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How Kentucky Built the Country's Best ACA Exchange

Unknown Lamer posted about 6 months ago | from the keep-it-simple-strikes-again dept.

Software 333

Hugh Pickens DOT Com writes "Dylan Scott writes at TPM that Kentucky, with its deeply conservative congressional delegation, seems like an unlikely place for Obamacare to find success. Instead, Kentucky's online health insurance exchange has proven to be one of the best, and shows that the marketplace concept can work in practice. Kentucky routinely ranks toward the bottom in overall health, and better health coverage is one step toward reversing that norm. It started with the commitment to build the state's own website rather than default to the federal version. On July 17, 2012, a few weeks after the U.S. Supreme Court upheld the Affordable Care Act, Democratic Gov. Steve Beshear created the exchange via executive order, over the objections of a Republican-controlled state legislature, which sought other means — including an effort to prevent the exchange from finding office space — to block the site's creation. ... Testing was undertaken throughout every step of the process, says Carrie Banahan, kynect's executive director, and it was crucial because it allowed state officials to identify problems early in the process. ... From a design standpoint, Kentucky made the conscious choice to stick to the basics, rather than seeking to blow users away with a state-of-the-art consumer interface. It 'doesn't have all the bells and whistles that other states tried to incorporate,' says Jennifer Tolbert. 'It's very straightforward in allowing consumers to browse plans without first creating an account.' A big part of that was knowing their demographics: A simpler site would make it easer to access for people without broadband Internet access, and the content was written at a sixth-grade reading level so it would be as easy to understand as possible."

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Wow. (-1, Flamebait)

grub (11606) | about 6 months ago | (#45267591)

"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."

They really are setting the bar high in Kentucky.

Re:Wow. (4, Insightful)

Cornwallis (1188489) | about 6 months ago | (#45267623)

Yes, as opposed to Vermont where we set the bar so high nobody can use the state's site.

Re:Wow. (5, Insightful)

kilodelta (843627) | about 6 months ago | (#45267851)

RI's system kind of, sort of, works. However I applaud Kentucky for understanding KISS - Keep It Simple Stupid. That's something that seems be thrown out the window in most web development projects.

Re:Wow. (5, Informative)

queazocotal (915608) | about 6 months ago | (#45267625)

To quote wikipedia.
"The study, the most comprehensive study of literacy ever commissioned by the U.S. government, was released in April 2002 and reapplied in 2003 giving trend data. It involved lengthy interviews of over 90,700 adults statistically balanced for age, gender, ethnicity, education level, and location (urban, suburban, or rural) in 12 states across the U.S. and was designed to represent the U.S. population as a whole. This government study showed that 21% to 23% of adult Americans were not "able to locate information in text", could not "make low-level inferences using printed materials", and were unable to "integrate easily identifiable pieces of information." Further, this study showed that 41% to 44% of U.S. adults in the lowest level on the literacy scale (literacy rate of 35 or below) were living in poverty.[2]

A follow-up study by the same group of researchers using a smaller database (19,714 interviewees) was released in 2006 that showed some upward movement of low end (basic and below to intermediate) in U.S. adult literacy levels and a decline in the full proficiency group.[3]"

The less literate seem likely to be over-represented in the users of these exchanges.

Re:Wow. (5, Insightful)

fuzzyfuzzyfungus (1223518) | about 6 months ago | (#45267801)

Also, given the generally negative effects of both poverty and ill-health on things like school attendance and performance, there is a fairly strong incentive to make these mechanisms accessible even to adults who are probably permanently screwed at this point. Even if it's too late to do much more than write them off, they are the ones we need to work with if we want to head off the next generation of probably permanently screwed people before it's too late.

Re:Wow. (0)

Anonymous Coward | about 6 months ago | (#45267735)

You obviously aren't from Kentucky. Sixth-grade reading level might honestly be overstating the capabilities of some of the people I grew up with.

Re:Wow. (5, Insightful)

mwvdlee (775178) | about 6 months ago | (#45267767)

"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."

They really are setting the bar high in Kentucky.

Yes they did.

It's far more difficult to write simple and easy to understand text than it is to simply copy & paste legalese.

The target demographic of this site is every adult living in the state, so it should be accessible to every adult.

Re:Wow. (1)

ebno-10db (1459097) | about 6 months ago | (#45267833)

The target demographic of this site is every adult living in the state, so it should be accessible to every adult.

You're on the wrong website. The GP is in the spirit of things, as he pretends to have a larger penis because he can read on a 7th grade level.

Re:Wow. (0)

Anonymous Coward | about 6 months ago | (#45268545)

Considering how many times you see such illiteracies as "there car's are over their, the looser's car is hear" at slashdot, a NERD site of all places, having a sixth grade reading level may be setting the bar too high. There are obviously people here (never mind those who don't consider themselves nerds and would never come here except to troll) who never read a book in their life that wasn't required by some teacher.

Re:Wow. (0)

Anonymous Coward | about 6 months ago | (#45268519)

"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."

They really are setting the bar high in Kentucky.

Yes they did.

It's far more difficult to write simple and easy to understand text than it is to simply copy & paste legalese.

The target demographic of this site is every adult living in the state, so it should be accessible to every adult.

I agree with the parent's point, that it is difficult to write things simply and well. And conversely, there are parts of the state where a sixth-grade reading level IS a high bar. Significant parts of the demographic, especially in the eastern part of the state, would be challenged by text written at a sixth-grade level. I'm guessing that the plan is that those people might know someone that does have a sixth-grade reading level and will get help from them.

Re:Wow. (5, Insightful)

fuzzyfuzzyfungus (1223518) | about 6 months ago | (#45267775)

"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible." They really are setting the bar high in Kentucky.

What I want to know is who they had to waterboard to get insurance companies to provide information about their policies written at a 6th-grade level...

Mine alternates between issuing cryptic tomes (with pictures of happy, smiling, healthy people on the front, naturally) that alternate between dense medical-billing-and-coding jargon and EULA-like 'eh, you'll discover what we don't cover after you've had the procedure' disclaimers.

As much as I enjoy making fun of the developing world, why should we permit vital, allegedly mutually-consensual, contracts to be couched in language that a substantial portion of the people who 'agree' to them aren't capable of understanding? Without mutual understanding, much less mutual consent, centuries of contract law are reduced to a mockery.

Re:Wow. (5, Funny)

ebno-10db (1459097) | about 6 months ago | (#45267819)

What I want to know is who they had to waterboard to get insurance companies to provide information about their policies written at a 6th-grade level

They probably had someone outside of the insurance companies do the translating, though I do prefer your waterboarding approach. Oh, that sounds so harsh. Better to call it "enhanced contract interpretation".

