HealthCare.gov deferred final security check, could leak personal data
arstechnica.com
arstechnica.com
Most analytics providers explicitly tell you not to pass along Personally Identifiable Information (PII). Their Terms of Contract usually state doing so is a terminable offense. It's part of the training process to be certified by most providers.
Basically, this only highlights how terrible the programmers at healthcare.gov are.
Since all appointees to this committee must be agreed upon by the Executive Branch as well as both minority and majority leaders from each party (hence 12 from Congress with the Presidents approval/recommendation) and 3 from the President, yes the Executive branch could very well determine what health options are available too you.
The real issues before us now are.
1) why can the Secretary of Health and Human Services even refuse to divulge enrollment numbers? 2) why is the same not keeping the President fully aware or made aware of the problems the site faced before launch and after (conspiracy advocated claim the President knew) 3) By regulating what must be covered and not covered they are deciding what you can have and have not. Remember, there are a lot of gray areas in the law which the Secretary has shown more than enough interest in creating actual rules.
Which, incidentally, I did today before this story broke.
This is utter nonsense on its face. If I have (or want) something under the minimum floor, they have regulated that away from me. They have regulated what I can have.
Have healthcare system where costs are externalized? People complain. Have healthcare system where costs are internalized and properly accounted for? People complain.
Given that the Guinness record for the oldest natural conception is 59, I think not (there are a few cases of older women giving birth, but those all involved in vitro fertilization or the like).
What other astoundingly unlikely events do you guys think people should be required to insure against? Meteor impact? Virgin birth? All the molecules of air rushing to one side of the room and suffocating you?
It is pretty much the same as me paying [through taxes] for the FDA beef inspectors even though i don't eat beef. Just a socialization of the cost of basic government services (healthcare is among them, it is just Republicans are slower as usual to recognize the facts of reality, and thus "socialization" of the cost happens inside an insurance pool instead of society-wide as it would be in the case of single-payer )
You're wrong. The law says what the policy has to cover. Whether the policy holder is male or female doesn't enter into it.
"It is pretty much the same as me paying [through taxes] for the FDA beef inspectors"
Really? Since when is the FDA (actually, USDA in this case) a private, for-profit operation?
i already addressed that - the Republicans forced for it to be done through private for-profit operations instead of a government agency like FDA/USDA/etc...
Then there is ethics.
Ethics and choice matter. Even if there were startling net benefits to this very toxic substance, using or ingesting it should be exclusively on an individual basis: personal choice, OTC, or per a physician. Advocating for needlessly and forcefully "medicating" (read: it's not medicine) other people through their communal water supply is, in no uncertain terms, blatantly unethical. It seems to stem from either psychopathy, greed, or sheer ignorance. It's on the same order as an industry and some physicians promoting nicotine cigarettes for health, once upon a time, and other such barbarities of an era.
That horribly toxic chemical chlorine is added to water too. It is significantly more toxic than sodium fluoride. It also happens to be responsible for the greatest improvement in public health in the 20th century.
Sane countries banned fluoridation long ago.
Most countries who don't fluorinate water didn't ban it. They simply never implemented it or stopped implementing it because it is quite expensive and technically difficult to do well. Instead many simply add fluoride to their table salt (like France, Germany, Switzerland) or heavily pushed topical fluoride applications. The countries that have neither (like say Japan), tend to have significantly worse dental health than the US.
Meanwhile, there is no hard, double-blind science backing any clear benefits of fluoridation
You must be kidding. We have long-term longitudinal studies that clearly show the benefits and safety. Every decade, someone puts out a review paper[1] of the studies and comes to the same conclusion, fluoridation at low levels is good. We have scientific consensus that it is beneficial.
1. http://www.nature.com/ebd/journal/v9/n2/full/6400578a.html
Fluoridation, alternatively, is not easy to remove. Fortunately, I can afford distillation and reverse osmosis. Many other people can't. I'm not sure why you're so eager to medicate the water supply when more studies, decade after decade, present more negatives. Positive fluoride studies are notorious for conflating correlation with causation, especially in light of the more direct causation of cultural advances in education for merely brushing teeth as well as access to dental care. There is a lack of evidence showing significant variance in dental caries between fluoridated and non-fluoridated municipalities. That should alarm you. Fluoride accumulates. For whatever reason, you don't seem interested in its negatives.
