Healthcare.gov and Failure
By Dennis Loo (11/23/13)
A core element of Obama’s legitimacy is tied to his promise to do things smarter and more competently. He has taken a huge hit as a result of his signature legislation, the Affordable Care Act (aka Obamacare)’s humiliating rollout failure. His popularity levels are at their lowest ever.
I had been wondering why Healthcare.gov was rolled out when it clearly was not ready to function. This is all the more surprising given the primacy of the ACA to the Obama administration’s agenda and reputation. The New York Times’ article “Tension and Flaws Before Health Website Crash” seeks to address this.
According to the Times’ analysis, everyone involved in this debacle did things wrong. The man put in charge of this for the government, Henry Chao for the Centers for Medicare and Medicaid Services (CMMS), which was chosen to head this effort, has no formal training in software engineering and was not given the authority to make decisions.
Can you say: big red flag right there?
While Chao appears not to have suffered from the additional sin of hubris, his superiors and other government figures with a role in this clearly do.
The prime contractor, CGI Federal, had long before concluded that the administration was blindly enamored of an unrealistic goal: creating a cutting-edge website that would use the latest technologies to dazzle consumers with its many features. Knowing how long it would take to complete and test the software, the company’s officials and other vendors believed that it was impossible to open a fully functioning exchange on Oct. 1.
The administration insisted over CGI’s objections, however, that the rollout date of Oct. 1 was non-negotiable.
The online exchange was crippled, people involved with building it said in recent interviews, because of a huge gap between the administration’s grand hopes and the practicalities of building a website that could function on opening day.
Vital components were never secured, including sufficient access to a data center to prevent the website from crashing. A backup system that could go live if it did crash was not created, a weakness the administration has never disclosed. And the architecture of the system that interacts with the data center where information is stored is so poorly configured that it must be redesigned, a process that experts said typically takes months. An initial assessment identified more than 600 hardware and software defects — “the longest list anybody had ever seen,” one person involved with the project said.
Anyone who pays attention to the news on even a semi-regular basis knows that even uncomplicated, well-functioning, and highly popular sites will crash when they are overloaded. Yet the people in charge of this project seem not to have recognized this danger of opening a whiz-bang, solitary, national website to millions that they expected to sign-up on it, even if it wasn’t deeply flawed, which it clearly was.
So let’s inventory what we know so far (based on what’s in the NYT article): the government chose to offer one website instead of many (a decision prompted in part by the fact that several states declined to participate, but that the administration could have found a work around); the insistence well along into the process of providing an informative and cutting edge website that dazzled rather than one that was straightforward and functional; against the advice of the prime contractor, the government’s insistence that code from a source that was not compatible with other providers be used; no one was given sufficient clout to co-ordinate this very ambitious venture; the president was apparently out of the loop as far as ensuring that his most highly touted law was properly introduced – telling the nation days before its release even though in the months preceding its release disaster was being openly predicted by people in the project:
“This is real simple,” Mr. Obama said, during a speech in Maryland on Sept. 26. “It’s a website where you can compare and purchase affordable health insurance plans side by side the same way you shop for a plane ticket on Kayak, same way you shop for a TV on Amazon. You just go on, and you start looking, and here are all the options.”
Just like Kayak, like shopping for a TV. This ought to go with “Mission Accomplished” as Bush infamously declared from an aircraft carrier.
So Obama snatches defeat from the jaws of victory. Within weeks of his partisan opponents in the GOP who had covered themselves in shame for their bringing us the government shutdown, the GOP has its stock rise instantly due to the Obamacare debacle of a rollout. Obama is additionally forced to back off from a widely touted promise he previously made about people being able to stay with their existing insurance if they prefer it to the ACA, thereby endangering the financial viability of the ACA which depends upon the heavy enrollment of the so-called “invincibles” of healthy young people.
This is the same government that constantly assures us that it knows what it is doing and that we can and should trust them. In the same issue of the NYT is an article based upon Edward Snowden’s revelations of the NSA’s attempts to exercise even more power, including providing information from “anyone, anytime, anywhere.” These are the people who our fates collectively are wrapped up in, people whose hubris knows no bounds in the face of large amounts of contradictory information and whose capacity to misrepresent to us and to themselves the level of trouble also know no limits. Consider the catastrophe of global warming:
While Obama believes global warming is a danger, the measures being undertaken to slow it fall grievously far below what is necessary at this point. As James Hansen, whose proven track record on anticipating the course of global warmings’ progressive danger signs makes him the most credible scientist around, has forcefully warned, the point of no return has already been passed and emergency measures are needed. In a 2003 report commissioned by Andrew Marshall and written by former Shell Oil Head of Planning Peter Schwartz and California think tank Global Business Network’s Doug Randall, the Department of Defense (DoD) itself warned of the convulsive effects that global warming in the not distant future will wreak in the form of forced migrations of tens of millions and wars over resources critical to actual survival; the DoD described this as a threat “greater than terrorism.”