Re:Wow. (2)

fuzzyfuzzyfungus (1223518) | about 6 months ago | (#45267877)

"We are going to achieve a consensus ad idem concerning this medical coverage policy, by one method or another. Now, would you like to do this the easy way, or are you going to make me do it the hard way?"

Re:Wow. (1)

TheDarkMaster (1292526) | about 6 months ago | (#45267855)

Without mutual understanding, much less mutual consent, centuries of contract law are reduced to a mockery.

That's the plan.

Re:Wow. (1)

fuzzyfuzzyfungus (1223518) | about 6 months ago | (#45267987)

That's certainly the impression that only gets deeper every time I interact with somebody who can afford more lawyers than I can. Plus, Mandatory Binding Arbitration with the arbiter of their choice, in the venue of their choice, according to a contract that they reserve the right to amend at any time if it wasn't bad enough originally!

Re:Wow. (1)

gtall (79522) | about 6 months ago | (#45267965)

The cryptic stuff comes because they used techno-geeks to build the sites. The techno-geeks talked to the insurance geeks and the new Geek-O-Rama was stillborn.

It is really hard work creating good user interfaces. Skimp on that or turn it over to people who don't converse well with the regular society and we get crap interfaces we have to suffer from. And it doesn't necessarily restricted to gui elements. I especially love the Verizon phone jungle where you can go around loops which are 9 interactions long:

Phone Systerm: Please allow us to direct your call to the responsible party.

Me: You have included a charge on my bill for feature A I did not ask for?

PS: Please press the correct button to choose features of feature A:
              1. Would you like feature A to walk the dog?
              2. Would you like to link feature A to feature B (but only if you choose feature C)?
              3. Would you like to pay even more for feature A?

Me: Errr...none of those.

PS: We work to ensure your enjoyment with this new feature for you.

Me: I don't want it.

PS: Please press the # key for instructions on how to use your new feature.


PS: Please allow us to direct your call to the responsible party.

Re:Wow. (1)

amiga3D (567632) | about 6 months ago | (#45267777)

It's just a matter of facing the reality of public education in the US.

But to put it another way.. (1)

Anonymous Coward | about 6 months ago | (#45268365)

If something *can* be described in sixth grader terminology, why use harder terminology to explain it?

Re:Wow. (1)

Anonymous Coward | about 6 months ago | (#45267795)

Nothing wrong with being honest about the situation, as in making sure your target audience is able to understand what you're saying.
I guess in some people's infinite wisdom it would just be better to leave the masses frustrated just to make it seem that the human race is more advanced than it is.
I bet you're one of those people who likes to make melodramatic quips to make yourself sound more insightful than what you really are too, huh? You people are a real treat. I think most of the time you do that just to say you disagree without someone being able to show you why you're wrong... as if you know something no one else knows.

Re:Wow. (0, Flamebait)

gtall (79522) | about 6 months ago | (#45267859)

Eh, they just wanted the bar set so Rand Paul could understand the site. Mitch McConnell is SOL though.

Re:Wow. (0)

Anonymous Coward | about 6 months ago | (#45267953)

Nice way to be a goose stepping bigot.

Re:Wow. (4, Informative)

mi (197448) | about 6 months ago | (#45268383)

Eh, they just wanted the bar set so Rand Paul could understand the site. Mitch McConnell is SOL though.

Rand Paul graduated college and medical school, and passed certification of American Board of Ophthalmology — before running for Senate and winning.

I'd wager, his reading comprehension is above that of most people — yourself included.

McConnel has "only" a bachelor degree of formal education, but that's still well above most people... Whatever your beef with your political opponents, sneering at their education only makes you look ridiculous [usatoday.com] .

Re:Wow. (-1)

Anonymous Coward | about 6 months ago | (#45267885)

The Democrats assembling the site understood well the limitations of a populace that voted in a Republican legislature.

Re:Wow. (-1, Flamebait)

Yosho (135835) | about 6 months ago | (#45267915)

They really are setting the bar high in Kentucky.

Are you implying the site should be made more difficult to use so that people with poor educations can't get health insurance? Hmm, I think you might have a promising future as a Republican congressman...

Re:Wow. (5, Interesting)

TechNeilogy (2948399) | about 6 months ago | (#45267977)

I'm a Kentuckian of several generations on both sides; I wrote my first computer program in Kentucky. It makes me happy to see our exchange is doing well. One thing about Kentuckians: we may not always know everything, but we know what we don't know and aren't generally too proud to try to remedy it given the means.

Re:Wow. (4, Interesting)

OakDragon (885217) | about 6 months ago | (#45268317)

As a programmer currently living and working in Kentucky, I am also proud of the state's website offering. Of course Obamacare should be thrown on a fire, and it will probably be crushed under its own weight if not heavily modified, but I'm glad we made a functional website.

Re:Wow. (0)

Anonymous Coward | about 6 months ago | (#45268205)

Nothing has changed here. Most newspapers have historically been written at a 6th grade level. What does that mean? It means keeping the sentences straight to the point and not trying to hide things with words that have several meanings.

There used to be an Amiga program called Excellence that used a grammar analyzer to tell you where your paper landed on reading scale.

I work in a very large multi national and I'd say most of my reports are written to that level. It allows people to pick up the information quickly and keeps them interested in the subject long enough to finish reading it. When I write higher level stuff its almost always ignored by business folks. Even some engineers wont read it.

I was once told to put all the information on the subject line thats important.

Just a note, none of the people reading the stuff I write are stupid or dumb, they are just busy and dont ussually have time to spend sifting through complex stuff.

Re:Wow. (1)

mi (197448) | about 6 months ago | (#45268267)

"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."

They really are setting the bar high in Kentucky.

Despite per-pupil costs of public schools quadrupling over the last 50 years [ed.gov] (inflation-adjusted), mere 30% of 8th-graders nation-wide are deemed "proficient" in reading [mediamatters.org] . Kentucky did the web-site right, even though their average [ed.gov] is slightly above national.

We are now all set for our healthcare to become the same sort of dizzying success, that the public schools already are.

Re:Wow. (5, Insightful)

Anonymous Coward | about 6 months ago | (#45268457)

While training to be a journalist in the 1970s we were taught to write at that level also. Reading at that level will take you through The Atlantic, National Geographic, Outside Magazine, Consumer Reports, The New Yorker, WebMD, Wikipedia, Reuters, Washington Post, New York Times. Considering the state of literacy in America, "setting the bar higher" would be stupid for a website designed to serve the public with health issues. If you happen to think this bar is too low, try walking into a classroom where kids have to learn to read, and teach them. Try teaching people to read when they grow up in poverty, a big problem in all states, including Kentucky. I've lived there. My own father had to get a GED because when he was in ELEMENTARY school he had to drop out to get a job so his family could get by. Over-privileged, over-bred, snarky people may look down at the unwashed masses. But those who grew up in comfortable homes with parents who had the time and resources to focus on their kids' education have lived soft lives. They haven't had to rise above it. In my childhood my father knew I had to graduate from high school. He told me he'd beat the hell out of me otherwise. But even though he knew the value of a high school education in the workplace, he still had no concept of the value of college. I've had to struggle to get where I am today, and many of the people I lived with in Kentucky still struggle just to make a living. I hated living there and won't do it again, but I'm damn proud that Kentucky, one of those states people laugh at, a Tea Party foothold, had the foresight to do something right that our glorious surveillance president couldn't get it right. And no, I'm not a right-winger. Just the opposite.

