Cover Oregon goes to Healthcare.gov

[nsaspook]

http://www.washingtonpost.com/national/health-science/technology-group-to-decide-cover-oregons-future/2014/04/24/cd96afd2-cb77-11e3-b81a-6fff56bc591e_story.html

PORTLAND, Ore. — Oregon, once expected to be a national leader in the federal health care overhaul, on Thursday moved to become the first state to dump its troubled online health exchange and use the federal marketplace instead.
...
Oregon has received a total of $305 million in federal grants to fund its operations from 2011 through the end of this year. As of March, the state has spent nearly $248 million of that money, Cover Oregon interim executive director Clyde Hamstreet said.

What a waste of money that could have been spent on actual heathcare instead of some pie in the sky bureaucratic program.

https://www.youtube.com/watch?v=xVUJNEDpEkg#t=19

Epic fail

 

[mheslep]

Two different viewpoints, cute and ~cute



https://www.youtube.com/watch?v=Dh9munYYoqQ#t=119

 

[nsaspook]

This state is a mess and the people in it have gone crazy.

http://www.katu.com/news/local/Women-arrested-accused-of-twerking-and-lewd-behavior-at-Beaverton-City-Hall-257151361.html

Dancing, urinating and drugs should have been the Cover Oregon theme song.

 

[mheslep]

So that bit of community action would be filed under the not cute category then.

 

[nsaspook]

They would have been perfect for a Cover Oregon Mental health and substance abuse disorder services ad.

 

[nsaspook]

Another case for a Cover Oregon Mental health and substance abuse disorder services ad.
http://www.katu.com/news/local/Man-doing-naked-pushups-on-Columbia-Blvd-hit-and-killed-by-passing-car-257861731.html

 

[OmCheeto]

Two different viewpoints, cute and ~cute

...

Awesome video. :thumbs:

ps. I've never heard a ukulele being played here. Mandolins maybe, but never a ukulele.

pps. Learning that Larry Ellison is the 3rd richest man in america, and CEO of Oracle, the private company paid to provide a product, which it didn't, made me wonder: Do uber wealthy americans yield the power to suck $250,000,000 out of federally funded state coffers by not providing what they were paid to do?

It's less than a buck per american, so I'm sure the rest of the nation doesn't really give a, um, hoot.

ppps. hmmm...

I wonder how much of Mr. Ellison's $77,000,000 paycheck last year came from your pockets?
hmmm... less that 25 cents per american. Who's going to notice that.

pppps. One of my favorite local yocals, Kari Chisholm, had the following to say:

Is Oracle's Larry Ellison going to pay Oregon back for the Cover Oregon debacle?

Yah, it looks bad on the surface, and makes you feel good to point fingers at stupid "Portlandy" type people, which might make you feel a little bit smarter. But in the end...

Why, if we're so stupid, is everyone, moving here? Please, go away, and move, back home.

Janes...

https://www.youtube.com/watch?v=k80nW6AOhTs

------------------------------
ok to delete, infract, and ban.

 

[nsaspook]

Tell it like it is man.
http://www.kpic.com/news/local/259530231.html

"It was a mass of excrement as far as what we got from the Health Authority and Oracle," Jovick told KATU. "It was a cockamamie system that nobody in their right mind could make work."

Jovick said there was not a single smoking gun but rather several problems that led to the website failure, including the lack of a system's integrator. A system's integrator is like a general contractor that would help ensure the exchange would be operational in time for open enrollment. While a vast majority of state-run exchanges hired one, KATU learned, Oregon did not.

It was one of the only states that chose instead to oversee the project itself.

Jovick also blamed Oracle's unusual contract with the state, which allowed Oracle to bill on what was essentially a time and materials plan, rather than charging the state a set fee for work delivered. Jovick believes Oracle got away with doing shoddy work and he felt OHA didn't hold Oracle accountable.
...
Cover Oregon went live on Oct. 1, 2013 but never managed to fully function as promised. Despite a grand vision, an earlier start and approximately $305 million from the federal government, the website has yet to enroll a single individual in a single sitting online. It's the only state in the country with that dubious distinction.

