81–90 of 259 posts
Title = No view. It's not "Obama's" website. It's the Federal Government's website. Or the Dept of Health's Website or, etc, etc, etc. Using Obama for link bait means your article gets no reads from me.
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> Hospitals don't let uninsured people die and insuring people doesn't magically save their lives. Not sure where you're getting this. A quick Google Scholar or PubMed search shows a consensus that mortality rate is significantly higher for uninsured than for insured. [1, 2, 3] [1] e.g. http://jpubhealth.oxfordjournals.org/content/32/2/236.short -- On multivariate analysis, uninsured compared with insured patients ha…
>mortality rate is significantly higher for uninsured than for insured. correlation doesn't mean causation. >to help make our government work better i somehow doubt that throwing a team of "rockstars" to clean up the mess is making the government to work better. If anything, it enables the typical government behavior we saw in the case of healthcare.gov.
there's no such thing as a monolithic 'government' being that can either work better or be enabled to act a certain way. there are people, and groups of people that do certain things. some of those things are worthless, some of those things are worthwhile. i'd argue the mess the 'rock stars' cleaned up is a generally positive activity.
I heard that several people from YC startups and Google are helping out. This is one of the reasons why we're seeing a lot of improvements to the Federal Exchange site.
A friend of mine, from Facebook's networking team, also spent a month there. He came back with a thousand-yard stare.
It's definitely a form of mental dissonance.
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"1 in 1000 uninsured people die each year. It's not an exaggeration to say that due to the work we're doing here, 5,000-10,000 people will live to see the end of 2014. You should be proud of what you've done, but we should also all be grateful to have this opportunity." Hospitals don't let uninsured people die and insuring people doesn't magically save their lives.
Hospitals don't turn away uninsured at the ER. However, due to lack of regular care, by the time you show up at the ER it might be too late.
Blood pressure medication will almost certainly add many years to my life - decades, maybe. Without insurance, I couldn't have afforded the half-dozen trips to the doctor or the meds. And I'd wind up getting lifesaving treatment for an early heart attack or stroke in the ER.
I'll take the insurance, thanks.
>> "It is also a story of an Obama Administration obsessed with health care reform policy but above the nitty-gritty of implementing it. No one in the White House meetings leading up to the launch had any idea whether the technology worked." I used to be this guy. The guy with the lofty ideas, but who thought the implementation was "beneath me". The guy who would sit around, waxing poetic about various features, user…
You're not wrong, but anyone who actually has an office in the physical whitehouse, or anyone within, say, 5 layers of the President, actually shouldn't be concerned with the implementation of the technology. They should be focused on getting money and resources to the people who do the tech and running interference for them to help prevent them from being sabotaged by political opponents. In between their other mill…
That's called cronyism, and, for the most part, it's either against the law, or will get you destroyed in the media. One of the biggest challenges in government is that, for those of us in startup-land, the process goes something like: "I need to hire someone, I'll call my friend who I know does good work". You can't really do that in the government, or everyone who isn't your friend won't be happy.
The standard federal contracting route is certainly a mess as well. The underlying belief that everything can be reduced to a series of checkboxes, and whoever can check the boxes the cheapest wins leads to a disaster.
Hopefully, one of the outcomes of all of this is we rethink how the government software (and other sorts of procurement) process is done.
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>mortality rate is significantly higher for uninsured than for insured. correlation doesn't mean causation. >to help make our government work better i somehow doubt that throwing a team of "rockstars" to clean up the mess is making the government to work better. If anything, it enables the typical government behavior we saw in the case of healthcare.gov.
so are you saying not having health insurance is better for people? I'll take the common sense angle that having health insurance increases the chances of medical care being applied to a health problem, versus not having any health care insurance. there's no such thing as a monolithic 'government' being that can either work better or be enabled to act a certain way. there are people, and groups of people that do cert…
i'm just saying that being from a poor or damaged family, uneducated, having mental illness or substance abuse problem, etc... usually leads to higher mortality and also to not having health insurance. Giving them a health insurance [i'm all for it, i think modern civilized society should provide basic level of free health insurance to everybody] would be inconsequential in many cases as not having the insurance isn't the cause, just a manifestation.
>there's no such thing as a monolithic 'government' being that can either work better or be enabled to act a certain way.
http://en.wikipedia.org/wiki/Systems_theory
and if we specifically consider a closed loop system of "government + society" then this may be of interest too:
I've been working on healthcare.gov for the last few months alongside a bunch of other Google, Facebook, and Y Combinator alums. I'll always remember what Mikey told us in December, after the site was back up, could handle a non-trivial amount of traffic, and people who wanted health insurance could finally get it: "1 in 1000 uninsured people die each year. It's not an exaggeration to say that due to the work we're d…
What if you'd like to help out but aren't an anointed™ one?
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>mortality rate is significantly higher for uninsured than for insured. correlation doesn't mean causation. >to help make our government work better i somehow doubt that throwing a team of "rockstars" to clean up the mess is making the government to work better. If anything, it enables the typical government behavior we saw in the case of healthcare.gov.
Many people believe that the Oregon Health Study is the best chance we have of teasing causation out of the data. It is still in progress but it is being watched closely. http://oregonhealthstudy.org/
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Yep, in spite of the progress made since October (when the site was entirely down for days at a time), there are absolutely still problems. I also see you're a YC alum! If you're interested in helping out, or just to provide an error report on the problem you encountered, email me at brandon@hcgov.us.
Do you have any involvement with the individual State websites? I've had so many technical problems registering in California.
To give some background, 36 states use the federal marketplace, and 14 built their own. Covered California is run by the state of California, with an independent contracting company, codebase, set of servers, etc.
We do have some ideas about how to improve that situation over the long term, but those will take time to bear fruit.