Re:Wow. (0)

Anonymous Coward | about 6 months ago | (#45268481)

"[T]he content was written at a sixth-grade reading level so it would be as easy to understand as possible."
  They really are setting the bar high in Kentucky.

Almost all public media, from newspapers to the evening news to cable headline "news" shows, targets a 6th - 8th grade reading level, and has for a very long time.
Of course you need to take this with a grain of salt, as the "reading level" is pretty vague. For example, in MT where I live we expect that by the end 6th grade you're no longer shopping in the "young adults" section of the bookstore, while in California they're just getting into the "Goosebumps" at the end of Senior Year.

Hey rest of the country.... (3, Insightful)

Anonymous Coward | about 6 months ago | (#45267619)

Kentucky did better than you did. One of the most ass-backwards hillbilly clueless groups of people around. And they beat you. Completely.

That's... Very very sad.

Re:Hey rest of the country.... (1, Informative)

ebno-10db (1459097) | about 6 months ago | (#45267887)

And they play a mean banjo too. I saw "Deliverance".

P.S. A widely used technique in American humor has long been to have an outwardly unsophisticated character who is actually more insightful than the superficially sophisticated characters. In the spirit of the Appalachian-American(1) stereotype, it looks like Kentucky has brought humor to real life.

(1) Bo Duke said that this term was now preferred to "hillbilly".

Re:Hey rest of the country.... (0)

Anonymous Coward | about 6 months ago | (#45267921)

Beat by kentucky on computer related thing and healthcare related thing. Thats unbelievable.

For this we should fire everyone in charge of this issue in the other 49 states and federal goverment.

Re:Hey rest of the country.... (1)

dmbasso (1052166) | about 6 months ago | (#45268299)

That's great! Now the other states can copy the site!
Ah, wait, I forgot... you people pay for the software but you don't own it. Yes, Free Software is for communists.

Not all republicans are republitards (0, Insightful)

Anonymous Coward | about 6 months ago | (#45267639)

Well it seems those hillibillies really have the basics anchored down. Good for them.

Re:Not all republicans are republitards (5, Insightful)

Anonymous Coward | about 6 months ago | (#45267715)

Well, the democratic governor did it via executive order while the republicans tried to deny them office space to do the work. I wouldn't give the republicans too much credit. This seems more of a success in spite of them not because of them.

Yup, it;s the success of the governor (1)

Anonymous Coward | about 6 months ago | (#45267761)

Yup, it's the success of the governor, not the senators.

And Obama could do with having a look at what they did when they said "Fuck it, these idiots 'DO NOT WANT' to do anything where a Democrat, especially a half-black one, may get plaudits".

Re:Not all republicans are republitards (0)

Anonymous Coward | about 6 months ago | (#45267803)

Ironically, the poor people in appalachia consistently vote yellow dog, continue to get their welfare checks (they have it to an art form; coal vouchers and all) and yet, the standards of living are still the lowest, education is laughable, and poverty is still endemic in spite of more than 100 years of consistently getting a blue majority.

Re:Not all republicans are republitards (1)

judoguy (534886) | about 6 months ago | (#45268463)

Why are all y'all equating a functional web site with a desirable policy? The web site can be great, but if it is merely facilitating the destruction of health care in the U.S., that ain't helping us.

KY gets it (5, Insightful)

drinkypoo (153816) | about 6 months ago | (#45267647)

Subject pun intended.

What is with all the websites which launch with a bunch of stupid bells and whistles? Just get the core functionality working, and then worry about the pretty pretty. Most sites never really make it that far, but they implement the gewgaws and glitter anyway.

Re:KY gets it (0)

Anonymous Coward | about 6 months ago | (#45267739)

Subject pun intended.

What is with all the websites which launch with a bunch of stupid bells and whistles? Just get the core functionality working, and then worry about the pretty pretty. Most sites never really make it that far, but they implement the gewgaws and glitter anyway.

That's how fucking programmers are brought up. Just look at the fucking mess they are making of linux, complexity for complexity's sake. And user be damned. It is the same philosophy applied across all the IT industry.
It's very rare to find people that KNOW how to engineer a well designed and usable software product.

Re:KY gets it (1)

Anonymous Coward | about 6 months ago | (#45268329)

It's not that we're "brought up" this way. It's that ABSO-FUCKING-LUTELY NOTHING rewards us for getting the basics right. Users presume that the basics just work, and they don't want to talk about them ("that's booooooring"). So, they want to talk about the sizzle... and guess what, what you talk about gets attention.... what you don't talk about doesn't. It's that flipping simple. Programmers want to please end users, and they ASSUME (wrongly) that end users know how to keep the donkey before the cart...

Users need to stop bitching about how bad software is, and start owning up to the fact that their childish behavior ("that's the boooooooring stuff") leads DIRECTLY to shitty software.

Honestly, we're reaching a point where casual users are basically no longer helpful in building software, except as kind of a casual checkpoint mechanism. We live in an Apple dominated world where people want to be dazzled without doing the hard work of thinking about how things should flow, so average end users are almost useless in helping define requirements these days. Now we're moving toward specialist users who are trained in how to balance HCI concerns with business concerns -- Product Owners. This paradigm -- Product Owners + Casual End Users with frequent checkpoints seems to produce a better balance. Anywhere where you don't see this, you see varying degrees of shitty software.

Re:KY gets it (3, Insightful)

Anonymous Coward | about 6 months ago | (#45268359)

Its called the iterative process. Make small thing test it run it verify it, make small test it run it verify it... Do it in small chunks so you can at least have a shot at having your integration work worth a damn.

I worked on one project totally hit all the marks. Hit all the performance, memory, blah blah blah... Nice simple iterative project. Just continue iterating and the project would have new features every 1-3 weeks. Another group took over didn't like the 'style' (naming) thought it was 'too hard to read' (spacing). As if they have never heard of a pretty printer (even though I told them about it 20 times). A refactor was maybe 2-3 weeks of work to match the naming the way they wanted it (even though it was fine). So they threw the whole thing out. Rewrote the whole thing from scratch. Did not bother with the original requirements (at first until it got to QA). Was more concerned with 'cool stuff' and 'how they feel' about naming. 8 months on and many 80-90 hour weeks they still have not matched the original code in performance, size, and features. They went monolithic design.

