Related link: http://www.medicare.gov/
Maybe you sat down to help grandma sign up for the new Medicare Prescription Drug plan this year? If you and gramps ended up staring at a HTTP 500 response code, you weren’t alone. The Medicare website, a mishmash of Microsoft ASP and ASP.NET pages, has been overwhelmed by activity, and, from most reports, is suffering from frequent outages. Read on…
Stories? Please share.
No Really, it’s broken…
Don’t believe me? Here’s an excerpt from the December 25th edition of the Richmond Times-Dispatch, “Coverage could lapse if timely choice not made”:
“Meanwhile, the Medicare drug plan Web site — www.medicare.gov — often freezes as trained volunteers start to help seniors, says C. Linda Barnhart, manager of senior resources and advocacy at Senior Connections/Capital Area Agency on Aging.”
The free health insurance counseling program Barnhart manages is still helping seniors figure out their top choices of drug plans offered in Virginia, but the volunteers are inundated with calls, she says. Each one takes 90 minutes to two hours or longer, if the Medicare site is inaccessible. Keep trying to access the Medicare site; eventually, it frees up, she says.
It failed…on TV…in November…
In fact, when Leslie Norwalk, Deputy Administrator, Centers for Medicare and Medicaid Services spoke to CSPAN on November 29th on Washington Journal, the segment included a live web demonstration of the web site enrollment process. Well, guess what, as luck would have it, the site errored out after the third or fourth step, and the CSPAN host quickly had to move on to other topics. (I happened to be watching this particular Washington Journal, and from what I can see there is no video archive of this particular show available for download). I remember watching as the screen switched to a view of a web browser, the host then set up the segment as an attempt to demonstrate how easy it was to sign up for the Part D drug plan online. Ms. Norwalk proceeded to describe the first step of the process of typing in a zipcode and selecting a prescription drug plan from the list of plans available in your specific area.
When she clicked to continue to the next step, the browser (presumably IE) displayed an error message one frequently encounters when an application server returns an internal server error or a HTTP 500 code. She continued to fumble with the system for a few seconds, and the host chose to quickly move on to another topic. In other words, they set up a segment about the ease of signing up through the web site, the web site failed, and they moved on to other important topics.
Summary of Facts
- Only 24 percent of seniors have ever used the Web. The poorest who would benefit the most are even less likely to have access to the appropriate technology
- The Medicare.gov enrollment application suffered a public failure on November 29th on CSPAN’s Morning Edition, and it clearly is something that has continued to experience failure for at least one month
- More recent news reports state that the Medicare site is frequently inaccessible. In fact, the independent agencies who advise seniors tell the Richmond Times-Dispatch of a site the “often freezes”.
An approaching deadline, a broken web site, and a (not so) hypothetical situation…
I know this issue isn’t a hot button O’Reilly topic, but try to take yourself away from Doom and iTunes for a moment to imagine the experience of a senior unlucky enough to be confronted with such a system.
Imagine, for a moment, that you are a 70 year old, who would benefit from signing up for this new prescription drug plan. Let’s make this easy, you’ve already figured out which of the 60 plans being offered in your area will pay for the specific set of drugs you depend upon to lower your blood pressure and keep you alive. All you want to do is use this web site to sign up for the new prescription drug plan. Remember, if you fail to enroll, your prescription drug benefits will end on January 1st. Sure, you can sign up until May 15th without penalty, but you don’t want to risk missing even a day of your blood pressure medicine. You’ve already had to cut back on essentials because of rising energy and healthcare costs, so this plan is literally a life-saver. No more choosing between your medication or your utilities.
Even though your sight is failing because of Macular degeneration, you’ve decided to stay at your one bedroom house as long as possible despite your son’s constant protest. You enjoy being around memories of your young family and you couldn’t conceive of moving into a retirement home. You know there are people you can call to help you signup for this service, but how hard can it be. You watch your grandson effortlessly use his Apple to download music to use iPod, and your 6 year old grandchild is sending picture email to her mother.
You can (barely) make out text on the computer screen, but you only really use your old Pentium 266 to balance your checkbook. Your grandson keeps on trying to convince you to buy a new computer and logon to the internet so he can send you email, but you’ve heard too many horror stories about scam artists stealing money from people’s bank accounts. Plus, you don’t want to spend your days fumbling around with technology. As of yesterday, you are content to leave the internet to your grand kids. But, after talking to a friend who used the internet to sign-up for Part D, you’ve decided to unwrap that AOL CD they left in your mailbox yesterday.
After fumbling around with AOL, you’ve managed to get what you thought was a new machine to successfully dial a modem. One you sign on, you click on something that says web, and you squint to read the Medicare instructions. You open a console window and type “http://www.medicare.gov”, pressing enter, the machine responds with a “Bad Command or Filename”. Resolving not to call your son for help, you spend a halfhour trying to read the AOL instructions with your Video Eye, a contraption which uses a video camera to enlarge printed text onto a 20″ flat screen your son set up for you. Reading text on this unit is a task because the system can only enlarge a 3″ by 3″ section of printed text at any given time and you haven’t grown used to the experience of reading a book from a TV.
OK, you’ve found a picture of the icon that launches something called a “Web Browser”. After launching this and following the instructions to the letter, you’ve ended up on the Medicare website. Damn, more text to read! It takes you a good deal of time to read everything, type in your zipcode and get to part two. Now you have to again read an entire screen of text and select the plan you choose from advertisements you received from the privately administered drug plan providers. Click….and now you are staring at a highly technical error message that is somewhat beyond you. You call you son on the phone and walk him through the same steps you took (you’ve written them down because you are used to pen and paper). Your son assures you that you must’ve typed something in wrong, but as he approaches step 3, he encounters the same errors.