Again...
Even if there are light or even startling benefits, it does not make valid the ethics of mass medication. You may feel strongly about wanting everyone to have fluoride. I suggest voicing your pro-fluoridation stance in a more positive way rather than advocating it be done through a water supply where it's very hard to remove, and compounds. Maybe advocate for "free fluoride tablets" and fluoride-filled toothpaste if you must. Don't include others in your treatment.
Some of this is because to be a medicine, a substance sort of needs to have a noticeable effect on our biology.
I'll rephrase. It isn't good medicine.
Fluoride treatments and water fluoridation are medicines like mercury treatment was once medicine. Explicit forms of "medication" must be relegated solely to an individual's active consent when consent is possible. That means a conscious choice to partake in the "medicine," on or in one's body, without medicating other people in the treatment. That's basic ethics. The benefit:negative ratio would have to be astronomically high to justify any less standard where medicine is concerned.
Medicine is very personal. Speaking for myself, when an extremely toxic substance to humans, no matter the dose, is intentionally added to something as important as water and thus a food chain, it has already lost the ethical equation. Massively "medicating" passive "patients" through the water supply is just sad. Worse still, ingesting fluoride hasn't been justified on any beneficial, medical level -- and quite the opposite with negatives. Thus, it's hard for me to associate the term "medicine" with it. I completely concede to that point though.
How you treat others and yourself is up to you, of course. Beyond your personal choices, you'll then have a titanic task of providing basis for your support of fluoride as a medicine to the point where you justify medicating the rest of your community through its water supply.
Under the new health insurance law, the penalty for not buying health insurance is a fine. I forget the yearly amount: $500-1000 (depending)? Yes, that's a form of force. The amount of the fine and who it impacts is the amount of force. It's economic taxation. It also further opens up a slippery slope in the ability for such forms of force to be used increasingly in other aspects of government and society. That's another topic.
Both propositions are easily argued as forms of force. They could easily be argued as unjustified compared to other systems and methods. However, for now, I'd argue that contaminating water is a larger form of force.
You may not like where the minimum is set, but that doesn't make it anything but a minimum floor.
Harry Reid even said that Obamacare is "absolutely" a step towards single payer.
And, by the way, the calls for Single Payer because of the Obamacare "mess" are starting, Paul Krugman seems to be leading the charge along with others.
So could making the Obamacare rollout rougher than necessary prime the pump for a single payer push? I don't know, could closing the WWII memorial and Mt. Rushmore scenic roadside stops make the government shutdown worse than it needed to be to make a political point? The White House would never do that would they? That's just paranoid conspiracy stuff right? Strangely enough the Andrews Air Force Base golf course stayed open during the shutdown but the privately run Mt. Vernon (who happens to lease land from the Park Service) was forced to close. The even closed the Normandy beach in France! Yet, I had no problems getting a routine consular appointment during the shutdown in Marseille.
It's not paranoia if it's really happening.
http://www.healthcare-now.org/sen-reid-obamacare-absolutely-...
http://www.forbes.com/sites/paulroderickgregory/2013/10/28/o...
Obviously we witnessed an administration that wanted to really put the screws to the voting public to score political points.
Now imagine when they want to do something similar with your healthcare.
1. Presidency
2. Repubs in Congress
3. Dems in Congress
I'd have to pick #2. Overwhelming disposition of evidence pointing in that direction.
In the spirit of your point: now imagine what those folks would be willing to do to your healthcare. Actually, we don't have to imagine. Look at their actions.
In DC in the last year we had a vandal deface the Lincoln Memorial and the National Cathedral. If during the shutdown the National Park Service just left all of the monuments unguarded and someone took a hammer to the nose of a statue of Jefferson, that'd be a humongous price to pay. In a national park, without park rangers to rescue people, if someone got themselves into trouble and died, that would be worse than ruining some people's vacations.
It is possible that the White House ordered parks and monuments closed for political reasons, but that's all speculation at this point. No different than speculating that George W. Bush allowed 9/11 to happen to justify invading Iraq.
Do you have any evidence that the president sent out an order to close the parks and monuments? In that case, yes he is responsible. Otherwise you are just speculating, just like everyone else.
