We previously discussed the gross negligence exhibited in the Patient Protection and Affordable Care Act (or Obamacare) rollout and how there appeared little accountability for such failures even when they cost hundreds of millions.(For a column, click here). Now it turns out that, after costing the country a fortune due to this shoddy work, the IRS has reportedly awarded the company yet another contract to do work on . . . you guessed it, Obamacare.
So it was only in January 2014 that Administration insisted that it had dumped the company despite CGI Federal’s connections to fundraising for the Obama campaign and personal connection to the First Lady (Toni Townes-Whitley, a senior vice president at CGI Federal, was a Princeton classmate and friend of First Lady Michelle Obama). The IRS contract is worth $4.46 million and will expire in Aug. 15, 2015. At the time, Health and Human Services Secretary Kathleen Sebelius told Congress that the CGI-designed website a “debacle” and “I am as frustrated and angry as anyone with the flawed launch of HealthCare.gov.” As I stated earlier, I still am mystified how Sebelius was not fired. However, if CGI is any example, she can now hope to be made Vice President or better.
Now the Administration has awarded an IT contract for its new Obamacare tax program. Wouldn’t the greatest failure in a federal contract weighed slightly against the awarding of the contract?
That seemed to be an issue with Vermont and Massachusetts which dumped the company last year.
However, CGI’s 2014 annual report reportedly omits its role in the prior disastrous rollout.
U.S. government, please take note:
Let me see…if I hired a company that not only screwed me over financially, but also did a horrible job, I would have to stop and think…”Hmmm, you fooled me once with your outrageous costs, you fooled me twice with your inadequate and horrible system installation, third time, I will be the fool for hiring you ever again.
Issac…we’re just going to have to agree to disagree. You said:
… keep the medical system with its superfluous facilities …
You mean like this. If not, please clarify. Relying on Medicare alone, I could not have afforded the treatment.
And you still assert that the co-payment differential isn’t part of the reason why Medicare is “apparently” cost effective?
I worked as a military “fed” for too long, and uniformed before that, to trust government for assuring my best interests. The “basic system” as you call it would have left me dead or on my way there.
Nick
You would understand my position more clearly if you read a little more closely. I have lived in three countries, am intimate with several more and have for most of my entire working life been self employed. I am anything but a government oriented person. I worked for a few years as a teacher and am well aware of the complacency originating from institutions and government systems. That is not the issue here. The issue here is that somethings are better when incorporated into a system that includes everyone. The military, aviation control, etc The inherent desire of the individual is to make as much money doing as little as possible, regardless of the profession.
I have always envied the security of the person that retired after 35/40 years of government service at 55/60 in one way but since I chose never to retire from functioning, regardless of recompense, I have lead a life closer to the bone. The bone has included understanding what should be run by the society and what should be run by the individual. The choice is typically decided by experience and/or ideology. The less ideology regarding what one should or shouldn’t do usually means less time in the experience sector. The US is heavy with ideology, perhaps the heaviest of all nations. The ideology has been reinforced by never having to start over. This inflexibility results in some good and some bad. In the bad department usually one can find the only one out of step. Regardless of opinions, one way or another, it would cost us all, individually as well as collectively, less if the administration of health care insurance was reduced. The health care insurance administration part of the equation has nothing whatsoever to do with the quality of health care. The US system detracts from it. Ask any doctor. They may not like the level of pay from Medicare, Medicaid, or that which is connected to the government but I have never heard a good word about the private health care insurance parasites uttered from a medical professional.
Airdog, Nick
The bottom line is there is no advantage from competition when the insurance industry is a monopoly controlled by the premiums set by the underwriters. It doesn’t matter how may Aetnas, Blue Crosses, or Humanas you have and how many state borders they cross, or how much access you have. The fact of the matter is that we all pay for health care. We all pay for unnecessary administration costs. Remove the administration costs, keep the medical system with its superfluous facilities, fraud, etc and the cost of all this will come down. This does not equate into higher co pays. In British Columbia, there are no copays. If you want supplementary insurance you can buy it, just like on top of Medicare. My Medicare is $115 a month. It works just fine. The copays are high but the premiums are low. The doctors have always been the same since I had Aetna at $450 a month. The only difference is under Aetna I needed a referral to a specialist and now I don’t.
This is a simple case of math and unnecessary costs. 1,200+ private insurance companies in the US have 1,200 times the administration, 1,200 times the CEO salaries, and for all those that are public the need to make a profit for shareholders. There is no advantage to the user. The only downside is that three to four hundred thousand workers will be looking for a new job. Think about that the next time you pay your premium to a private insurer. You are paying for thousands of useless administrators, huge CEO salaries, corporate jets, shareholder profit, etc. Under a two tier system you would have the choice to pay for all that if you wished but if you only wanted the basic system you wouldn’t have to. Isn’t that just a little bit what America is supposed to represent, freedom from monopoly and freedom of choice.
In my local clinic there are eight office workers for two doctors and a nurse. When I go there, we chat. The only thing they seem to comment on is the nonsense of dealing with the myriad of insurance companies. This is a perfect example of ‘My son, the only one in step.’ When you look for examples to bolster your argument, look for examples for the other side. The one with the most examples usually is the right one. Right now the US is the only one and it does not have the best health care system.
