TBD on Ning
Houston, We Have a Problem...
It was 43 years ago that the voyage of Apollo 13 to moon was interrupted by a malfunction, an explosion of the fuel cell's hydrogen tank that crippled and put the astronauts at risk and required a rescue plan where failure was not an option. The entire Apollo space program was a daring, innovated and risky government sponsored program that put national prestige and technology at stake, putting together teams of private and government resources into one agency with one mission to support, the moon landing program.
They succeeded.
Those on the ground were able to come up with a solution that both saved the astronauts from death and relieved a country and a people of the terrible lost that would have been the only enviable result not only of failure of technology and engineering, but of problem solving and implementation of a hoped for fix by the astronauts themselves.
We are now faced with another failure, never as dramatic as Apollo 13 but to some the consequences are just as life altering if not life ending as it was for the three in space 43 years ago.
In the case of Apollo 13, the blame for the accident was traced to a 50¢ defective part, in the case of ObamaCare's enrollment web site, HealthCare.gov, the blame has yet to be determined and allocated. However, the idea that after at least two years'lead time to setup and test the web site, at a cost yet to be determined, but certainly one that includes many millions of already spent money, the site does not work to the level necessary to support the initial enrollment effort for the federal run healthcare insurance exchanges, and someone has to take responsibility to fix it. This the president did, finally, yesterday, with the result that failure is not an option for the administration much less the Department of Health and Human Services where the administrative responsibility for ObamaCare implementation lies and starts with the secretary of the department, Kathleen Sebeilus.
Embarrassing yes, fixed no, not right now and that is the problem. The web site has to be fixed within a timeline that is compressed and ticking. Worse, the first explanations of why the thing didn't work aren't true. The first explanation was that the site was experiencing a Denial of Service phenomenon because of the success of ObamaCare not the failure of the site, as too many people were attempting to access the site at the same time and overwhelming the serving computers making the site unavailable. The solution was that overtime the site demand would back off and additional servers would be dedicated to supporting the web site so people could access the site. Though capacity was added, the web site still was not functional, and the next explanation was that the coding was in error and needed to be repaired and replace which would require updates to be created and maintenance shutdowns to made. Now the problem with coding has been examined and fixes attempted addition functional problems has been identified that have to do with the web site design and functional requirements that will require a higher level of intervention including a redesign of many of the parts and then a rewrite of the code to incorporate those design changes.
And none of that happening within a day, and be more likely at least a week or maybe more as new
resources are brought to bare on the problem, or more likely problems, of running the site.
Of course, none of this means that ObamaCare has no access, there remain the 800 number and paper, but that this was not a part of the design or the timeline necessary to implement ObamaCare insurance coverage signup and enrollment for the January 1, 2014 benefit start date.
As to whether the federal exchange web site can be fixed, sure, of course, but it will take time and as in Apollo 13, time is everything when failure is not an option.
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Replies to This Discussion
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Permalink Reply by LoveLife&Laughter on
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The Sky Is Falling: Understanding and Coping with Phobias, Panic, and Obsessive-Compulsive Disorders
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Permalink Reply by exedir on
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So, day One of the oversight hearings on the HealthCare.gov web site are over and the results are, and yes, mistakes were made...but, wait for it...by others, primarily in the government. As to mea culpas, not going to happen from the lowest bidders.
What we do get is a view of what was reasonably to be expected, troubles with and using new and complicated software which was poorly managed, integrated and tested with at least the complicity if not on the orders of those in charge at CMS, the Centers for Medicare and Medicaid, at HHS . As to the reason why this happened, well, that will have to wait until the secretary of Health and Human Services, Kathleen Sebilus, reluctantly, will testify next week the day before Halloween, and yes, it will be scary.
In the meantime, order will be restored by the appointment of a new czar, Jeff Zients, previous the director to the Office of Management and Budget in the Obama White House. Zients is to be the lead of what and how the fix will be made to the operation of the HealthCare. gov web site and will be the go to guy with the press as to developments which includes press conferences, like today, Friday, October 25th, in which Zients stated that the site will be fully operational and functioning by November 30th.
In the meantime, the administration has changed the deadline for the enforcement of mandatory enrollment penalties from February 15th to March 31st as recognition of the troubles with the web site and the enrollment process.
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All the states that accepted Obamacare are having no problems at all, only the Fed system -- and that at a time when some crazies shut down the government.
Conservatives are right -- we should have let the states do it in the first place.
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Probably, at least as a start.
However, the Democrat plan was a single payor extension of Medicare. The health exchange approach is a Republican insurance cost solution scheme designed to address the lack of competition in the health insurance and amongst health providers and therefore impact insured medical costs in both the short and long term.
