Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

content.time.com

Post reply on HN
Print view View original

101–110 of 259 posts

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#101

Post by djKianoosh »

jquery wrote: post #68
brandonb wrote: post #38

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?

what do y'all mean by anointed? I've been a gov contractor for many years. It doesn't take all that much to get into this space.

Basically, if you're a citizen and don't lie on applications and resumes and in interviews then there's really not any significant barrier to entry.

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#102

Post by keithwarren »

brandonb wrote: post #38

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…

Aside from the rhetoric, the political opinions and people firing at you now over the 5-10K thing, I do have an actual question of substance.

My assumption when things melted down so drastically, was that the key problem was integration with the various vendors. Yes we all could look at the Html itself and make assumptions about poor practices but given that you are on the inside - what was the biggest issue?

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#103

Post by sailfast »

aristus wrote: post #29
dannyr wrote: post #23

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.

This is the case across billions of taxpayer dollars worth of IT systems in hundreds of agencies, but many of the contractors don't realize the insanity they generate and the stares they have caused.

The government needs a lot of help. I wish there were more crisis opportunities like this to use as an excuse to hire the right team to build good systems for citizens. Tough to get systems integration above the fold regularly to call attention to the issue.

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#104

Post by runamok »

wooter wrote: post #41
brandonb wrote: post #38

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…

"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.

They don't let them die right there because of the Emergency Medical Treatment and Active Labor Act (EMTALA). But they patch them up and send them home as soon as they're stable. That absolutely leads to significantly worse outcomes which others have referenced.

http://en.wikipedia.org/wiki/EMTALA

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#105

Post by twoodfin »

tunesmith wrote: post #85

It's a great article, but this last line drives me crazy: "But in the end [the President] was as aloof from the people and facts he needed to avoid this catastrophe as he was from the people who ended up fixing it." It sounded to me more like he was trusting people whose job it was to deliver. So his failure to micromanage is somehow being "aloof". Never pass up an opportunity to reinforce a media meme, I guess.

This was the signature accomplishment of his first term and a substantial part of his legacy as President. He was out on the hustings making speech after speech about how buying health insurance on the exchange was going to be as easy as shopping for a plane ticket on Expedia.

It would not have been "micromanaging" for him to have done what was necessary to be sure that what he was saying matched up with reality. Yes, it was a giant IT project of the sort governments usually suck at. But that was the bill he got passed and signed. If his administration wasn't capable of leading that project to successful, timely completion, he has to shoulder much of the blame.

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#106

Post by saraid216 »

alexhaar wrote: post #62
saraid216 wrote: post #32

Earlier quoted context omitted.

> You need both. Implementation people aren't all that useful without a vision. A vision isn't all that useful without implementation. It's a symbiotic relationship. 37signals' take on this was the best one I've seen (paraphrased): Ideas are a multiplier. If your execution is good, a good idea will multiply that. If your execution is minimal, a good idea will scrape by. If your execution is abyssal, a good idea will…

Derek Sivers talks about this idea as well: http://sivers.org/multiply

Actually, that's exactly what I remember. I think I have been misattributing it this entire time.

Damn it. Thanks. :P

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#107

Post by saraid216 »

trhway wrote: post #87
anon808 wrote: post #82

Earlier quoted context omitted.

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…

>so are you saying not having health insurance is better for people? 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] wo…

I completely support the conclusion that we should be fixing our third variables.

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#108

Post by untog »

ryanhuff wrote: post #92
untog wrote: post #54

Earlier quoted context omitted.

People have to be inside hospitals for hospitals to help them. If you don't have insurance you're less likely to go in the first place.

I question the validity of your statement. In the US, for many uninsured, the hospital ER is their primary care outlet.

But by the time they go to the ER it's too late. People with insurance go for regular checkups that will catch things early. Those without will only go to the ER when their situation is desperate.

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#109

Post by saraid216 »

sehr wrote: post #61
lutusp wrote: post #17

Earlier quoted context omitted.

I wonder how many readers will recognize this famous quotation and its source. (long pause ...) http://en.wikipedia.org/wiki/Dr._Strangelove

A lot, I hope! Strangelove is pretty well known for the most part across the internet. Fantastic movie

I watched it. I wasn't blown away. I don't remember it with enough detail to recognize random quotations.

Re: Obama's Trauma Team: Inside the Nightmare Launch of HealthCare.Gov

#110

Post by beat »

liber8 wrote: post #100
beat wrote: post #84

Earlier quoted context omitted.

I have high blood pressure. Thanks to insurance, I was able to spend a few months with my doctor, experimenting with medications until we found the combination that brought it down to manageable levels. Meds cost me $15 a month or so. 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. A…

Honest, non-snarky question for you: How is it that you could not afford a half-dozen trips to your doctor, but you could afford your medical insurance premiums? Are your premiums subsidized or free? Is the doctor terribly expensive? (I'm assuming that your doctor charges $250 or less per visit. Six visits would cost $1,500. I'm assuming those visits were spread over at least a number of months, so you could see whet…

Honest, non-snarky answer... to be pedantic, for me it's not a question of affordability. I'm a software professional with a very good income, and I could do it on my own.

I have a friend a few months younger than me. She makes less than $15k/year, and has two children living at home. Under those financial circumstances, she has totally paid off her home, which should tell you how frugal and responsible she is. She has also experienced extensive hospitalization due to illness. If she had to pay for that (it was paid for by state-subsidized health care), she'd have lost her house.

edit: Medical costs are the leading cause of bankruptcy in the US.

Post reply on HN