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Thread: It's time for national healthcare - Page 183







Post#4551 at 10-04-2013 11:25 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by Copperfield View Post
Oh and do you actually believe that a writer for the NY Times understands IT terminology better than someone with a degree in Computer Science? Like, for reals Wendy?
Instead of going with this Forum's faux IT 'genius,' let's instead hear from an actual IT expert involved with the heathcare.gov websites -

http://www.washingtonpost.com/blogs/...-so-difficult/

Heres why getting the Obamacare exchanges to work was so difficult

This week, the new health-care exchanges created by the Affordable Care Act, dubbed Obamacare, have come in for a lot of criticism. The sites cost millions in some cases hundreds of millions of dollars to create. And some of them weren't ready for the traffic they received on Oct. 1, the day Obamacare went into effect.

On Wednesday, I asked Robert Moss, an IT expert who has helped both states and insurance companies prepare for the launch of Obamacare, to take us behind the scenes. He explained to me why building the exchanges and keeping them running has proven so difficult. The transcript has been edited for clarity and length.


Timothy B. Lee: What kind of experience do you have with the implementation of Obamacare exchanges?

Robert Moss: I'm a software developer and software executive by background. Up to two years ago, I was vice president for products at a company called Benefit Focus. Even before Obamacare passed, we were watching and figuring out what to do. We backed away from it, decided not to go that route [e.g. bidding for work building an exchange]. In part because of the complexity of standing up large-volume Web sites.

Since then, I've been working for a firm called Optimity Advisors. In that context I've worked with both state governments as well as commercial insurance carriers to help them prepare. I've been behind the scenes. I've not led development, but I've helped them understand what to require and how to organize the project.
I've also worked with a lot of commercial insurance companies as they've tried to organize their operations to interact with the exchange. Once someone purchases their insurance, it has to get transmitted to the insurance companies. There's been a whole lot of work insurance companies have had to do.

Have you been surprised that many exchange sites have had problems in the first few days?

Everybody who's on the inside has really expected it to be pretty rocky at the start. It's a very large undertaking, and there are so many players involved. Such fixed deadlines. Everyone has expected it to be quite a challenge.
It's a "big bang" launch. On October 1, they're open for business. Their heaviest traffic, millions of hits, is going to come on the first couple of days after they're launched. When we've launched these types of systems in the past, we always direct [clients] to do a phased rollout strategy. Bring it out segment by segment or state by state. In the case of federal exchanges, it may not have been politically feasible. Had to open for business on a single day. Get this massive amount of traffic all in one day. That's a huge factor. The attempt to roll something out that fast, all at once, is bound to have these [problems].

But there are strategies for coping with a big initial burst of traffic, right?

There are many strategies for handling that kind of big burst of traffic, which is things that some of your larger companies, your Twitters, your Googles, your Amazons, these are things they do to be able to scale up, scale down their servers as needed to handle the traffic. I'm not exactly sure what's in place in terms of the federal government infrastructure if they have that kind of bursting capability or how they're able to add capacity dynamically. But certainly the behavior, this is exactly consistent with servers being overloaded.

So do you think these early hiccups are a sign of deeper problems with Obamacare's online infrastructure?

It remains to be seen obviously. If over the next few weeks, the exchanges can make adjustments to add the bandwidth they need, scale out, get the sites to work, this will all be forgotten at some point. [People will say] "it wasn't available the first couple of days, but eventually we got through." If traffic patterns follow what you expect, you should expect traffic falling off and capacity coming up. However, this is really just one piece of the story. There's many more steps to the whole process that could yet [cause problems].
What you're seeing right now is people going to Web sites and trying to select a plan. The next step is for data about the plans that shoppers pick to be submitted to insurance companies. I haven't heard back from contacts in the carriers if they've received orders yet. It's possible that will work, or there could be lots of errors in that data. Typically, there's a shaking-out period where there are problems or errors. They'll have to work on that.

Hopefully that will work well. If it doesn't, you'll see a lot of errors in the system. You buy a certain product from a certain insurance company, or you don't have it quite right. Any number of things that could go wrong. That would start showing up when people, around the beginning of the year, they go to the doctor or the pharmacy and find that there's no record of them having signed up.

And then there's the whole billing and payment aspect. That's a whole new wrinkle where if you go shopping, and you're eligible for a subsidy, you'll get an invoice in the mail from the insurance carrier. So there's the potential for things to go wrong with a field being incorrect. These are all just natural parts of the project where you're rolling out a large system and a complex system. You just have to go through those stages and shake out the bugs, shake out the kinks.

These Web sites cost a lot of money. [California's exchange, for example, reportedly cost $313 million to build.] Start-ups often build sophisticated Web sites for a tiny fraction of the cost. Why are these things so expensive?

There are lots of different reasons. Part of it is these are large IT projects being conducted by government agencies, by large contractors with large teams. There are a lot of layers of project management, of requirements, design, coding. It looks very different than your small start-up where you've got 10 people in the room working closely together and rapidly developing things.