I screamed yelled whatever no one cared. I dont care anymore. Last projection they had another 2-3 months of work to 'get it working'. The whole original project took 1 plus another 6 of iterations and 0 overtime. They come to me for questions 'its your project and your code you wanted it so badly live with it'. I spent months warning them they were setting themselves up for a death march. But they didnt care. They felt good about the naming.

Best complement I ever got was 'your code is super easy to read'. The worst one 'I dont feel good about the style of the code'. Two different people. One liked the ease of flow. The other didnt like it because it didnt match the style guide for the company he used to work for (as if I have access to it). My style guide fits on an napkin his takes 40 pages.

Why did I go on a rant about style? Because complexity for complexity's sake. That is how we end up with it. Everyone wanting to redesign things that *do not need it*. I get refactor, I get reuse, I do not get throw it out and start over. Many times it is done for no real good reason. So you end up with 20 programs that sorta do the same thing.

You're absolutely correct. New Rule: (1)

DahGhostfacedFiddlah (470393) | about 6 months ago | (#45267955)

All websites must be designed for use by rural Kentuckians.

Re:You're absolutely correct. New Rule: (0)

Anonymous Coward | about 6 months ago | (#45268089)

All websites must be designed for use by rural Kentuckians.

But Fark.com still sucks.

Re:KY gets it (0)

Anonymous Coward | about 6 months ago | (#45267959)

I'm not a fan of Obamacare but if you're going to implement the exchanges then this is the way to do it. Simple and effective.

Re:KY gets it (2)

Anne_Nonymous (313852) | about 6 months ago | (#45268111)

>> and then worry about the pretty pretty

For that matter, most sites can forgo pretty altogether.

Google, Zillow, Amazon, Wunderground were all more usable and useful when they were simple.

Re:KY gets it (2)

interkin3tic (1469267) | about 6 months ago | (#45268453)

If everyone is doing something that seems stupid to you, then either everyone else is stupid or you are missing something.

The bells and whistles in those cases are perhaps more to generate buzz among non-nerds. If I go to say university website and it has all the information (like address) I need in plain black text on plain white background, and I can ctrl+F and get on with my life in a second, I appreciate that. However, for every one person like me who doesn't want any frills, there are a dozen silly people who will complain about how boring the website is and oh can't we do better and maybe highlight some of the unique features of state college university like maybe the bell tower and some multiracial group of kids playing frisbee on the quad and the logo and at least have some sports updates and twitter and facebook link and I saw a dancing baby image a few years ago...

It's not made by us and it's not exclusively FOR us. Yes, the bells and whistles shouldn't need to be there, but there are a lot of idiotic customers who want silly bells and whistles, even with health care.

Doesn't justify websites not having their basic functionality of course. I'm not trying to rationalize that.

Re:KY gets it (3, Insightful)

T.E.D. (34228) | about 6 months ago | (#45268525)

In fact, perhaps it is time to repost this on Slashdot for today's fresh audience of developers, lest our classics be forgotten:

The Rise of Worse is Better [jwz.org]

I and just about every designer of Common Lisp and CLOS has had extreme exposure to the MIT/Stanford style of design. The essence of this style can be captured by the phrase ``the right thing.'' To such a designer it is important to get all of the following characteristics right:

  • Simplicity-the design must be simple, both in implementation and interface. It is more important for the interface to be simple than the implementation.
  • Correctness-the design must be correct in all observable aspects. Incorrectness is simply not allowed.
  • Consistency-the design must not be inconsistent. A design is allowed to be slightly less simple and less complete to avoid inconsistency. Consistency is as important as correctness.
  • Completeness-the design must cover as many important situations as is practical. All reasonably expected cases must be covered. Simplicity is not allowed to overly reduce completeness.

I believe most people would agree that these are good characteristics. I will call the use of this philosophy of design the ``MIT approach.'' Common Lisp (with CLOS) and Scheme represent the MIT approach to design and implementation.

The worse-is-better philosophy is only slightly different:

  • Simplicity-the design must be simple, both in implementation and interface. It is more important for the implementation to be simple than the interface. Simplicity is the most important consideration in a design.
  • Correctness-the design must be correct in all observable aspects. It is slightly better to be simple than correct.
  • Consistency-the design must not be overly inconsistent. Consistency can be sacrificed for simplicity in some cases, but it is better to drop those parts of the design that deal with less common circumstances than to introduce either implementational complexity or inconsistency.
  • Completeness-the design must cover as many important situations as is practical. All reasonably expected cases should be covered. Completeness can be sacrificed in favor of any other quality. In fact, completeness must sacrificed whenever implementation simplicity is jeopardized. Consistency can be sacrificed to achieve completeness if simplicity is retained; especially worthless is consistency of interface.

Early Unix and C are examples of the use of this school of design, and I will call the use of this design strategy the ``New Jersey approach.'' I have intentionally caricatured the worse-is-better philosophy to convince you that it is obviously a bad philosophy and that the New Jersey approach is a bad approach.

However, I believe that worse-is-better, even in its strawman form, has better survival characteristics than the-right-thing, and that the New Jersey approach when used for software is a better approach than the MIT approach.

Let me start out by retelling a story that shows that the MIT/New-Jersey distinction is valid and that proponents of each philosophy actually believe their philosophy is better.

Two famous people, one from MIT and another from Berkeley (but working on Unix) once met to discuss operating system issues. The person from MIT was knowledgeable about ITS (the MIT AI Lab operating system) and had been reading the Unix sources. He was interested in how Unix solved the PC loser-ing problem. The PC loser-ing problem occurs when a user program invokes a system routine to perform a lengthy operation that might have significant state, such as IO buffers. If an interrupt occurs during the operation, the state of the user program must be saved. Because the invocation of the system routine is usually a single instruction, the PC of the user program does not adequately capture the state of the process. The system routine must either back out or press forward. The right thing is to back out and restore the user program PC to the instruction that invoked the system routine so that resumption of the user program after the interrupt, for example, re-enters the system routine. It is called ``PC loser-ing'' because the PC is being coerced into ``loser mode,'' where ``loser'' is the affectionate name for ``user'' at MIT.

The MIT guy did not see any code that handled this case and asked the New Jersey guy how the problem was handled. The New Jersey guy said that the Unix folks were aware of the problem, but the solution was for the system routine to always finish, but sometimes an error code would be returned that signaled that the system routine had failed to complete its action. A correct user program, then, had to check the error code to determine whether to simply try the system routine again. The MIT guy did not like this solution because it was not the right thing.

