KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Longer Looks: Website Problems ‘Could Be Worse;’ Why Poor People Take More Health Risks

Every week reporter Ankita Rao selects interesting reading from around the Web.

Computerworld: Healthcare.gov Website 'Didn't Have A Chance In Hell' 
[President Barack Obama's] advisors shouldn't be surprised -- the success rate for large, multi-million dollar commercial and government IT projects is very low. The Standish Group, which has a database of some 50,000 development projects, looked at the outcomes of multimillion dollar development projects and ran the numbers for Computerworld. Of 3,555 projects from 2003 to 2012 that had labor costs of at least $10 million, only 6.4% were successful. The Standish data showed that 52% of the large projects were "challenged," meaning they were over budget, behind schedule or didn't meet user expectations. The remaining 41.4% were failures -- they were either abandoned or started anew from scratch (Patrick Thibodeau, 10/21).

The New Yorker: Healthcare.gov: It Could Be Worse 
For large software projects, failure is generally determined early in the process, because failures almost exclusively have to do with planning: the failure to create a workable plan, to stick to it, or both. Healthcare.gov reportedly involved over fifty-five contractors, managed by a human-services agency that lacked deep experience in software engineering or project management. ... I signed up for an account on Healthcare.gov last week. It wasn’t the smoothest process, but I was able to create an account. Some parts are slow; sometimes you have to reload a page to make progress. But it’s starting to work. It will be fixed, because it has to be. And now that the launch and inevitable crash has finally happened, in a way the worst is over. Real-world traffic is providing programmers all the debugging data that they could ever want (Rusty Foster, 10/21).

Slate: Don't Jump!
Shortly after 1 p.m. on March 8, San Francisco officials pulled the fully clothed body of a 56-year-old white man from the waves off secluded Marshall’s Beach, just south of the Golden Gate Bridge. … As surely as a leap from the Golden Gate Bridge kills—98 percent of jumpers die—barriers on suicide hot spots can save lives. The evidence showing that bridge barriers work is "overwhelming," says Paula Clayton, professor of psychiatry at the University of New Mexico School of Medicine and former medical director of the American Foundation for Suicide Prevention. Most people die the first time they try to kill themselves. The easiest way to prevent suicide is by restricting access to methods with a high risk of death, Clayton says—such as jumping from a bridge (Liza Gross, 10/15).

Los Angeles Times:  Rich Brain, Poor Brain
Study after study has suggested that poor people are more likely than wealthy people to behave in ways that are imprudent and counterproductive. ... including more risk-taking (not using seat belts, for example), worse adherence to protocols (such as failing to complete a full course of a medicine) and poorer financial management (impulse buying, for example, or buying on credit, which adds considerably to an item's cost) Why is this? ... When asked to think about a minor repair, the rich and the poor performed equally well on the cognitive tests (arguing against the notion that the poor make poorer decisions because they aren't as smart). But when the repair was described as costly, performance crashed dramatically in the poor but not the rich. In other words, having to reflect on tight finances increased cognitive load for poor people  (Robert Sapolsky, 10/18).

The New York Times: Fear Vs. Radiation: The Mismatch 
It has been more than two and a half years since the Fukushima nuclear disaster began to unfold, and still the world watches events closely, fearfully. The drumbeat of danger seems never ending: Earlier this month, to take just one example, international news reports spread word that six workers at the plant had been accidentally doused with radioactive water. Yet leading health scientists say the radiation from Fukushima has been relatively harmless, which is similar to results found after studying the health effects of Chernobyl. With all that evidence, why does our fear of all things nuclear persist? And what peril does that fear itself pose for society? (David Ropeik, 10/21).

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