If you want to make the argument that ultimately the president is responsible for everything that happens on his watch, that's a different argument. The parent post was saying that Obama sent an order to close the parks.
We've been at sequestration level funding for months. Some agencies moved things around to minimize disruption, some didn't. Do you think the president sent orders down to individual agencies on how to mitigate the effects of sequestration, but didn't send that guidance to others? It's possible, but it is more likely that the different agencies figured things out for themselves and some made out better than others.
You have to really be taking big gulps of the Kool Aid to have missed all the stories about how far park services went to deliberately shut down monuments. There were even reported stories of government officials showing up at some independent park operators who were utilizing government land. They ordered those parks shut down. So they didn't have money to operate parks but they had money to send people to shut down parks the government doesn't even operate?
If you start questioning the official line from the Administration, you might ask why the President and his spokespeople kept threatening default on national debts when the servicing of the debt is mandated by the 14th Amendment and easily accomplished with one tenth of the incoming federal revenues. It was all a big house of cards once you started looking at it.
There are plenty of reasons to not take Obama's word at face value, and there are plenty of real things to criticize him over without making up stuff.
For what it's worth, there's some crazy delegation of tasks in the ACA. For over a year now, I've been on the interim Preexisting Condition Insurance Program. (expires 12/31, so I'm in a bit of freakout mode, but that's another story for another time ....) It's administered by the Department of Agriculture. Ummm.... moo?
The executive branch has 2.1 million employees and is structured as set of a dozen subsidiary companies each with dozens of subsidiary companies. It is impossible for the Whitehouse, any Whitehouse, to manage except in a completely delegatory way. The idea that someone at the Whitehouse is going to be doing checkins with the contractors brought in to build a website is, frankly, laughable considering the number of things competing for attention.
I mean, would you call Warren Buffet incompetent if GEICO rolled out a faulty website because he ultimately controls it?
As Harry Truman said, the buck stops here. By the way, Warren Buffet isn't the CEO of GEICO. Tom Nicely is and yes, I would certainly call Mr. Nicely incompetent is a website they had over 2 years of lead time to build faild, especially if it were part of Mr. Nicely's "Signature" achievement and grand promise to revolutionize auto insurance for the company's customers. Should Steve Balmer be blamed for Windows Vista? Balmer had almost 100K employees, so obviously Vista couldn't have been his fault.
Guys, it's a damned website! It's essentially just a guided questionnaire. The "tough" part is that it probably has to talk to insurance company APIs. Other than that, it was purely a greenfield project. I'm sure we could assemble a team of 10 guys (or girls) from right here in Hacker News and could build a better product in 25% of the time at 1/100th of the cost. Actually, I would go so far as to say that the basic functionality could be built with a team of 6 with a budget of $500K. Remember, this site ISN'T administering insurance. It's Kayak for insurance -- that's pretty much it.
There is NO excuse for this level of incompetence. If I built healthcare.gov for a private client I wouldn't have been paid. I probably would have been sued. Yet according to the person to whom I am replying, The White House bears no responsibility because the government is just too damned big for the President to be responsible.
I didn't elect the President to suck, but that's what's happening.
Healthcare.gov is not just a damned website. The backend has to integrate with the IRS, Medicare/Medicaid, Social Security, private insurance companies, and the various state exchanges. No you could not have assembled a team of 10 developers in 25% of the time for 1% of the cost. No offense but you clearly are not familiar with any of the details of why healthcare.gov failed.
Requirements came in so late that development didn't start until March, giving them at the most, 7 months of time to develop this thing. So you're saying that a team of 10 could've gotten this thing built in less than 2 months? And that this fictional team could've gotten away with 1 week of full integration testing? The government integrators (CMS) didn't make that full test happen until 1 week before launch.
I agree that there is no excuse for this level of incompetence, but a lot of that incompetence is on the part of the customer. An ill-prepared group was given systems integration responsibilities, requirements came in very late and they were changing right up to release, not enough time was allocated to integration testing, and no one sounded the alarm that this was going to be a disaster.
Now maybe the president knew, maybe he didn't. The responsibility for something like this would've fallen on Kathleen Sebelius. Did she know the project was off the rails? Did she inform the White House? If she didn't know, she didn't do her job, if she did know and didn't sound the alarm, she didn't do her job. The only scenario where she is not to blame is if she sounded the alarm to the president, and the president told her to push ahead. So far there has been no indication that this was the case.