As to whether either, or neither will work, only time will tell, maybe.
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Permalink Reply by ProblemAgain on
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yeah that's worked out real well over the years, hasn't it? 100 plus years to try to get a healthcare system that actually provides healthcare rather than serving as a profit model for big business
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We really do have a problem...and no, profit is not a total negative if it allocates resources and investment to be efficient and effective, which in medicine and health care delivery ishard to get a grip on as to what is the best results for the money, regardless of who is paying.
The social medicine model is allocate funds by fiat, by budget and let the care be set by whatever limits there are to funds. It isn't insurance, it is policy. We have used a different model mostly based on the idea of insurance, that funds collected are the funds spent, that services to be rendered are "prepaid", more or less. As to how the collected funds are paid has been based on what is billed, by procedure rather than by results.
The US system is, more is better, and even more is even better, whereas other systems there is a cap as to what is provided and as to what is done based on budget, so in the end service is rationed across a scale of those that need the services to be provided. So, delay, limited access, slow adoption of technology and set criteria as to severity and reasonable expectations of outcome are used to ration what is available in most other systems and why they "cost" about half of what the US spends on health care and health care delivery.
And yes, medicine is big business, very big business indeed, and a major driver of employment in our economy.
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i have no issue with companies being run for profit. i do have issues with medically associated companies being run for profit with no ethics and that seems to have been occurring across the board whether the companies involved are insurance companies who sell worthless policies or have so many exclusions that they might as well be stealing the premiums or providers who fraudulantly bill the payor whether it is insurance or medicare or the private individual. we have a history replete with incidences of price fixing and collusions involving not only supplying services but also paying employees. i fail to see the better in that system when, not only do most of these people NOT go to jail for fraud but in some cases they even get elected to public office after the incidences. those who steal from the till whether through fraud or overcharging are rationing the healthcare for all patients not by availability but by the lessening of the dollars available for the patient care.
Pacific Health Corporation and Three of Its Southland Hospitals Agree to Pay $16.5 Million in Cases Stemming from Illegal Kickback Scheme
Marketers were Paid to Recruit Homeless from L.A.’s Skid Row to Undergo Often Unnecessary Treatments That were Billed to Medicare and Medi-CalU.S. Attorney’s Office August 23, 2012 LOS ANGELES—A Los Angeles-based hospital chain has agreed to pay $16.5 million to resolve allegations that several of its subsidiary hospitals participated in an illegal kickback scheme in which so-called marketers were paid to recruit homeless persons from locations such as downtown Los Angeles’ “Skid Row” and bring them to Southland hospitals regardless of medical necessity, which allowed the hospitals to improperly submit bills to Medicare and Medi-Cal.
A global resolution of civil and criminal investigations conducted by the United States and the state of California was announced today when federal prosecutors filed a criminal case against Los Angeles Doctor’s Hospital Inc. (LADH), which has agreed to plead guilty to conspiring to defraud Medicare and Medi-Cal through the payment of illegal kickbacks to the marketers.
“To root out and deter those who seek to exploit publicly funded health care programs, we need to pursue all available remedies—civil, criminal, and administrative,” said United States Attorney André Birotte, Jr. “The guilty plea, civil settlement agreement, and corporate compliance agreement that we are announcing today—the result of efforts of civil and criminal attorneys in my office and officials at the Department of Health and Human Services—reflect this approach and should remind unscrupulous health care providers of our determination to bring to justice those who exploit federal and state public health programs for their personal gain.”
LADH is a subsidiary of Pacific Health Corporation (PHC), which has entered into a deferred prosecution agreement with the United States Justice Department. PHC is also being criminally charged today, but if the company abides by the deferred prosecution agreement, the charges will be dismissed in six years.
http://www.fbi.gov/losangeles/press-releases/2012/pacific-health-co...
Health Care: Hospitals in Michigan and Blue Cross Blue Shield of Michigan were recently ordered by a federal magistrate in the Eastern District of Michigan to provide documents to the Division. The document dispute grew out of a Division lawsuit claiming that most-favored nation clauses in Blue Cross contracts with hospitals violate anti trust laws. The clauses allegedly protect Blue Cross from competition by other insurers and increase the price of health insurance in Michigan. Michigan’s attorney general is part of the same lawsuit. Blue Cross also faces a class action lawsuit and billion-dollar allegations from a competing insurer.
http://www.jdsupra.com/legalnews/criminal-antitrust-update-october-...