The New Jersey guy said that the Unix solution was right because the design philosophy of Unix was simplicity and that the right thing was too complex. Besides, programmers could easily insert this extra test and loop. The MIT guy pointed out that the implementation was simple but the interface to the functionality was complex. The New Jersey guy said that the right tradeoff has been selected in Unix-namely, implementation simplicity was more important than interface simplicity.

The MIT guy then muttered that sometimes it takes a tough man to make a tender chicken, but the New Jersey guy didn't understand (I'm not sure I do either).

Now I want to argue that worse-is-better is better. C is a programming language designed for writing Unix, and it was designed using the New Jersey approach. C is therefore a language for which it is easy to write a decent compiler, and it requires the programmer to write text that is easy for the compiler to interpret. Some have called C a fancy assembly language. Both early Unix and C compilers had simple structures, are easy to port, require few machine resources to run, and provide about 50%--80% of what you want from an operating system and programming language.

Half the computers that exist at any point are worse than median (smaller or slower). Unix and C work fine on them. The worse-is-better philosophy means that implementation simplicity has highest priority, which means Unix and C are easy to port on such machines. Therefore, one expects that if the 50% functionality Unix and C support is satisfactory, they will start to appear everywhere. And they have, haven't they?

Unix and C are the ultimate computer viruses.

A further benefit of the worse-is-better philosophy is that the programmer is conditioned to sacrifice some safety, convenience, and hassle to get good performance and modest resource use. Programs written using the New Jersey approach will work well both in small machines and large ones, and the code will be portable because it is written on top of a virus.

It is important to remember that the initial virus has to be basically good. If so, the viral spread is assured as long as it is portable. Once the virus has spread, there will be pressure to improve it, possibly by increasing its functionality closer to 90%, but users have already been conditioned to accept worse than the right thing. Therefore, the worse-is-better software first will gain acceptance, second will condition its users to expect less, and third will be improved to a point that is almost the right thing. In concrete terms, even though Lisp compilers in 1987 were about as good as C compilers, there are many more compiler experts who want to make C compilers better than want to make Lisp compilers better.

The good news is that in 1995 we will have a good operating system and programming language; the bad news is that they will be Unix and C++.

There is a final benefit to worse-is-better. Because a New Jersey language and system are not really powerful enough to build complex monolithic software, large systems must be designed to reuse components. Therefore, a tradition of integration springs up.

How does the right thing stack up? There are two basic scenarios: the ``big complex system scenario'' and the ``diamond-like jewel'' scenario.

The ``big complex system'' scenario goes like this:

First, the right thing needs to be designed. Then its implementation needs to be designed. Finally it is implemented. Because it is the right thing, it has nearly 100% of desired functionality, and implementation simplicity was never a concern so it takes a long time to implement. It is large and complex. It requires complex tools to use properly. The last 20% takes 80% of the effort, and so the right thing takes a long time to get out, and it only runs satisfactorily on the most sophisticated hardware.

The ``diamond-like jewel'' scenario goes like this:

The right thing takes forever to design, but it is quite small at every point along the way. To implement it to run fast is either impossible or beyond the capabilities of most implementors.

The two scenarios correspond to Common Lisp and Scheme.

The first scenario is also the scenario for classic artificial intelligence software.

The right thing is frequently a monolithic piece of software, but for no reason other than that the right thing is often designed monolithically. That is, this characteristic is a happenstance.

The lesson to be learned from this is that it is often undesirable to go for the right thing first. It is better to get half of the right thing available so that it spreads like a virus. Once people are hooked on it, take the time to improve it to 90% of the right thing.

A wrong lesson is to take the parable literally and to conclude that C is the right vehicle for AI software. The 50% solution has to be basically right, and in this case it isn't.

But, one can conclude only that the Lisp community needs to seriously rethink its position on Lisp design. I will say more about this later. rpg@lucid.com

Attn: Slashdot Socialists!! You Are Screwed. (2, Interesting)

Anonymous Coward | about 6 months ago | (#45267649)

Something Bad is going to happen, because Obama called upon his Bottomless Well of Executive Power to delay the Employer Mandate unilaterally, fearing political fall-out for the 2014 elections should millions upon millions of previously-covered workers be dumped into the exchanges.

Will this happen? I don't know. But here's what I do know: Obama sufficiently feared this possibility to violate the Constitution and delay his own beloved pet boondoggle to avoid the possibility of it.

Right now we are talking about the millions and millions of people in the individual insurance market. They are getting screwed. But as a percentage of the country, this is a small number of people -- I think the fraction is something like 8% or so.

Caveat: I just made that up. But it's low.

We should be talking about What Happens Next. And critics of ObamaCare have some good authority to speak about What Happens Next, given that they already predicted What Already Happened.

The individual-market Losers are the canaries in the coalmine for tens of millions more likely losers.

I would like Obama and his Minions to be questioned closely about what they predict will happen next. I want them on the record as to their new promises about "if you like your plan, you can keep your plan" as regards employer-paid coverage.

Let's face it: If 90% of the country thinks, probably wrongly, that only 10% of the country is getting screwed, they will probably just shrug it off and say "Sucks to be them." All of these anecdotes about people getting screwed will not move the general public.

Only worries about What Comes Next, regarding themselves, will agitate them for the 2014 elections.

Honestly I don't know if the disruption in the employer markets will be as bad. I think it will be bad, but not as bad -- for one thing, I think employer-provided insurance already includes a bit of subsidization for sick workers-- in as much as the employer buys coverage for an undefined group, which might include very sick people -- the risks then are already pooled, at least to some extent. But only to some extent, because the sickest of all people probably do not work, and thus do not ever enter the employer coverage pools.

Employer coverage is also generally decent, and thus won't be much affected by increased demands for coverage. But it will be affected somewhat, and when ObamaCare demands that a business give its employees, effectively, a $1,000 or $3,000 annual raise in the form of a health care policy that covers previously uncovered things (and also steals money to subsidize the uninsurable), many companies may balk and simply stop providing insurance altogether.

Maybe this is the secret evil genius of Obama's plan -- he will get all those healthy people subsidizing the sick on the individual markets, because when his employer mandates start kicking in, many companies will dump their huge numbers of relatively low-risk people (remember, the most sick people can't actually work for a living) into the high-risk individual market pools.

Do I know these things? No, I don't. But after having not looked into these matters for five years straight, perhaps our media could trouble itself to rise from its lazy slumbers for a few minutes to begin asking some questions about ObamaCare.

Until now they've gotten everything about ObamaCare wrong. Can they attempt to get some of it right, before the employer mandate kicks in?

Re:Attn: Slashdot Socialists!! You Are Screwed. (-1)

Anonymous Coward | about 6 months ago | (#45267717)


I just freaking *hate* socialists.


