Obama’s Broken Promise of Better Government Through Technology – Businessweek

The top part of the article is typical Klein (intent is all that mattered, not execution, which he only allows to one party), but his writing about government in general and government IT in particular is interesting:

The saga of healthcare.gov has been a symphony of government inefficiency. The effort, directly overseen by the IT department of the Centers for Medicare and Medicaid Services, involved no fewer than 55 contractors. The process was thick with lawyers and political interference. In violation of current best practices in the software world, the code was kept almost entirely secret; other engineers weren’t able to point out its flaws, and it wasn’t tested rigorously enough. The Obama administration has been assailed for not calling in Silicon Valley’s top minds to collaborate, but that misses the fundamental problem: The best coders in the Valley would’ve never agreed to work under such deadening, unpleasant conditions.

There are people in Washington who share Bracken’s views, but their struggle against bureaucratic inertia can seem Sisyphean. “Government becomes really afraid of failure, which is a bit ironic, as this ends up leading to failure,” says Clay Johnson, a technologist who was one of the White House’s presidential innovation fellows. “But that fear of failure leads them to only want to work with known quantities, and known quantities mean contractors who’ve done this work in the past. That puts them with a group of entrenched vendors who haven’t really had to compete in the world of technology.”

That fear of failure has been institutionalized in the way the federal government awards contracts. The complex, arcane process favors those companies that devote resources to mastering it and repels the Silicon Valley startups the government desperately needs. “I realized I could figure out how to develop these very complex, very new software programs, or I could figure out how to contract with the government,” says Trotter, who worked on health IT projects with the Veterans Administration. “And so I chose to do the thing that was innovative.”

via Obama’s Broken Promise of Better Government Through Technology – Businessweek.

The front end of the website will eventually get fixed, then the back end. Then we’re going to wait for the employer mandate to hit. All this market disruption was just the self-insured, a very small piece of the health insurance pie.

 

Peter Schiff Blasts “The Website Is Fixable, Obamacare Isn’t!” | Zero Hedge

Wait, wait, this was supposed to bend the cost curve Down…

It is also ironic that high-deductible, catastrophic plans are precisely what young people should be buying in the first place. They are inexpensive because they provide coverage for unlikely, but expensive, events. Routine care is best paid for out-of-pocket by value conscious consumers. But Obamacare outlaws these plans, in favor of what amounts to prepaid medical treatment that shifts the cost of services to taxpayers. In such a system, patients have no incentive to contain costs. Since the biggest factor driving health care costs higher in the first place has been the over use of insurance that results from government-provided tax incentives, and the lack of cost accountability that results from a third-party payer system, Obamacare will bend the cost curve even higher. The fact that Obamacare does nothing to rein in costs while providing an open-ended insurance subsidy may be good news for hospitals and insurance companies, but it’s bad news for taxpayers, on whom this increased burden will ultimately fall.

via Peter Schiff Blasts “The Website Is Fixable, Obamacare Isn’t!” | Zero Hedge.

Lack of skin in the game.

The Onion to the Rescue

Remember this? (From this blog):

Heroic State Attorneys General band together to force lawful commerce to stop, because they don’t like it.

July 13, 2013 by GruntDoc

So, 22 State Attorneys General sent a letter to Urban Outfitters demanding they stop selling gag merchandise described as their ‘Prescription line’, which includes the terrifically dangerous items of

glasses, coasters, mugs, drink holders and related products that mimic prescription pill bottles and prescription pads.

via Heroic State Attorneys General band together to force lawful commerce to stop, because they don’t like it..

Want to guess what I found at The Onion’s online store?

Yep.

The mug that causes death by prescription drug OD’s.

2013-10-23_19-52-37

I knew I liked The Onion.

