Albrecht Durer, Weeping Angel Boy
I cannot begin to tell you all how tired I am of hearing about Healthcare.gov and all of the glitches. Yes, I get it, really I do. It is hinky, the roll out was not seamless and smooth, it is well let’s just say it is imperfect.
It is in fact an ugly baby.
What Healthcare.gov is not; it is not the Patient Protection and Affordable Care Act (ACA). Healthcare.gov is simply a delivery vehicle, one of many and one that is currently not performing as it should but it is not the law itself. Democrats on the Hell Hill, pundits in the media and all of us truly need to separate the two and discuss them as distinct and not at all equal. It is contingent upon those of us who support the idea of access to affordable Health Insurance for all citizens that we not confuse or confabulate the issues surrounding the ACA (aka: Obamacare) and the rollout of one hinky delivery system, Healthcare.gov.
All this being said, let’s first talk about some of the idiotic conspiracy theories first. Don’t think they exist? You don’t read the Right Wing My Head is Exploding with all my f’ng insider knowledge, do you? So, here are a few of my recent favorites, those Right Wing walks resulting in False Equivalency that eventually makes their way into the mainstream because everyone is afraid to call Bullshit:
- No bid contract awarded to CGI, the Canadian corporation, prime contractor.
- Since 2007 CGI has had an ID/IQ designation with the Department of Health and Human Services (DHHS). The designation means Indefinite Delivery, Indefinite Quantity and covers contracts from $1K to $4B. CGI is one of 16 companies granted this designation prior to President Obama’s first term. These designations are consistent throughout the government, whether they are appropriate or not is a different issue. (sourced from various sites including DHHS). It is possible, though not probable some work orders for Healthcare.gov were awarded under this designation. It should be noted however, CGI was not the only vendor working on the Healthcare.gov integrated solution.
- Further, on various sites (no confirmation yet) the RFP (Request for Proposal) was sent to several qualified vendors. DHHS received four (4) responses and of these, only CGI’s response was reviewed and accepted (again no confirmation of the veracity of this statement). There is only one reason why other responses would have been rejected without review; the response did not meet the stated requirements of the RFP.
- Senior Vice President of CGI Federal, Toni Towne-Whitley was a Princeton classmate, class of ’85 of First Lady Michelle Obama and is a member of the Princeton Black Alumni.
- Yes, both of these statements are true on their surface. Careful examination of some facts would find though, it is unlikely they are friends or ever met each other at school. They traveled in different circles, attended different schools at Princeton with different educational goals and attainments. Simply attending the same very large school does not instantly mean you know each other. By the way, Daily Caller, not every Black Person in the country knows every other Black Person in the country.
- Upon award of the contract to CGI the President of CGI Group, George Schindler donated to the President’s reelection campaign.
- Yes, in fact he did, $1,000; big money there. Mr. Schindler also donated to Mitt Romney and previously he had donated the max of $2,300 to John McCain. To make this easier though, let’s just debunk all of this and go ahead on to Open Secrets if you are interested. Follow the money, use the following criteria;
- CGI
- George Schindler
- CGI Technologies and Solutions, Inc. PAC
- Toni Townes-Whitley
- Yes, in fact he did, $1,000; big money there. Mr. Schindler also donated to Mitt Romney and previously he had donated the max of $2,300 to John McCain. To make this easier though, let’s just debunk all of this and go ahead on to Open Secrets if you are interested. Follow the money, use the following criteria;
- The cost of Healthcare.gov was somewhere in the neighborhood of $693M.
- No, no it was not anywhere close to this. In fact, the awarded contract was approximately $70M originally, when you factor in all the changes required due to recalcitrant GOP Governors who refused to implement their own state marketplaces, the final cost might be closer to $115M. The final costs are not in, however Daily Kos have done an excellent job of pulling apart the Right’s argument with facts here, including a great spreadsheet here. I love facts!
Now, those are my favorites of the weekend. Really, how hard is it to stick with facts and stop making shite up?
Can we talk for a minute about what Healthcare.gov is and what it is not? I don’t want to bore you with tech-speak; I do some of this for a living and even my eyes glaze over. I do want to talk about what Healthcare.gov is and why the idiots on the Hill should not be holding hearings over which they have not a clue.
- Healthcare.gov is not a simple website. The website is a frontend; it is how you and I access the system behind it.
