HealthCare.gov can’t handle appeals of enrollment errors, http://www.washingtonpost.com/national/health-science/healthcaregov-cant-handle-appeals-of-enrollment-errors/2014/02/02/bbf5280c-89e2-11e3-916e-e01534b1e132_story.html, is a very scary report of problems in the US govt. website healthcare.gov which seems to be the primary mechanism for the new health insurance 'marketplace'/'exchange' system in the USA.
Some notes and comments:
The report mentions tens of thousands of appeals having been filed related to supposed overcharging, being steered into wrong insurance programs or being denied coverage by healthcare.gov website. [Ravi: What a stressful thing it would be for such users! Medical costs in the USA are said to be very high due to which most people barring the super-rich have to have a health insurance plan. Otherwise, as I understand it, they simply may not be able to undergo medical care involving operations.]
It gives the case of a lady who was not given the right amount of subsidy by the website due to which she was advised to pay full price for insurance cover (she was due for surgery) and then appeal.
It mentions that the (USA) 2010 Affordable Care Act provides a guarantee for timely hearings for appeals dealing with subsidies or being denied insurance and that legal advocates are looking at the matter. [Ravi: Is this going to be a legal issue? Will somebody also look at the contractual obligations of the software provider and whether such obligations are fair and include accountability?]
It reports that, as of now, the system can only store the appeals and does not have the functionality to permit officials to process these appeals. [Ravi: Not a happy picture.]
...
The system seems to have asked some users to opt for Medicaid as they quality for it but their state Medicaid agency denied that. These users 'loop' back to the federal system and that is not able to fix the error. [Ravi: What a mess! I can imagine the fury and frustration some of these users would be having with the software system.]
...
The article mentions that after undergoing surgery the above mentioned lady checked about resolution of her problem with the website and was told that the system does not have ability to fix a mistake in somebody's account. [Ravi: I am so disappointed that the software system handling such a vital part of the life of US citizens has let down some people so badly.]
--- end notes and comments ---
I think steps must be taken to ensure that software dealing with such vital matters ('infrastructure software'), even if they are more of application type of software (as against systems software), go through a more professional software development and test lifecycle before release to users. Further there must be accountability like in so many other professions - civil engineering, medicine etc. with serious failures like these resulting in investigations and some kind of professional action against those software managers, analysts, designers, developers and/or testers found to be at fault.
Some people may feel I am being very harsh especially since I am no longer in the software industry. But I think that it is the lack of accountability and lack of fear of professional action being taken for serious lapses that makes software development a 'Wild West' kind of enterprise. If software development earns people a lot of money then they need to be accountable for what they have developed. Is that not a fair thing to ask? I mean, will we accept going to a medical doctor who is not accountable for the treatment that he/she gives us? Will we live in a house/apartment whose builder and civil engineer are not accountable for the safety and durability of the construction?
Some notes and comments:
The report mentions tens of thousands of appeals having been filed related to supposed overcharging, being steered into wrong insurance programs or being denied coverage by healthcare.gov website. [Ravi: What a stressful thing it would be for such users! Medical costs in the USA are said to be very high due to which most people barring the super-rich have to have a health insurance plan. Otherwise, as I understand it, they simply may not be able to undergo medical care involving operations.]
It gives the case of a lady who was not given the right amount of subsidy by the website due to which she was advised to pay full price for insurance cover (she was due for surgery) and then appeal.
It mentions that the (USA) 2010 Affordable Care Act provides a guarantee for timely hearings for appeals dealing with subsidies or being denied insurance and that legal advocates are looking at the matter. [Ravi: Is this going to be a legal issue? Will somebody also look at the contractual obligations of the software provider and whether such obligations are fair and include accountability?]
It reports that, as of now, the system can only store the appeals and does not have the functionality to permit officials to process these appeals. [Ravi: Not a happy picture.]
...
The system seems to have asked some users to opt for Medicaid as they quality for it but their state Medicaid agency denied that. These users 'loop' back to the federal system and that is not able to fix the error. [Ravi: What a mess! I can imagine the fury and frustration some of these users would be having with the software system.]
...
The article mentions that after undergoing surgery the above mentioned lady checked about resolution of her problem with the website and was told that the system does not have ability to fix a mistake in somebody's account. [Ravi: I am so disappointed that the software system handling such a vital part of the life of US citizens has let down some people so badly.]
--- end notes and comments ---
I think steps must be taken to ensure that software dealing with such vital matters ('infrastructure software'), even if they are more of application type of software (as against systems software), go through a more professional software development and test lifecycle before release to users. Further there must be accountability like in so many other professions - civil engineering, medicine etc. with serious failures like these resulting in investigations and some kind of professional action against those software managers, analysts, designers, developers and/or testers found to be at fault.
Some people may feel I am being very harsh especially since I am no longer in the software industry. But I think that it is the lack of accountability and lack of fear of professional action being taken for serious lapses that makes software development a 'Wild West' kind of enterprise. If software development earns people a lot of money then they need to be accountable for what they have developed. Is that not a fair thing to ask? I mean, will we accept going to a medical doctor who is not accountable for the treatment that he/she gives us? Will we live in a house/apartment whose builder and civil engineer are not accountable for the safety and durability of the construction?
No comments:
Post a Comment