 

[mheslep]

Why is it that with any other commercial enterprise that buys or builds bad IT the CIO loses his head but when govt does this, why, then it's the fault of evil forces who stole from the people? The Target CEO who was just forced to resign would no doubt love to have media writing articles on his behalf, deflecting negligence onto nefarious dark forces.

 

[nsaspook]

There's plenty of blame to go around but Oracle has been at the center of several big failures in the past. I partly blame simple human nature, if somebody throws a few hundred million for you to spend with a tight time schedule, you get busy spending it.

 

[nsaspook]

Yet another case for a Cover Oregon Mental health and substance abuse disorder services ad.

http://www.katu.com/news/local/Womans-car-attacked-by-self-identified-high-elf-battling-evil-259598811.html?mobile=y

A man dressed in chain-mail with a helmet, shield and carrying a sword and staff ran into traffic and started attacking her car.

She called 911, reporting that "a pirate" was attacking her car.

When police got there, they detained Konrad Bass of Glendale, Oregon.

Bass told officers that he wasn't a pirate but a "high-elf engaged in battle with the evil Morgoth."

 

[nsaspook]

http://www.oregonlive.com/health/index.ssf/2014/05/cover_oregon_kitzhaber_says_it.html

It promises to be a difficult case. With $37 billion in annual revenue, Oracle is a deep-pocketed foe. That the company failed to deliver a functional product is well documented. But several poor decisions by state managers contributed to the mess. Opting not to hire an experienced technology company to serve as systems integrator, a sort of general contractor overseeing the project, was a big mistake, Kitzhaber conceded.

Also, the state signed Oracle to so-called "time and materials" contracts that typically didn't require Oracle to deliver anything specific. "There is no question that the failure to hire a system integrator and the use of time-and-material contracts contributed significantly to the culpability on the state side, and we have taken steps to address that," Kitzhaber said.

Another idiotic legal mess of a time and materials contract, follow the money.

http://www.oregonlive.com/health/index.ssf/2014/05/fbi_issues_subpoena_to_cover_o.html

The federal criminal investigation of Oregon's health insurance exchange took a step into public view Tuesday when the U.S. Attorney's office issued broad subpoenas seeking information from Cover Oregon and the Oregon Health Authority.

While the Federal Bureau of Investigation's interest in the exchange debacle had been previously reported, the legal demands dated May 13 indicate things may have moved beyond a preliminary inquiry to a full-blown investigation.

 

[SteamKing]

And if the U.S. Attorney for Oregon gets too close to the truth, AG Holder in DC is there to backstop anything from sticking to Obama.

There's nothing inherently wrong with a T&M contract, but when the system you are trying to implement is only partially designed or, in this case, described by the ACA legislation and subject to a continuing series of interpretations and rule-makings by at least two huge bureaucracies, HHS and the IRS, not to mention various waivers issued to friends of the administration, you can expect some slippage in the delivery schedule and a reduction in the quality of the finished product.

 

[nsaspook]

you can expect some slippage in the delivery schedule and a reduction in the quality of the finished product.

I would still expect actual delivery of something that works to the point that people can login and complete the basic forms that they have to do in paper now. They never enrolled a single person with the system. Other states and the feds seem to have at least something functional.

http://govwin.com/knowledge/time-and-materials-contracts

 

[SteamKing]

I would still expect actual delivery of something that works to the point that people can login and complete the basic forms that they have to do in paper now. They never enrolled a single person with the system. Other states and the feds seem to have at least something functional.

http://govwin.com/knowledge/time-and-materials-contracts

It's not clear why you think the Oregon program should be singled out for special notice, or that these sorts of problems have not cropped up elsewhere.

In fact, the other states which have dabbled with setting up their own exchanges, not to mention the federal exchange itself, have reportedly experienced a multitude of problems and delays. Even Massachusetts, which has been in the mandatory health insurance biz for a lot longer (Romneycare, anyone?) is scrapping their website entirely:

http://www.bostonglobe.com/lifestyl...-broken-fix/oVT1f1X9hE4jaNOfF5XaiP/story.html

Maryland is scrapping their system in favor of one used by Connecticut:

http://www.washingtonpost.com/local...6a3a3e-b6d2-11e3-8cc3-d4bf596577eb_story.html

The federal website still has its share of problems for the enrollment portions of the site, while the payment back end is still undergoing development, so healthcare.gov is not a done deal by any stretch of the imagination. As time goes on and people start having life changing events, like moving to another state or having kids, expect to see more problems crop up with users having to shop for insurance in a different state and add new family members to their policies.