Even though in this type of setting the development teams are using what you might call agile methods, there's still a huge layer of requirements and review and sign-off. There's lots of policy decisions that have to be made that shape ever step of the way. There's much more overhead involved in this sort of thing than if you're trying to have a small set of people developing the Web site.

The [bottom] layer is the Affordable Care Act, which laid out the parameters. Then on top of that are all the regulations that HHS issued over the course of two years. Then it goes to contractors who have to build it. If you look at the contract, there's usually a prime contractor and subcontractors. And I think that just adds to the complexity and adds to the number of parties involved. The state governments had to comply with CMS mandates and then work with their contractors. So it's a pretty complicated structure of trying to roll out. To design what you're trying to build and build it at a time where the regulations were being written.

If you're a commercial software start-up, you work very differently, you have an idea of what you want, develop quickly, roll it out, evolve on it, as opposed to trying to figure it all out in advance.

These sites handle a lot of sensitive data. Does that add to the complexity and cost?

These projects so big is that there is a very rigorous security oversight involved and layers of audit, layers of rules. The kind of thing that small start-up companies who are just winging it [don't deal with]. The Center for Medicare and Medicaid Services has been doing this for a long time in terms of the Medicare and Medicaid program. There's already a lot of rigor, security audits that have to be passed.

These exchanges also have to interact with a lot of government systems, right?

Yes, there's a thing called a federal data hub. The Internal Revenue Service is involved for tax reasons. The Department of Homeland Security is involved because of immigration status. The Social Security Administration is involved. Lots of agencies are involved to confirm eligibility for coverage and subsidies. Part of the challenge has been building a data hub to connect data from all of these agencies.
When you submit your application, they need to go out and validate whether the tax records show you're in the right income bracket for subsidies and all these other things. That's a massive amount of coordination, but there's a lot of complex system integration behind the scenes there.
So, once again, you can see it's the politics, specifically the t-bagger politics, that is at the root of preventing society from moving forward in as effective and efficient manner as it might. The exchanges could have been rolled out state-by-state on staggered timelines, but NOOOOOOOOOOOO!!!, that would have been a reason for the t-baggers to pile on. So, the good guys, suck it up and move on, and just get it done - eventually.

What's little notice is that we have moved from screams of death panels, and the Blackhawks swooping in for your freedom fries, to "OMG, people have to wait a few days to pre-order their insurance!" Ignored by most, but brings a sly smile to Progressives with Brains (TM pending).

The other thing is the naysayers that come out of the woods, Right or Far Left, eventually move on when proven wrong. Why, does anyone remember the Syria, Benghazi, IRS, etc. etc. 'fiascos'???

But before we move on and leave Obamacare to the good guys and the 10s of millions that they are, you know, actually helping, let me pose one more very important question -

Copperhead, do you want to throw our gold hordes into the bet?
Last edited by playwrite; 10-04-2013 at 11:33 AM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4552 at 10-04-2013 11:34 AM by Marx & Lennon [at '47 cohort still lost in Falwelland joined Sep 2001 #posts 16,709]
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Quote Originally Posted by JohnMc82 View Post
Doing so would still be much easier if we weren't constantly being led in the wrong directions.
Please, feel free to row as you please, and end-up where you end-up.
Marx: Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies.
Lennon: You either get tired fighting for peace, or you die.







Post#4553 at 10-04-2013 12:03 PM by JohnMc82 [at Back in Jax joined Jan 2011 #posts 1,962]
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Quote Originally Posted by playwrite View Post
Again, tell us, IT genius, how do you know those 4 million unique visitors were NOT "trying to see if they could get insurance through Obamacare"??? I mean most non-IT geniuses would assume most people going to an insurance exchange website would be looking to see about, you know, insurance. So what is it you know or did that would disabuse us of that assumption - did you hack into the site and run a secret program, and if you did, how did that program ascertain the purpose of each the site visitor - have you guys got a program now that reads minds - is the word "insurance" now some secret word for really weird porn that 4 million people are all into; if so, how do you know about it and I don't?
You just keep moving those goal posts!

First of all, healthcare.gov shot up to the #681st most-visited website in the U.S. this week, per alexa.com. It also doesn't work.

When a private sector website launch generates that kind of PR and first-day traffic - then doesn't work - it ends up as a joke while the investors trip over each other on the way to the exit (see Cuil).

But your assertion that every visitor (or even a majority of visitors) represents someone who is now getting healthcare they couldn't get before, is just... absurd. The site has been front page news on every major paper. It's circulating around Facebook. People are clicking through to read what it is about, but they're spending about five minutes on the site before getting back to other news of the day. People who had affordable insurance are trying to figure out why their rates are about to double.


I'll make some predictions right now about headlines five years from now, after the "successful implementation" of the ACA:

"Millions of Americans still uninsured"
"Despite insurance, healthcare remains unaffordable for many families"
"Congress approves emergency premium rate adjustment"
"Exchange 'working better than ever,' say administration IT experts"
"Healthcare stocks continue to outperform broader market"
Last edited by JohnMc82; 10-04-2013 at 12:36 PM.
Those words, "temperate and moderate", are words either of political cowardice, or of cunning, or seduction. A thing, moderately good, is not so good as it ought to be. Moderation in temper, is always a virtue; but moderation in principle, is a species of vice.