- Healthcare.gov is an integrated system. This system requires tens of thousands, if not millions of lines of custom code to parse information you and I enter, including our names, address, financial status, this determines what products to show us. This is essentially “If, Then, What” lines of code based on multiple options. Then, once the products we qualify for are delivered to our screen and we have the opportunity to review and decide this same solution must send our choice(s) to external private vendors, outside of the Healthcare.gov system.
- Integration is not simple and it is not a one-to-one process at the federal level. For every single state that did not create their own marketplace the integration had to be created for that state. What this means, for example in Texas every single district, county, city, zip code combination had to be entered. All of the private insurance companies willing to offer plans for Texas citizens had to offer those plans to the marketplace. The State of Texas vetted those plans and made their own rules that had to be incorporated into the system.
- This was true of every single state. Every Red State that did not create their own Marketplace made up their own rules; rules in many cases with the sole intention to case the ACA to fail in their state, to prevent their citizens from accessing Affordable Insurance and ultimately affordable healthcare.
- Finally, nothing in Healthcare.gov stores your medical information, thus nothing in Healthcare.gov is in non-compliance with HIPPA. Keep in mind, one of key provisions of the ACA is the elimination of ‘pre-existing conditions’. With this provision, you and I no longer fill out extensive medical histories when applying for Health Insurance, in fact the only information we are asked is if we smoke.
If you are a Democrat, Liberal, Progressive or Left Leaning Independent please stop referring to Healthcare.gov as Obamacare or the ACA, or even a Website. It is none of these. It is just one of several delivery systems for the Patient Protection and Affordable Care Act, it isn’t the entirety of it. Could it have been done better? Yes, certainly, it could have been and I suspect all that is wrong with this particular delivery system will be corrected fairly quickly but let’s not fall into the trap the Right is laying for us, let’s not repeat their idiotic talking points as if they were gospel.
The truth is we are now going to have to watch as the GOP members on the Hill waste valuable time and money following their boogiemen down every conspiracy hole. Their insatiable appetite to find this President at fault for something, anything is horrifying, wasteful and frankly boring. The propagandizing by the Right is tiresome; that we fall into their trap repeatedly is shameful. They throw the Red Herring and we run with it.
Next up, what likely went wrong in developing Healthcare.gov.
QBG_Tilted Tiara 
“The states with the biggest problems are the ones that didn’t get on board.” Actually that is incorrect, Denver was “on board” and now 200,000 have lost their plans and the total that have registered, last I checked, was less than 10,000. You want to blame people for being angry? Hmmmm I think they have a right. The worst part about all of this is that this stupid healthcare movement has cost people that aren’t even benefiting from it the most money. But I guess if we are paying for the healthcare of everyone in America that is the point. I will wait for it to get worse and simply move. 🙂 Nice post, even if I disagree.
BTW, that is a quote from a commenter below that I used. 🙂
BTW, thank you I am glad you appreciated the post even if you disagree.
Since this was not a discussion of indiviuals and their issues, rather a discussion of the Website and the language we use around the ACA it is difficult to respond. The issue is whether the indivual technology solutions work within the states that signed on, they do.
If individuals are losing plans that do not meet basic requirements, they have the opportunity to purchase better plans. They do not have to purchase those plans from their current providers. The President and the administration were mistaken in their message and should own up to their mistake. The fact is, those plans people are losing would not cover even basic requirements of healthcare though.
Finally, ACA is flawed. Most of us agree, there are things that could be done to fix the flaws. If our Congress would work together this would be undertaken in a bipartisan manner and the country would be better served. To be the only industrial world and the wealthiest nation at that without universal healthcare, where our citizens are afraid of medical services and bankruptcy because of medical bills is a sign of a sick society. We already pay for healthcare for everyone, emergency services are far more expensive than the alternative of personal responsibility, paid for insurance coverage which is what the ACA represents.
So really, why are people angry?
Reblogged this on Bastet and Sekhmet's Library and commented:
Someone talks sense…yes it is actually possible!
Thank you
Welcome-
Reblogged this on The Arkside of Thought and commented:
Finally, someone with some sense and technical understanding wrote something that made sense.
Why thank you sir.
You know what I find frightening? As America pushes for health care for all, Australia is slowly shifting towards your model of only the rich can afford cover. I pay $200 a month for health care cover yet it still doesn’t cover me for dental. I have to use doctors and hospitals that accept my health care cover or it is basically worthless. I would prefer Norway’s attitude. High taxes so EVERYONE gets FREE health care. They don’t have a pathetic welfare system, unemployment is low. If you can lick a stamp you can can friggin work.
