Finding bugs in the new health care code

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David Gewirtz | BIO
AC360° Contributor
Director, U.S. Strategic Perspective Institute

I've said it before and I'll say it again. Insurance companies are not to be trusted with our health. While the Democrats are out celebrating that they finally learned what the term "majority" means, America's insurance companies are looking for loopholes.

They already found one. Even though the health care bill is 2,700 pages long, apparently the lawmakers forgot one detail: although kids can't be refused insurance because of pre-existing conditions anymore, the law wasn't written to explicitly prevent kids from being flat-out refused.

That's right. While the law's intent was to make sure kids born with birth-defects could get health care coverage, and it was written specifically so that insurance companies can't drop kids with pre-existing conditions, there are bugs in the new legal code.

Yesterday, the New York Times reported that some insurance companies were saying that there's no law that says they have to cover kids at all.

Insurance companies have one, fundamental trade skill: saying no.

Here's where it's going to get even messier. Even if the law really does say an insurance company has to provide a service, a typical consumer - say a single mom - has no way to fight the company. Oh, sure, she could find an attorney and sue, but the case would take so long and cost so much that, effectively, the mom would wind up losing.

As different elements of the Patient Protection and Affordable Care Act come online, there is no doubt insurers will find holes. These are either unintentional holes, or gaps they managed to insert during the months of behind-the-scenes battling over the wording of the bill.

In some ways, law is a lot like computer programming. You try to find all the contingencies, you try to account for all the possible error conditions, you try to test, simulate, and debug the problems before the release. But as with any enormous software release, the health care bill is going to "ship" with bugs.

As each new part of the law goes live, there will undoubtedly be more bad news. The challenge for the Democrats in Congress and the White House is whether they're just going to ship this buggy software and then go on to other projects, or whether they're going to fight to fix every bug as it's reported, and close every nasty loophole as citizens report getting screwed.

Now, as it turns out, it looks like the White House has managed to fix this first bug. Health and Human Services Secretary Kathleen Sebelius was quick to clear up the ambiguity and got a letter from an insurance industry representative that essentially indicated their intent to cover kids as the new law intended.

Even so, it's clear the insurance industry is feeling threatened, and, to many Americans, it appears that Big Insurance could be comfortable playing dirty. Why? Because although it's gaining millions of new, subsidized customers, Big I is facing big changes in its business model, and could still lose the war.

Right now, Americans with good insurance generally like their providers. But if the insurance industry continues to find loopholes or game the system,  at some point the American public will wake up and realize that the only option is the one where we pull the life-support plug on the health insurance industry.

Finally, this is also a challenge for Republicans and conservatives. Their first impulse will probably be to celebrate every nasty bug in the health care act. But it won't just be their Democratic competitors losing points, it'll be their own constituents who pay the price. Assuming the Dems even bother to try to fix the bugs as they're reported, if each time they try to fix a nasty one, the GOPers get in the way, they're going to be perceived as part of the problem.

In a sense, House Minority Leader John Andrew Boehner is right when he says this is Armageddon. If this health care bill doesn't get fixed quickly as the bugs get discovered, our politicians will be judged.

In the software business, we keep bug databases - long lists of the bugs that users have reported and which need to be fixed. Some bugs get fixed right away. Others take months or years.

When a bug is fixed, the repair often solves the problem. But because software code is often wildly complex, sometimes a fix in one area of the program can cause new, and unexpected bugs in an apparently completely unrelated area of the system.

Because it's so complex, far-reaching, and has so many interdependent elements, I expect we'll see software bug-like behavior with the Patient Protection and Affordable Care Act.

Hopefully not too many Americans will get caught in the health care equivalent of a system crash. And hopefully, we'll all avoid the insurance equivalent of the Blue Screen of Death.

Follow David on Twitter at @DavidGewirtz.

Editor’s note: David Gewirtz is Director of the U.S. Strategic Perspective Institute and Editor-in-Chief of the ZATZ magazines. He is a leading Presidential scholar specializing in White House email. He is a member of FBI InfraGard, the Cyberterrorism Advisor for the International Association for Counterterrorism & Security Professionals, a columnist for The Journal of Counterterrorism and Homeland Security, and has been a guest commentator for the Nieman Watchdog of the Nieman Foundation for Journalism at Harvard University. He is a faculty member at the University of California, Berkeley extension, a recipient of the Sigma Xi Research Award in Engineering and was a candidate for the 2008 Pulitzer Prize in Letters.