Assessing the Exchanges | National Review Online

Read and weep. My comments in [brackets]:

…[interviews with medical insurance policy-type reps in Washington]

One key worry is based on the fact that what they’re facing is not a situation where it is impossible to buy coverage but one where it is possible but very difficult to buy coverage. That’s much worse from their point of view, because it means that only highly motivated consumers are getting coverage. People who are highly motivated to get coverage in a community-rated insurance system are very likely to be in bad health. The healthy young man who sees an ad for his state exchange during a baseball game and loads up the site to get coverage—the dream consumer so essential to the design of the exchange system—will not keep trying 25 times over a week if the site is not working [1]. The person with high health costs and no insurance will [2]. The exchange system is designed to enable that sick person to get coverage, of course, but it can only do that if the healthy person does too [3]. The insurers don’t yet have a clear overall sense of the risk profile of the people who are signing up, but the circumstantial evidence they have is very distressing to them [4]. The danger of a rapid adverse selection spiral is much more serious than they believed possible this summer [5]. They would love it if the administration could shut down the exchange system, at least the federal one, until the interface problems can be addressed. But they know this is impossible [6].

via Assessing the Exchanges | National Review Online.

A terrifically scary article (read it all ™), but this paragraph has so much implied information in it it jumped out as needing some amplification.

1: Why would he? He’s actuarially bulletproof, and has as much need of medical insurance as he does a 401k (unemployment joke), but seriously: this youngster is the basis for paying the ACA bills. If the young and healthy and unlikely to need medical insurance don’t sign up the ACA insurance house of cards collapses (see next):

2: Why wouldn’t they? This is the group the ACA is aimed at, those who can’t get insurance at all, or who have it (Cobra, etc), but for this group insurance is prohibitively expensive. Were I in their shoes I’d be hitting this site 18 hours a day and not quitting until I got insurance and a subsidy. Hint, this group is very to horrifically expensive, and require their costs to be spread far and wide for insurance to work.

3: To belabor the point, insurance companies don’t print money to pay bills, they transfer money from the payments of those paying for insurance who don’t wind up using it to the bills of those who do. Therefore not enough insured paying (but not using) the insurance company runs out of money, then the insured aren’t insured when the company goes broke. That’s ungood.

4: Insurance companies understand medical cost risk like no other group, and were this good news for them (non-distressing news) they’d be singing this to the heavens/news, as a way to sign up the [1] group. Then it’d be ‘cool!’, which would cascade into more young/well signups.

5: This is inexplicable. Insurance companies abhor risk, this was a completely foreseeable risk in an unknown situation, unless there were some significant assurances from On High that Nothing Can Go Wrong. Which they would be dumb to just swallow whole. This part of the mechanism of bargaining still bugs me, as I don’t have an explanation for why an entire, smart and profitable industry would buy into a scheme that could destroy it quickly and painlessly. Remember this, they walked into the ACA eyes wide open.

6. It’s hard to stop a process bought into under a combination of duress and greed, either objection draws credibility into question.

No secret, I’m totally against (and aghast at) the ACA. That said, it’s more than curious a nation that put men on the moon with slide rules cannot make an insurance marketplace with roughly a half a billion dollars and a three year head start.

Interesting times.

 

 

 

 

Why we should be very wary of using clot busting drugs in CVA

Why we should be very wary of using clot busting drugs in CVA.

A concise treatise on the problems with TPa. Well Done!

Facebook Like Now Covered by the First Amendment – Applications for Healthcare | Hospital EMR and EHR

This is at the end of an article talking about something else, but it deserves it own highlight:

My favorite thing is when healthcare organizations try and control and restrict social media. As many institutions have learned, that’s impossible to do. Instead, it’s much more effective to educate and inform people on their use of social media. The best reason you should educate and inform as opposed to control and restrict is the message it sends to your employees. The former sends a message of trust and respect while the later does the opposite.

via Facebook Like Now Covered by the First Amendment – Applications for Healthcare | Hospital EMR and EHR.

Well said.