At this point in the story, you end up calling Senior Connections/Capital Area Agency on Aging, a group that has helped you navigate the confusing world of Medicare in the past. They promise to help you sign up for the plan you want, but when you tell them about the problems you were having with the Medicare website, they simply tell you to keep at it “Keep trying to access the Medicare site; eventually, it frees up”, she says.
Conclusion
I’m sure there are savvy seniors, and this hypothetical isn’t mean to insult anyone born before 1935, but, I’m also sure that there is a large majority of seniors who just don’t care to be bothered with HTTP, XML, ASP, JSP, or those damn silly iPods. To base a Medicare Prescription Drug plan for seniors on a web enrollment application is folly and to build one that doesn’t work properly under load is less folly than crime. I certainly hope that Congress gets around to extending the signup deadline and mandating oversight over technology implementation, and I don’t think anyone can be certain that there are seniors who will lose healthcare coverage because of bad implementation and arhitecture.
I guess their website reflects other problems they are having, all of which involve mismanagement. Some of the news i have been reading on this medicare news blog for instance makes it pretty evident that technology isnt medicare's only pitfall
May 8, 2006
Someone needs to do something, perhaps you can help.
The new Medicare Drug plan is a disaster! Most people seem to think that it's a result of all the old people on Medicare being empty headed but that is not so. Here is what really happens:
You pick a plan that seems great since it has the drugs that you use or an equivalent on its formulary list and you enroll. I enrolled in Mutual of Omaha. They use Caremark for drugs. Now you get a prescription from your physician, which requires an office call. You get that and submit it but weeks later you find out that your physician has to get prior approval. You are told that prior approval requires only a simple phone call from him but later you discover that isn't true either. What he must do in cases when the drug is expensive even though you have been taking it for years is start you on a lower cost different treatment for a while and if that doesn't help, try another still lower cost drug and only if that doesn't work and if he provides copies of your medical records you may get the drug. But that's only if they haven't removed it form the formulary list by that time.
In my case I have suffered from GERD for several years and have had medical treatment for it. My Gastroenterologist (sp?) had prescribed Prevacid, which I had been using for several years. I was told that I would have to take it for the rest of my life when the doctor prescribed it.
The Plan I accepted in January did not have Prevacid but it had Nexium, which I assumed would be equivalent. I went to my Physican, who said that Protonix would be better than Nexium. I got my prescription and mailed it in. Weeks later we called since I had received nothing. First we were told that my prescription was lost since my wife and I both mailed in prescriptions in the same envelope. We assumed that pharmacist would read the prescription. Anyway, it turned out that the prescription wasn't lost, they just wanted some time so they could remove Protonix from the formulary list. In order to get the time they needed they required that my physician try something else first as well as fax my records. After several phone calls about the faxes which somehow never get through according to the drug company, they finally mailed me a letter stating that Protonix was no longer on the formulary list and would not be provided.
All during this time, I'm suffering from chest pain, trying everything I can of OTC medications and swigging the pink stuff. Only managed to stay out of the ER by taking left over ulcer medication from an earlier doctor visit.
Finally we realize their game so after another office call, we have a prescription for Nexium and thanks to our blessed physician a bag of samples to maybe hold me over until the Nexium arrives. Guess what, it turns out to be a repeat of the same sorry story, they have removed Nexium from the formulary list. My physician told my wife that they had as many as 19 rejections in one day from such companies and they were no longer trying to work with them, as they couldn't afford it.
Now I have dropped that plan, which by the way was from a well known and reputable insurance company, and am going through the waiting period of one month after enrolling in another well known and reputable insurance company's plan before they will provide service. This time I enrolled in Humana. I can only hope this plan is better than the first. It is now May and it looks like I will not have my much needed medicine until sometime in June, maybe.
Here is what should be changed:
The provided should only be able to remove drugs from the formulary list if the FDA says they are unsafe.
The physician's prescription should be sufficient to bypass the cheaper drug trial plan. Generics would be okay if the physician approves.
The physician should not be required to copy and submit patient records. They are already overloaded.
The patient should be able to get a prescription for more than one month's supply thereby being able to use the mail-in service and save money for all concerned. All the expensive drugs have a 30-day limitation.
The one-month waiting period before you can submit a prescription is also a serious drawback as that means probably a two-month wait before you can get drugs.
Gene Adair
2017 Beam Rd.
Columbus, IN 47201
812-372-9019
The Medicare website is joke. Even if you a web savvy twenty year old you simple can not get accurate results.
Gene (if you chance to read this):
When dealing with Humana try to get everything in writing ASAP. Call back to confirm and take down names and dates you spoke to anyone. Like your old plan, they change the formulary list and demand special approval of drugs they say they cover. They also make a lot of mistakes and lose the paperwork and "forget" what they tell you on the phone.
All I have to say is I am out of medicine August 1 and not sure what to do. I called Wyeth and they told me to get an application and send a letter explaining why I am out of medicine and request the patience assistance program. Since I had been on all free medicine before Part D, I am hoping they will continue this for me. I never thought I would live to see the government mess up like this.
The current government would like shut down Medicare and Social Security. The way to do this is without angering the public is to throw as many "wretches" as possible to prevent the smooth running of these plans and say see it doesn't work. Stuff like this did not happen when when Medicare first became active.
This is also a great opportunity for the politicians to make some money on the side from the drug/insurance companies.
Something else doctors no longer have samples to give patients.
For folks who don't qualify for Medicare but would like to have a discount card, there's a great one at www.rxdrugcard.com. Prices posted on the website. Low membership fees. Check it out!!