 

[nsaspook]

It's not clear why you think the Oregon program should be singled out for special notice, or that these sorts of problems have not cropped up elsewhere.

We are the worst by a long shot and saying others have had problems is not an excuse for a child , a company or a government and if it's given as a reason then you should compare it with the efforts of others. Others have had the implementation problems seen with any large task but the entire process here was a disaster from start to end and was completely avoidable with proper management and accountability.

http://www.washingtonpost.com/blogs...-up-with-the-nations-worst-obamacare-website/

And it's not just health care the state bungled, they can't even build a bridge across the Columbia.
http://www.oregonlive.com/business/index.ssf/2014/04/columbia_river_crossing_tab_ap.html

 

[SteamKing]

Unlike Massachusetts and Maryland, it seems that the state officials in Oregon are still grappling with reality and are reluctant to make the hard choices necessary, w.r.t. healthcare and insurance.

I remember another state recently built a bridge to nowhere, so that particular failing is not unique either. With less than $200 million sunk in the still-born bridge, I'd say Oregon got off easy. Massachusetts and the feds poured over $14 billion into the Big Dig in Boston.

It's not as if Oregon politicians and bureaucrats have been struck by some incompetence virus which has left officials in other states or in the federal government unscathed. It's been said that "Politics is the art of the possible," (by Otto von Bismarck, no less), but when politicians delude themselves into thinking that anything and everything is possible by writing this or that legislation, that's where the trouble starts.

If the voters don't hold their representatives accountable at election time, that's the voters' problem.

 

[Locrian]

Kentucky Kynect worked great from early on, and California's seemed to perform reasonably well (California's problems stem more from very limited networks and an over-focus on low premiums).

So I strongly disagree with the idea posed by some in this thread that it's the ACA that made these exchanges to difficult to implement. They really shouldn't have been that hard to lay out, and they're working better every day.

It's the incredible incompetence of our gov't that has made them such a disaster.

 

[mheslep]

To which people do you refer? The ACA is not directly mentioned in this entire thread. There are a couple mentions of other exchanges (#15), and an oblique reference to healthcare.gov

 

[Locrian]

The ACA is not directly mentioned in this entire thread.

Yes it is.

My response was not restricted to that one post, but it's a good example.

 

[mheslep]

I did miss that one. You mean there are other examples here in this thread?

 

[SixNein]

Kentucky Kynect worked great from early on, and California's seemed to perform reasonably well (California's problems stem more from very limited networks and an over-focus on low premiums).

So I strongly disagree with the idea posed by some in this thread that it's the ACA that made these exchanges to difficult to implement. They really shouldn't have been that hard to lay out, and they're working better every day.

It's the incredible incompetence of our gov't that has made them such a disaster.

From a software engineering perspective, the web sites are difficult to create. I don't think people respect the real complexity involved. Many software engineering projects are just as complicated as the space program. Failures are going to happen.

In my opinion, software engineers are getting belittled by a lot of people. I could use similar arguments that one should cancel funding on science programs because they have failures. Instead of accepting the reality of the field, we could just blame it on government.

 

[Locrian]

I guess hard is a relative term.

I couldn't create the exchanges in my basement.

But the government of a 16 trillion dollar economy with a three year head start should have been able to build them pretty easily*. If you read post-mortems on the federal exchange fixes, the problems were utlimately administrative, not technical in nature (meaning there were technical problems that were easily solved given the right management).

* Edit: And states should have been able to as well. We know this, because two did.

 

[Locrian]

So one thing I'm trying to get across is that the answer to this statement:

It's not clear why you think the Oregon program should be singled out for special notice,

Is that we should single out Oregon for special notice because it's especially bad.

A few other exchanges may go down. I believe all of them had different vendors than Oregon, and hearsay suggests they had differing problems, too. A few state exchanges will not work this year, but may come up to speed next year. Exchanges in these two groups include MA, VT and at least one other in the northeast (forget which).

Some exchanges will work, but may get shut down for financial reasons, rather than technical ones. HI and CO I think fall into this category, and maybe NV, too.