The research suggests that …adverse weather conditions could develop relatively abruptly, with persistent changes in the atmospheric circulation causing drops in some regions of 5-10 degrees Fahrenheit in a single decade. Paleoclimatic evidence suggests that altered climatic patterns could last for as much as a century, as they did when the ocean conveyor collapsed 8,200 years ago, or, at the extreme, could last as long as 1,000years as they did during the Younger Dryas, which began about 12,700 years ago. . . .
[A]n increasing number of business leaders, economists, policy makers, and politicians are concerned about the projections for further change and are working to limit human influences on the climate. But, these efforts may not be sufficient or be implemented soon enough. Rather than decades or even centuries of gradual warming, recent evidence suggests the possibility that a more dire climate scenario may actually be unfolding. . . .
As famine, disease, and weather-related disasters strike due to the abrupt climate change, many countries’ needs will exceed their carrying capacity. This will create a sense of desperation, which is likely to lead to offensive aggression in order to reclaim balance. Imagine eastern European countries, struggling to feed their populations with a falling supply of food, water, and energy, eyeing Russia, whose population is already in decline, for access to its grain, minerals, and energy supply. Or, picture Japan, suffering from flooding along its coastal cities and contamination of its fresh water supply, eying Russia’s Sakhalin Island oil and gas reserves as an energy source to power desalination plants and energy-intensive agricultural processes. Envision Pakistan, India, and China—all armed with nuclear weapons—skirmishing at their borders over refugees, access to shared rivers, and arable land. Spanish and Portuguese fishermen might fight over fishing rights—leading to conflicts at sea. And, countries including the United States would be likely to better secure their borders. With over 200 river basins touching multiple nations, we can expect conflict over access to water for drinking, irrigation, and transportation. The Danube touches twelve nations, the Nile runs though nine, and the Amazon runs through seven.
The response from the Pentagon’s spokesperson Dan Hetlage to this report was interesting:
We did not expect any White House response to the Pentagon on this report. Andrew Marshall is our Yoda, our big thinker who peers into the future. But it’s all speculation. It was very ethereal, very broad in scope. It wasn’t like, “Oh, wow, that totally debunks the president’s stand on global warming,” because it was merely a thought exercise. We don’t have a crystal ball. We don’t really know. [Emphasis in the original.]
They “don’t really know.” When astronauts go into space, the back-up systems NASA creates to protect the astronauts and their missions are multiple in nature in case the first few fail. The scenarios they run in preparation for outer space travel are diverse and complex. These efforts are protecting a handful of people in space; yet, when the entire planet is at risk, the trigger for action is based on whether or not they know for certain that something will happen. Of course, at the point when the dangers are manifest and present, action in response is much too late. This is the equivalent of packing the entirety of humanity into one big car and those in charge of the welfare of the passengers deciding that they are not going to put on any seatbelts because they do not know for certain that there will be an accident. (Globalization and the Demolition of Society, Pp. 166-168)
The point here is not that the Obama Administration is incompetent and the solution is simply that we should replace them with more competent administrators. That is not the central issue although one of the government’s glaring weaknesses is that bureaucracy runs the show and bureaucracies are inherently bad at doing new things. Competence, nonetheless, is part of the problem. But lack of competence is not something that exists in isolation. It exists in relationship to other more primary factors. Single-payer insurance is what ought to be offered to the people. It’s simple and it does not need to siphon off huge sums for the profits of the HMO middlemen. The worries about the “death spiral” of insolvency of the ACA if there are not enough young and healthy people paying premiums is a problem that exists because Obama refused to buck the HMOs and offer a single-payer plan and would not bring forth the issue of health insurance as collective in nature in which there is a sharing of risk. He would not put this forward probably because it would sound too anti-capitalistic to do so.
The problems that beset Healthcare.gov and Obamacare are a microcosm of what is wrong with capitalism/imperialism as a whole. No matter who is elected to take charge of life and death matters such as healthcare, the insidiousness of profit-making intrudes. Those who head up this Empire believe that they have unparalleled power in their hands and they are positively giddy about that power. Yet the masters they serve are not the people. They serve the needs of capital and the "expand or die" logic of capitalism and empire. As long as the governing system remains capitalist, there will be disaster after disaster, both on the individual level and on the global level.