Disastrous

As the disastrous rollout of Obamacare's federal insurance exchange continues, politicians are palpitating over what went wrong.
On Tuesday Marilyn Tavenner, head of the Centers for Medicare and Medicaid (CMS), expressed regret for the difficulty people have receiving insurance. In typical fashion for the Obama administration, she blamed the contractors and high portal traffic. While President Obama has publicly apologized, no one has yet explained what really went wrong.
This fiasco is rapidly becoming Obama's Katrina, and it could get a lot worse before it gets better. Hurricanes eventually subside, but flawed software systems rarely heal themselves. Throughout the push for national insurance reform, the president and his Democratic allies in Congress repeatedly overpromised and underdelivered. The Republicans didn't help the situation, opposing Obamacare long after the U.S. Supreme Court declared it the law of the land.
We can trace the origin of the problems back to the inception of the Affordable Healthcare Act (AHA), which tried to accomplish far too much, far too fast. Instead of offering limited insurance coverage for catastrophic events, the president "overpromised" by offering full health care coverage for all Americans -- without a sound way to pay for the cost of 30 million new enrollees. He promised individuals they could keep both their doctor and their insurance plan, knowing full well that the high standards of Obamacare would cause many physicians to refuse inadequate reimbursement and many insurers to drop their plans.
As egregious as these errors were, they are overshadowed by the "underdelivery" of the information technology system managing these processes. Better management certainly could have prevented these problems, but once they arose, the White House staff chose to treat this challenge as a political issue, not a business issue. Eager for power, President Obama's staff, which has little experience in complex health care business issues, did not properly delegate this initiative to the head of Health & Human Services (HHS).
As a consequence, an extremely complex web and software application challenge is being treated as a political issue. The White House communications staff has tried to control the rollout of the health care exchanges, taking a political approach instead of recognizing this as an extremely complex technical and business issue. Sadly, this approach is quite typical of the Obama administration which has repeatedly placed politics ahead of leadership and sound management principles.
The fundamental error that Sebelius and Tavenner made was to think they could manage this massive project internally, instead of putting an experienced health care contractor in charge. As a result, no one wound up in charge. In her Congressional testimony on Tuesday, Tavenner ducked responsibility, blaming the contractors for the myriad problems involved.
All too late, HHS figured out it needed a general contractor. Fortunately, it chose CGI Federal and Quality Software Services (QSSI), a unit of UnitedHealth Group that was willing to step up immediately to the challenge. United's Andy Slavitt, one of the nation's leading health care experts, has personally taken charge of the project. He has been given an impossible deadline of November 30, 2013 to fix what would take most companies 6-12 months. We can only wish him well. If the deadline is missed for sound technical reasons, let's hope that the Obama administration doesn't try to blame QSSI instead of stepping up to its own responsibilities for these failures.
Many of us in the business and health care communities recognized this disaster in the making. We felt powerless to do anything about it though -- especially since we weren't being asked.
At the start of his second term, the president should have replaced a skilled politician like Secretary Katherine Sebelius with a seasoned health care veteran like George Halvorson, former Chair and CEO of Kaiser Permanente, the nation's largest non-profit health care system. Halvorson, who retired at the end of 2012, successfully implemented the nation's leading health care information system at a cost of $1.8 billion. It's still not too late for the president to ask Halvorson to save his beloved plan.
Ironically, the states that built their own health care exchanges, such as New York, California, Kentucky, and Minnesota, have fared much better than the federal exchange. What the Obama administration should have done was to test out its system on a pilot basis in one or two states before rolling it out nationally. That's what any private company would have done.
When the federal exchange is finally up-and-running, we can turn our attention to the real questions: how many people will actually sign up? Will they include the healthy young people the administration is counting on to offset the high cost of older, sicker Americans? How will people react to their inability to retain their current plans and their doctors, a direct contradiction of the president's promises? How will the government fund the high cost of the new patients in the system?
Ultimately, this administration must get serious about focusing on improving the health of our population rather than focusing downstream when people are really sick. An integrative approach to health in mind, body and spirit that integrates the medical system with a wide range of health and wellness practitioners is required to put America on a healthier path and bring health care costs in line with other nations. Without this, we cannot bring costs under control. Without tackling that fundamental challenge, any IT system is built on a shaky foundation.

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Just Thinking

Is anyone really shocked? I know I am not. These people have hated and disrespected Obama from Day One. The entire formation of the Tea Party was based on hatred for a black President. And the evidence I have of that are all the disgusting, hateful signs we saw at their rallies--the Obama Monkey pictures and Witch Doctor. In addition, this all started as soon as he was elected so nobody can convince me  Read More...
this movement was about policies.