'82 - Once & always independent







Post#4554 at 10-04-2013 12:55 PM by Bad Dog [at joined Dec 2012 #posts 2,156]
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Post#4555 at 10-04-2013 04:32 PM by Justin '77 [at Meh. joined Sep 2001 #posts 12,182]
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Quote Originally Posted by playwrite View Post
So, you believe your worship of the Randian nightmare and the accompanying sucking-up to its more visible adherents is limited to only where the name is mentioned explicitly.
Huh? I can't tell here if you're just dodging via change-of-subject, or if you've had a stroke or something to damage your ability to follow coherent trains of thought. How about you back up a bit and actually ask a question?

Okay, then tell us of your own viewpoint of Ayn Rand and her 'philosophy' and Rand Paul's practice of those tenets.
I grew out of Ayn Rand sometime around my fifteenth birthday or so. I wonder, to be honest, whether you have the slightest clue what she wrote. As a point: her philosophy doesn't look very kindly on anarchists (one of the more visible manifestations of the internal discordance that broke its sophomoric appeal to me).

I want to see how far you are willing to go to hold onto the defensive mechanism of lashing out at me for presenting the facts that destroy your world view. I got Rani in writing to reveal she's a faux nihilist, using it only when convenient; let's see if we can reveal the inner Justin as well.
What's to reveal? I've been pretty upfront from the start here. You could go back to the lengthy judo sessions that Brian Rush and I engaged in back in the '02-'05 timeframe to get at least a decent basic grounding in "Justin's worldview". Although, to be fair, you'd have to at least include a lot of what I wrote in the '07-'10 timeframe as well, since a fairly important part of my intellectual development happened during the time that I actually started to live outside the box, instead of just hypothesizing about what it might be like out there.

Or, alternately, you could continue down the liar's road of inventing your own cartoons and beating them senseless. I think we both know which better fits your inclinations.
"Qu'est-ce que c'est que cela, la loi ? On peut donc tre dehors. Je ne comprends pas. Quant moi, suis-je dans la loi ? suis-je hors la loi ? Je n'en sais rien. Mourir de faim, est-ce tre dans la loi ?" -- Tellmarch

"Человек не может снять с себя ответственности за свои поступки." - L. Tolstoy

"[it]
is no doubt obvious, the cult of the experts is both self-serving, for those who propound it, and fraudulent." - Noam Chomsky







Post#4556 at 10-04-2013 05:28 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by JohnMc82 View Post
You just keep moving those goal posts!

First of all, healthcare.gov shot up to the #681st most-visited website in the U.S. this week, per alexa.com. It also doesn't work.
The only goal post being moved is in your own head.

The same challenge to you - tell us of a comparable website being inundated with 4+ million unique visitors (or whatever measure you want to pull out of Copperhead's ass) within its first 24 hours.

psss, it's the same goalpost -

Quote Originally Posted by playwrite View Post
Give us one example of a first-time website that requires form application that faced anything like this onslaught on opening day.

[cue the crickets]
Those crickets are sure coming in handy.

Quote Originally Posted by JohnMc82 View Post
But your assertion that every visitor (or even a majority of visitors) represents someone who is now getting healthcare they couldn't get before, is just... absurd.
Show us exactly where I said that, moron.

Let's cut to the chase. I believe the healthcare.com websites are in the mist of signing up millions of people. There's no reason why they have to sign up yesterday, today or tomorrow, but they are in the process and the number of "unique visitors" is a sign of that interest to do so.

In that regard, I'll give you the same opportunity to put-up-or-shut-up that I gave the IT genius moron -

By this time next year, if 4 million have gotten insurance through the obamacare.gov websites, you will apologize to me on this forum and then leave this forum for at least a year. If on the other hand, if they don't, then I will apologize to you and leave the forum for at least a year.

If you want to up the ante, I'm okay with that as well.

Now lets see if you're as slimy as Copperhead and Justin in wiggling out of your bullshit.

[Hey, mom, do you have any more crickets; we're getting a run on 'em here!]
Last edited by playwrite; 10-04-2013 at 05:38 PM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4557 at 10-04-2013 05:36 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by Justin '77 View Post
Huh? I can't tell here if you're just dodging via change-of-subject, or if you've had a stroke or something to damage your ability to follow coherent trains of thought. How about you back up a bit and actually ask a question?

I grew out of Ayn Rand sometime around my fifteenth birthday or so. I wonder, to be honest, whether you have the slightest clue what she wrote. As a point: her philosophy doesn't look very kindly on anarchists (one of the more visible manifestations of the internal discordance that broke its sophomoric appeal to me).


What's to reveal? I've been pretty upfront from the start here. You could go back to the lengthy judo sessions that Brian Rush and I engaged in back in the '02-'05 timeframe to get at least a decent basic grounding in "Justin's worldview". Although, to be fair, you'd have to at least include a lot of what I wrote in the '07-'10 timeframe as well, since a fairly important part of my intellectual development happened during the time that I actually started to live outside the box, instead of just hypothesizing about what it might be like out there.

