One has to wonder how much of the code for the website was written overseas and with government contractors we know that purchasing commercial software is not always a pre-requisite as the contractors won’t make as much money if they integrate off the shelf software into an entire project solution, so again this may offer some answers as to why there were limitations on the amount of US created software was used.  Again keep in mind there were very short timelines to meet and one does wonder if the two even crossed.  This is a screenshot from the SEC page from United Healthcare.  If you have not seen it, it’s well worth a look to see 15 pages of subsidiary companies and entities. 





There was quite a bit of scuttlebutt when United purchased the company as it was not initially listed at the SEC and there’s a rule about “significant operations” that may have come into play here with the SEC where subsidiaries don’t have to be listed if they are not significant and I don’t don’t know if this applies to owned companies outside the US as QSSI has a domicile country of India listed.  We all know there has been nothing but secrecy surrounding the build of the Federal Hub. 

SEC Rules Ask for Disclosure Only When Subsidiary Operations Are “Significant”-Was The Federal Hub Contract Awarded to QSSI Not Significant When the Company Was Bought By United Health Group?–Subsidiary Watch

Another interesting bit of subsidiaries has to do with Health Net as United when Health Net was in the process of losing the big Tri-Care contract a few years ago in the northeast, which they eventually got back as Aetna cheated who was the first awardee, was put in a big cash issue and they area  much smaller carrier.  They had to sell to United upon the news of losing Tri-Care as it was such a huge part of their business and thus so if you are with Health Net in New York, Connecticut, Bermuda  or New Jersey, your policies are really owned by United Healthcare.  Here’s from 2009 when I blogged it, a “subsidiary watch” post as I call them. 






CanReg which is listed as a Canadian domicile (2011 post) is a subsidiary that helps drug and device companies get introduced to the FDA and works with the consulting of the submittal and approval process.  ChinaGate in China and Hong Kong, another interesting subsidiary, post form 2010.  Evercare is hospice and palliative care for profit.  H&W Indemnity, (SPC), Ltd. in the Caymans and I don’t know what exactly this subsidiary does.  Ingenix Innovus (Netherlands) B.V. and OptumHealth International B.V. kind of got my attention as many companies, and big ones with name you will recognize use the Netherlands as a a location to protect their intellectual property due to the country’s laws and I don’t know what these entities are but this documentary “The Free Tax Tour” will show you how Wal-Mart and many others do it.  Remember when you see OptumInsights that’s the software creation and analytics arm as the company advertises, not insurance services but a lot of what they have get’s sold to healthcare organizations along with the software under Optum itself.

I see a ton of the IPAs from California listed (formerly independent physician’s associations) as subsidiaries.  I’m sure you may have heard of the Lewin Group with their reports, this is United as well.  I still see the old PacifiCare on there which United bought and I might guess there’s a reason for it with perhaps some unsettled business as otherwise it’s been pretty well absorbed and all employers in the OC had to change from their PacifiCare contracts to United contracts.  I’ve blogged about others you don’t see here to where they own 51% controlling interest of several partner owner ships and then there’s the bank they ownI follow these stories as I try to inform my readers to where the absolute bottom line is on who’s profiting on the money we spend. 

Back on topic in another post I asked about the turnkey “state exchange software platforms” built by Oracle and Microsoft, and I happened to remember they were there because I blogged them in following the news.  I mixed it with a little Daily Show content here as Stewart is right on most of the time and always makes me laugh but scroll down pas the videos for the meat and potatoes.

Daily Show–Jon Stewart Takes on the Healthcare.Gov Website And My Questions On Why Were Oracle and Microsoft “Turnkey” State Exchange Platforms Not Used or Mentioned–Could Have Saved Writing A Lot of Code

I had a couple developers and a former CMS executive tell me too that contractors really don’t want to look at projects like these to where a lot of the code is already done so I am interested to see how much code was written from bottom up, how much was done in India and last why these two platforms were never mentioned as they would be “HUGE” time savers and the CGI project is already using Oracle ID and Access manager which works with Oracle Fusion Middleware which can be used, and probably already is used in government installations to  help old legacy systems scale and fetch data.  With the platforms, all you need to do is write apps for the integration built in and add some code and scripting to complete all. 

