What's happening to the US of A?

My daughter-in-law has said that the people that would benefit from an American 'NHS' are the rich and the poor, those who are the middle wage earners apparently will have to pay the higher taxes to fund it but won't benefit from it.

 

When the NHS started it was basic human medical care, everyone welcomed it because in 1948 everyone was in the same boat BROKE and POOR the odd few had Harley Street, The same with Unions, everyone chipped a LITTLE in to help those in need out

It could never start now due to the excesses
Breast enhancement, IVF, Cosmetic surgery, blood tests and scans for everything under the Sun, self inflicted Tattoo removal, Alcohol and drug damage
The big business of Medical insurance and BUPA Plus the people with money would not approve, there are so many well off now especially in the USA they are not going to chip in

Maybe if OSAMA introduced it as a minimum health care it MIGHT go through

The budget problem is not a problem to the President, all he has to do is declare a National emergency and he can up the budget to whatever he wants Billions in fact, it is in their constitutional rights bill 14 th ammendment

Jack McH

 

No different here? High proportion of middle wage earners have private health care (themselves, or provided by employer, same thing - paying tax for NHS and not using most of it)

I don't think you should lump IVF in with the others ...

 

Not sure if any of you are amusing yourself with this latest.
But the Affortable Care Act the website is not working correctly. So this is after 3 years to get it up, and 500million dollars and contracting with a company in Canada (which was fried by another company) instead of finding a USA company to do the job. So now today a big panel and the computer company are bickering it out. Love it.

 

The fact that the company is based on Canada has no relevance. There is no league table that I'm aware of that ranks nations by their IT skills. If there was, I'm afraid the USA would not be close to the top of it. There are many, many high profile well publicised cases of US based IT blunders.

 

IT is the same the world over! Everyone can do it, then when push comes to shove it doesn't work.

 

The existence of your post proves otherwise

 

That's only £309 million pounds. The UK's failed NHS computer system wasted £10 billion pounds http://www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn Sounds like the USA got an absolute bargain failed computer system.

 

Jeez - there's always one smartass!!!!

 

By comparison yes, but both figures are much higher than they should be. Just done a few basic calculations, and £309 million pays for roughly 165,000 man/hours, or about 3,550 man/years (allowing for holidays). Lets say that 50% of the cost is third party licenses plus hardware. That's still about 1,775 man/years.

Right, now, I've been in the IT industry for long enough to know how it works. I've worked on some pretty massive projects too. For a project of that scale, you'd be looking at a maximum time of 3 years to get the first working version 'to the market'. So lets say you take those man/hours and work out the team structure. Personally, I don't see the point in teams larger than 20 developers. The productivity curve is not linear. 10 times as many people doesn't mean 10 times the productivity. Too few and there is too much work per person obviously, but too many and all that happens is people start waiting for each other. The work has to be divided more carefully and there are more work streams to coordinate, so it starts to fall apart.

So I'd go for maybe 3 teams of 20 people each with one team responsible for the 'back end' (database design and build), one team at the front (all the 'design' stuff that the end users will see), and one team in the middle taking care of all the gubbins that wires the front end to the actual database. Within each team, I'd want a minimum of 5 people to have mixed skills so I could shuffle them about if need be, ie if the front end team is waiting for the back or middle, I'd want to be able to pull people from the front and middle to help at the back.

There would also be a much smaller team, no more than 5 people, coordinating the whole thing.

That's 65 people in all.

I've worked on some huge projects, and I know that 65 people can achieve a huge amount in 3 years. In fact I'd go so far as to say that there isn't really a database system out there that should take more than that to get to version one, and that includes the NHS farce.

So, based on that, I reckon it should be 65*3 = 195 man/years, not the 3,550 man/years that the yanks have just forked out for or the gazillion or so man/years that we're paying for.

Earlier I costed people at £50 per hour, which is about right for good staff (cost to the company, not payment to the actual person which is often considerably less). 37.5 * 46 * 50 = £86,250 per person per year. Multiply that by my team size (65) = £5,606,250. Multiply that by 3 (number of years I reckon is enough for any project to get to version 1) = £16,818,750. Double that figure to allow for third party software licenses, hardware, and a new Bentley or two for the management team = £33,637,500.

So there we go. I'm available to hire by either the US or UK government for the development of our/their healthcare systems or other systems, and I'll only charge £66 million for the whole thing