It’s so bad, I don’t know where to start. The first portion of Obamacare to become visible to the general public are the Health Insurance Exchanges. Some States are creating their on exchanges and others are defaulting to a Government run exchange. View your states health insurance exchange plans here.
The exchanges should all be up and functioning by October 1st of this year. Let me make a rather bold prediction.
THEY WILL NOT BE READY
No way, no how. Also, this really isn’t a bold prediction if you’ve been paying attention.
Michael Barone of the Washington Post has examined this issue in two separate postings. First a blog post, Implementing Obamacare? “Impossible endeavor”. This post is based on information supplied by an 83 year old retired Director Level “IT” guy with a long history in the industry and who worked on Y2K. His main bullet points are:
- Programmers (Here he mentions COBOL, which I really hope is not the case)
- System Analysts
- Technical and Subject Matter Specialists (has anyone read the law and the regulations?)
- Computers: Mainframes, desktops, browser compatibility, the list goes on
- Interfaces
It’s the last point that strikes me as the death knell of getting exchanges up and operating on time. Here is the list of interfaces based on the GAO report:
- IRS
- HHS
- TREASURY
- INSURANCE COMPANIES
- SOCIAL SECURITY ADMINSTRATION
- STATE EXCHANGES
- CORPORATIONS
- SMALL BUSINESS
- MEDICARE
Dear readers, THIS IS THE TOWER OF BABEL. The interface to all of these systems is going to be working by October 1st? The Government has a better chance of recreating the Saturn V rocket, the Apollo capsule, the moon lander and sending people to the moon by October 1st.
Not to pile on or anything but we haven’t even touched on Michael’s 2nd article, More on the Obamacare IT nightmare. The first blog post resulted in a response from another IT specialist by the name of John Capron with 35 years of IT experience. I will include his response in it’s entirety as there is not good place to split it up (and it IS a run-on paragraph!)…
Wow, what can go wrong here? Let me assess this based on my years of experience in this industry. The federal government is going to build 50 exchanges, using a data hub that doesn’t exist physically and in fact, the design hasn’t been solidified, and must be accessible to a variety of data processing technologies that range from archaic to old. Each of the 50 states have different eligibility rules, and with a significant number of states opting out, the federal government now has to learn the intricacies of each state’s Medicaid eligibility models which then scale to different applicability rules for different members of a given family. The thousands of pages of bureaucratic rules that will drive requirements haven’t been completed yet, and those requirements are needed to drive design not only for the application programs, but for the entire processing architecture. The issue of network, processor, and storage performance has to be decided, modeled and tested. To complicate matters, the convoluted federal procurement rules for hardware and software have to be adhered to, which require mixing different hardware brands, software packages and service providers. Add to this compliance analysis to validate and revalidate trusted sources of data. All legal requirements at the local, state, and federal level have to be met by the design. And last but not least, staffing up for customer support which requires hiring, training on applications not yet designed and real world tested, the creation of support documentation, building or retrofitting facilities for these folks, setting up backup sites for the required redundancies, plus hardening the sites for natural disaster power failures. Additionally, the people hired must meet the Equal Opportunity criteria, and all GUIs must be handicapped usable, as well as the facilities themselves. I could be here all evening defining additional work to be done. Oh, did I mention this will be done by next year. Now I know why this has never been attempted. We are a country made up of 50 separate and distinct states, with all their own rules of governing, and to make things more unworkable are all the federal rules that have to be adhered to. I think we the people are going to be safe for quite awhile here.
Mass chaos in October, we should be hearing muffled screams of panic in August. I only hope that John Capron’s conclusion is correct:
I think we the people are going to be safe for quite awhile here.
