We're doomed...
By TheRealDawn
@dawnald (85146)
Shingle Springs, California
April 24, 2013 12:27am CST
So I texted my friend at the Health Insurer that I used to work for, and I asked him if they were more doomed than we were at the Health Insurer that I currently work for. He said they were far more doomed. So I said, we are still working on requirements for an October implementation. "Affordable care act", he asked? Yup...
Backing up...
Those of you in the US have surely read about the Health Care Reform changes that are going into effect on 1/1/14. Well, insurers are working like crazy people trying to figure out how to make those changes work in their computer systems.
First they interpret the law, they write the business requirements (what the system must to in order to comply with the law), then they write the technical requirements (how the system is going to do what it needs to do to meet the requirements), then they program/configure the changes, then they have to test it. All this has to be done in time to enroll people into their new plans starting October 1st, so that people can get their new ID cards, etc., and get their medical care paid for starting in January.
Meanwhile, the government is still issuing clarifications to the regulations, which means that our requirements are changing all the time. It's a moving target.
So come the end of the year, when you get your new ID card, and everything is cockeyed, and you call your insurer and they don't know who you are, and you try to use your new benefits in January and they don't pay the way your enrollment package said they were supposed to, just rememember all the overworked, crazed systems people who tried to make it happen, and couldn't quite manage it. You can visit them in your local asylum (unless you're in Nevada, in which case they've been bussed to California).
And be nice to the customer service person when you call them up and want to holler at them. It's Obama's fault.
Not really. But we weren't given enough lead time to do it right.
Trust me.
5 people like this
14 responses
@suspenseful (40192)
• Canada
24 Apr 13
Oh don't you know Obamacare was not designed to work. Putting so many uninsured people on it will overrun the system and so they have to decide what diseases or conditions will not be covered and not only that the doctors will be so overwhelmed and get less pay for the conditions that the rich used to pay for and what was covered by the old medical insurance programs so they will not offer those cures pro gratis to some of the poor. That also means if you paid into your medical insurance plan, that the money to pay for that operation or medicine you needed will have already run out before you need it.
Yes it is Obama's fault. He wanted everyone to be insured and he lied and said everything will be covered. And he wants bureaucrats not doctors to decide whether you need the cure. 'Affordable care act' no way.
2 people like this
@suspenseful (40192)
• Canada
25 Apr 13
Oh because Obamacare is so complicated, they probably have in it that after a certain number of months or in a certain year, benefits for certain procedures will not be covered. But they will have it on page 200 or later, in very small print. After a long explanation where on reading it, no one unless one if Einstein will be able to decipher it. I do not know how long the Obamacare rules are, but assuming it is quit lng
1 person likes this
@Lakota12 (42600)
• United States
24 Apr 13
THis Obama care pack is a crck thats why ya cant get it to fit for it goes against Ins companys policys that are already in place If Ins companies would refuse to set this up maybe this wouldnt go into effect EVER! and who says its a law??j WHEn it passed by force and only by Obama NOT the congrees for they havent read the whole 2000 some odd pages
2 people like this
@Lakota12 (42600)
• United States
24 Apr 13
ok I read that if you dont buy Ins you pay a fine and got to jail/prison????
Now what about people that dont have a job havent worked in years for living with someone but not married just how does that person buy ins. this is a dumb law like ins companies never made enough money as they have been. I already pay more now than what I had been paying thru my SS they take it before I even see it.
and alot of times dont cover the whole bill for hospitals can charge what ever they want to for the same service. one place could be higher than another one TO me the ins. ya pay for should cover the whole thing the hospitals and DOctors shoul not charge more than what the ins company pays for!
1 person likes this
@dawnald (85146)
• Shingle Springs, California
24 Apr 13
It's not nearly the best solution. I would have preferred a single payer system, something like Canada or the UK, but this is what we got.
You do have to have insurance, yes, but if your income is low enough, you get a subsidy. And Native Americans get full coverage.
Doctors and hospitals paying too much is one part of the problem. There are too many parts of the problem...
@dawnald (85146)
• Shingle Springs, California
24 Apr 13
It's a law, and it was a compromise. If anything, I think the ins companies WON since everybody will now be required to use their product. There are good parts and bad parts, that's what happens when you compromise. but I do believe premiums will go up.
@GardenGerty (160996)
• United States
24 Apr 13
I have not had insurance in so long it is not even funny. I know what you are talking about, in a way, because our state just overhauled the medicaid program and then split it and told every body you would get new cards but you have to choose one of three providers. My sister never got the letter teling her to choose and it seems that there is a whole separate category called "exempt" that keeps their old card but no one told the providers this and so each physician she sees wants her to hurry up and get her new card.
2 people like this
@carmelanirel (20942)
• United States
24 Apr 13
Thanks for the warning, I am sure that my husband or I will be a couple who is calling constantly. I don't know exactly how this will work, but I read a little and what I read I hated. I will try to not take it out on workers like you..