There are issues with every system, we can likely find the issues if we look hard enough. However, the one thing most of humane people believe is healthcare in this day and age should be a right for all not a priviledge for some.
We should not be fighting over who can afford to see a doctor and who should just die quickly.
You are so right, Val. It’s driving me crazy. I’ve had to tune it out, all this talk about the lousy website. And it’s maddening that the Right feel like they have to have a hearing a la Benghazi! You hit the nail on the head when you said they have an insatiable appetite to find this President at fault for something. They are so friggin’ desperate it kills me. Gosh, I find I keep having to come up with new ways to express how much I despise the whole lot of them! Infuriating!
Monica, I find myself generally enraged at those we send to Washington these days. The worst part is Congress experiences the lowest ‘popularity’ in decades, yet we send the same clowns back time and again. It is simply mind boggling.
I find this overwhelming. A front you say. I don’t know of any government that play nice. Or fair. Or logically. ;-(
I worked for an engineering and infrastructure firm that held many contracts with various government agencies. In Dallas, the biggest contract was with the EPA. The level of bureaucracy and red tape I saw was almost laughable.
Where there’s money there’s always some kind of tug of war. 😦
I find it nearly laughable if it weren’t so simply ignorant. You are right Tess no one in government plays ‘nice’ anymore, they seem to have forgotten the ability to govern. It is bad.
*Heavy sigh*
Val,
I shall be voting for you in, what, 2016?!!!!!!!!!! Xxx
You made me laugh, I tell you Kim these are not jobs I would want.
I can’t thank you enough for writing this, Val! I’m as left-leaning as they come and a huge supporter of the Affordable Care Act, but I hadn’t thought of the distinction–that the website is only a delivery mechanism. I appreciate this insight!
Hope you had a wonderful weekend, my friend.
Hugs from Ecuador,
Kathy
When the Red Herring is tossed it is hard sometimes for any of us to not pick it up. We all need to call things what they are.
Healthcare.gov = delivery system
ACA = law
Obamacare = ACA = law
Most Americans would rather have ACA then Obamacare. Most people are too stupid for words.
Hugs back
The entertaining part of the story is how suddenly EVERYONE is a tech expert. Every Fox News “journalist” is a techie, and knows all there is to know about launching a website. It’s ridiculous!
Having worked for an internet company, I have a better idea than most about the horrors of launching something new — the site had been launched when i started, but we did a major redesign, and, wow, was that a mess for a couple of days!
I, too, agree with Joan Walsh, though, I do also think Ezra Klein makes some valid points.
During the hearing, I wanted to smack the Congresswoman who was making the remark about “Flowers.com doesn’t crash on Valentine’s Day, etc.”… well, no, of course they don’t crash NOW, because they’ve been around for awhile, they’re NOT a new site. Duh!
Are there things wrong with the site: yes. Can they be fixed: probably. Were there mistakes: definitely. Doesn’t mean the whole program is a failure.
What I don’t understand is why there was no Beta launch … well, ok, there are many things I do not understand. But, in states where they have their own exchanges, things are going well… which bodes well for the whole program.
And, finally, can I just say that the GOP hypocrisy in this is jaw-dropping. They’ve been fighting the ACA since the beginning, fighting tooth and nail, even shutting down the government, and now, all of a sudden, they’re concerned that people can’t sign-up? “We’re angry that you cannot sign up for the program we’ve been trying to take away from you, before you could sign up for it, because we know once you get it you’ll like it, but, we’re mad that you can’t get it.” It’s insanity!
The hypocrisy is annoying to me as well. A better comparison would be Amazon, which does now and then crash especially when an order must be sent to one of their partner sellers. Amazon is a great integrated site, lots of moving parts with the website being the delivery system only.
You are right, why was the testing so limited. Why wasn’t the system Beta tested? There are so many questions we should be asking and for those of us who have worked in this field, we are the ones who should be leading the charge for asking them.
Val, you write brilliantly about these issues, so that even an ignoramus the other side of the world can follow… more power to your elbow, Braveheart !
Thank you Valerie. This issue has simply annoyed me (can you tell). I intend to write more around this issue, but was done for the day. The system crashed last night. I am not defending the errors made, only the errors in the way those who should know better are talking about it are making.
