Monday, December 2, 2013

Healthcare.gov working (except for that pesky back end)

In an opinion piece in USA Today, HHS Secretary Kathleen Sebelius writes:

    So we've been working 24/7 to make improvements, and more consumers are successfully shopping online and enrolling in a health plan each week. As a result, today's user experience on HealthCare.gov is a dramatic improvement over where it was on Oct. 1. The site is running faster, it's responding quicker and it can handle larger amounts of traffic.

Yet, according to the Washington Post, Henry Chao, deputy CIO and deputy director of the Centers for Medicare and Medicaid Services' Office of Information Services, testified during a hearing before the Oversight and Investigations Subcommittee of the House Energy and Commerce Committee on Tuesday:

    [H]is team has yet to complete 30 to 40 percent of the overall project. ... Chao said the Centers for Medicare and Medicaid Services is [sic] still working on a number of “back office” aspects of the project, including a system to send payments to insurance companies.

And WSJ reports:

    Insurers and some states are continuing to look for ways to bypass the balky technology underpinning the health-care law despite the Obama administration's claim Sunday that it had made "dramatic progress" in fixing the federal insurance website. Federal officials said they had largely succeeded in repairing parts of the site that had most snarled users in the two months since its troubled launch, but acknowledged they only had begun to make headway on the biggest underlying problems: the system's ability to verify users' identities and accurately transmit enrollment data to insurers. ... Our favorite line in the report is the HHS boast that "the team is operating with private sector velocity and effectiveness." That sure is a remarkable two-month turnaround for the same team that took three and half years to botch the initial launch at a cost of more than $1 billion, according to an analysis by Bloomberg Government.

A while back, I wrote:

    When customers fill in data, click on buttons, and so on, in the Obamacare portal, backend business processes will be set in motion. It is one thing for software to capture data in a form, send that data over a wire, and store that data as a transaction in a database. It is quite another thing for the backend business processes to make sense of and reconcile all this data, to take appropriate actions based on the data, and, to operate in such a way that all the transactions taken together aggregate and add up to a net benefit to users. In short, once a user has enrolled in a policy, the entire lifetime of that policy, including premium billing over the long term, must be administered in a consistent, auditable way.

A system is hardly complete if the back office functionality required to verify identities, forward applications to the insurance companies, and make payments is not working. Who does Kathleen Sebelius think she's fooling? A system that is "running faster" and "responds quicker," but doesn't know who you are, sends your data down the bit bucket, or doesn't make payments to the insurance companies, is, by Silicon Valley "private sector" standards, not yet working.

More to the point: even when the software engineers get the back office functionality up and running (after maybe another year and another several billion dollars more in consulting fees), the perverted incentives created by Obamacare (cover the sick and poor at the expense of the young, affluent, and healthy) will still doom Obamacare and the Democratic Party.

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