U.S. pilot scares off Iranians with ‘Top Gun’-worthy stunt: ‘You really ought to go home’ – Washington Times

In what only can be described as a scene out of Tom Cruise’s “Top Gun,” Gen. Mark A. Welsh III, Air Force chief of staff, describes how F-22 stealth jets scared off Iranian jets from a U.S. drone flying in international airspace.

via U.S. pilot scares off Iranians with ‘Top Gun’-worthy stunt: ‘You really ought to go home’ – Washington Times.

Click through to see what happened. I’ll be the in-cockpit tape of that gets out someday…and it will be cool.

 

Two other thoughts: are we now riding shotgun on drones (aren’t the drones so we don’t have to endanger pilots), and/or, was this bait to see what Iranian air intercept does?

Your Government at Work, Army Corps of Engineers Division

Our Government is out of money. That’s given. Related but unrelated, our Government=Things we do together.

The Army Corps of Engineers recently decided that plowing Govt. Park access fees back into the parks through non-profits is verboten, because, get this, the money isn’t going into the US Treasury.

No thought to what makes the parks work. No thought to what the NonProfits (that’s Washington for sucker-bait) put into the parks, or what the Federal version of park running and maintenance will cost (that’ll be way way more than non-profits did it for). Or the park non-profit employees who are now out of a job.

This smacks of bureaucracy run amok, remote pencil pushers running roughshod over local policies that actually serve the constituents, i.e., normal people who like parks.

I’ll call my Congressperson tomorrow. Perhaps sense will prevail, but I have doubts.

Now, about that Government takeover of healthcare, still think that’s a terrific idea?

Best Police quip of the year:

Wait for it….

Owner isn’t blaming dog for accidental shooting, Police say

By Deanna Boyddboyd@star-telegram.com

FORT WORTH — Surprisingly, this canine isn’t in the doghouse.

A 78-year-old woman was shot in the foot late Saturday when her shotgun discharged after her dog accidentally knocked it over, police reported….

You have to click through to read the best Police quip of the year. [Read more...]

Defikopter drone air-drops a defibrillator to EMTs on the ground

The Defikopter is a UAV that can be activated by a smartphone app to automatically take to the skies and drop a defibrillator to medical personnel on the ground, shaving precious seconds from the time it takes to receive treatment for cardiac arrest.

The idea for the drone comes from Definetz, a non-profit group dedicated to preventing deaths due to heart failure.

via Defikopter drone air-drops a defibrillator to EMTs on the ground.

Interesting idea. Won’t work here in the Land o’ the Lawsuit.

The Untold Story of the Battle of Camp Bastion

One year ago this month, under cover of night, fifteen Taliban, dressed as American soldiers, snuck onto one of the largest air bases in Afghanistan. What followed was a bloody confrontation highlighting a startling security lapse, with hundreds of millions in matériel lost in a matter of hours—the worst day for American airpower since the Tet Offensive. Yet the attack faded from view before anyone could figure out what went wrong. For the first time, Matthieu Aikins relives those heart-pounding moments and offers an extraordinary account of the Battle of Bastion

via The Untold Story of the Battle of Bastion.

Amazingly well written story of close combat by air wing Marines.

Happy Birthday to our youngest

Enjoy your birthday, sweetie!

 
Moriah and Scott (120 of 803)

A Special ‘Thank You’ to the TSA | The Truth About Guns

Let the man explain.

No, seriously. Let me explain . . .

via A Special 'Thank You' to the TSA | The Truth About Guns.

Good on someone.
hope this doesn’t get someone in trouble.

Jeffrey Singer: The Man Who Was Treated for $17,000 Less – WSJ.com

Medical sticker-shock, and one mans’ remedy.

By JEFFREY A. SINGEREvery so often I have an extraordinary and surprising experience with a patient—the kind that makes us both say, "Wow, we’ve learned something from this." One such moment occurred recently.

via Jeffrey Singer: The Man Who Was Treated for $17,000 Less – WSJ.com.

What genius looks like

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