Wow, Valentine, so much information (and opinion!) again – just excellent.
I visited a site just this morning where they said everyone has to choose an Obamacare package & there was one citizen who, on the internet, chose theirs, but was told they weren’t eligible for it and they had to choose a higher package (more expensive). This person couldn’t afford the alternative package & so is set to be fined $4,000 per year for not choosing a package. Is that right? It seems a bit much, if true.
That is propaganda and fuldurol, or as we say in Texas it is Bullshit. More Right Wing story telling my friend. There is so much of this going around right now it is difficult to find all the stories and debunk them. The fines are not $4,000 unless that amounts to 2% of that persons income (doubt it). A person may select any package out of the Marketplace they wish, there is no requirement to select a different package.
Oh, thanks for that Valentine. It did seem pretty outrageous.
All one has to do is listening/watch the hearing, which delivered more than its share of pathetic questions. … Yep, HiPPA has nothing to do with this site, so why did Rep Marsha Blackburn go down that road? Hello … many of us think for ourselves! 🙂 … Now … don’t let this goofballs get under your skin.
I think because I am by profession a Project Manager in IT and even worse, I have worked on Federal contracts, I know this rodeo. I have seen this one up close and personal Frank. The constant BS does get me. I actually blew the whistle on one of the Beltway Bandits, maybe someday I will tell that story.
Plus, as you know, the federal procurement system/process/etc is a world of its own.
Yes, that is indeed another very real problem. It is even worse in IT Services.
Feds procurement process would be a series of posts!
Great summary, Valentine, and not all of this information was readily available. I spent some time trying to figure out just how much exactly the website cost, and was still coming up with $300-$400M.
It is difficult to get to all the numbers because of how the contracts were awarded. CGI was the prime contactor, thus all the work orders were through them. The spreadsheet is helpful. I downloaded to make it easier to filter, but Daily Kos made it very easy.
Red state governors – and every far right-wing fool – just don’t want to accept the fact that it’s immoral that the richest nation in the world has so many people without health insurance. For some reason, they just think it’s a non-issue. I have to admit, I’m leery of the ACA. I don’t have a grand income, so affordable insurance is an impossibility for me right now. Forcing me to buy it, or taking money from whatever meager tax refund I might get, doesn’t win me over. I understand the desire to provide people with health care, but I’m really at a crossroads with this.
Frankly, if your income is to low to qualify than you should qualify for Medicaid. If this is the case, you would not have to pay the penalty. If you do not qualify for Medicaid, the penalty is $95 or 2% of your income which ever is lower (I think). It is important to understand these issues, I went through this with someone else sometime ago but don’t remember all the numbers now.
Well done, Val! Most people don’t really understand health insurance. I remember the days back when claims and pre-existing were done manually so I understand how complicated an online system must be.
Thank you. I simply grow tired of all the misdirection, truly. It is unfortunate this was done so poorly, but it isn’t the end of the world and it isn’t truly as bad as it seems.
“For every single state that did not create their own marketplace the integration had to be created for that state.”—This is what most people don’t realize. The states with the biggest problems are those that didn’t get on board. Those states that did are weathering things quite well. Still, it’s frustrating that they made signing up a free-for-all. It should have been more systematic, whether alphabetically or by region or what not.
Thanks, as always, for clarifying the facts. 🙂
Yes, the opening of the marketplace was handled poorly. Doing it any other way though would have created its own problems.
There will be more to come Carrie.
MSNBC pundits pile on, so much so that Joanne Walsh had had enough of it and wrote something about this.
I happen to agree with Joan Walsh, the fact those on the Liberal side of the house have piled on without facts is frightening. The discussion between Ezra Klein and Joan Walsh was a further example of this.
If anyone is interested, read Joan Walsh at Salon, here: http://www.salon.com/2013/10/21/liberal_pundit_fail_rush_to_attack_obamacare_site_only_aids_unhinged_right/
Read about the discussion between Ezra and Joan, here: http://www.mediaite.com/tv/chris-hayes-referees-brutal-takedown-of-ezra-klein-by-joan-walsh/
yes, I got to watch that.
Well done, as always, Val.
Thank you Elyse, it was getting so long I had to cut it short. So part two, perhaps in a day or two. The reality? This is what I do for a living, deployment of integrated solutions. This isn’t easy stuff especially in the government. Oh the stories I could tell. Maybe I will