And then some exchanges may run for some time. I certainly can't imagine CA coming down anytime soon. I think, ultimately, that there's no reason for state exchanges - might as well use the federal one. But as soon as they built them, they created jobs in their state, so it may be hard to undo. . .

Oregon definitely deserves its own thread, and its failure is special in its own unique and wonderful way.

 

[SixNein]

I guess hard is a relative term.

I couldn't create the exchanges in my basement.

But the government of a 16 trillion dollar economy with a three year head start should have been able to build them pretty easily*. If you read post-mortems on the federal exchange fixes, the problems were utlimately administrative, not technical in nature (meaning there were technical problems that were easily solved given the right management).

* Edit: And states should have been able to as well. We know this, because two did.

A website is nothing more than a description of the type of interface being used. It doesn't communicate the complexity of the over all system.

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

In general, most people who have been writing about the web sites have no experience what so ever with software engineering, and they don't seem to have bothered with consulting those who do before publishing.

he biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process.

http://www.nytimes.com/2013/10/13/us/politics/from-the-start-signs-of-trouble-at-health-portal.html

Software engineering projects are extremely hard to estimate. The real failure here was in estimation. Someone took the software requirements and gave a bad estimate on what it takes to create it, and the time required to complete it. There may have also been some bad feasibility calls on certain methods. In addition, there were political realities involved that made the project even more difficult.

Project developers for the health care website who spoke to the AP on condition of anonymity - because they feared they would otherwise be fired - said they raised doubts among themselves whether the website could be ready in time. They complained openly to each other about what they considered tight and unrealistic deadlines. One was nearly brought to tears over the stress of finishing on time, one developer said. Website builders saw red flags for months.

http://apnews.myway.com/article/20131022/DA9JEPK81.html

 

[Locrian]

Great links.

I'll note that nothing there contradicts anything I've written.

 

[SteamKing]

Even Massachusetts, which has been in the mandatory health insurance biz for a lot longer (Romneycare, anyone?) is scrapping their website entirely:

http://www.bostonglobe.com/lifestyl...-broken-fix/oVT1f1X9hE4jaNOfF5XaiP/story.html

A few state exchanges will not work this year, but may come up to speed next year. Exchanges in these two groups include MA, VT and at least one other in the northeast (forget which).

The Massachusetts health care website reportedly worked OK until it had to be upgraded to comply with the ACA, according to the Boston Globe article. The contractor upgrading the Mass. website was CGI, which was also the lead contractor chosen by the feds to develop healthcare.gov. CGI's contract with Mass. has now been terminated, and state officials are scrambling to adopt a new system and get it running by Nov. 15, 2014 in order to enroll people for coverage in 2015.

 

[SixNein]

Great links.

I'll note that nothing there contradicts anything I've written.

Sure it does. Those are technical problems.

In the SRS, it would be listed as a non functional requirement. They were unable to comply with the requirement, so the project failed. The developing companies signed off on the SRS, and they are responsible for it's failure to meet all requirements. Software engineers in their requirements team reviewed the SRS, and they made some bad calls.

But in defense of these people, the public has unrealistic expectations on software. These kinds of problems are common, and usually companies allot more time or even cancel the project. Politically speaking, many people were looking for an excuse to snipe obama on health care. So extending the time in the SRS became politically impossible.

 

[nsaspook]

But in defense of these people, the public has unrealistic expectations on software. These kinds of problems are common, and usually companies allot more time or even cancel the project.

I think the public expectations are not unrealistic, they, perhaps naively, expect professionally constructed results from people who call themselves software 'engineers and architects' while spending hundreds of millions on systems that are in fact poorly engineered to scale, fragile to failure modes and in the end fail to perform even the most basic functions reliably in some cases like Oregon.


Gerald Weinberg:

"If builders built houses the way programmers built programs, the first woodpecker to come along would destroy civilization."

Weinberg attributed with the quote in: Murali Chemuturi (2010) Mastering Software Quality Assurance: Best Practices, Tools and Technique for Software Developers. p.ix

http://en.wikiquote.org/wiki/Gerald_Weinberg

 

[SixNein]

I think the public expectations are not unrealistic, they, perhaps naively, expect professionally constructed results from people who call themselves software 'engineers and architects' while spending hundreds of millions on systems that are in fact poorly engineered to scale, fragile to failure modes and in the end fail to perform even the most basic functions reliably in some cases like Oregon.


