Friday, November 15, 2013

Some Shit I Know How To Fix



Once upon a time, many years ago, I worked for several insurance companies cleaning up other people's stupid, expensive mistakes.

So when I read this --
...
For insurance regulators and health insurance carriers, though, this supposed glide path is about to create a whole bunch of headaches. They have been expecting, for years now, that these insurance plans would be phased out of the market in 2014 — and have planned accordingly. Here's how Robert Laszewksi, an insurance consultant, put it in a note to clients earlier this morning:
This means that the insurance companies have 32 days to reprogram their computer systems for policies, rates, and eligibility, send notices to the policyholders via US Mail, send a very complex letter that describes just what the differences are between specific policies and Obamacare compliant plans, ask the consumer for their decision — and give them a reasonable time to make that decision — and then enter those decisions back into their systems without creating massive billing, claim payment, and provider eligibility list mistakes.
All by January 1.

There's also worry, among health policy wonks, that allowing people to stay on these plans will be bad for the new insurance marketplaces. Anyone who enrolls in one of these pre-Obamacare plans will be kept in a separate "risk pool," meaning that their premiums are set based on their smaller group. Everyone who buys an Obamacare-compliant plan is put in a different risk pool. The concern here is that healthier people are more likely to stay in these pre-Obamacare plans; they're probably more okay with a skimpier benefit package. And that could drive up premiums in the new Obamacare markets. A short-term fix, in other words, could become a longer-term problem for the president's health-care law.

"This puts the insurance companies," Laszewski writes, "who have successfully complied with the law, in a hell of a mess."
...
 -- I knew that someone, somewhere has broken out the supermarket-opening-sized Kleig lights to shine me on.

Not that it won't be a raging mess.  It will be.  But one of very short duration because insurance company IT departments are full of people with poor attitudes who have developed the very thick hides and agile, tricky minds that come from having other people's red-hot fuckups dropped on them every week with "Hurry!Hurry!Hurry!" memos stapled all over them.

First, the relevant data for the people insurance companies scammed into buying these one-year, churn-and-burn policies are still there: still backed up on their databases somewhere.  Age, name, address, medical history, disclaimers, renewal dates, actuarial arcanum.  A copy of every one and zero they need to roll everyone right back into the flimsy, cardboard-shack "coverage" they had two months ago is copied off and stored somewhere, because insurance companies are fanatical about data storage and protection.  There are regular backups make of everything.  Then annual backups of those backups.  Then copies of the most critical backups stored offsite somewhere in case of disaster.  One company I worked for used an abandoned salt mine.  Another used a refurbished floor of a ramshackle hotel.

Second, all of the billing and processing information needed to process that flimsy, cardboard-shack "coverage" is still there too.  I know it may come as a big shock, but all of that isn't worked out on chalkboards and then typed up by Madge from the secretarial pool.  Since the 1950s, insurance companies have used things called "computers" which runs stuff called "software", which insurance companies are equally assiduous about backing up and reusing.  In the normal, everyday course of doing business, large blocks of code are swapped in and out constantly based on changes that are made to the policies of millions of people.

Back when I was still coding, programmers would almost never delete functional code because it was always 50/50 that the same idiots who told you to pull it today would want it put back tomorrow. Instead you would just comment it out -- in COBOL we called it "flower boxing" because your would surround the section of code you wanted to nullify with asterisks as well as drop in a few written remarks for future generations of programmers about what you were doing, why you were doing it, as well as a couple of obscene shots at your co-workers, because why not? In addition, every major change made to every piece if software is documented somewhere in a project log for precisely this reason.  I guarantee that most of the programmers who pulled this stuff out a couple of months ago know where every bit of it is and how to reactivate it.  If not, as I mentioned already, insurance companies are obsessive about backups and it would take virtually no effort to roll the software back to the previous version that processed and billed these shitty policies.

All the complicated, techie stuff could be done over a normal week or a long weekend, but of course I no programmer in his or her right mind would ever tell the boss that because our reputations as miracle workers who saved the day at the last minute against impossible odds is what we live for.

Lastly, any insurance company that has the nerve to publicly whine about having to send a "very complex letter" via the "US Mail" needs to be shot into the Sun.

4 comments:

Geese Howard said...

As a sysadmin type myself you never promise miracles. If you do that eventually someone will plop something on your desk that cannot be turned around in a long weekend no matter what. But if you set the expectation that you can, when you explain why it is not possible this time, they will accuse you lying to them and make the demand all the same.

To make matters worse, they will then march into the company officers meeting and tell them that IT will have it done. Then, when it does not get done IT will be blamed and flogged in public for this screw up. That you said it was not possible and why will be ignored.

Then all of us admin types will be hauled up and screamed at in private with giant lectures about why they are paying us and idiotic claims that apple and google could have done it. They will threaten to contract out their IT services becomes some contractor told them they could do it in a weekend.

So in a few days, said contractors will show up and make a complete hash out of shit, and run out the door with a bigger mess than when we started. Which we will now be blamed for despite the fact we are trying to clean it up.

Horace Boothroyd III said...

@GH

Very interesting. It sounds like the suits treat the IT people pretty much like the goopers treat President Obama.

Anonymous said...

You are spot on about software being "kept around" for just such occurrences. I have worked/taught in the software industry for almost 40 years (yes, I know how to run a punch card machine on a Univac 1100).

I routinely teach my programming students to initially build software into a system that the user is likely to need but has not yet been asked for, to comment out this code-that-will-have-to-be-added-later, and, when it is finally requested to be added under emergency conditions, un-comment the lines of code (but not too fast) and have a beer.

Anonymous said...

REM "This will fix healthcare" REM