Legal Updates
The Fix Is In: Wage-Fixing Lawsuits Against Hospitals Illustrate The Risk Of Sharing Wage Data
Hospitals beware: sharing copies of your collective bargaining agreements (or otherwise discussing wage data) with other health care institutions may give rise to wage-fixing lawsuits under the antitrust laws. The latest reminder of this is a federal lawsuit filed in Memphis, Tennessee, Clarke v. Baptist Memorial Healthcare Corp, in which the court ruled recently that allegations of information-sharing among area hospitals could support a charge that the hospitals unlawfully conspired to fix the wages of registered nurses (“RNs”). Clarke is one of four separate wage-fixing cases filed in 2006 in Albany, Chicago, Memphis and San Antonio by RNs with the apparent support of the Service Employees International Union (“SEIU”).
Each of the four cases is a class-action lawsuit alleging that area hospitals have conspired to exchange wage information and depress RN wages in violation of federal antitrust law. The plaintiffs in each case seek to represent all RNs employed by the defendant hospitals since June 20, 2002. They contend that, as a result of the alleged unlawful conspiracies, RNs have been underpaid annually by approximately $14,000 in Memphis, $6,000 in Albany, $5,000 in Chicago and $1,300 in San Antonio. The plaintiffs seek to recover treble damages with respect to each class member, plus costs and attorneys’ fees, as provided by federal antitrust law. Thus, the stakes for the defendant hospitals are high.
The Clarke decision, which denied defendant Baptist Memorial Healthcare Corporation’s motion to dismiss, reflects the court’s determination that the RNs have stated a plausible claim and, accordingly, may proceed with their lawsuit. This decision is significant in the broader context because it reflects a preliminary acceptance of the legal theory on which all four cases are based (and, in turn, on which future such cases may be based).
The RNs’ theory is that in each metropolitan area, the defendant hospitals have exchanged information about RN wages through meetings at trade shows, telephone conversations among the hospitals’ human resources staffs and written or oral surveys about wages, the results of which were circulated among the hospitals. The RNs contend that (i) these communications evidence an unlawful conspiracy to exchange RN wage information, and (ii) the hospitals used this information in an unlawful conspiracy to depress RN wages.
http://shpclaw.com/Schwartz-Resources/the-fix-is-in-wage-fixing-law...
Seven Hospitals in Six States to Pay U.S. More Than $6.3 Million to Resolve False Claims Act Allegations Related to Kyphoplasty
WASHINGTON – Seven hospitals located in Florida, Mississippi, Texas, South Carolina, North Carolina and Alabama have agreed to pay the United States a total of more than $6.3 million to settle allegations that the health care facilities submitted false claims to Medicare, the Justice Department announced today.The settlements resolve allegations that these hospitals overcharged Medicare between 2000 and 2008 when performing kyphoplasty, a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis. In many cases, the procedure can be performed safely as a less costly out-patient procedure, but the government contends that the hospitals performed the procedure on an in-patient basis in order to increase their Medicare billings."Hospitals that participate in the Medicare program must bill for their services accurately and honestly," said Tony West, Assistant Attorney General for the Department’s Civil Division. "The Department of Justice is committed to ensuring that Medicare funds are expended appropriately." -
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Once, when I began my involved in the industry, the idea of making a profit from people's illnesses was considered unethical, however, making a living was, ethical.
Most of the institutions I dealt with then were faith based and as such covered by mission statements that included the poor and disadvantage as being those most needing help. At the time many of those leading those institutions had also taken vows of poverty and chastity, as for myself I was only able to maintain one of those vows.
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Most "Faith Based" health care institutions do have compassion for the poor whereas most faith-based GOP and T-Party "Republicans" have no compassion for the poor. Being a Republican these day must be like living a lie for those that have any conscious. Those same are leaving the party in droves and now even leaning Democrat. The "GOP" has made enemies of just about everybody, even old white moderate men, to the point where 2014 and 2016 can be nothing more then a wet dream.
I have seen many of both side shoot themselves in the foot, but this hatred of anything and everything not Ted Cruz - like is awesome.
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Republican judge switches parties, slams GOP’s “pettiness and bigotry”
"Make no mistake: I have not left the Republican Party. It left me," says Texas Judge Carlo Key VIDEO
Topics: Video, GOP, Republicans, anti-gay disc, Texas, lgbtq rights, Gay Rights, Homophobia, Life News, News, Politics News
(Credit: YouTube)Bexar, Texas, County Judge Carlo Key announced Monday that he is leaving the Republican Party and will seek reelection as a Democrat, explaining that the GOP is no longer representative of his principles.
