IT’S TEOTWAWKI REDUX, NOT! Obamacare And The Exploitation of Technology Fear.

Last updated on October 26th, 2013 at 11:31 am

The right-wing uses the people’s fear of new technology to try to stop “Obamacare”.

While I have spent most of my career as a management consultant and now politics/current events columnist for PoliticusUSA, I was previously an information technology consultant and technology writer for the Washington Post/Newsweek Syndicate’s Newsbytes.

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Because I was working as an IT consultant and interim IT department executive, I somehow became known as an “expert” on the Year 2000 date processing problem, also known as the Y2K bug. I was in the decided minority of these experts who said that Y2K would not lead to TEOFTWAWKI (the end of the world as we know it). Yes, there would be a few bugs, but overall life would go on as it did before.

I started getting death threats from the Armageddonists who said I was the devil incarnate for causing people to not prepare for the end of times. But I also got an invitation to appear on a special NBC was doing on Y2K. I became one of the central points of the special, which was later shown on all of the NBC networks. Funny how, on 1/1/2000, the death threats stopped.

Despite our increasing dependence on information technologies, many people still have an innate fear that technology will be the ruination of their lives and of mankind. Of course, our good friends on the right-wing know this and are not afraid to exploit this fear for their own political benefit. But, they have gone into overdrive on attacking the technology glitches during the start of implementing the Affordable Care Act, a/k/a Obamacare. And that’s what they are, glitches, people are still able to get information and sign up for health insurance.

I still don’t understand their hatred of the private sector based universal health insurance plan, other than the blatant racism and political partisanship involving the first African-American President. Yes, the start of the Internet-based sign-up interface has been bumpy and there have been many errors. Given the complexity of the information technology systems and integration involved, I’m not surprised at all. There are back up systems available, like a call to an 800 number to enroll over the phone.

I was one of the project managers/systems architects for a then-Fortune 100 Information Technology company’s creation of a new Order Processing system. There were 4 other architects and the overall project team of systems analysts, programmers and user representatives became 400+ people. Seven different large IT consulting companies were involved, which led to a large amount of consulting company hubris, especially from the newly Harvard MBA graduate snots from Bain Consulting. Yes, the was the causation of my hatred of Willard Romney, whom I met briefly while on this project. He was a handsome, well dressed, empty suit. Part of my anger was that these Bain Consulting IT tyros were being billed at 3 to 4 times the hourly rate that I was. Yet I was managing them and spending too much time cleaning up the damage they caused.

The project took three years, with the first year spent on developing the specifications and the design of the overall system. The new system had to run on the company’s proprietary computers while accessing and updating the mainframe-based existing accounting information systems. It was being able to update all the mainframe information: customer records, accounts receivable, inventory control and general ledger in real time from each salesperson’s computer which made the design so complex. I stayed on the project for 2 years. Ultimately, the system worked well, after a 2 month bumpy start, in part due to lack of training of and resistance from the sales force.

The ACA information system’s scope, design and development for the state insurance exchanges’ personal information gathering, accessing the pricing and provisions for each private insurance providers policies’, and placing of the actual orders makes the order processing system I helped develop seem minuscule. It’s probably 100 times more complex. My understanding is that 49 different computer applications from various private sector, federal and state computers had to be accessed to process the insurance quote requests and orders. Just the connections between the various federal agencies involved, including Social Security, Medicare, and other Health and Human Services department’s programs are extremely complex. Not all of the various systems involved are state-of-the-art; far from it. They do not use the same computer hardware, operating systems, software or networks, either. It’s a staggering information technology systems integration feat to pull off.

I went to the Massachusetts Health Connector, my state’s  version of the ACA website. I have health insurance, but I was interested to see if there were more insurers available and whether I could get better coverage, lower premiums, or both. Massachusetts has the most experience with on-line health insurance purchase, but I was not impressed with this site at all.

Some of the questions were confusing. The site did not follow up on one of my answers which was different than the standard list. I had to fill out one page of information twice because the system didn’t take the first set of data I entered. I was expecting a list of potential insurers and premium quotes when I completed entering the 20+ pages. What I got instead was a message saying that “someone would be in touch with me in the next few weeks”. There would be a lot of redesign work done, if I was in charge of the Massachusetts Health Connector site, because it is not user-friendly. If Massachusetts, one of the two leaders in information technologies, does not use all its available resources to design, develop and maintain the best site, then expecting more from the federal government and other states is problematic.

But, I’m greatly impressed at what has been accomplished by the federal site, in a relatively short time,  and that’s not me being a progressive/liberal toady. I have 30+ years of experience in the information technologies industry. In the private sector, I did not have to deal with the agenda of and interference from every federal, state and local official remotely involved. I did not have to deal with government shutdowns, budget slashing, political crony project team members, medical industry interference, and political rancor. And certainly, I did not have to deal with a nationwide simultaneous implementation. It had to be virtually impossible to stress test this system to see if it would handle the volume of the user logins (over 500,000) and demands involved, which ultimately led to the initial failures. The 4 major vendors involved will be testifying to that before Congress.

There was precedent for this scope of systems start-up: Social Security and Medicare, two of the most efficient and most liked government programs. The start up of both were not without problems.

In comparison to the ACA launch, Apple’s introducing a new version of the Iphone is relatively simple. Even after being on the market for 2 years, in 2009, the Iphone technology was having problems. This was just building new software functions on top of existing working software function.

Very few of the politicians and political pundits understand this, or want to. Rationality and history is lost in the current politically rancorous environment. The ACA is just a logical extension of Medicare to provide access to those who could not afford or were previously denied to purchase health insurance. Medicare works well. I consider health as integral part of everyone’s life, liberty and the pursuit of happiness. Lives are at stake.

The Affordable Care Act is not perfect, but it was the best that could have been passed at this time. Like all legislative programs, it will be changed and modified over time. Social Security and Medicare have been, too. The technical glitches are being worked out and will be fixed shortly. Have patience and disregard all of the spew of the technologically ignorant and politically hateful who want ACA to fail for political or business, not citizen benefit reasons.

It’s not the end of the world as we know it, at all. But not having affordable health care can be.

UPDATE : 10/25/2013 During the their testimony in front of the House Energy and Commerce Committee yesterday, the system developers stated that there was a crucial last minute change to how the Healthcare.gov website was to function ordered by the Center for Medicare and Medicaid project executives:

“The system didn’t receive adequate end-to-end testing,” declared Andrew Slavitt of Optum, while Cheryl Campbell of CGI Federal added “no one ever gets enough time for testing.”

“Slavitt, whose company stands to make up to $85 million for its work, acknowledged that unexpected volume at the start overwhelmed the “enterprise identity management” or EIDM entry portal blamed for the initial blockages.

He and Campbell blamed a decision by CMS within two weeks of the launch to require users to fully register in order to browse for health insurance products, instead of being able to get information anonymously, as originally planned.

While the technical change to require registration was easy, the result was a much greater burden on the system that it failed to handle, Slavitt and Campbell said. ”  ( Note: Andrew Slavitt is the executive vice president of Optum/QSSI,  Cheryl Campbell is Senior Vice President of CGI Federal Systems).

This is inexcusable. It is standard software development standard practice to freeze the software functions from changes other than bug fixes during testing. To be making a critical change like this 2 weeks before implementation is very bad practice. The project management executives of CMS, Optum/QSSI and CGI Federal Systems are at fault.  I understand the political ramifications of why this change was made, to get people enrolled before looking at insurance policy details and pricing, but doing this was bad policy and bad politics. The agency, companies and the  people involved need to be fined, punished and/or fired.