Opinion: ACA ‘glitches’ inexcusable

October 16, 2013


The appalling mess that has faced people trying to sign up to obtain medical insurance under the new Affordable Care Act (aka Obamacare) is both inexcusable and dismaying. Regardless of what position one takes as to the wisdom of the new law, there can be no excuse for the unbelievable incompetence that seems to have resulted in  a “launch” for the new insurance exchanges that has already soured many Americans on the new legislation.

Statements by various federal officials that one must expect “glitches” in a new program or that there will be plenty of time for people to sign up before the deadline simply make the situation worse in my opinion. The new online registration program should have been tested and tested again before the launch date and the federal government should have been certain there would be no “glitches” or, at the very least, these problems should have been foreseen and actions taken to correct them immediately. Instead, the government seems incapable of recognizing how serious a problem it has. Further, nobody seems willing to admit fault for what has happened.

Personally, I find it rather amazing that the same federal government that includes the National Security Agency which seems perfectly able to create and run computer programs that monitor millions of Americans’ telephone calls every year and which seems to have incredibly sophisticated cyber-spying capabilities is incapable of creating a program to permit Americans to sign up for medical insurance. Is it possible that all the competent computer programmers are so busy spying on Americans that none are available to implement the Affordable Care Act?

There is also a very serious potential ramification of the botched launch of the Affordable Care Act. For months we have been told that the economic success of the ACA will depend on healthy Americans signing up to be part of the system. One has to ask whether the federal government believes that the mess that has faced those trying to sign up since Oct. 1 is going to encourage young, healthy people to participate. How many will want to go through the misery of the online mess?

For me, the bottom line is simple. If the Obama administration thinks that the Affordable Care Act is really necessary for Americans then they need to make sure that it’s implementation takes place without the kinds of “glitches” that have plagued the program so far. If they do not think that this is important or are incompetent to make implementation go smoothly, then maybe it’s time to go back to the drawing board.

— Mike Hoeflich, a distinguished professor in the Kansas University School of Law, writes a regular column for the Journal-World.


Lawrence Morgan 4 years, 7 months ago

This is ridiculous. From all that I have read, and that is a great deal of information, the real problem with these websites is the developers and implementers of the sites, not Obama.

You, obviously, have good health insurance. What about those who don't have it, and/or have existing conditions? There is not time for many of these people to go back to the drawing board. That's made from your point of view, which is very different from middle class and poorer people in Lawrence, This is typical of many people at the university level - they have no insight into other people's lives in Lawrence, and this has been going on for many years.

The Obama administration should go directly to these developers. They are able to create other sites which serve millions of people, such as Google, or Amazon.

If they can't do these sites correctly, they should be sued immediately and other developers found!

There's a lot of people out there, in the computer industry, who need work! And there are many who can do this work correctly and thoughtfully.

Greg DiVilbiss 4 years, 7 months ago

So are you saying that when faulty Intel was provided to the President regarding WMD's that it was not his fault he sold the country on going into Iraq?

It really was just those pesky intelligence officers who should have been fired immediately and then we should have found some who knew how to provide accurate information. I seem to remember a saying that seems appropriate. "the Buck Stops Here"

Frank McGuinness 4 years, 7 months ago

GREG, There was no faulty intel. I CLEARLY remember UN Weapons Inspector Hans Blix saying over and over and over again that there was ZERO evidence of WMD's in Iraq.

There was however manufactured intel to support Bush's desire to enter Iraq.

Also YOU may have been sold on going to war with Iraq but countless, critical thinking Americans were not!

John Graham 4 years, 7 months ago

No actually Kevin's comments were correct and there is nothing you can do about that except resort to hyperbole and nothing more.

John Graham 4 years, 7 months ago

I guess you do as you do it quite well. I am honored to be critiqued by such a profound thinker as you.

Frank McGuinness 4 years, 7 months ago

Not True Kevin, "In an interview on BBC 1 on 8 February 2004, Blix accused the US and British governments of dramatising the threat of weapons of mass destruction in Iraq, in order to strengthen the case for the 2003 war against the regime of Saddam Hussein." "Senior U.S. officials ordered the U.S. Central Intelligence Agency (CIA) to investigate Blix to gather "sufficient ammunition to undermine" him so that the U.S. could start the invasion of Iraq. The U.S. officials were upset that the CIA did not uncover such information"

North Korea, and Iran likely have WMD but we are not invading them or even considering it. So the potential that Iraq had WMD was no reason to invade, particularly without ANY clear cut evidence.

