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Healthcare.gov crashing because backend doomed in the requirements stage

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Re: Healthcare.gov crashing because backend doomed in the requirements stage

#51

Post by genwin »

jamroom wrote: post #30
powertower wrote: post #25

Earlier quoted context omitted.

The problem here is that for some people's coverage to be lowered, impoverished people to be covered, and pre-existing conditions paid for, a bunch of young and healthy individuals (without families) are now required to sign up for insurance. And the cost of that insurance for those healthy individuals is now 2-4x more expensive than it would have been before Obamacare took place (obviously the money has to come from…

Of course - that's the whole reason for the mandate. Similar to social security, there needs to be a pool of people paying into the system that are not using it. I don't agree with you that the plans will be worse though - maybe in some states, but certainly not here in Washington.

But keep in mind they are using it, since the insurance reduces the risk they'll be saddled with high medical bills (or more likely that they'll saddle others with those bills). They are healthier, but can still have an accident of course.

Re: Healthcare.gov crashing because backend doomed in the requirements stage

#52

Post by Plasmoid »

betterunix wrote: post #45
Plasmoid wrote: post #38

Earlier quoted context omitted.

On government contracts that's actually a problem. You can't bill for any work you did without 'authorization'. Which means you can't do anything until a finalized spec, signed in triplicate, is physically delivered to you.

I have wondered for some time now if it is legal to develop tools and libraries that are relevant to an upcoming contract, but which are also general purpose and could be used elsewhere.

Totally legal.

You just won't get paid for it.

Re: Healthcare.gov crashing because backend doomed in the requirements stage

#53

Post by r00fus »

EpicEng wrote: post #49
powertower wrote: post #31

Earlier quoted context omitted.

> It still boggles my mind that people are surprised by this... I was surprised because I was told that this new coverage affordability came from getting insurance companies greed in check. I didn't know that insurance companies were actually lobying for Obamacare, not against it. http://www.policymic.com/articles/62541/here-s-the-proof-oba...

Of course they are; this bill feeds them a guaranteed customer base. This is the largest issue I have with ObamaCare. The sole job of an insurance company is to assess risk. With a government mandated customer base there is no longer any risk to asses. So... Why are the insurance companies involved at all? Why are they still in business? That's rhetorical, I know the answer, and I don't like it. We're all paying a mi…

> Of course they are; this bill feeds them a guaranteed customer base. This is the largest issue I have with ObamaCare. The sole job of an insurance company is to assess risk. With a government mandated customer base there is no longer any risk to asses.

I'm no fan of insurance companies, but this statement does not compute. Of course there's still risk involved - the risk that the patient's costs will exceed premiums. If you set the premium too high, the customer will flee to a competitor. You also can't raise your premiums too high, because you have the 80% medical loss ratio - you can no longer just eat the rest as profit [1].

Totally agree that government should be the single payer or even the sole provider of healthcare (though that model isn't as widely implemented (UK NHS, US Veterans Admin) and has it's challenges as well).

[1] http://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-R...

Re: Healthcare.gov crashing because backend doomed in the requirements stage

#54

Post by r00fus »

lightstrike72 wrote: post #47
jamroom wrote: post #21

Earlier quoted context omitted.

Just want to add another data point, that here in Washington State, a comprehensive plan for my family is going to be around $600 less per month under Obamacare than what I can get right now. This is without any subsidies of any kind, so while I know it is just 1 extra data point, I consider myself a "typical case" (3 dependents, 1 pre-existing condition). I can say that the Manhattan institute's numbers (what the Fo…

Adding another anecdotal Washington state data point, my private individual health insurance plan (Regence Evolve HSA) with a premium of $149/month will no longer be available come January. The plan most similar to my current one is $252/month (Regence Direct Silver), which is a pretty massive increase. As a healthy, single 25-year old though, I knew some version of this was coming.

Are these two plans equivalent? What are the deductibles involved? What's your copay?

Some of this is because ACA prevents unreasonably high deductible, unless you get "catastrophic" coverage. It was quite possible that your plan was a "catastrophic" plan. You might be able to get a similar catastrophic plan via state exchanges, I know that it varies state to state.

