Posts Tagged ‘Obamacare’

I’m into the third week of the UI (user interface) design course I am taking via Coursera called Human Computer Interaction. The lectures for this week include a discussion of some prototyping techniques to use to quickly create a mockup of the interface for your system. The objective is to have a prototype to put in front of users to see how they interact with it and identify issues early in the development cycle. One of the techniques is called the “Wizard of Oz” method.

The name is inspired by the movie of the same name in which the wizard is really just a small man behind a curtain who is pulling the levers to make something much bigger appear operational. This technique is really great for early evaluation of user interfaces because you don’t have to spend a lot of time solving complex issues in the backend. You just need to have an interface that looks somewhat realistic. A “wizard”, which is a person behind the scenes not usually visible to the users, operates the controls to make it appear as if an automated system is actually running everything.

Today I was reading a story at Natural News with the headline “Head fake! Is Healthcare.gov only an empty shell MOCKUP of a working Obamacare exchange?” and it struck me right away that maybe healthcare.gov really is just a mockup in a Wizard of Oz prototype fashion. All the evidence would seem to indicate that. Like the fact that the people in charge can’t even say how many people have signed up through the system. That kind of information just falls out of a real system. Maybe they don’t know because it really is just a mockup with a bunch of people behind the scenes pulling the levers and they have to poll all them and collate the information before they know.

Another reason to think it might just be a mockup is how quickly and thoroughly it has been overwhelmed. Seriously, any system designed for this purpose would have to consider this volume of users at initial roll-out. I don’t think there is really any system on the backend.

And finally, anyone who has done contract work for the government knows how ridiculous it is. It is standard procedure to have specifications thrown at you that are bloated, poorly written, and often times scoped by inexperienced people. Then the specs get changed repeatedly, causing rework and delays. Then there is a funding issue at the end of each fiscal year when funding runs out, the project has to shutdown, and then later gets restarted again when the funding finally comes through, but in the mean time the previous development team went off and found other jobs. I know this one well from my previous work at an aerospace firm where I was a project manager.

My guess is that the system was not completed in time due to all the vagaries of government contracting. The government was firmly committed to a roll out date, but the system wasn’t ready so they threw up a mockup. The wizards, of course, were immediately overwhelmed.

I shouldn’t be smug about this. Being smug tempts fate. But I can’t help it, because I don’t have to sign up for Obamacare! That’s right. Because I am an expat I can completely ignore all the nonsense and overreach of the U.S government as it forces everyone residing in the U.S. to purchase a product even if they don’t want it. As an expat who resides more than 330 days per year outside of the U.S. I am presumed to have “Minimal Essential Coverage” under the ACA so I am not required to purchase health insurance and am not subject to any penalty for not doing so.

So now that I have tempted fate by gloating about this I will worry that the USG overreach will extend further, and in the future they will force people like me who don’t even visit the U.S., and therefore cannot receive medical care in the U.S., to purchase U.S. health insurance anyway. They could very well do that since they already do many things that are completely unreasonable. Perhaps if they do force that on expats they will make some sense of it by requiring insurance benefits to be paid to where we actually use medical services, which is at our local medical facilities outside the U.S. That might be reasonable, although it is likely that the cost of insurance will far exceed any benefit we receive. That’s because I can meet my “Minimal Essential Coverage” by paying out of pocket since I get better health care at a fraction of the cost compared to the U.S. Here’s a good example, my foot surgery at Siriraj Hospital.

After I had that surgery I wondered how much would it cost in the U.S. Questions like that have long been tough to answer due to the sleazy evasiveness of the U.S. medical industry who won’t quote prices and just drop a bomb on you afterwards with outrageous fees. For this post I did some Googling and found something interesting called HealthCareBluebook.com. They list a “fair price” of US$16,398 for foot surgery consisting of $2,074 for physician services, $13,855 for hospital services, and $469 for anesthesia services. Here is the link. Interesting. That is 20 times the price I paid when I had my surgery at Siriraj Hospital in Bangkok by one of the top foot specialists in the country. Let me just say that I am a bit surprised the multiple is that high. I was expecting a multiple of 5 to 10.

Now what would happen if I had to buy insurance under Obamacare? I’m guessing that a single year of premiums would be more than the US$709 I paid for the surgeon + two nights in a private hospital room + anesthesia that I paid for my foot surgery. And of course I would have some deductible, probably at least 10% of the bill which would be at least US$1,600 for that surgery in the U.S. So probably at least, I mean the very least, I would be US$2,500 out of pocket for that procedure if I had U.S. insurance and did it in the U.S. And of course I would not have enjoyed the warm care and hospitality of the Thai medical staff; they are so nice and make you feel so comfortable even in difficult circumstances.

So no thanks America. I will stay right where I am. I just need to keep working on how to protect my hard-earned assets from the next attempted grab by the USG. We all do, no matter who we are or where we are.