Your previous post is incorrect and worthless.

Frank McGuinness 4 years, 7 months ago

I am not aware that any of those people made the case we should invade Iraq.

Seth Peterson 4 years, 7 months ago

There's little need for accusation, most of what you post is incorrect and devoid of fact.

Greg DiVilbiss 4 years, 7 months ago

You miss my point Frank the "Buck stops here" applies to President Bush as it does President Obama. The responsibility for inferior information (doctored or not) lies squarely on the presidents lap. Just the same as President Obama is responsible for the debacle regarding the technology aspects of the ACA.

If my company fails, then it is not my employees fault it is mine. If my company succeeds then it is due to the hard work of my employees not me. I was simply pointing out to Lawrence the responsibility lies where the "Buck Stops" in a system failure.

I am not sure how anyone can disagree with that. I also did not state my opinion on whether I am in favor of action in Iraq or whether I am for or against the ACA. I did state an opinion regarding the responsibility of leadership.

Joshua Montgomery 4 years, 7 months ago

I don't necessarily agree with Greg, but his post is civil in both its content and its presentation.

I appreciate the change in tone on the forums, and though I may disagree with Greg on this topic, I fully appreciate his willingness to share his opinion in as a part of our community discourse.

George Lippencott 4 years, 7 months ago

Problems with major software developments are legendary. Why anyone expects more from the ACA implementation given our experience is - well - stupid.

Yes Obama is at fault. Once the expected problems surfaced he should have put a moratorium on electronic registration to allow time for fixes and to avoid frustration with the system.. Just slip the mandatory coverage date accordingly. The fear of Republicans is clouding judgement.

George Lippencott 4 years, 7 months ago

Good question. Because 1. It takes time to fix things as complicated as the ACA System and has been demonstrated as such many times. 2. Pushing the developers to "fix" it under great pressure has frequently proven to be counter-productive 3. Frustrating the citizenry in fighting a "broken" system is not good public policy. 4. There is no specific reason why this month as opposed to Christmas makes any real difference.

As I said, too many people cannot get out from among the trees to see the forest. We should make technical and not political decisions on something like this.

George Lippencott 4 years, 7 months ago

Really?? This is not an existing web where you can patch a piece without major impact to anyone. This is a major new software system resident on the web. Leaving it up impacts those trying to gain access. Good public policy says you take it down and fix it and roll it out again when it is truly ready.

I do not care about Kevin. I am accusing you of being overly political by rationalizing that the system can not be taken down and repaired and that saying so must be political. You are worse than Kevin.

IMHO I was attempting to defend our former Governor and the Obama administration against charges that the system is disposable. IMHO it is just growing pains. but leaving it up because you are afraid of the Republicans is bad public policy and bad politics.

One can still register by snail mail ()and I believe in some markets by phone). The program does not start until January and having to make a months deposit suggests that most people who might need the system will likely wait until December to actually "join".

George Lippencott 4 years, 7 months ago

Well we disagree. Do you have any experience in bringing in a large software system. I do as I have been a program manager on more than one. Patching the way you suggest is only called for if you must have the system operating. There is no such imperative here. Shut it down and set a new roll out date for people to again engage it.

Frank McGuinness 4 years, 7 months ago

Mike, you live in quite the bubble don't you. You likely already have government subsidized healthcare don't you so its pretty easy for you to complain about the rollout for those less fortunate?

1) With a house that is bent on repealing the ACA it's kind of difficult to secure any additional funding to launch the program in an ideal fashion. Furthermore State officials like the Brownback administration have done nothing to help the rollout as they decline funds to setup state based exchanges putting additional strain on the federal systems.

2) "How many will want to go through the misery of the online mess?" Well apparently Millions have visited the site and at least a million have completed the signup in the first 2 weeks. How about you voluntarily drop your families healthcare and let me know if its worth dealing with a bit of an inconvenience to provide your loved ones health care.