Money was poured into this movement in an effort to get the black guy out of office and they failed miserably and they will continue to fail because hatred always loses in the end. Then they bought some seats in red districts and gained seats in our House of Representatives and all they have done since then is obstruct and destroy this nation ALL in the name of hatred for the black President.

It is truly shameful and unprecedented, and Obama needs to give them a does of their own medicine--yelling and expletives --so they won't forget anytime soon just who is in charge.

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24 Billion

Republicans responsible for the shut down and the near default should be on the hook for paying back the 24 billion that they cost this country in their failed attempt to destroy America. They should not be allowed to get away that. Down here on main street, when real Americans incur debts in any way, we have to pay them or face collections. It should no way be any different with reckless politicians. Make then pay the money back, it was not their money, it was ours.

George Wilder Jr.

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They are going to try this again

What is very baffling is that 144 Republicans voted to keep the government shutdown and wanted a default. We must never forget this and hold these people accountable because they are going to try this again and real soon. All we did was to kick the can down the road, and in February 2014 we will be back in this sh't again. Believe me they are already plotting their next move. They will be coming after your healthcare, social security, your job, your tax money, Medicare, Medicaid, Snap benefits, and whatever else they can extract from us all. They are going to  try and destroy the President once again.The Republicans do not care about America, they care about their party. They  care about their rich donors who they take orders from. In my  opinion no one wins in this thing because Americans have already has lost so much in tax money, 24 Billion for 16 days of the shutdown. And the republicans continue to want to waste more hard earned tax dollars of your and my money. And they talk about cutting spending, how is wasting 24 billion cutting spending? Why were the republicans taking their marching orders from a group call the teaparty when it was hard working Americans who gave them their jobs? Because they were/are afraid of losing their offices. Americans have to stop voting in people who are not for their own best interests. Americans must take charge of their government, not the politicians. Americans have to stand up and say enough is enough from these clowns. This country belongs to you and me, we hire them to keep up safe, we hire them to keep us informed, and we hire them to represent all of America. We do not hire them to lie, cheat, and to hate America. And to go against every value that we stood for since the beginning of time. 

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George Wilder Jr.

Fight Fire With Fire

There is no doubt that Republicans in the House of Representatives rigged and planned this government shutdown months in advance. Now trying to blame the entire thing on Obama and the Democrats. Americans everywhere are outraged. Republicans  are pissed off that Obamacare is now the law of the land. They are terrorists in Congress. They do not want the government to reopen, they want the default. American Affordable Care has many flaws, single payer would have the best for Americans, However, Obama and Emanuel did not want that. Yeah, that is Mayor Rahm Emanuel.  Republicans are standing tall in their hate for America, that is a fact. They lost the last election in a landslide, the American people rejected their nonsense. They are now using that slim majority in the House to reek hardship on the United States while other countries are watching us self-destruct.  Republicans hate Medicare, Medicaid, Social Security, and the middle class. They do not care about their low polling among the people that they hate. You know all the rest.
It is time to turn the tables on the Republicans and their tea party. They want to destroy American, then Americans must destroy them first. Stop giving them face time with the television cameras to spew their lies and hate. Stop propping them up on the Sunday shows. Turn off Fox News. Call them out for what they are, haters of America and its people. Keep them off television when they are running for office. Do not cover their debates, and call them out for what they are, deadbeats. Stop sending them or hard earned money. They should go to prison for treason to their country. The Republicans are shaming this country to lunacy. They can't get what they want, so take the country down the sewer. This country is a lot bigger than a few hateful Republicans. Fight Fire with fire and destroy them first, they hate America, then America hates the Republicans. 

George Wilder Jr.
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Backbone!!

Backbone is totally necessary. If you look at the way the tea billy republican party has been acting you will realize that they are playing a dangerous game. They want to put off the implementation of the ACA (Obamacare) because they want more time to demagogue it without taking responsibility for the shut down of the govt. They want to destroy all social programs that the vast majority of Americans rely on to have some decent way of living. They want to destroy the coming holiday season for the poor and middle class. They want a ransom for doing what they already get paid to do, that is silly. Washington is suppose to work for the people who sent them there in the first place but it is not and why? The Republicans are saying that they always cared about the poor, the middle class, children, and seniors. We know that is a bald faced lie. They and their tea party friends wants to rewrite the Constitution to fit their own agendas. Republicans and their rich friends wants to own America. They do not care about the poor, they do not care about workers, they do not care about children, they do not care about seniors, they do not care about the hungry, they do not care about the sick, and they do not care if you work or not. They do not care about the economy. They do not care about the debt ceiling and they do not café about the shutdown. The Republicans care about only one thing, that is their party. The rest of can rot in hell.