So how much was outsourced of this project is a question that’s going to asked by more than just me I am guessing and again why were our own resources we have in the US not fully evaluated as I am reading?  In June the same company, QSSI was busted for security non compliance. 

QSSI, Subsidiary of United Healthcare Building Federal Data Hub Gets Busted by the Inspector General Regarding USB Security And Compliance With Federal Requirements

Here’s a long post below that covers a bunch of questions and even goes back to the scuttlebutt on when Steve Larsen left HHS and become a VP at Optum. 

States Slowly Getting Insurance Exchanges Set Up as Federal Exchange Hub Built By United Health Group Subsidiary. QSSI Still Remains a Mystery

This was from June of this year and everyone all over the web was asking as was I “why all the secrecy” and now one wonders was it to hide all the code writing going on in India possibly?  Sebelius is just flat lost in all of this like I said in 2009 that Health IT would eat her up and it was so obvious in the CNN interview and even some with the Daily Show discussions.  The Gupta interview even started irritating me and I’m in on this pushing for the program but it was too much to stomach with the “canned” and “rehearsed” same lines spouting stats over and over. 

I know that routine of “throw numbers at them” I was in sales for 25 years and recognized it and worked people who did nothing but “canned” presentations they learned as rookies and if you interrupted them, they had to start over.  I used to toss numbers at folks right and left to get them to buy, but not “canned” and like a broken record as I knew my product too and if you don’t then all you have are the “canned” lines to fall back on.  Ok enough of that..and we could also use a break on everyone’s addiction to “how many people have signed up, reported in real time, every couple days for an update is fine.  I was right too in 2009 that “data addiction and abuse is going to be the next and upcoming 12 step program” for many (grin).  Yes we do have those spasmodic algorithms and data with lack of integrity floating around out there. 

Data Addiction and Abuse –The Up and Coming Next 12 Step Program Is On the Horizon–Side Effects Include Lack Of Data Quality, Integrity And Spasmodic Algorithms

So are we waiting for a tech surge of developers from India to rescue us now?  Are they writing code from the bottom up without looking at what was available to work with that was already done?  If Fusion Middleware was scripted and coded from Oracle to help legacy data bases and equipment scale and if  the connections were already there with Oracle to send insurance information to insurers (hint the insurers all use Oracle in a large way already) what are we doing here? 

Software is the easiest thing to dupe a non tech person with as far as a sale, been going on for years and then you end up with a mess if you don’t allow your trusty CIO and CTO to run everything with the business and engineer it.   Now the poor CIOs will end up with another tick on their backs with a silly non tech “chief digital officer” as well with no more than another “I want list”.  A chief digital officer better have some tech in their background otherwise they will not end up being an asset to the Health IT CIO, and we are burning those guys up like crazy wanting magicians where there are none.  The show down hearing on Thursday at the House should be interesting so get your popcorn, enough digital illiteracy to go around from all sides. 

So while we are sucking up this fantasy here about Chief Digital Officers and and how important the “I want” lists are with some very silly perceptions created by whack job marketing, we have India in charge of building our Health Insurance Exchange?  BD

Algo Duping 101 and the Attack of the Killer Algorithms…reality video education available here…

WASHINGTON: The Obama administration has turned to a technology company run by Indian-Americans to fix the problem ridden website for Americans to buy insurance under President Barack Obama's signature healthcare law.

Columbia, Maryland, based Quality Software Services Inc, or QSSI, will now serve as a general contractor to oversee repairs to launched Oct 1 under the 2010 law nicknamed "Obamacare," said a management consultant hired by the White House to fix it.
The website that runs online insurance exchanges for 36 states to buy compulsory health insurance under the new federal law should be working smoothly for most users by the end of November, Jeffrey Zients, assured reporters in a conference call Friday.


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