Gerald Weinberg:http://en.wikiquote.org/wiki/Gerald_Weinberg

You're right.

We should use the same kind of logic to cancel the NASA budget, and also cancel most science funding by government. These programs are full of people who frequently go over budget and over time. They are not professional enough because they are working for the government.

Government is just too incompetent for those types of things.

I should make a talk show.

n 2006, NASA estimated that Webb would cost $2.4 billion and could launch in 2014. In 2008, the price tag rose to $5.1 billion. A congressionally mandated report released last year found that NASA had underestimated costs and mismanaged the project. This summer, NASA said it had already spent $3.5 billion on the project and needed a total of $8.7 billion to launch in 2018.

http://www.washingtonpost.com/natio...ce-telescope/2011/10/13/gIQALjYLKM_story.html

After all, I can build a telescope in my basement.

 

[SteamKing]

But in defense of these people, the public has unrealistic expectations on software. These kinds of problems are common, and usually companies allot more time or even cancel the project. Politically speaking, many people were looking for an excuse to snipe obama on health care. So extending the time in the SRS became politically impossible.

The ACA did not come about in response to a great clamor by the public. It was something passed on a purely partisan vote in both houses of congress due to some questionable parliamentary maneuvering by the Democrats, which forms the basis of at least one federal lawsuit still wending its way through the courts.

The whole program was designed first and foremost to be a one-stop-shop to purchase health insurance, as mandated by the law. The whole process of enrolling at healthcare.gov was to avoid the hassle to doing the enrollment by filling out stacks of paper forms.

When a person sat down to enroll, he was supposed to be able to examine the types of coverage available and make a selection based on health coverage needs. In order to price these plans, the prospective customer had to provide information about his family, where he lived, whether he was already covered, etc. Because of the way premium subsidies were structured, based on the income of the prospective customer, the system also needed to know something about that to determine eligibility and then the amount of the subsidy available.

Government being government, the plan administrators wanted to verify all these personal and financial details in real-time while the customer was enrolling; no call backs, or we'll see you later type delays. This meant that the healthcare.gov website needed to interface with other federal databases, which were not designed to be accessed by people at large.

Whatever the reasons, the contractors chosen by the feds to develop the website for healthcare.gov reportedly did not have a stellar resume of performance. Their last big contract was developing a firearms registry for the Canadian government, which contract also went over budget and slipped past its delivery date.

It's not that the public at large has unrealistic expectations about what software can or cannot do, because the public was not in charge of this mess. It's the politicians and other bureaucrats who cooked up this 'stinkburger' (to use Obama's phrase) who had unrealistic expectations but persisted in forging ahead nevertheless against some pretty well-reasoned advice until the disaster was made real when the website premiered.

But for one fateful encounter with an iceberg, the TITANIC might have sailed happily for many years with no problems. It's not like there was a crowd of people at the dock when the ship sailed warning that she was doomed to fail so spectacularly and so suddenly.

And it's not like this is the first time the US government has run into problems developing a large software system. To cite two examples, the FAA has spent many years trying to upgrade and modernize its air-traffic control system:

http://gcn.com/articles/2013/07/22/faa-next-generation-air-transportation-system.aspx

An inspector general's report has concluded that the new system will take 10 years longer to complete and cost billions more than anticipated.

A similar report concluded that the Social Security Administration was relying on woefully obsolete computers and software to manage the data it collects on wages earned by US workers and to work through the backlogs in processing disability claims and providing administrative hearings to resolve disputes:

http://otrans.3cdn.net/134afc3b9a10670ba2_vgm6y9zu5.pdf

I have little sympathy for Obama & Co. All during the protracted development and roll-out of healthcare.gov, the party line was that if you were satisfied with your insurance and your doctor, you could continue on as before the ACA was passed. When the regulatory structure was being built around the law, it became clear that the president's solemn promises were no longer 'operative', to coin a phrase used about a previous occupant of his office, everyone continued as if these promises had not been made.

