Tag Archives: obamacare

Problems with ObamaCare

Quite apart from the wisdom of interfering with great swaths of the economy to create new entitlements, there is the practical matter of making it work. And that’s proving to be a problem for people working on the Obamacare web site at HealthCare.gov:

The better way to do things is a school of software development called Agile — it’s been around since the 1950s, was basically codified in the early 2000s, now has a whole non-profit devoted to it, and is the dominant form of software design in teams. Rather than moving from one static stage to the next, it emphasizes constant iteration and testing, with prototypes building on prototypes so the endpoint is something that works. The only problem, from a government perspective, is that you need to be comfortable with not knowing exactly that they will look like.

Yes. Just because a type of software development got us to the moon (back when 1K of RAM was a lot) doesn’t mean it’s the right approach to use in the 1990s. Or especially the 2010’s.

That’s one lesson from software development. Here are some others:

1) avoid building centralized systems. The mainframe has given way to minicomputers and PCs then a client-server world and now a web of devices, browsers, and various types of service providers. Web 2.0, baby.

Where does a centralized “Five Year Plan” approach to governing fit in a world of decentralized independent actors?

2) have the right type of abstraction. A spinning metal disk has nothing in common with a USB stick nor with an internet connection, but I can save a file on any one of them with the same program. That’s because there is an abstraction called a file system, and my word processor doesn’t really care what the hardware looks like: it can be silicon, magnetic disks, or something in the cloud. Software drivers for each type of hardware present a common interface that makes them all look the same to the word processor.

A centralized approach to governing doesn’t permit there to be appropriate abstractions. A mix of federal, state, and local governments, with large and small commercial and nonprofit organizations, allows you to have abstraction. Each one does what it needs to do and only that.

Last Frontier for Obamacare Exchange

A week ago I asked prospective Democrat candidate for governor Hollis French if he, as governor, would enter Alaska in the new Medicaid program. He replied, “Absolutely, yes.” (The argument he made is depressingly common among the people here: you spend $28M and the Federal government gives you a $1000M bridge to nowhere.) So Hollis French won’t be getting my vote next year.

In other Obamacare news, since Alaska doesn’t have its own exchange for nobody to enroll in, they’ve all not enrolled in the Federal exchange:

Enroll Alaska chief operating officer Tyann Boling confirmed that no one has enrolled as of late last week.

“Now things are looking a little bit better this week,” she said. “It’s not for sure we’ve enrolled anybody yet, but things seems to be functioning a little bit better, but as of last week, we had not known of one person that had enrolled in the state of Alaska.”

Obamacare – the real problem

The original Affordable Care Act was only 2700 pages. So far, the various executive agencies have published 20,000 more pages of regulation to implement the act. So far. Senate Minority leader Mitch McConnell’s office tweeted a picture that illustrates how the ACA is like an iceberg.

The part above water, is the law itself, and the regulations are the part underwater. Only the tip was voted on by our elected representatives in Washington.