Thursday, September 26, 2013

ObamaCare: just leave it alone, it will die all by itself.  So says Daniel Henninger, writing in today's Wall Street Journal.  He wants Republicans to just leave ObamaCare alone, while pushing the alternatives that will be needed after ObamaCare inevitably implodes.  Key passage:
Medicaid is the worst medicine in the United States. It grinds on. Doctors in droves are withdrawing from Medicare. No matter. It all lives on.

An established political idea is like a vampire. Facts, opinions, votes, garlic: Nothing can make it die.

But there is one thing that can kill an established political idea. It will die if the public that embraced it abandons it.

Six months ago, that didn't seem likely. Now it does.

The public's dislike of ObamaCare isn't growing with every new poll for reasons of philosophical attachment to notions of liberty and choice. Fear of ObamaCare is growing because a cascade of news suggests that ObamaCare is an impending catastrophe.

Big labor unions and smaller franchise restaurant owners want out. UPS dropped coverage for employed spouses. Corporations such as Walgreens and IBM are transferring employees or retirees into private insurance exchanges. Because of ObamaCare, the Cleveland Clinic has announced early retirements for staff and possible layoffs. The federal government this week made public its estimate of premium costs for the federal health-care exchanges. It is a morass, revealing the law's underappreciated operational complexity.

But ObamaCare's Achilles' heel is technology. The software glitches are going to drive people insane.

Creating really large software for institutions is hard. Creating big software that can communicate across unrelated institutions is unimaginably hard. ObamaCare's software has to communicate—accurately—across a mind-boggling array of institutions: HHS, the IRS, Medicare, the state-run exchanges, and a whole galaxy of private insurers' and employers' software systems. 
My emphasis above.  My most recent employment experience was developing exactly the type of large-scale software system Henninger is talking about.  In my case, the system reconciled the needs of several hundred major corporations, all with different internal systems and processes – very much like the ObamaCare situation.  I can attest to the complexity and difficulty of getting such systems to work at all, much less to work accurately.

Until the last few days, I hadn't thought much about the IT aspects of ObamaCare – even though I have quite a bit of personal experience with the slow-motion disasters that poorly implemented IT projects can produce.  Yesterday I read Megan McArdle's excellent piece on Bloomberg, and that started me thinking along exactly those lines that Henninger is.  Her point about the crazy-short time frame for the project is particularly well-taken.  My own experience with government “requirements creep” (software engineer lingo for constant incremental changes to the definition of what they're supposed to build – the direct cause of failure for many a project) backs up Megan's assertion that this should have been a 5 to 8 year project, not a 10 month project.

I'm feeling more hopeful about ObamaCare's demise this morning than I have in months.  I think McArdle and Henninger are onto something with the IT issue, and that Henninger is quite likely right that leaving the Democrats to own ObamaCare alone will just end up making them fiddle it to death.  The opposition – which Henninger assumes is Republican, and I'd like to see more Tea Party or libertarian – needs to have a strategy in place to clean up after that ObamaCare debacle.  They need to present an attractive alternative to an electorate thoroughly pissed off by ObamaCare and its spectacular IT failure.

Now if we could just keep the politicians meddling with the requirements (that sounds easy!) and the competent software engineers out of it (that might be hard, if they throw enough money at the problem), this likelihood will become the reality...

No comments:

Post a Comment