 

[SixNein]

Whatever the reasons, the contractors chosen by the feds to develop the website for healthcare.gov reportedly did not have a stellar resume of performance. Their last big contract was developing a firearms registry for the Canadian government, which contract also went over budget and slipped past its delivery date.

These things happen in complicated projects. And it's not limited to software. As I stated above, many hard engineering and scientific projects go over budget and over time.

It's not that the public at large has unrealistic expectations about what software can or cannot do, because the public was not in charge of this mess. It's the politicians and other bureaucrats who cooked up this 'stinkburger' (to use Obama's phrase) who had unrealistic expectations but persisted in forging ahead nevertheless against some pretty well-reasoned advice until the disaster was made real when the website premiered.

Like I say, we should use this logic for science budgets. And you know I could cite many examples here.

For example, the Large Hadron Collider was a disaster. In addition, a great many projects by NASA has been a complete disaster. Here is a list of a few of them:
http://www.nbcnews.com/id/29514257/...t/big-nasa-projects-over-budget/#.U5j8rvldWHM

Fair is fair right?

I have little sympathy for Obama & Co. All during the protracted development and roll-out of healthcare.gov, the party line was that if you were satisfied with your insurance and your doctor, you could continue on as before the ACA was passed. When the regulatory structure was being built around the law, it became clear that the president's solemn promises were no longer 'operative', to coin a phrase used about a previous occupant of his office, everyone continued as if these promises had not been made.

Maybe people should read the bills.

 

[nsaspook]

You're right.

We should use the same kind of logic to cancel the NASA budget, and also cancel most science funding by government. These programs are full of people who frequently go over budget and over time. They are not professional enough because they are working for the government.

Government is just too incompetent for those types of things.

Science projects are pushing the frontiers of what we can do past the boundaries of simple engineering with current technology and is exactly the type of projects the 'Government' should invest our tax dollars in. If NASA was in the business of making failed complex health-care systems instead of developing and engineering the space exploration knowledge base of the future I would agree to your logic but you have a straw-man argument that's completely off track. I don't see much that's new and novel about the 'Cover Oregon' software system specifications and requirements that you could possible compare to a complex physics based scientific project like the LHC that can recreate conditions as close to the birth of the universe as humanly possible with todays technology.

 

[SixNein]

Science projects are pushing the frontiers of what we can do past the boundaries of simple engineering with current technology and is exactly the type of projects the 'Government' should invest our tax dollars in. If NASA was in the business of making failed complex health-care systems instead of developing and engineering the space exploration knowledge base of the future I would agree to your logic but you have a straw-man argument that's completely off track. I don't see much that's new and novel about the 'Cover Oregon' software system specifications and requirements that you could possible compare to a complex physics based scientific project like the LHC that can recreate conditions as close to the birth of the universe as humanly possible with todays technology.

Software engineers are also pushing the frontiers. In fact, a substantial portion of the success of LHC is due to software engineering. The same can be said of many of NASA's projects. Building health care systems is also a worthy goal. And these systems are very complex, and they too will run into budget and time issues. These issues just comes along with complex systems. Health care system of this kind might not seem complex in many peoples mind, but those people have probably never had to interface with lots of different systems while doing real time calculations so that someone can see how much he or she pays. And all of this is outside of all of the regulation requirements and security concerns in a high traffic environment.

The whole point I'm trying to make is the double standard used here. People are making arguments similar to something like: I can build a telescope in my basement, so why is the James Webb telescope over budget and time? It's disingenuous. We don't do that to scientists or engineers, and they should show the same respect.

 

[nsaspook]

Software engineers are also pushing the frontiers. In fact, a substantial portion of the success of LHC is due to software engineering.

The problem I see is the 'Dark Side' of software engineering with some failed IT projects like Cover Oregon. The problem is called lying. It's knowing that deadlines and milestones can't be met in the beginning and 'lying' about it. People don't like to hear the L-word but it's often the root of the failures we see in large software (and hardware) systems. It's just too damn easy to create mythical front-end demos that dazzle when the people who will actually construct the system know it's all a big lie when they write the estimated project costs, schedules or status reports. I'm not talking about 'hype', just flat out lying about the true scope and complexity to get the ball rolling with a 'we'll fix it later' software management system.