Re: Healthcare.gov crashing because backend doomed in the requirements stage

#55

Post by lhc- »

EpicEng wrote: post #49
powertower wrote: post #31

Earlier quoted context omitted.

> It still boggles my mind that people are surprised by this... I was surprised because I was told that this new coverage affordability came from getting insurance companies greed in check. I didn't know that insurance companies were actually lobying for Obamacare, not against it. http://www.policymic.com/articles/62541/here-s-the-proof-oba...

Of course they are; this bill feeds them a guaranteed customer base. This is the largest issue I have with ObamaCare. The sole job of an insurance company is to assess risk. With a government mandated customer base there is no longer any risk to asses. So... Why are the insurance companies involved at all? Why are they still in business? That's rhetorical, I know the answer, and I don't like it. We're all paying a mi…

Because Obama was unable to garner enough support for Single Payer... at least, not yet. While the ACA is hardly a perfect law, its quite possible that the greatest thing it accomplishes is showing Americans how much worse our current system is than the Single Payer systems the rest of the 1st world employs.

While the insurance companies were generally lobbying for the ACA (although there's definitely clauses they did not support), they are vehemently against Single Payer, since it puts them all out of business.

Re: Healthcare.gov crashing because backend doomed in the requirements stage

#56

Post by lightstrike72 »

r00fus wrote: post #54
lightstrike72 wrote: post #47

Earlier quoted context omitted.

Adding another anecdotal Washington state data point, my private individual health insurance plan (Regence Evolve HSA) with a premium of $149/month will no longer be available come January. The plan most similar to my current one is $252/month (Regence Direct Silver), which is a pretty massive increase. As a healthy, single 25-year old though, I knew some version of this was coming.

Are these two plans equivalent? What are the deductibles involved? What's your copay? Some of this is because ACA prevents unreasonably high deductible, unless you get "catastrophic" coverage. It was quite possible that your plan was a "catastrophic" plan. You might be able to get a similar catastrophic plan via state exchanges, I know that it varies state to state.

Definitely have a catastrophic plan and the new options are essentially the same as well. Here are some more details:

Old plan: Regence Evolve HSA Plan - Premium: $149, Deductible: $3,500, Coinsurance: 20%, Out-of-pocket max: $5,000

New plan: Regence Direct Silver - Premium: $252, Deductible: $3,000, Coinsurance: 20%, Out-of-pocket max: $4,900

I would lose the HSA benefits from the new plan, which I could keep if I wanted to accept significantly worse terms (with a premium increase of only 33%!):

Regence Direct Bronze HSA - Premium: $198, Deductible: $5,000, Coinsurance: 30%, Out-of-pocket max: $6,250

I don't see how I can come out ahead on this one, once I was able to finally get quotes on the exchange, no other plan was comparable in terms of value and cost. :(

Re: Healthcare.gov crashing because backend doomed in the requirements stage

#57

Post by teyc »

I bet you half the problem is the software being specified in a synchronous and not asynchronous manner.

If a flow chart is expressed synchronously, it immediately bottlenecks around the slow backend systems. e.g. check the applicant has 4 kids, and if that checks out, present them with these options.

I attribute some of these problems to inadequate advances in today's mainstream programming languages.

For instance, if futures/promises were common parlance in programming, some of these bottlenecks would have been identified earlier.

I once read an interesting essay on what future programming languages could work on. One of the interesting ideas is a language that allows programmers to implement undo/redo easily. Recently there was a blog post about fuzzy computing, where a function is able to return approximate values when it is busy. The Knight Capital incident teaches us that if we architected our monitoring systems the same was as intrusion systems are done, we could have stopped activity when suspicious incidents occur outside the normal operating range. There was another incident where a Japanese trader accidentally keyed in the wrong number and promptly lost his employers a lot of money. Languages that incorporate ideas like validation and expected values as first class constructs might be able to help here. The Adriane reminded us how badly humans do when reasoning about systems where multiple agents perform the same task.

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