George Wilder Jr.
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Stand Firm

We know that Obama has a track record with comes to caving in to the Republicans. In the past, Obama have giving up some much to the republicans for little or no return. The president must not cave in as is being talked about. The republicans will only slap him again and then demand more and more. Mr. do not let the Republicans ruin our Thanksgiving, Christmas, and New Years by kicking this this thing down the road. Americans are with you, do not let them down. Republicans are trying to find a way to get out of the mess that they have made for themselves. Stand firm and we will take back the House of Representatives, and hang on to the White House. As mentioned, the republicans are desperately trying to save face by making this all about Obama. John McCain has stated that this shutdown was caused by Republicans, and they are being beaten over the head with constantly bad polling numbers. The history books are written and will put this government shutdown clearly on House Republicans and "it would not be wise to deal with a first ever default in the middle of the Holiday season," as Obama has stated. He is absolutely spot on with this. 

George Wilder Jr.
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Government Shutdown

Blaming Obama for the Government Shutdown? Really? You have got to be kidding me!
Republicans are far to misinformed of the American system to know that Obama does not control the funding. He can only sign legislation. It is the job responsibility of congress to fund the laws that get passed. If they can't agree on a law, it does not get passed. The act of passing a law that requires funding to implement IS THE AUTHORIZATION required for funding. Going in after the fact to block ALL money from being authorized for release is an end around subversion of democracy to bypass the Law making and Law repeal process.

OBAMA DOES NOT HAVE ANYTHING TO DO WITH IT. OBAMA is in the EXECUTIVE BRANCH of Government. He CAN'T force a government shutdown. You are out of bounds for even saying it.

It was NEVER possible for President Obama to be responsible for a funding-lock shutdown... but you sure were stupid enough to repeat what your lemming leaders tell you. Smart people that can think for themselves and understand how our system of government works and which branch has the authority over the purse knows better.

Just One Man

It is not right for one man, John Boehner, one man to hold this country hostage because he doesn't want struggling Americans to have healthcare. This is one man who is bringing America to its knees because he doesn't like the president. This is one man that is going to take all of us down the sewer because he doesn't like America. Come on, he is just one man!
These republicans want to abolish social security, the minimum wage, workplace protections, healthcare, and just anything that works for America. The republicans will not reopen the government because they do not like Obamacare. What is it about a bunch of well paid officials with healthcare that don't want see the rest of us with that same healthcare? It looks like the US will default and become more dysfunctional, this is what they want and this is what they will get. America will be more hurt.
Boehner is a pathetic example of a human being for openly lying to the entire nation when the reality is that enough votes exist to bring a clean CR to the floor for a vote and it will pass.
The Republicans are the most ridiculous suicidal politicians we have witnessed in a long time. By midnight they had shot themselves in both feet. Nobody will get near Obamacare, how hard is that to understand? Most of the Republican House knows that, I'd like to say they are not that stupid. But they seem even more stupid for being manipulated by the 80 suicide districts, The Obamacare health care LAW is in effect and it's going to be a hit! 
The people that don't like it are not effected so what have they got to complain about . Today is the beginning of the end of Republican Politics.One thing is certain - Boehner has secured his place in history as the absolute WORST most ineffective Speaker of the House of all time, too busy cowering to the bagger fringe to do his job. Crawl back in your bottle John, because no matter what happens, you're through as Speaker and all you can do at this point flail and blubber. Perhaps we'll be treated to another tearful meltdown worthy of future comedy soundbites, maybe an image of Boehner curling into a fetal position while he drunkenly sobs for his mommy, but other than that, this squid is out of ink and the blame for any shutdown will lay solely upon the Boehner's do-nothing bagger House. Buh-bye Boehner.

Who is the blame for the shutdown?
While appearing on Fox News over the weekend, Rep. Devin Nunes (R-CA) was very frank when he told fellow-Republican and embarrassing soundbite machine Louie Gohmert (R-TX) that he felt the GOP had over-promised and misled their base, and that they could even stop the Affordable Care Act in the first place. It’s quite stunning to hear a Republican congressman speak plainly to the fact that his party basically lied to their constituents to drum-up support for this irresponsible government shutdown, isn’t it?

“I thought it was a big mistake to say that we were going to get rid of ObamaCare,” Nunes told the show’s host. “I think we’re giving our base — and I’m a conservative Republican, just like Louie — the false interpretation that somehow by not funding the government, we’re going to get rid of ObamaCare, and we simply don’t have the votes to do that.” By Nunes simply admitting that the Republicans don’t have the votes to do anything on the Affordable Care Act, he has become one of maybe a handful of Congressional Republicans who have been candid and truthful about the situation.

George Wilder Jr.
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