Or, alternately, you could continue down the liar's road of inventing your own cartoons and beating them senseless. I think we both know which better fits your inclinations.
Oh, I see, being a Randian nightmare is only at your convenience; and what you now really are is an anachist.

Please enlighten us and tell us the three primary points that make you different than the Randians; you know, for the archives.
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I can almost feel the wiggling in the ether.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4558 at 10-04-2013 07:13 PM by Copperfield [at joined Feb 2010 #posts 2,244]
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Quote Originally Posted by playwrite View Post
Instead of going with this Forum's faux IT 'genius,' let's instead hear from an actual IT expert involved with the heathcare.gov websites -

http://www.washingtonpost.com/blogs/...-so-difficult/
Um, you do realize that nothing in the quoted article contradicts anything I have said right?

I guess maybe you don't.

My work laptop is sitting right behind me right now running a query on a database that positively dwarfs the government database running underneath Healthcare.gov* in size, complexity, and daily activity and it runs like a champ. That's the difference between IT in government and IT in the private sector though. Here in the private sector, our shit has to work or we lose business.

Once again (I can't say it enough) I already know you don't understand the differences between terms like hits, unique visitors, pages, forms, databases, queries, bandwidth, traffic, severs, clients, cookies, IP addresses, logs, ISP's, PHP, HTTP, HTTPS, XML or how all of these things interface with each other and with the user... You are dumb as shit. I know, I know. Really, you are wasting so much energy trying to prove to me what I already know. But hey, it's your bits n' bytes.

*Before you ask how I know that, you should try to understand that for people who have an understanding how forms on a website interface with a database behind the scenes this is actually pretty easy to figure out.
Last edited by Copperfield; 10-04-2013 at 08:11 PM.







Post#4559 at 10-04-2013 07:16 PM by Copperfield [at joined Feb 2010 #posts 2,244]
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Quote Originally Posted by Marx & Lennon View Post
Maybe, but you'll still have to row.
That depends entirely on where the crew chooses to mutiny.







Post#4560 at 10-04-2013 07:46 PM by Copperfield [at joined Feb 2010 #posts 2,244]
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Quote Originally Posted by playwrite View Post
This is your basic point. Somehow you know that 4 million plus have gone to the web site for something other than the obvious "trying to see if they could get insurance through Obamacare."
4 million? You said it was 10 million 3 days ago:

Quote Originally Posted by playwrite View Post
So you really think finding some people out of 10 million hits; 2.something million people that signed on, just yesterday, proves it wasn't about traffic???
Indeed the entire point is that claiming to know any of the specific motivations of users by using an inaccurate estimation tool that consists of a single data point is dishonest. This is why I asked you to post the statistics for people who actually purchased insurance through the exchanges. Those numbers at least would show that an individual had an interest (though not the motivation for that interest) in purchasing. It is certainly a more accurate a number than "hits." Again we still can't ascribe a specific motivation to a given action as some (potentially many) individuals who purchase will do so out of fear of government reprisals. Buy this or else is entirely different from I want to buy this.

So how about those actual sign up statistics? I know you have them (they have been out in the media). We both know what they are.
Last edited by Copperfield; 10-04-2013 at 08:09 PM.







Post#4561 at 10-04-2013 07:55 PM by Copperfield [at joined Feb 2010 #posts 2,244]
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Quote Originally Posted by playwrite View Post
Again, tell us, IT genius, how do you know those 4 million unique visitors were NOT "trying to see if they could get insurance through Obamacare"??? I mean most non-IT geniuses would assume most people going to an insurance exchange website would be looking to see about, you know, insurance. So what is it you know or did that would disabuse us of that assumption - did you hack into the site and run a secret program, and if you did, how did that program ascertain the purpose of each the site visitor - have you guys got a program now that reads minds - is the word "insurance" now some secret word for really weird porn that 4 million people are all into; if so, how do you know about it and I don't?
I know some visitors to the web site never had any intention of buying insurance which is precisely what I said. As for proof, John was nice enough to link to some statistical metrics. You should probably read those (some of those metrics suggest the same thing). Of course you could simply just post the number of people who have purchased insurance through the exchanges and we can compare them to those unique visitor numbers to see if they match up.







Post#4562 at 10-05-2013 09:03 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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wiggle patrol

Quote Originally Posted by Copperfield View Post
Um, you do realize that nothing in the quoted article contradicts anything I have said right?

I guess maybe you don't.

My work laptop is sitting right behind me right now running a query on a database that positively dwarfs the government database running underneath Healthcare.gov* in size, complexity, and daily activity and it runs like a champ. That's the difference between IT in government and IT in the private sector though. Here in the private sector, our shit has to work or we lose business.