This is an example also of America being wrong and having to admit it. That is the biggest hurdle.
Tom, George Will did a good piece today about the exploding welfare state. A large part of that is Social Security Disability scammers, documented in the piece. Well, these folks get Medicare as well. Lot’s of perfectly healthy people of ALL ages getting monthly checks and free healthcare while law abiding hard working people pay for their lifestyle. The revolution is coming.
Those who advocate expanding Medicare coverage for all should take a look at the budgetary train wreck called Medicare. Are the lower administration costs the reason that Medicare is on such “sound” financial footing?
Expanding that program from c. 50 million to over 300 million only magnifies the scope of the train wreck.
Isaac, We all see the world from our unique prism. There are some truths in your comment. But @ my core is you must have govt. do what it is supposed to do, make companies COMPETE, not collude. And, I can show you myriad examples of how incompetent, lazy, corrupt and hostile govt. employees are compared to private. I was a govt. employee and was profoundly unhappy because of the slovenly work done by people. In the private sector, I had to deal w/ govt. employees on a daily basis. I know how to get them to perform, and it ain’t pretty. There is no comparison regarding service and product w/ a private company, in competition w/ others, and the govt., a classic monopoly w/ a money tree called hard working, productive citizens. This is irrefutable Isaac. This is a fundamental difference between you and I. My prism was cast by experience. I was a Vista volunteer out of college for chrissake. I have worked for the Federal govt., county govt. school boards, large corporation, mid sized law firm, and operated my own small business. I grew up working in a family restaurant biz that operated for 60 years. I have lived in 7 different states in 3 time zones. I have lived in very blue and moderately red states. Here’s what I acknowledge. While I have travelled more than most Americans[7 countries on 3 continents], unlike yourself, I have not lived abroad. That is integral to your prism. But, you are @ your core, a “govt. is good” person. I am a libertarian and believe only less govt. is good.
Issac said …
It is a simple issue of math. The fewer people administering whatever system you have, the lower the cost.
Really? No consideration of higher co-payments and deductibles as added costs? As I’ve said multiple times now, the system I am under is competitive. Yet, I have no doubt that the carriers under the ACA love the opportunity to raise the co-payments and deductibles…and assert virtue.
I only hope I am not forced in to the ACA system one day while also on Medicare parts A & B. I won’t be able to afford to live.
Nick…you just made a great argument for my case vis a vis alternatives to the ACA or cradle to grave Medicare. There really is a system that competes carriers in the private sector, nationwide. However it is apparently the ugly step child that no one speaks of in public.
It is also the reason some Congresspersons got their knickers in a wad when they discovered what was required of them (to give up their alternative competitive system) under the ACA that none read before passing it on a strict party line vote with odd procedural maneuvers to boot.
As a noted leader once said (paraphrasing): We need to pass this so we can find out what’s in it.
Whoops. 🙁
Nick and Calypsofacto
Please read the comment more carefully. There is no competition when Blue Cross, Aetna, Humana, etc do not pay from their own pockets the costs they are covering. They insure the hapless individuals, us. They are in turn insured by global underwriters. The global underwriters are where the premiums are set. When you understand how insurance works then comment on competition. There is no competition, won’t be, never was.
The parasitical private system simply costs more because it employs more people. That can’t be that hard to understand. Along with hundreds of thousands of unnecessary workers, paid for by us, comes the costs of shareholders dividends, CEO salaries, etc. It is a simple issue of math. The fewer people administering whatever system you have, the lower the cost. The proof is everywhere to be seen except in the only country on earth that still does this, the US. Ask why, but don’t roll out the ‘We’re number one.” or the “Cuz it’s in the Constitution.” stuff. The reason is simple. The oligarchs run the country. The insurance lobby owns the politicians. Americans as a whole are a disassociated and confused people.
Jeez.
Source: Newsmax and Daily Caller.
I’m willing to hold my fire until this story appears in media that aren’t right wing.
Issac, you said …
This is administrative costs and has nothing to do with medical care, availability of hospitals, equipment, or anything else.
Perhaps not, however, have you compared the deductibles and required co-payments under Medicare versus the private sectors’ offerings? Even under Part B, one is responsible personally for 20% or so of costs for services provided. That is a huge amount for any serious treatment. Like the cancer I’ve dealt with (successfully so far). Thus a need for supplemental coverage, via the private sector, as I mentioned. How then does my alternative system supplement, all private sector, meet all ACA criteria, and still cost less, in total, than the alternative of just Parts A & B Medicare? Even beats all ACA exchange plans that I’ve read about….so there we might agree, the carriers have a vested interest perhaps in the ACA. The answer is that my supplement, previously my entire package, is competed annually, state by state, nationwide, among private carriers, by a system that has worked rather well for 50+ years now. Why it has not seriously been considered as an alternative to the ACA or cradle to grave Medicare is beyond my simple mind. Last iteration of an attempt to utilize the system I am under was Issa’s HR 3319 in 2013. Previously it had been proposed by John Kerry and others on both sides of the aisle.