2 people like this
@cynthiann (18602)
• Jamaica
24 Apr 13
Wow! Is this what you do? I am so impressed. Take it easy and do not end up in a Home For The Bewildered
So each time there is an ammendment then you have to re write the programme? I once wrote a silly article on computers talking 
to each other when people had left the office. Was published too. Gonna see if i can find it.
My advice to you is 'stay sane'.
So each time there is an ammendment then you have to re write the programme? I once wrote a silly article on computers talking to each other when people had left the office. Was published too. Gonna see if i can find it.
My advice to you is 'stay sane'.2 people like this
@dawnald (85146)
• Shingle Springs, California
24 Apr 13
yeah, more or less. right now I"m in QA, so the part at the end that tests all this muck. which we are NOT going to have enough time to do. fun...
@bounce58 (17385)
• Canada
26 Apr 13
I'm not in the health care/insurer industry, but I've been part of a change in company systems early in my career. Granted that it wasn't as big as a nationwide change, but I'm familiar with the tests that had to be done (or maybe not, as it was more than 10 years ago).
I remember long days, and even longer nights. And a lot of fast food!
And thinking 'we're doomed' as the deadline drew near.
@dawnald (85146)
• Shingle Springs, California
26 Apr 13
heck, even y2k wasn't nearly this stressful....
@KrauseHome (36447)
• United States
27 Apr 13
Personally with issues such as my being insulin dependent diabetic, it will be interesting. I am in the process of switching to another job come august possibly along with trying to work my online business, so let's somehow hope things do get better instead of worse. I am a little scared like everyone else, and really hope Obama really knows what he is doing. It will be interesting the next 7 months and then comenext yr in January as well. All I know is a lot of extra prayers can never hurt.
@dawnald (85146)
• Shingle Springs, California
25 Apr 13
Yeah, well, the government's primary goal was not to make things easy for the systems people! :)
@artemeis (4194)
• China
24 Apr 13
After visiting America, I always have the impression that everyone has insurance and I was very impressed because I really believe in this financial product. At the same time, I have concerns about the unemployed population who would not have any due to their economic status and situation. So, when I read about the Obamacare, I thought that it is a brilliant idea and I had no idea that there are so much work behind the scenes.
Your post reminds me of businesses in general where the marketing and operations will never be able to see things eye to eye in that the marketing will go about promising that everything is possible while upon arriving at the operations' doors will be stuck with failures of every kind, Murphy's included. So no matter how well thought out and angles covered there will be some hitches every where and it will be some time before the dusts can finally settle. Just be positive and assured that you're not the only one facing this ginormous project.
Stay positive always.
@dawnald (85146)
• Shingle Springs, California
24 Apr 13
You are so right about marketing. I have been in so many situations where they have sold a product and never found out whether the system could handle it until it was a done deal.
@katsmeow1213 (28716)
• United States
24 Apr 13
Funny how these laws that are supposed to help us are actually making things more difficult on us..
1 person likes this
@dawnald (85146)
• Shingle Springs, California
24 Apr 13
Some things are more difficult, but at least I know if I can't get insurance through my employer, that I won't get excluded for having a pre-existing condition. Can I afford it though?
@celticeagle (168420)
• Boise, Idaho
24 Apr 13
Doesn't sound like any fun at all. Poor program writers/changers. Hope it all works out.
@dawnald (85146)
• Shingle Springs, California
25 Apr 13
It is going to get very busy and very stressful, but it will all come right in the end.
@vandana7 (100616)
• India
25 Apr 13
Oh those politicians...lol It happens to Income Tax act ALL THE TIME out here. lol
At times there is estate duty, at other times there is none. Some relations have gift taxes, others dont. Some donations are hundred percent exempt, others are exempt only fifty percent. You bet people need to be conversant with these laws if they gotta get most of them. In which case, why have those accountants...
Politicians need to think issues deeply instead of ways to raise monies TEMPORARILY. Their stupidity costs the nation. Those programs errors and customer care people and phone calls and time spent to learn new things and fight for "right" all cost the nation. Right Dawny? Costing is a big subject ..politicians dont know its spelling.
1 person likes this
@dawnald (85146)
• Shingle Springs, California
25 Apr 13
The tax laws here are very confusing as well...
@much2say (56142)
• Los Angeles, California
24 Apr 13
Your line of work sounds exactly like what my friend does - although as of a couple months ago she is no longer with an insurance company. Throughout the years, I've heard her talk about the very same things - about the programming and testing and insane deadlines. Meanwhile she's had to deal with company and management politics - the downsizing of even the larger of insurance companies - and overall madness that seems to come with the job. The thing is, she seems to let her work consume her life to the point her own health suffers . . . hubby and I have often wondered how she can even be an effective programer (assuming they have to be extremely focused and organized "up there") when my friend is completely scatter brained otherwise. But you seem to have far better balance for sure! I'm applauding those behind the scenes - I know I couldn't do it! 
1 person likes this
@dawnald (85146)
• Shingle Springs, California
24 Apr 13
IT is the same everywhere, not just in the insurance business...
@randomarts09 (1405)
• Indonesia
25 Apr 13
it’s really a very stressful job. Although I am not living in America. From what I read it seems pretty hectic.
1 person likes this
