gets Comment of the Day :p
Posted by: Cass at September 27, 2013 03:56 PM
I agree w/ earlier comment by Cass. The failure of Obamacare may be good thing to the elite Left, even an intentional one. And the new solution will be British style one payer. British style so the fat cats in the elite will still be able to get personally financed, quality care.
Posted by: DaveJ at October 5, 2013 12:32 AM