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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: DMaA who wrote (6910)	6/7/2009 5:44:10 PM
From: skinowski	Respond to of 42652

The Federal track record of managing large computer program developments is abysmal. Time after time they dumb $billions on a problem and end up with nothing usable. If they cannot centralize medicare, which they have been running for several decades, I can't see how they could make work any new single payer scheme.

To: DMaA who wrote (6910)	6/7/2009 8:43:58 PM
From: i-node	1 Recommendation Read Replies (1) \| Respond to of 42652

The Federal track record of managing large computer program developments is abysmal. Time after time they dumb $billions on a problem and end up with nothing usable. Couldn't agree more. They do have an excuse though -- getting your hands around systems as big as most government systems is a big job. Due in part to the regulatory environment in which they operate. While SSA does a pretty good job, their task is far simpler than that of, say, Medicare or IRS (IRS does the heavy lifting for SSA, i.e., collecting the taxes). Medicare's internal systems are abysmal and I believe beyond help. The adoption last year of the "NPI" is proof positive. The concept was to have a single identifying number for every provider -- hospital, physician, lab, whatever. All insurance companies would use the same ID, and tons of problems would be solved (that is, every provider wouldn't have tens or soon-to-be hundreds of different IDs for use with every insurance company -- since there are no fewer than 4 providers on a typical insurance claim, tracking all these numbers was a problem). Okay, so it all sounds good. Except. Medicare can't handle it. Medicaid can't handle it. So, now, not only do providers have NPI #s, they also have a Medicaid ID (which requires a taxonomy code to be used with it in many circumstances) and a Medicare ID (AKA the "PTAN", which is -- you guessed it -- their old "provider number"). Even worse, Medicare STILL cannot accept claims over the Internet. Those who submit their claims directly to Medicare use a 56K dialup modem. Same with Medicaid. Most other insurances have multiple options. But not Medicare/Medicaid. It is a mess and we're getting ready to create another one if Obama has his way.