Once again (I can't say it enough) I already know you don't understand the differences between terms like hits, unique visitors, pages, forms, databases, queries, bandwidth, traffic, severs, clients, cookies, IP addresses, logs, ISP's, PHP, HTTP, HTTPS, XML or how all of these things interface with each other and with the user... You are dumb as shit. I know, I know. Really, you are wasting so much energy trying to prove to me what I already know. But hey, it's your bits n' bytes.

*Before you ask how I know that, you should try to understand that for people who have an understanding how forms on a website interface with a database behind the scenes this is actually pretty easy to figure out.
Dude, here again is what you said I lied about -

The other major story was that the government's servers were crashing because so many people were trying to see if they could get insurance through Obamacare.
And again, this is a quote from the Washington Post and again, how does "trying to see" equate to every visitor "applying for"

Here's the underlying problem you have -

Someone like Justin, who lives in various fantasy worlds where he scores lots of "hit points" and believes he's very powerful, takes that belief into the real world and can't understand why things don't work out for him.

That, however, is exceeded by the IT guys (bought and sold for a dime a dozen around the world) who make the rules in Justin's fantasy worlds and come to believe they are all omnipotent in the real world - can you see how that might lead you to believe you can read the minds of 4+ million people accessing a website? If you can, there might be some hope for you; if not, I suggest you stay down in your mom's basement for a few more years.
Last edited by playwrite; 10-05-2013 at 09:32 AM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4563 at 10-05-2013 09:28 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by Copperfield View Post
4 million? You said it was 10 million 3 days ago:
One was "hits;" the other was "unique visitors." For someone who brought up what should be the unit of measure, you sure seem to be distracted and inconsistent - not exactly the traits one goes looking for in a good IT guy.


Quote Originally Posted by Copperfield View Post
Indeed the entire point is that claiming to know any of the specific motivations of users by using an inaccurate estimation tool that consists of a single data point is dishonest. This is why I asked you to post the statistics for people who actually purchased insurance through the exchanges. Those numbers at least would show that an individual had an interest (though not the motivation for that interest) in purchasing. It is certainly a more accurate a number than "hits." Again we still can't ascribe a specific motivation to a given action as some (potentially many) individuals who purchase will do so out of fear of government reprisals. Buy this or else is entirely different from I want to buy this.

So how about those actual sign up statistics? I know you have them (they have been out in the media). We both know what they are.
You see, this is one example of how a guy dealing with computer programs all day can both begin to feel omnipotent and be actually completely clueless in dealing with the real world - the real world consist of real people that are more than just the latest data base.

Why would someone rush to actually buy their insurance three months ahead of it actually kicking in? I realize you can write a program that assumes that they will and then run a little computer model with all sorts of impressive bells and whistles and then shower the world with the results on Internet websites, blogs, forums, chatrooms, Facebook, e-mails using Google, Hotmail, etc. and Tweet with # so it can go viral, etc, etc and feel really really omnipotent - all that, however, doesn't make your basic assumption true.

Now a human being who puts off actually buying his insurance for a month or so might still go onto the website for the purpose of "trying to see if they could get insurance through Obamacare."

I sense a lot of Justin-like wiggling here of trying to get out from under the bet (at least Justin apparently tried but found himself in the emergency room with a self-imposed gun shot to his leg; poor Glick actually shot himself in the head and apparently is still in a coma )

Tell you what, let's make this more simple and give you better terms. The issue before us is, whether website glitches or overenthusiastic hordes, you believe that there's really not much interest out there for getting insurance through Obamacare. So let's make it simple: how many people do just that in the next year. AND, just for you, lets double the number of people from 4 million to 8 million - we don't reach 8 million, I apologize and I'm out of here; but if we do, we say goodbye to you with, of course, a bittersweet sense of losing another fish in the barrel
Last edited by playwrite; 10-05-2013 at 09:35 AM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4564 at 10-05-2013 10:03 AM by JohnMc82 [at Back in Jax joined Jan 2011 #posts 1,962]
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Quote Originally Posted by playwrite View Post
Why would someone rush to actually buy their insurance three months ahead of it actually kicking in?
Uh what? Self-employed people and anyone purchasing individual coverage just found out that everything they've planned for has been flipped upside down. We're trying to get information from someone, but the exchange website STILL isn't working* and insurers are so swamped with calls that you have to wait half an hour to talk to someone who also doesn't know what's going on.

This is a major budgetary decision that is going to have huge implications for my household, whether we get sick or not. Trying to get the first sliver of information, three months before a final decision has to be made, feels more like procrastination than being in a rush.

*I've spent a good hour a day at that website, putting me well above the average time on site for most visitors. I've managed to get so far as creating an account, but when I try to log in, I'm just sent to a blank page or an Oracle DB error page. The whole experience has been pathetic, and for sharing in that, I get the pleasure of spending twice as much on health insurance so my insurer can increase their middle-man margins.
Those words, "temperate and moderate", are words either of political cowardice, or of cunning, or seduction. A thing, moderately good, is not so good as it ought to be. Moderation in temper, is always a virtue; but moderation in principle, is a species of vice.