Something being scary doesn't make it untrue. It would not particularly surprise me if the first that Bush heard of Abu Ghraib was when it hit the news.
There are of course relative degrees of responsibility - you are responsible for the people you hire, and if you have few concerns then your responsibility for those concerns individually goes up since you have more time to devote to oversight on them. But do any of us think that a president has few concerns and is directly involved with hiring three or four levels of abstraction beneath them?
I picked GEICO because it is a wholly owned subsidiary of Berkshire Hathaway. Berkshire Hathaway's CEO is of course, Warren Buffet. Warren Buffet has the power to fire Tim Nicely the same way Barack Obama has the power to fire Kathleen Sebelius. Both of them however have very little daily direct interactions with projects at their subsidiary organizations.
Now, I would argue that Sibelius is ultimately responsible for setting unrealistic timelines, and general culture at HHS, but without a smoking gun I'm not going to blame the President. Yet. Although I think he entrusted his only signature act in the hands of a very incompetent woman, and gave her carte blanche for 3 years.
The programmer responsible (and his QA) should still be relegated to typewriters for the rest of their careers.
Rumsfeld eventually resigned, but Bush didn't push him out, meaning Bush owns Rumsfeld's failures. In my opinion, if Obama doesn't hold Sebelius and Clapper accountable, he owns their incompetence and misconduct.
The mind still boggles. If I was even asked by a client to put a password reset in analytics, I would report it to my manager immediately, then refuse the client's request. If the client didn't give up on tracking this, we'd have to stop working for them. That's how serious raw PII is in analytics.
You'd have to be seriously incompetent to even consider tracking a password request.
I think that situation was probably just sloppy coding of some sort, not an intentional act.
The data is present in the URL (queryString) for the page, so there is nothing malicious about the analytics code, which is merely going about it's default of reporting the URL of the page.
Returning that sort of data in a queryString is still far outside the realm of common sense.
They already had to do a password reset for everyone -- it's probably been breached already.
Which is of course why big IT projects are such horrible things. The risks (some would say inevitable results) are well researched at this point.
There is a reason the world has switched to Agile or Agile-like processes. There is no reason a project with a 3 year timeline didn't have a build and testing starting at year 1 and continuing periodically.
There shouldn't have been any development by the start of September 2013. None, except fixing bugs found by testers.
But we don't even know if they received enough requirements to start development before this year. We also don't know if the customer would've authorized them to start development before this year. Bad decisions and failings from the customer can doom projects like these very early in the process.
And even if CGI had used Agile and gotten as much done as they could, if you didn't get all of the requirements in time to implement them, you still probably couldn't launch. Politically HHS probably would not agree to launch without certain functionality completed. In a sane project if you're getting big requirements changes late in the game you'd either push them to another release or you'd push back the release date. Neither happened and predictably, disaster ensued.
Then there's the whole idiocy of allocating one week for full integration testing. Of course that test failed but again, no one sounded the alarm (at least not publicly).
This is going to set back electronic medical records for quite a long time. Don't forget the Obama admin put aside $20 billion dollars to fund that, and contractors have been eating up that money for a few years now.
http://spoiledtechie.com/post/2013/10/23/What-Scares-Me-abou...
If you think the UI is designed badly, just imagine how bad the backend is...
When I worked for the federal agency responsible for providing health care services to tribal entities, we would routinely accept and issue waivers for high-level risks discovered in RPMS (called VistA at the VA), the 30-year-old EHR application we used to store PHI and PII. Honestly, I don't know why we even bothered performing C&As and penetration tests -- everybody knew we weren't going to mitigate the vulnerabilities, even before we started testing for them.
It was an incredibly frustrating environment to work in. Federal law required us to test for vulnerabilities, but the director and CIO didn't give a shit about infosec and the CISO just kept issuing waivers for everything.
Wouldn't that be the IHS, which is underneath HHS? Suggesting a general disdain for security within the HHS?
Healthcare.gov is underneath CMS, not IHS, but I don't think it's unreasonable to conclude that the overarching body, HHS, has poor security practices.