"“I spent two years defending Obamacare. I had constituents scream at me, spit at me and call me names that I can’t put in print. The congressman was not re-elected in 2010 mainly because of the anti-Obamacare anger. When the congressman was not re-elected, I also (along with the rest of our staff) lost my job. I was upset that because of the health care issue, I didn’t have a job anymore but still defended Obamacare because it would make health care available to everyone at, what I assumed, would be an affordable price. I have now learned that I was wrong. Very wrong.”

For Klinkhamer, 60, President Obama’s oft-repeated words ring in her ears: “If you like your health plan, you will keep it.”

Well, possibly not.

When Klinkhamer lost her congressional job, she had to buy an individual policy on the open market.

Three years ago, it was $225 a month with a $2,500 deductible. Each year it went up a little to, as of Sept. 1, $291 with a $3,500 deductible. Then, a few weeks ago, she got a letter.

“Blue Cross,” she said, “stated my current coverage would expire on Dec. 31, and here are my options: I can have a plan with similar benefits for $647.12 [or] I can have a plan with similar [but higher] pricing for $322.32 but with a $6,500 deductible.”

She went on, “Blue Cross also tells me that if I don’t pick one of the options, they will just assume I want the one for $647. ... Someone please tell me why my premium in January will be $356 more than in December?”

Ahh the schadenfreude just cannot be real! Can you get insurance from terminal schadenfreude!

Oh fuck all you dirty socialists up the ass with a hot iron anvil sideways.

Re:Attn: Slashdot Socialists!! You Are Screwed. (1)

Anonymous Coward | about 6 months ago | (#45267747)

wait, you mean my employer was paying for 50%-75% of my health insurance this whole time, and the "monthly charge" I thought I was paying doesn't come close to buying the same thing privately?

wow, who knew?

Re:Attn: Slashdot Socialists!! You Are Screwed. (1)

Anonymous Coward | about 6 months ago | (#45267823)

When Klinkhamer lost her congressional job, she had to buy an individual policy on the open market.

Meaning, she paid the ENTIRE cost of the plan out of her pocket as she was not employed.

Re:Attn: Slashdot Socialists!! You Are Screwed. (5, Insightful)

ebno-10db (1459097) | about 6 months ago | (#45267949)

I agree with your criticism of Obamacare. The answer is to have real "socialism", like in Canada, Japan, Australia, and most of Western Europe. Then we could save a third off the top. Total US healthcare expenditures are 50% greater as a percentage of GDP than any other country, for no more care and no better results.

I'm too much of a cheap bastard to worry about ideology.

Re:Attn: Slashdot Socialists!! You Are Screwed. (1, Informative)

khallow (566160) | about 6 months ago | (#45268097)

You could get most of that by dropping the tax subsidy for employer insurance plans.

Re:Attn: Slashdot Socialists!! You Are Screwed. (3, Insightful)

ebno-10db (1459097) | about 6 months ago | (#45268199)

Good theory, but do you have an example of that working in the 21st century? If not, I'll stick with facts and empiricism, and go with what works in dozens of countries around the world.

Re:Attn: Slashdot Socialists!! You Are Screwed. (2)

khallow (566160) | about 6 months ago | (#45268333)

Good theory, but do you have an example of that working in the 21st century?

I see you chose to exclude the 20th century where health insurance did work.

Re:Attn: Slashdot Socialists!! You Are Screwed. (0)

Anonymous Coward | about 6 months ago | (#45268171)

Or, you know, you could stop shitting on the constitution and do it at the state level. Instead of doubling down on a "failed" republican policy (it accomplished the purpose of making hte insurance companies rich), you could, you know, implement single payer health care at the state level and have no constitutional problems, get everything you want and make a mockery of the republicans.

Re:Attn: Slashdot Socialists!! You Are Screwed. (2, Insightful)

Anonymous Coward | about 6 months ago | (#45268017)

There are some of us in other parts of the civilized world that just go WTF at the total mess that is the US Healthcare System. To say it is Fucked Up would be generous.

Thank god the politicians on all sides got together towards the end of WW2 and gave birth to the UK's NHS. Paid for out of general taxation and free at the point of delivery to everyone. I pay approx $200/month out of my earned income but even that ends when I reach official retirement age. from then on it is free. No loss of benefits if you are out of work either.

so we get called Socialists/commies/or worse by big sections of the US politicos and media. so fucking what. With our healthcare sorted we can get on with other things free from worrying how we are going to pay for healthcare.

You Yanks really should get your act together and join the rest of the developed nations and have a decent system. The aim you seeming have of making every Doctor a millionaire is just stupid.
I lived and worked in MA for several years. Luckily my employer took care of all my insurance. But to hear two medics arguing over who was going to be able to put in a bill for my treatment was the final straw. My family & I returned home soon afterwards.
Fuck the American Dream. If that makes me a rabid commie then so be it.

Re:Attn: Slashdot Socialists!! You Are Screwed. (-1)

Anonymous Coward | about 6 months ago | (#45268469)

"The aim you seeming have of making every Doctor a millionaire is just stupid"

You are a commie.

Listen to me, do you not understand that people do things because it benefits them? That is they work hard and perform jobs that may be difficult or streeful, or what ever for money. The more difficult the job the more money people want. They do not do things just because they are fun, or they want to help humanity (I am speaking in the general of course). In general, if you pay people crap, the work they do will be just that, crap.

A favority saying in the old USSR was (and Russinas are big on these things in case you didn't know); "as long as they pretend to pay us, we will pretend to work". How do you like it is this is the attitude your doctor takes on while treating you for a life threatening illness?

Do you not understand that just being a "doctor" does not mean you become a millionaire just like that?

Do you not understand that the term "millioniare", or what the Democrats call the "rich" basically means any family that earns $250,000, or even less? This is really not a "millionaire". Do you also understand that a "millioniare" really isn't that rich to begin with?

Do you not understand that some of the richest people in this country are the people who write these laws designed to take the money away from people who they term as "rich" and really aren't?

Do you want the doctor performing heart surgery on your child or your spouse to be someone who isn't really paid very much for what they do?

If you think a "million" is too much, then how much is enough? Why? Who should decide? -- This is a *really* important question here.

If you say you like state run healthcare so much then I have a question; how much experience have you had with the healthcare system - that is the socialized medical care system over there? I mean real experience, you state you were in an ambulance, but that is not very specific... have you had any significant medical treatments or problems? This is an important question becaise if you state that socialized medicine is just happy dandy then that really doesn't mean shit if you have been healthy and haven't really undergone any significant treatments.

Health exchange sabotage (5, Insightful)

Required Snark (1702878) | about 6 months ago | (#45267741)

Remember, the original plan was to have every state do their own exchange. It was never intended that the federal exchange would be doing a large percentage of the work. One big exchange is riskier and much more difficult then 50 state sized exchanges.