'82 - Once & always independent







Post#4565 at 10-05-2013 11:40 AM by Justin '77 [at Meh. joined Sep 2001 #posts 12,182]
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Quote Originally Posted by playwrite View Post
Oh, I see, being a Randian nightmare is only at your convenience; and what you now really are is an anachist.
If your "now" extends back to before you started posting here (playwrite join date: july 2005), then sure, I've been an anarchist for all that "now" (and then some; I haven't tried to date it, but a good marker is probably between the last time I participated in the National Sacrament back in '96 and the first time I rejected it in '98). I only hold to belief systems until I recognize them as flawed or damaging -- which, for Rand's objectivism came for me in the mid-90s. Clearly, that's not the way you do things, but adults change their minds when the world shows their old views to have been flawed.

Please enlighten us and tell us the three primary points that make you different than the Randians
Irrelevant, but it sounds entertaining. Gimme a sec....

Three fundamental points of objectivism which I see as flawed or damaging:

  • Objectivism holds a monopoly on the rightful initiation of force to be necessary and proper
  • Objectivism sees property as existing without-and-superior-to a context for enforcing exclusion
  • Objectivism holds that Person not only can exist independent of their being a social context, but that it necessarily does



Since I assume all the Rand you know comes from the lines your betters pass down to you for parroting, the above in all likelihood confuses you. Rest assured, nonetheless, those three above are fundamental Randian principles, and that the evolution of such a radical difference as I have with even a single one of them should more than suffice for a mature adult who had previously held to it to reject that philosophy.
Last edited by Justin '77; 10-05-2013 at 11:45 AM.
"Qu'est-ce que c'est que cela, la loi ? On peut donc tre dehors. Je ne comprends pas. Quant moi, suis-je dans la loi ? suis-je hors la loi ? Je n'en sais rien. Mourir de faim, est-ce tre dans la loi ?" -- Tellmarch

"Человек не может снять с себя ответственности за свои поступки." - L. Tolstoy

"[it]
is no doubt obvious, the cult of the experts is both self-serving, for those who propound it, and fraudulent." - Noam Chomsky







Post#4566 at 10-06-2013 11:53 AM by JohnMc82 [at Back in Jax joined Jan 2011 #posts 1,962]
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Good news everybody!

After spending way too much time on the healthcare exchange site, I managed to debug one of their major functionality issues. In 4-6 weeks, this information should find its way up and back down the chain of red tape, and find it's way in to some obscure training manual!

Anyway, it turns out there's exactly one insurer on the NC exchange. The entire website is a fucking squeeze page for Blue Cross, funded by tax dollars.

Furious is an understatement.
Those words, "temperate and moderate", are words either of political cowardice, or of cunning, or seduction. A thing, moderately good, is not so good as it ought to be. Moderation in temper, is always a virtue; but moderation in principle, is a species of vice.

'82 - Once & always independent







Post#4567 at 10-06-2013 09:07 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by JohnMc82 View Post
Uh what? Self-employed people and anyone purchasing individual coverage just found out that everything they've planned for has been flipped upside down. We're trying to get information from someone, but the exchange website STILL isn't working* and insurers are so swamped with calls that you have to wait half an hour to talk to someone who also doesn't know what's going on.

This is a major budgetary decision that is going to have huge implications for my household, whether we get sick or not. Trying to get the first sliver of information, three months before a final decision has to be made, feels more like procrastination than being in a rush.

*I've spent a good hour a day at that website, putting me well above the average time on site for most visitors. I've managed to get so far as creating an account, but when I try to log in, I'm just sent to a blank page or an Oracle DB error page. The whole experience has been pathetic, and for sharing in that, I get the pleasure of spending twice as much on health insurance so my insurer can increase their middle-man margins.
Sorry, dude, I'm not going to measure the success of Obamacare against yours or anyone else living in North Carolina, a state that has decided in one election to return to the Gilded Age - you all are F'd not just by health insurance but every which way come sun down.

Elections have consequences at the state as well as the national level. Good luck.

For others living in other states, particularly Blue states, its a lot easier. It's a trend that's only going to get more so until Red state voters grow some brains. Sorry, that apparently leaves NC out of the picture; just hope you all get it worked out before what are consider some of the best state universities in the country become a joke.
Last edited by playwrite; 10-06-2013 at 09:11 PM.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4568 at 10-06-2013 09:22 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by The Rani View Post
While we're talking about lies:

Here's the post in question, unedited:

Anyone who would interpret this comment as any sort of "revelation" is either a liar or delusional.
Now I guess I'll be challenged to bet a lump of coal against his pot of gold, or some such nonsense.
I wonder what percentage of playdude's trust fund is invested in the healthcare industry?
That didn't take long. I thought you were going to ignore me.

Ah, it's a little bit more exact than you're letting on. What we have established is that you have a firm belief that the US Congress is the final determinant of the people's will -

http://www.fourthturning.com/forum/s...440#post481440

- that does put you at odds with many of your previously-stated positions on many a matter that could only come from a nihilist. I'm just here to note when you turn to that convenience once again. Without it, you should have many more conflicting viewpoints with our resident "anarchist" (assuming he is not being convenient as well) that you should be having with me.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4569 at 10-06-2013 09:47 PM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by Justin '77 View Post
Three fundamental points of objectivism which I see as flawed or damaging:

  • Objectivism holds a monopoly on the rightful initiation of force to be necessary and proper
  • Objectivism sees property as existing without-and-superior-to a context for enforcing exclusion
  • Objectivism holds that Person not only can exist independent of their being a social context, but that it necessarily does
Well, not exactly the most elegant presentation, but it will suffice.