Then again, I keep thinking that nothing the NSA does will surprise me anymore on a weekly basis, until another story like today happens.
Edit: The Queensland health Payroll system was quoted at $6.19 million, latest revised cost is $1.2 billion.
It's almost always the go-to excuse though, I just don't know if it's the truth anymore. Of course we'd blame management. Depressing.
I have a friend in this general field. Last time I checked, he told me those two words in the "Stimulus" bill expands in ~ 700 pages of regulations and it has made a bunch of consultants on it quite wealthy. Per Michelle Malkin, who lost her Primary Care Physician to this insanity, talking about another (http://michellemalkin.com/2013/10/23/dont-forget-obamacares-...):
"Dr. Michael Laidlaw of Rocklin, Calif., told EHR Practice Consultants that he abandoned the Obamacare EMR “incentive” program “when I realized that I spent the first two to five minutes of each visit endlessly clicking a bunch of garbage to make all the green lights show up on the (meaningful use) meter. I said to myself: ‘I’m not wasting precious seconds of my life and my patients’ time to ensure some database gets filled with data. I didn’t go into medicine for this. It is not benefiting my patients or me. I hate it.’ I actually refused to take the $10K-plus this year. I have even accepted that I would rather be penalized in the future. What is worth the most to me is AUTONOMY."
The later refers to the concept that this is firmly inserting the visible foot of government into the physician patient relationship.
I mean even DC created their own exchange, what was the excuse of the other 30+ states?
Plus my Purple home state of Missouri isn't doing one based on a citizen initiative in 2012, where 62% of us voted to outlaw the creation of a state exchange unless authorized by the people or the legislature (http://ballotpedia.org/wiki/index.php/Missouri_Health_Care_E... ).
I also find it highly questionable to score elections like you have. Not only are you ignoring Scott Brown and 2010, but the one in 2012 was between Mr. Obamacare and Mr. Romneycare, the eGOP handed voters the single worst possible candidate to have a referendum on Obamacare about.
More generally, you should acknowledge this is the first ever major entitlement program that didn't pass on a widely popular bipartisan basis, from FDR's Social Security to Bush's Medicare Part D prescription one. It would be remarkable if that didn't have consequences we've never seen before.
Or more specifically, how did not building an exchange "sabotage" Healthcare.gov? Sounds like you're trying to magic a perceived by you sin of omission into a sin of commission.
Can't be a volume problem, seeing as how the site failed in integration testing a week before launch before achieving 200 simultaneous logins, and so much has to go through it for every exchange (remember when Verizon's goof shut them all down) and perhaps one day if they get around to it insurer (it's the only allowed source of subsidy calculations, which does make some sense).
This is government accountability 101.
But to the extent that there are real people who want to purchase health plans through the federal exchange and can't: yes, this is a disaster and has to be fixed.
Regardless, it's not as though bigger problems make it so that smaller but still very large problems should be ignored. Similarly, one does not need to decide between foreign policy mistakes, nsa wiretaps, and bailouts to be angry about, you can be angry about all of them, and hold government officials responsible for all of them.
Besides which, healthcare.gov is a cornerstone of the affordable care act, which is a multi-trillion dollar endeavor.
Yet, it was "deem and passed" and here we are. Power to the people?
Wait.
Coming from the "extreme right wing" side of the political spectrum, I assure you that few of us considered any "severely conservative" promise from Hairpiece Q. Motherf----- credible. The eGOP managed to hand us the single worst possible candidate in every way to run against Obamacare.
Sorry, it just isn't.
The website has major problems. Shocking.
Sometimes, we should get out of our engineering bubble; it would put a perspective on things. It'll be fixed, but people will eventually forget about it.
Why not bring up the Teapot Dome Scandal? The Trail of Tears? The Mexican American War? Any number of other examples of Government Fail?
What you're trying to do is like a guy getting pulled over for speeding who grouses that the officer should be out catching burglars and muggers. It doesn't work in that situation either, as a rule.
If this is what it takes to get to single payer eventually, so be it. I expect the road to be bumpy.
If you think this disaster is going to make it easier to "get to single payer", you're dreaming.
I'm 30, and I would bet large sums of money we'll have single payer by the time I'm 40.
I would bet large sums of money that this disaster has killed single payer for at least a generation, if not longer.