3) Since when is it appropriate to scrap a health care program or any program for that matter just because the rollout is less than ideal? Maybe the federal government should have consulted you in how to best launch a program designed to improve the quality of life for millions since you appear to know it all. The only thing I see that needs to go back to the drawing board is your misguided opinion piece.

John Graham 4 years, 7 months ago

What I find funny is that the same people that blamed Bush for every negative thing that happened during his 8 years in office and several years after, refuse to blame Obama for anything. Nothing is Obama's fault, it is somehow always a Repulicans fault. My how open minded they are.

Frank McGuinness 4 years, 7 months ago

There is a significant difference in seeing fault within the context of going to war and providing health insurance.

Greg DiVilbiss 4 years, 7 months ago

Ok Frank, lets not use Iraq as an example lets use the unfunded mandate No Child Left Behind. The responsibility for the failures of this program is the responsibility of GWB. Just the same as the responsibility for Technology failures are BHO's.

Seth Peterson 4 years, 7 months ago

I almost support the first half of this LOE's point - however, he misses several major facts. Probably most importantly that Brownback turned away around $35,000,000 designated for creating and operating the system to help it run efficiently. If you're problem is how ridiculous it is operate, the problem starts there.

George Lippencott 4 years, 7 months ago

Help me with how you reasoned that Brownback had anything to do with the overall system we are trying to create??

George Lippencott 4 years, 7 months ago

Ok. I understand your rationale. If the guy you hate had chosen to build the site it would certainly be running better???? Being the evil being you detest would he have not sabotaged it???

Yes, we could have expanded Medicare for the additional populations included in the ACA legislation. I support that. I am also of the opinion that that is as far as we should go with subsidies. Pandering to people who make the average national income is a losing game that will eventually bankrupt us!!!

George Lippencott 4 years, 7 months ago

Oh. How do you come to that conclusion?? The governor has wide latitude in where federal money coming to the state goes. It probably would have been a contract. While I have considerable respect for Ms Praeger and wish that she would run for a higher office I seriously doubt she is the right answer to build a complex software system Again you seem to be driven by politics and not by technical considerations.

Richard Heckler 4 years, 7 months ago

Got an idea. Just forget Obamacare and that monster reckless mess that preceded Obamacare for approximately 80 years and move into a program that will reduce the cost of big business,small business,public education,higher education, local government,state government and dare I say the federal government.

Let's Compare: Single-Payer (HR 676 and S 703) Expanded Medicare for All Vs. Proposed Healthcare “Private insurance with Public Option”

--- http://www.healthcare-now.org/docs/spreport.pdf ( very interesting findings)

--- http://www.pnhp.org/facts/single-payer-resources Physicians for a National Health Program

IMPROVED Medicare Single Payer Insurance for ALL would cover every person for all necessary medical care 24/7 to include:

Wellness /prescription drugs / hospital / surgical / outpatient services / primary and preventive care / emergency services / dental / mental health / home health / physical therapy / rehabilitation (including for substance abuse) / vision care / hearing services including hearing aids / chiropractic / medical equipment / palliative care / long term care

No deductibles / No Co-pays http://www.healthcare-now.org/docs/spreport.pdf

Now we're talking practical and fiscally responsible insurance coverage. NO re-inventing of the wheel necessary.

Richard Heckler 4 years, 7 months ago

For all of the whining about Obamacare look what can be found in the news.

Republicans Quietly Requesting Obamacare Dollars http://www.thenation.com/article/174669/revealed-letters-republicans-seeking-obamacare-money#axzz2W9Q3zls0

Paul Ryan Also QUIETLY Requested Obamacare Dollars http://www.thenation.com/article/169896/paul-ryan-quietly-requested-obamacare-cash#axzz2W9Q3zls0

Why did they shut down government and cost the taxpayers about $20 billion dollars?

George Lippencott 4 years, 7 months ago

The deficit to which Obama care adds another $250B per year when fully implemented.

George Lippencott 4 years, 7 months ago

I lost a post. The data you used is accurate but badly corrupted. The CBO is not a good source here because they are required by law to price the assumptions associated with the law. The zero impact results from assuming a savings in Medicare of about $700B which the trustees have declared unobtainable without cutting services. It was further corrupted by using six years of expenses and ten years of new taxes and payments.

