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Affordable Healthcare … Hi! I’m from the Government to Help You

Category: Andy Marken's blog Published on Saturday, 07 December 2013



Better than Paper – The healthcare industry has made tremendous strides in patient care and records management by riding themselves of paper records and doing more and more online and on device. The increased use of technology has helped control quality and cost, except when it comes to reporting patient services/care to the government.


I haven’t bothered to sit down and read the American affordable healthcare act that was passed a year ago, so that makes me about as qualified to talk about it as anyone in Congress (either side).


But in doing a little research, I’ve come to realize that:

  •  The American healthcare system just isn’t working for most folks
  •  The idea that you sign up or else (something like that) sorta’ bothers me
  •  Bureaucrats can’t develop a website to save their behinds
  •  To believe they can ensure data security defies logic

    Globally, around 54.5 million people die each year because of disease or preventable healthcare issues.


    One in eight of these deaths occur in children under the age of five.


    At the same time, our worldwide population is over 7B and climbing.


    Since people aren’t going simply disappear when they turn 30 (as they did in Logan’s Run), we’re going to have to address the healthcare issue with the same focus and determination that has produced today’s feature-rich technologies.


    It can’t be that the countries of the world aren’t spending enough on health.


    The World Health Organization (WHO) estimates that globally, we’ll spend more than $6.5T this year. Despite that expenditure, healthcare isn’t available to everyone.


    In fact, there are gross shortages of healthcare professionals in way too many countries.

    Care Distribution – While industrialized countries have done a lot to ensure better healthcare and services are provided to citizens, there is still a very large portion of the world’s population that doesn’t have even the basic assistance.


    While WHO indicates the U.S. has sufficient services available, they also noted:

    •  The government spends more than any other country - $8362/person per year
    •  That works out to about $948 per person per year
    •  The WHO’s highly contested 2000 health report put the U.S. healthcare system in 15th in overall performance
    •  The US was 37th in overall ranking


    WHO didn’t bother ranking countries in their 2010 report but … the Commonwealth Fund ranked seven developed countries on their health care performance and surprise … the U.S. was dead last.


    The U.S. may be last, but they are investing in healthcare.


    According to McKinley, seven percent of the average household income goes for healthcare and another 11 percent for personal insurance and pensions (if you live that long). That expenditure is expected to be 13.6 percent of the GDP (gross domestic product) this year; and by 2020, it is expected to be 19.8 percent of GDP.


    All of those U.S. healthcare payments come from:

    •  32 percent private health insurance
    •  20 percent Medicare
    •  15 percent Medicaid
    •  13 percent other government funds
    •  12 percent out of the consumer’s pocket
    •  8 percent from private funds


    It just doesn’t look like Americans are getting the same ROI as people in other countries.

    Room for Improvement – Even though the U.S. government, citizens and companies spend more on healthcare that others on the planet, citizens still have a lower average life expectancy than people in many other countries.


    Americans have a lower life expectancy as well as higher rates of infant mortality, low weight birth, injuries and homicides, adolescent pregnancy and sexually transmitted diseases, HIV/AIDS, drug-related deaths, obesity, diabetes, heart disease, chronic lung disease and disability than people in other industrialized countries.


    Throwing more money at the problem isn’t working.


    It’s easy to see why Senator Ted Kennedy championed healthcare reform right up until he died, and Hillary Clinton (among others) pushed really hard for it.


    The U.S. Affordable Healthcare Program got off to a rocky start…it sucked!


    We spent $630M in technology to get the federal health insurance website open for business. Right after it was unveiled, someone figured they’d use it and … BAM!!!


    Didn’t anyone run the numbers and notice that there are 300M plus people in the U.S. who might sign up or at least be a little curious?


    Rotten Take-Off – The federal government said the healthcare web site was open for business and ready to fly, but it crashed within hours of being made available. Even a duck knows you try a few test flights, including take-offs/landings, before you show folks how good you are.


    Instead of a showcase for Verizon’s data centers and the site developer, it’s an embarrassment … it crashed right out of the gate.


    Amazon, Google, Oracle, Microsoft and other folks have jumped in to bail out CGI, “the important part of the team,” and straighten things out.

    These folks don’t work for the government; they work for a living and understand the importance of availability, fast response/page refresh, customer satisfaction.


    Hey, I’m not an IT guy but after 20-plus years, I know IT is complex, was never meant to be commercialized like it is and that the Internet wasn’t developed to handle the media and workload it does.


    It’s so complex. With constantly changing with each browser, each device, system/tablet/smartphone, it’s a wonder that websites and the Internet work at all!


    That’s why the companies listed earlier let people test it, try to break it, find the bugs … there are thousands of folks who just love doin’ that sorta’ thing.


    If the federal folks had done some testing, they might have figured out, “Hey, this pig isn’t ready to be put on display.”

    Big, Ugly – It didn’t take long for people to find out that the government’s healthcare services site was a bloated pig with a lot of serious issues. Not a great way to start a new, better program.


    Millions of people tried, but early reports said only 100 – 250 struggled through the early process.


    Even though they worked for the government or were trained government contractors, they should have figured out it had been thrown together, hadn’t been thoroughly tested and wasn’t ready for primetime.


    All they had to do was have the cajones to go to the boss and say, “we’re gonna’ have to have a few more weeks before we’re ready for business.”


    The boss would have been ticked and the opposition would have something to crow about for a little while, but that’s better than showing the world you’re incompetent.


    All they’ve done is insulted the intelligence of the people they’re trying to win over.


    Trust is hard to win back--especially when you’re asking people to give you all of their personal and vital information.


    Heck, we all know government spies, hackers, whackers and cyberspies are rubbing their hands together just waiting to start mining the site.


    Inside, Outside – Most IT people will tell you that their major security problems arise from inside the organization, not from outsiders attempting to penetrate the organization. Most of the time, the security breaches aren’t malicious, it’s just easier if you bypass the security hurdles. But then, there are bad folks on the inside as well … sometimes.


    As the recent Snowden “excitement” has proven, government agencies can’t even handle their own internal security.


    With all the stuff Snowden “releases” the dude had to be taking 8-10 6TB HDs home every night!


    And that was all about grabbing information from … well everyone.


    The idea that suddenly one government department is going to keep a citizen’s information safe and secure from others is a real leap of faith.


    We all know that bugs, crashes, delays and hacks are a fact of life in the industry. But if you’re trying to convince folks the site is good for their health and well being, putting up a garbage site as a finished product just doesn’t resonate.


    Poor Norm – The U.S. Affordable Care Act was designed – and heavily promoted– to Americans to reduce fee-for-service provider payment updates and lower payments to private plans. The way the website registration has gotten off the ground, you may wonder.


    It wouldn’t have taken much to dodge the bullet … label it BETA and you’d attract techies like flies who love telling you where you mucked up!


    True to governmental protocol though, they opened a finished site and then were selective in the “facts.”


    They tried to make you believe the site was pretty good, even though there were/are “a few problems.”

    •  HHS (Health and Human Services) said 15 million site visits proved it was popular
    •  Pew Research said 70 percent of the visitors had insurance and were curious
    •  Pew Research reported that 46 percent said that the online exchanges weren’t working well
    •  65 percent of the uninsured were going to get regardless of the law


    The biggest issue with the site’s failure is that it makes people question the credibility, viability of the entire program and the competence of the people in charge.


    Anyone who turns on a device and surfs the web knows the stuff should work perfectly – the first time, every time.


    You also know that isn’t going to happen.


    Just don’t lie to us … it makes us mad.

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