Let's see if we can make this more about you. Since these are flaws in your eyes, we can then assume that you -

- don't believe govt should have the monopoly on sanctioned violence;
- property does not exist except as a result of govt's monopoly on sanctioned violence, and
- "personhood" IS a social construct.

That's what your English tells the reader (although the last statement seems to be internally inconsistent), but I do want to make sure that's what you would want someone to derive from what you presented.

From there, we can move on to what I believe will be very entertaining... for one of us. And I think we can do it within the context of this thread - i.e., national healthcare.

I await your confirmation or clarification.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4570 at 10-07-2013 12:25 AM by JohnMc82 [at Back in Jax joined Jan 2011 #posts 1,962]
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Quote Originally Posted by The Rani View Post
Are the rates the same, higher, lower?
Exact same thing my current insurer offered, since they're the only one on the exchange: less coverage than my old catastrophic plan, 115% premium increase because they can call it bronze now. Their state website is also posting a bunch of updates about all the various hospitals that won't be covered in their plans.

Starting to feel pretty sick.... wish I could afford to see a doctor about the sudden overwhelming nausea I feel when I think of how badly D.C. sold us out before taking their little vacation.
Those words, "temperate and moderate", are words either of political cowardice, or of cunning, or seduction. A thing, moderately good, is not so good as it ought to be. Moderation in temper, is always a virtue; but moderation in principle, is a species of vice.

'82 - Once & always independent







Post#4571 at 10-07-2013 08:36 AM by Justin '77 [at Meh. joined Sep 2001 #posts 12,182]
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Quote Originally Posted by playwrite View Post
Well, not exactly the most elegant presentation, but it will suffice.

Let's see if we can make this more about you. Since these are flaws in your eyes, we can then assume that you -

- don't believe govt should have the monopoly on sanctioned violence;
- property does not exist except as a result of govt's monopoly on sanctioned violence, and
- "personhood" IS a social construct.
Congratulations on displaying an adequate high-school level of reading comprehension. I'm going to call that real progress!

I'd quibble with your restatement of the second point. The three fundamental points of disagreement I identified are not (necessarily) mutually-dependent, nor are any of them particularly consequential from any other. So your introduction of point 1 into point 2 is mistaken. I would better state my own contra-Rand view regarding that second point as something along the lines, "property is a function of a context for enforcing exclusion". That context need not be government, and need not be monopoly -- it goes all the way down to "this stick is mine because it's in my closed (that is, not immediately accessible to anybody else) hand". We've got a lot of other, more nuanced modes of exclusion, but the principle remains that property -- contra Rand -- is not and cannot be an a priori.

Similarly, your restatement of the third introduced two term that seems to add nothing of value over the one I had used, while at the same time subtly shifting the context (or so it seems to me) in a way that may cause us problems down the line. Strike your word "personhood" and use the one I did -- "Person". Then further on you make what appears to be a small shift, but which actually changes the idea drastically. That is, you turn "social context" into "social construct". The first is true, the second is not. To be correct, you would state the third point as something along the lines of: "Person only exists in a social context". I've analogized before that people are social creatures in the same way that fish are aquatic creatures.

From there, we can move on to what I believe will be very entertaining... for one of us. And I think we can do it within the context of this thread - i.e., national healthcare.
I strongly suspect otherwise, but I'm more than willing to play along on the off chance that you actually have a coherent point this time. Bearing in mind, of course, the context of the current discussion -- you falsely claimed me among a number of "Randians" (along with the ludicrous assertion that I was somehow responsible for a particular parasite coming to wield political power!); I disputed that claim; you asked for three points of fundamental difference between my worldview and the Randian one; I provided, arbitrarily ordered, the first three that came to mind.
Last edited by Justin '77; 10-07-2013 at 08:39 AM.
"Qu'est-ce que c'est que cela, la loi ? On peut donc tre dehors. Je ne comprends pas. Quant moi, suis-je dans la loi ? suis-je hors la loi ? Je n'en sais rien. Mourir de faim, est-ce tre dans la loi ?" -- Tellmarch

"Человек не может снять с себя ответственности за свои поступки." - L. Tolstoy

"[it]
is no doubt obvious, the cult of the experts is both self-serving, for those who propound it, and fraudulent." - Noam Chomsky







Post#4572 at 10-07-2013 10:39 AM by JohnMc82 [at Back in Jax joined Jan 2011 #posts 1,962]
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Quote Originally Posted by The Rani View Post
I share your nausea.
And wow, less coverage than a catastrophic plan ... do you mean a lower maximum benefit?
Nope, neither had a maximum benefit cap. It seems like generically speaking, catastrophic insurance was used to refer to any plan with a relatively high deductible/OOP combination. Now it specifically refers to a plan where the deductible/OOP combination is greater than $6350 - and they can only be sold to people under 30 who can't afford something better.

