I’ve never actually written a paper on what I do. At least, this is what I’ve done for over 30 years now. I started at the bottom, as a Programmer Assistant. In reality, I started as a Data Entry Operator, but that was a temp job, that got me into the Programmer Assistant position at Hughes Aircraft way back in 1985. Anyhow, Cheryl and I went to In-N-Out Burger today for lunch. I was struck by the fact that in the drive-thru lane, they have this guy with a tablet taking your order to speed up the process. He was very efficient, knowledgeable, courteous and especially careful to make sure he got the order correct. He even came back by a 2nd time and made sure he’d gotten our order.
I was kinda intrigued that he did all that on a remote data terminal that was in reality a tablet supporting a multi-user, real-time system used for ordering and inventory and Point-of-Sale transactions and all. Cool. So, I asked Cheryl how much she thought it might cost to build such a system? Well, she had no idea, so I educated her. I told her that it probably took a team of perhaps as many as 30-40 engineers, about that many testers, administrators, technicians, database support people, hardware guys and so on, let’s call it 100 folks. They worked on that system for about a year I told her. Price tag: about $5M I would say. Let’s say I’m off by a factor of 2, make it $10M I told her. It’s in the ballpark I’m sure. Remember that this system probably costs a couple million per year to run, so make it $15M total in its first two years of service. It supports literally hundreds of thousands of transactions per day, about the same number of customers, with LOTS AND LOTS OF SATISFIED customers.
Now, let’s look at the Affordable Healthcare system. Take, for example, the Healthcare Exchange built for the State of Hawaii. Hawaii has just under 1.5M people. There are probably 30-40 hospitals spread around the island, let’s make it about 20x that number in clinics, medical care facilities, perhaps as many as 2,000 doctors, etc… About the same in size and scope as the System built for In-N-Out Burger. Now, the system is arguably more complex. Let’s make it 10x more complex even. That would be $50M dollars on the low end, and perhaps as much as $100M for development. I’m being very generous. It may cost as much as $10M per year in operating costs. So, in its first two years it should have cost (at MOST) $120M. What did it cost so far? $205M!!!!!!!! And it’s dying also, and not really fulfilling its purpose. In reality, none of the ACA “Exchanges” are doing their job, since ER visits on a year to year basis continue to rise, which is one of the key things that the ACA was supposed to deal with.
Only in government. I tell you, it’s the biggest boondoggle ever perpetrated on the American people by any government agency! And that’s just for one single state, arguably the smallest state (population wise) in the Union! Why on earth didn’t they build one system, make it modular and adaptable for each and every state? I just can’t tell you how I despise this kind of nonsense. It makes me so frustrated I just can’t even tell you.
Bear in mind that my estimates are accurate +/- 50% especially for such a large system. But, as I said at the beginning, this is what I do and have done for over 30 years. I’m pretty good at rough figuring on a project at the outset. There’s also laws in systems development that you rely on, chiefly that a system that is twice as complex as another one doesn’t really necessarily require twice the development effort. Engineers are good at building systems in a modular fashion such that adding complexity, once the infrastructure of a system is done, is not a huge undertaking, it’s not linear in systems speak.