“Make no mistake: I have not left the Republican Party. It left me,” Key says in the video announcement, a blistering indictment of anti-LGBTQ sentiment within the GOP and the party’s “pettiness and bigotry”:
I can no longer be a member of the Republican Party. For too long, the Republican Party has been at war with itself. Rational Republican beliefs have given way to ideological character assassinations. Pragmatism and principal have been overtaken by pettiness and bigotry. Make no mistake: I have not left the Republican Party. It left me. I cannot tolerate a political party that demeans Texans based on their sexual orientation, the color of their skin or their economic status. I will not be a member of a Party in which hate speech elevates candidates for higher office rather than disqualifying them. I cannot place my name on the ballot for a political party that is proud to destroy the lives of hundreds of thousands of federal workers over the vain attempt to repeal a law that would provide health care to millions of people throughout our country.
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The news was today that the deficit is 1/2 of what it was in 2008's horrible Bush borrow and spend with no budget. Also the stock market is making tons of money. And...
the CBO announced again today that the ACA will lower the deficit by 100s of billions more.
And our crazies continue to say...
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and everyone worries about the website for the affordable care act but no one seems to worry when the pentagon pisses millions upon millions away and even in duplicated programs....
US military's airship programs lose altitude
By Daniel De Luce October 26, 2013 2:49 PMWashington (AFP) - The US military has invested billions in blimp-like aircraft to track militants planting roadside bombs but the spyship experiment is losing altitude because of technical failures and changing priorities.
The lighter-than-air projects were billed as an innovative revival of an old aircraft design to conduct "unblinking" surveillance on the battlefield -- at a fraction of the cost of fuel-guzzling planes or helicopters.
The Pentagon invested $7 billion in airship programs between 2007 and 2012, but the funding has mostly dried up amid budget cuts and embarrassing setbacks.
Tethered balloons equipped with radar have been used routinely for surveillance by US forces over the past decade and are a common sight floating over American bases in Afghanistan.
But the big money went towards airships, which are a step up from the "aerostats" held by ropes. The airships fly on their own power similar to the zeppelins of the World War I era, while carrying more technology on board.
The most ambitious project was the Army's massive, unmanned airship, the Long Endurance Multi-Intelligence Vehicle (LEMV), which was launched in 2010 with plans to deploy the craft to Afghanistan within 18 months.
The LEMV, manufactured by Northrop Grumman, was supposed to be equipped with sensors that could track enemy mortar rounds, withstand small arms fire with special material and also serve as a cargo ship that could handle up to 20 tons of supplies.
Northrop Vice President Brad Metzger promised it would "redefine persistent surveillance."
After falling behind schedule, the 300-foot-long (90 meters) airship ran into major trouble after its first flight at Lakehurst Naval Air Station in New Jersey in August 2012.
It turned out to be 12,000 pounds (5,400 kilograms) overweight because of problems with its tailfins and other systems, according to a report from the Government Accountability Office, the investigative arm of the US Congress.
The weight problem meant that the craft could not stay in the air for three weeks as planned at an altitude of 20,000 feet, but only for four to five days.
After the first test, there was a post-flight review and engineers came with up "with a long list of things that needed to be repaired," said John Cummings, an Army spokesman.
Facing daunting technical hurdles, along with a reduced appetite for surveillance in Afghanistan amid a troop drawdown, the Army decided to scrap the program after spending an estimated $294 million.
For critics, the program's short-lived, expensive history seemed to embody everything wrong with the Pentagon's bureaucracy. But officials said the concept was promising and the results simply were not up to expectations.
"This was a very interesting program. We are all disappointed it didn't go the way we wanted it to," Cummings said.
The US Air Force pursued its own helium-filled spyship, the Blue Devil 2, that was supposed to hover over battlefields for days, equipped with state-of-the-art sensors and cameras.
The Blue Devil 2 suffered similar problems as the Army's project, missing deadlines and failing technical thresholds.
Like the LEMV, the Blue Devil's tailfins were far too heavy, so heavy in fact that the airship could not fly, according to the GAO. There also were problems with flight control software.
After spending about $115 million, the Air Force called off the Blue Devil program in June 2012.
Other airships have flunked their flight tests.
The HALE-D, or high-altitude airship demonstrator, crashed on its first flight in July 2011, causing the destruction of its solar cells. In 2010, the solar-powered HiSentinel airship had a propulsion system failure after eight hours of a scheduled 24-hour flight.
A more modest Navy project, the MZ-3A research airship, has survived and is used to test sensors for the military and other government agencies.
The Navy calls it a "flying laboratory" that offers a "slow moving, vibration free" way to test out sensors designed for various aircraft.
As for the Army's failed giant airship, the Defense Department tried to sell the LEMV for $44 million. Last month, it settled for a modest $301,000, officials said.
Under the terms of the sale, Cummings said that if the airship's new owners "fly it again, we would be provided with data from their flights."
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