In effect the deliberately obstructionist Republican governors put the entire project at risk, and now the Republicans are screaming that it doesn't work. They are sick manipulative bastards who will do anything to get their way.

By the way, a friend of mine just signed up through the California exchange, and it was not a big deal. If the people in charge want it to work, they can make it work. If they want it to fail, they can make it fail. The Republicans want government to fail, so it does. By analogy, it's like going to a doctor who thinks medicine is bunk, and he proves it by having his patients die. In both a literal and figurative sense, Republicans are happy to see Americans die.

Re:Health exchange sabotage (5, Interesting)

hrvatska (790627) | about 6 months ago | (#45267863)

My son just applied for insurance for his family through the NY exchange. I sat with him through the process just to see what it was like. The process was pretty painless and he found a plan that offered the same coverage as his current one for about $250 per month less. What I didn't like about the process is that you had to officially register in order to comparison shop.

Re:Health exchange sabotage (1)

SJHillman (1966756) | about 6 months ago | (#45267969)

New York did a damned poor job advertising its own exchange... this is the first I've heard of it. Most people in states with their own exchanges are still probably trying to get on the Federal site, which certainly won't help the current issues.

Re:Health exchange sabotage (1)

hrvatska (790627) | about 6 months ago | (#45268391)

Once he selected NY as his state he was presented with a link to the NY site. That happened at the beginning of the federal site, before he started entering registration data. Once he got onto the NY site he had to enter registration data before he could compare plans.

Re:Health exchange sabotage (0)

Anonymous Coward | about 6 months ago | (#45268533)

Of course this is a meaningless data pont without specifics. $250 per month less? Less than what? What is the coverage... there is much more to consider than premiums - there are deductables, available doctor choices, coverage for things like major surgeries etc.

So you say your son had a good experience, wonderful for you. But even if this is true - and I am not saying it isn't, just that we do not really know the answer to that without more details; even if this is true that means nothing as it relates to other people in other situations.

Young people don't need a lot of medial care in general, insurance is more relevant when we are speaking about people who need more expensive care.

So, good for you and your son. But this doesn't mean shit to the rest of us.

Re:Health exchange sabotage (0)

Anonymous Coward | about 6 months ago | (#45267919)

I didnt know Jon Stewart posted on /.

Re:Health exchange sabotage (0)

Anonymous Coward | about 6 months ago | (#45268003)

No kidding.

The Republican party put the Obamacare website at risk? Really? Have you been watching too much [url="http://www.ijreview.com/2013/10/88538-mystery-solved-msnbc-blames-gop-disastrous-obamacare-roll/"]MSBNC?[/url]. I didn't know that the Republican party was able to infiltrate the terribad contractors and sabotage code in their repositories, for example, but wow you really have opened my eyes!

Of COURSE it is the Rpublican's fault. It can't just be, you know a shitty contractor, or it couldn't be that they were forced to use a bunch of old tech, or deal with a bunch of federal bullcrap the entire way. Nope, none of that could be true. Hell why stop at the Republicans - it's BUSH'S fault! I swear I saw him lurking around the web servers!

Dear OP: Stop being such a partisan hack. I hope that someday you realize that it isn't always "the other party" that is to blame. Most of the time it's really BOTH parties that are screwing it all up.

Re:Health exchange sabotage (2, Informative)

gtall (79522) | about 6 months ago | (#45268015)

I think you are cutting the Republicans too much slack. The current crop of faux Republicans want to destroy trust in government. That way the voters will decide on less government. The Tea Baggers (and I include that Svengali, Grover Norquist) are even worse than that. They want to destroy the rest of the world's trust in the U.S. so that there will be no "foreign entanglements". Their belief is just the same as it was in the 1930's, that if the U.S. leaves the rest of the world alone, it will leave the U.S. alone. And that ended very badly.

Re:Health exchange sabotage (1)

Mr D from 63 (3395377) | about 6 months ago | (#45268227)

There is always an excuse, never accountability. This made up excuse was floated by this same poster. At least last time the poster admitted there was no substantiation. Regardless of what the original approach plan was, there was more than enough time and money to do the website right. Clearly, some folks feel better if they can manufacture a way to shift blame. Most level headed Democrats actually admit it was a bungle.

Those that love blaming others and don't believe accountability, go ahead and moderate me down.

Ironic (5, Insightful)

Overzeetop (214511) | about 6 months ago | (#45268285)

I found it amazingly ironic that the states which take the hardest stance on wanting to do everything their own way because the federal government can't possibly know the nuances of their state needs nearly all chose to let the feds make the ACA website for them.


Anonymous Coward | about 6 months ago | (#45267757)

800 w/512 Megs of more gay than they Then disappeared to decline for turd-suckingly The failure of over to yet another Clearly become project returns Users. BSD/OS obtain a copy of platform for the perspective, the She had no fear they learn from our the wind appeared , a proud member good to write you Working on various irc.easynews.com

What is an ACA Exchange? (0)

Anonymous Coward | about 6 months ago | (#45267773)

The summary does not explain that at all.

Re:What is an ACA Exchange? (1)

KitFox (712780) | about 6 months ago | (#45267901)

Technically: Affordable Care Act in the US (or "ObamaCare") Health Insurance Exchange, where people are able to shop for and purchase health insurance that meets federal requirements.

Officially: A TLA (Three Letter Acronym) that is US-Centric and probably half or more of the folks in the US don't even know what it means, so never mind the folks outside the US who have better things to worry about than more TLAs.

Re:What is an ACA Exchange? (0)

Anonymous Coward | about 6 months ago | (#45268397)

Slashdot is a US site with predominantly US users and is admittedly and intentionally US-centric.

It's literally in the F.A.Q.

Re:What is an ACA Exchange? (1)

ebno-10db (1459097) | about 6 months ago | (#45268005)

An ACA Exchange is a joke (the joke's on you and me). Health care exchanges have been tried and did little or nothing to improve things. They're a pretense to have some sort of free market competition inside of a government mandated system, which only seems like a contradiction only because it is. Either throw everybody to the scum, or have either a properly regulated system of non-profits or the government as a universal health insurer. That works everywhere else, but we have to maintain a pretense and get the worst of both worlds. An alternative explanation is that it has little to do with ideological pretense, and much to do with guaranteed customers for for-profit insurance companies.

Re:What is an ACA Exchange? (1)

Overzeetop (214511) | about 6 months ago | (#45268403)

Healthcare is full of fake non-profits. They're NP because they "donate" care to the needy - though in reality they are required to treat everybody by law, and they write off the debts which they find they can't collect though the court system. Nearly every NP hospital has a team of lawyers which clog the judicial system chasing payments from non-paying patients.