They both also covered annual checkups and other preventative services, and they both allow for a very limited number of primary care visits.

This thread goes fast so I'll copy the exact changes from what I had, to what I'm being offered (via legally-mandated monopoly):


  • The $10 prescription copay is replaced by a $25-100 copay.
  • Primary care visits are $45 instead of $25, and they're still limited to four.
  • Specialist visits used to be a 40% copay, and now they're just part of the deductible.
  • Speaking of the deductible, it's up to $5,000 from $3,500.
  • I'm not even sure if they're going to count the deductible toward the OOP max in 2014, there's a loophole in the law that might let them out of it. Anyway, the OOP is going to $6,350 from $4,000


So in the old plan, basic stuff was really cheap unless I was using it all the time, and really bad stuff was out of my pocket until $7500 was spent - at which time it became completely covered. In the new plan, basic stuff is more expensive, and bad stuff is completely out of pocket until $5000 is spent. Then I split the next $3000 with the insurer until I've paid a total of $6350. The increase in the premium is significantly more than the $1150 saved in such a worst-case scenario.

This seems to pretty much destroy the argument that prices are going up because the ACA is forcing providers to offer better plans.
Last edited by JohnMc82; 10-07-2013 at 10:56 AM.
Those words, "temperate and moderate", are words either of political cowardice, or of cunning, or seduction. A thing, moderately good, is not so good as it ought to be. Moderation in temper, is always a virtue; but moderation in principle, is a species of vice.

'82 - Once & always independent







Post#4573 at 10-07-2013 10:57 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by The Rani View Post
Nope, another lie.
In the case of Syria, it worked. In other cases, it doesn't work so well.
Yet another example of how you twist people's words to suit your own warped agenda.
Ah, so you are a nihilist, other than when Syria is the topic.

Now just how did I get wrong that nihilism is a convenience for you???

Too funny.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4574 at 10-07-2013 11:13 AM by playwrite [at NYC joined Jul 2005 #posts 10,443]
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Quote Originally Posted by JohnMc82 View Post
Exact same thing my current insurer offered, since they're the only one on the exchange: less coverage than my old catastrophic plan, 115% premium increase because they can call it bronze now. Their state website is also posting a bunch of updates about all the various hospitals that won't be covered in their plans.

Starting to feel pretty sick.... wish I could afford to see a doctor about the sudden overwhelming nausea I feel when I think of how badly D.C. sold us out before taking their little vacation.
If you don't want to hang around for the next NC state election or you believe that it will not result in the ousting of the t-baggin troglodytes you put into office in the last election, maybe you should consider moving?

You just need to go a few miles north into Virginia. The ways thing look, VA's executive branch is going Blue and MAY remove enough t-baggin troglodytes from their state legislature to get full Obamacare implemented. Even with VA's election next month, it will take a year for them to recover from their own lunacy - admittedly nothing compared to the t-baggin shithole that NC placed itself in, but still will take VA a little time to recovery. If you can't wait to get to an area of sanity, I suggest a move further north into Maryland or such.

You would likely just be an early adopter of the trend that is coming - Red state depopulation.

Or you can just sit there on your keyboard and be miserable with the Rani - she does like to share. Obviously that's not actually going to help you with your healthcare and financial problems, but misery sharing can make one feel better - next step is choosing between alcohol or drugs, maybe both. Although in your case, you may already so delusional (e.g. blaming DC for the NC t-baggin shithole you all made for yourselves) that getting wasting is not really necessary- obviously your brain is already fried.
"The Devil enters the prompter's box and the play is ready to start" - R. Service

Its not tax money. The banks have accounts with the Fed so, to lend to a bank, we simply use the computer to mark up the size of the account that they have with the Fed. Its much more akin to printing money. - B.Bernanke


"Keep your filthy hands off my guns while I decide what you can & can't do with your uterus" - Sarah Silverman

If you meet a magic pony on the road, kill it. - Playwrite







Post#4575 at 10-07-2013 11:22 AM by JohnMc82 [at Back in Jax joined Jan 2011 #posts 1,962]
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Quote Originally Posted by The Rani View Post
Prices are going up "because they can."
Congress basically said: "Here's the lowest form of coverage you can offer, and here's how much of a person's income they can afford to pay in premiums. Now everyone, sign up or pay up anyway!"

Of course, the country is so polarized that the actual laws don't need to reflect the public discourse. It's so effective that the GOP has shut down the government because everything every insurer had ever lobbied for suddenly seems like not enough compared to how much they can get away with against this passive population.
Last edited by JohnMc82; 10-07-2013 at 11:24 AM.
Those words, "temperate and moderate", are words either of political cowardice, or of cunning, or seduction. A thing, moderately good, is not so good as it ought to be. Moderation in temper, is always a virtue; but moderation in principle, is a species of vice.

'82 - Once & always independent
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