Footnote: I sort of knee jerk react to suggestions that we need to copy what others do…a regular meme in federal government, in my case, DoD. Drove me nuts and still does when I consult with people, still active in DoD, that I still work with now and then. We can and should be innovative not just copycats. It was once our strongest virtue. What happened?
@ Isaac:
1) “Statistics …” Bull. But love the passive (aggressive?) voice!
2) Socialist Federal and foreign medical payment systems DO have the advantage of setting their own prices, irrespective of supplier costs, and free-riding off of the medical advancements developed through the free market. The difference then gets passed on to taxpayers and those paying full-fare.
3) Yes, let’s certainly designate the causes: 3rd party payments (largely through the gov’t and gov’t tax structure encouraged employer plans) and lack of competition because of government restrictions would be good places to start.
Isaac apparently thinks that the solution to the problem of government’s intervention in health insurance is for MORE “consolidation” and government involvement (because large central bureaucracies have always proven themselves so efficient?) . In fact, the answer lies in the only proven method of increasing service, efficiency, and satisfaction while reducing costs: free market competition, including free choice for participants.
You can spot chronic BDS when a person is INCAPABLE of writing even one comment w/o a reference to the Bush Administration.
One of the common sense remedies to exorbitant insurance premiums is to make them compete. Big corporations are bullies and pussies. They bribe the govt. to create a system where they are not “allowed” to compete interstate, like ALL other insurance. A very simple law allowing insurance companies to compete would bring down premiums. And, collusion prosecutions[they’re tough to prove but can be won] to back up this new competition would make a significant reduction in premiums.
Airdog
Statistics, that have not been refuted by either Democrats or Republicans, have proven that the private health insurance industry’s administrative costs are five to eight times of medicaid, medicare, and comparable systems in other countries. This is administrative costs and has nothing to do with medical care, availability of hospitals, equipment, or anything else.
We pay twice as much as we should for a variety of reasons. The parasitical private insurance industry is underwritten by a half dozen ‘re insurers’ such as Swiss Re, Munich Re, Lloyds, AIG etc. They set the premiums. The private industry in the US employs from three to four hundred thousand people that are unnecessary and whose salaries come out of our premiums and other costs. Included in our premiums also are the huge salaries of CEOs and profits for shareholders.
I have nothing against the private sector but this is extortion, a monopoly at the very least. Regardless of the pros and cons of the ACA, and for every horror story there are more than one opposing positive results, the main reason we are paying two to three times more than we should be paying is because the fox is guarding he henhouse. The insurance lobby makes sure that voters remain ignorant and their candidates and elected officials do what they’re told.
It might be a good first step to separate the problem into its parts and fix each part. First get rid of the parasites. Second consolidate facilities. Third nail fraudsters to the cross. Fourth, and so on.
Before one can fix a problem one has to differentiate between its causes.
Karen S … I should add to my remark above that so long as we continue to operate under repetitive CR’s, no changes can be made. Not until we operate under a conventional discussed and debated, by Congress, formal 12 appropriation budget can changes be made. Under CR methodology I assure you I could take all the contents of your purse without disturbing the purse or you noticing it until too late. We have not had a formal budget for 6 years running now. 🙂
As someone who was responsible for building computer systems in large organizations, I should point out that if the client wants something that is impossible (like a baby in 5 months) the only legitimate criticism of those building the abortion is that their morals weren’t sufficient for them to turn down the work and, perhaps, lay off employees or go out of business.
I’m not saying that’s what happened – just that this is the more likely history. I’m guessing that all the inquiries into the details of this travesty were conducted by people chosen for their partisanship.
Issac….I have cited a bi-partisan alternative to the ACA several times here. Crickets. Since I am on Medicare A & B now, I get my supplemental coverage through that same alternative system and all of that coverage is after Medicare pays what it pays…and all of the supplemental coverage is by the private sector and meets the ACA criteria. Before I turned 65 I was covered entirely by the alternative system, and at gross rates/deductibles superior to anything under the ACA…even after my combined monthly premium increased $230 once enrolled in Medicare. I really doubt cradle to grave Medicare would solve anything while increasing debt hugely. You will pay for it one way or another and I seriously doubt low income, or even middle, families and individuals could afford it.
Karen S … actually in the lower echelons of federal procurement, most try to follow 48 CFR or they face potential Congressional appropriation violations. Protests filed by bidders can expose you. That, and FOIA can be a butt kicker that tosses one under the bus if it reveals malfeasance. It seems to me that most of these hugely egregious violations occur at the highest levels. I am personally aware of one flagrant instance where the egregious determination of necessity was made by Cheney and/or Rumsfeld. This is no reason the practice doesn’t continue under Obama’s administration, nor occurred in those instances under administrations prior to Bush43. Institutionalized behavior is just that.
To fix this will require some haircuts at the highest levels and changes to 48 CFR that would criminally prohibit making egregious exceptions. If there actually was a J&A (or bid analysis) written for this case with the IRS & CGI I would love to have a copy to read…I need some laughs now and then.