Exchanges are a purely republican idea, though not without merit if there is actual competition. I'm still baffled why the ACA didn't take the simple route and simply require that the FEHB (fed employee system) be opened to all citizens. It's already got a 2M person group, so it's not like its going to get horribly worse, and there are plans available in every state and territory.

all we really are is livestock. (0)

Anonymous Coward | about 6 months ago | (#45267809)

Nada: You see, I take these glasses off, she looks like a regular person, doesn't she? Put 'em back on...

[puts them back on]

Nada: ...formaldehyde-face!


Bearded Man: We could be pets, we could be food, but all we really are is livestock.

That's really the best website for ACA? (0)

Anonymous Coward | about 6 months ago | (#45267835)

After seeing this headline on slashdot, I decided to look at the KY ACA website. It is terrible. Their website has navigation "glitches" where hitting the "back" button will not actually go back and will reload the same page.

Re:That's really the best website for ACA? (1)

SJHillman (1966756) | about 6 months ago | (#45268007)

Obviously you haven't seen the other ACA exchanges. I browsed through it and it's loads easier to figure out than the NY or federal sites.

Re:That's really the best website for ACA? (1)

Overzeetop (214511) | about 6 months ago | (#45268431)

You haven't surfed the internet much lately. Many sites do a multiple re-direct that prevents the use of the back button from working correctly. It's annoying as hell, but it's not uncommon.

What happens when you don't have to "have it all" (2)

MikeRT (947531) | about 6 months ago | (#45267861)

They succeeded because the governor accepted a system that doesn't do it all, but gets right what it does. That is totally bass ackwards from how government normally does it in the US. It's pretty normal for 1.0 to be just about everything and the kitchen sink, not a modest product that's well-tested and positioned for rapid iteration through point releases to address bugs the full user base finds and new features.

80% Medicaid Enrollment (0)

Anonymous Coward | about 6 months ago | (#45267937)

21,000 out of the 26,000 who signed up in KY are enrolling in Medicaid [therightscoop.com] .

Why not swap in this one? (0)

Anonymous Coward | about 6 months ago | (#45268001)

Are there any major features the federal site has to cover that these functional state-specific sites aren't handling? It depends on how fundamental the problems with the federal site are, but it seems like it might make sense to just take one of the better state exchange sites and add in whatever extra things are necessary for the federal site.

Obama / Democrats Caught Telling Lies (-1)

Anonymous Coward | about 6 months ago | (#45268043)

Obama admin. knew millions could not keep their health insurance

Report: Obama administration knew millions wouldn't be able to keep insurance

White House knew as early as 2010 millions would lose health plans under ObamaCare

Re:Obama / Democrats Caught Telling Lies (0)

Anonymous Coward | about 6 months ago | (#45268485)

NBC Predicts: All Americans Will Receive A Microchip Implant In 2017 Per Obamacare

ObamaCare Death Panels illegally withholding treatment

Look to Communism to Explain Obamacare

NiGga (-1)

Anonymous Coward | about 6 months ago | (#45268131)

you 4ave a play

Free market concept beats goverment: surprise! (0)

Anonymous Coward | about 6 months ago | (#45268217)

So the gist of the story is that a more conservative state that applied true free market ideas fared better than the ones that went with the usual big goverment ideas? Why am I NOT surprised? It is amazing to me that when you see SO much evidence that the free market is infinitely better than goverment that so many statists still claim otherwise.

Re:Free market concept beats goverment: surprise! (0)

Anonymous Coward | about 6 months ago | (#45268231)

The state most likely signs their paycheck, and as you know, dogs are loyal to their masters when fed.

Different states = experiments (5, Interesting)

GlobalEcho (26240) | about 6 months ago | (#45268225)

A point I've read in The Economist, and has really stuck with me, is how one of America's strengths is the somewhat loose federation of the states, which allows for different approaches to any given problem. Each state can try its own approach to the ACA, or education, or taxation laws, et cetera. Eventually the "better" approaches should become clear, and the country as a whole will adopt them.

Now in practice it doesn't always work like that, but I think we see it in action right now with marijuana legalization and gay marriage.

Of course, the federation also means that, in cases where the "best" approach is known a priori, we lose efficiency when some states fail to adopt it. I don't consider that a big problem, because I think politicians are rarely capable of identifying and engendering quality programs right from the start, especially at the national level.

Let's hope the rule proves true here, and that other states copy Kentucky. (Maybe Kentucky can even share the code?)

Answer's in the question (1)

T.E.D. (34228) | about 6 months ago | (#45268357)

How did KY do it, you ask? What's their magic secret?

weeks after the U.S. Supreme Court upheld the Affordable Care Act, Democratic Gov. Steve Beshear

There's your answer right there.

Re:Answer's in the question (0)

Anonymous Coward | about 6 months ago | (#45268437)

He wanted to make sure the 21,000 ( 80.76% of those who signed up ) eligable for Medicaid were able to sign up and get free health insurance, while everyone else paid for it.


Gotta grab the goodies before they are gone.

If the table is empty when you arrive at the buffet then you get to pay the bill.

Testing and feature prioritization? (4, Insightful)

EmperorOfCanada (1332175) | about 6 months ago | (#45268435)

Testing and feature prioritization, how innovative! I am actually not being sarcastic. So many big projects push testing off as a "waste of resources" and absolutely don't prioritize features. For instance I don't know how many government web sites have a "Message from the ...(fill in organization head)" front and center of the front page of the website. I am willing to bet that less than 1% of people actually click on that. Then after that you often find news about awards and other ribbon cutting crap that the leaders feature in. And hidden away in the corners are the stuff that people actually want.

So with so many projects you have too many cooks who have their own internal priorities and the result is the wonderful British expression, A Dog's Breakfast.

Did the article author actually attempt to apply? (4, Interesting)

CmdrPorno (115048) | about 6 months ago | (#45268537)

Because I'm on my fourth online application and kynect had me in some sort of infinite loop purgatory (in which I wasn't allowed to complete the application process) for the past three weeks. This morning, I finally got a message asking me to upload additional documentation.

For what it's worth, the Cabinet for Health and Family Services is in charge of Kentucky's exchange. The same Cabinet which is responsible for child welfare and has a history of hiding information [kentucky.com] about child fatalities which occur under their watch.

We all know why it's OK to mock KY (-1)

Anonymous Coward | about 6 months ago | (#45268559)

Let's see, too many NON-PROTECTED CLASS individuals, too many FIREARMS, too much ALCOHOL, too much CHRISTIANITY, too many HORSES and PICKUP TRUCKS, too much PATRIOTISM, too many HOODS and SHEETS, too many BURNING CROSSES, too much ENGLISH LANGUAGE.


I regret that the cesspool has not been agitated unto actionable effect, damn it!

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