The newest CBO estimate suggest the next ten years (2020 to 2030 ) are a 1.7 trillion dollar cost ($170M per year).

My estimate used nobody's data. I obtained the annual cost per patient for Medicaid (the best comparative I believe available) from CMS data divided by 2 (half of Medicaid is nursing home care) and multiplied by the number of people the democrats claim will be served by the new system. That is where my $250 billion comes from.

So I will spot you that Obama Care when fully implemented will cost between $170 and 250 billion per year.

I would also note that in the long haul claiming all the additional revenue can only be used to off set Obama Care costs is a loaded political matter. The additional revenue could just as well be allocated to the shortfalls in Medicare and Medicaid. The new money goes into the general fund from which the majority of all federal operating expenses are paid

George Lippencott 4 years, 7 months ago

OK $170 Billion per year!. That is a CBO number. You can go with anyone you want but you do have the responsibility to understand the numbers and where they come from.

All these numbers are estimates. Mine is as defensible as anyone else. Buy in for new programs whether in Defense or Social Programs is a given in our country. Do look up the original estimates for Medicare or Medicaid.

Apparently you do not really understand the OMB numbers. You can not repeat the trick of counting ten years of income and six years of expenses.

Yes you can claim that all the offsets like Medicare and new taxes continue to reduce the costs of Obama Care but it still costs $170 Billion per year or more. Offsets are part of making a bill look revenue neutral but the program still costs what it costs.

Unfortunately the additional revenue is not locked away for Obama Care. IT just goes onto the general pot against which the true costs of Obama care is levied.

George Lippencott 4 years, 7 months ago

This thread baffles me. I started out to defend the Obama administration pointing out that the software to implement this program is complex. I then made the mistake of suggesting that Mr. Obama was adding to the problem by not pulling the system to fix it . I spent the next twenty posts arguing about whether the system should be taken down and fixed or allowed to malfunction in place. In retrospect that is irrelevant to my original intent.

We did digress to the costs of Obama care and I learned something. Apparently at least some posters believe that the cost of the program is zero because other things were cut or taxes were raised. I never thought of it that way before.

Regardless the program does cost the government money even if there are offsets and IMHO that cost is somewhere between $170 and $250 billion a year when fully implemented. Those of you who want to believe it is zero be my guest as long as I can consider the cost of a new tank zero because taxes were levied at some point to pay for it.

Is there too much politics on here? Well IMHO we managed to politicize what started as a neutral statement about software complexity and the predictable consequences of building complex systems.

George Lippencott 4 years, 7 months ago

And your missing my point as you turn all of it into politics. The failure of this system is not political. It is technical. Noting that failure is not political it is a fact!

From the hearings today it sounds like the technical people recommended against releasing the system. Would you care to clarify as to why it was released?

George Lippencott 4 years, 6 months ago

You have me laughing. The government shutdown was about release of the ACA system??? Not in my world or the world of reality. The issue started our about the funding for the ACA in its entirety. Nobody but a handful of tea party faithful believed that would happen. It then morphed into an argument about the 0ne trillion we are spending each year that is in excess of our tax take (they agreed to talk more about that as they should.. Finally it crawled away being about almost nothing - except the pain it caused many many people..

The shutdown was a waste but from a Democratic perspective it made the system problem almost invisible for two weeks. Free time to fix the problems - unfortunately not enough time.

As far as politics the failure of the system was a technical failure. The likelihood that it would draw flack is a political reality for a system conceived and implemented by only half of us (Democrats) Releasing the system just added to the ammunition that the Republicans can use against it and the administration. Sometimes admitting to a problem can and does limit the scope of the fallout. As I have noted (and I am not a Democratic) it is a very complicated system and the administration deserves the benefit of the complexity. Why we had to have hearings to determine it might be several months before it is ready escapes me. I guess I am nowhere as political as you.

Richard Heckler 4 years, 6 months ago

Had the politicians simply moved into Medicare for ALL Obama wouldn't be faced with this mess of reinventing the wheel. ACA is not anywhere near a great success as yet because no one can be sure how many ways the website may still be flawed,

Due to the incompetency of the designer...... who should be fired.

Kathleen Sebelius should not be fired. The designer was not hired to screw up.

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