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HealthCare.Gov: Much, Much, Much Worse Than You Thought



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From the Thursday edition of the Morning Jolt:

HealthCare.Gov: Much, Much, Much Worse Than You Thought

I know you’re probably growing tired of “the Obamacare health insurance exchange web sites don’t work” stories but this one leaves you gasping, “What?

Amid all the attention, bugs, and work happening at Healthcare.gov in light of the Affordable Care Act, potential registrants talking to phone support today have been told that all user passwords are being reset to help address the site’s login woes. And the tech supports behind Healthcare.gov will be asking more users to act in the name of fixing the site, too. According to registrants speaking with Ars, individuals whose logins never made it to the site’s database will have to re-register using a different username, as their previously chosen names are now stuck in authentication limbo.

Delay Obamacare? Heck, at what point does this website start to count as a delay?

Tell you what, Mr. President. We’ll reopen the screen if you agree to waive the tax/penalty for not buying insurance and until 2014, everyone stays at this screen:

“Why is Jim always picking on me? I’m just an unlucky subject of stock photography.”

And while the administration insists the performance is getting better . . . the evidence is scant:

The Obama administration promised “significant improvements” in accessing the federal health overhaul website this week, after taking down the system for maintenance. But many were still unable to enroll.

The administration has refused to release the numbers for how many have signed up and media outlets have struggled to find people who have actually signed up.

“It wasn’t designed well, it wasn’t implemented well, and it looks like nobody tested it,” Luke Chung, an online database programmer, told CBS News.

“It’s not even close. It’s not even ready for beta testing for my book. I would be ashamed and embarrassed if my organization delivered something like that,” he said.

They insisted we were in “Recovery Summer” when there was no recovery; they insisted there wasn’t a terrorist attack in Benghazi when there was; and now they’re insisting the websites are working when they aren’t.

The spin, like the web site itself, isn’t working:

Seven percent of Americans report that somebody in their household has tried to sign up for insurance through the health care exchanges, according to an AP-GfK poll.

While that’s a small percentage, it could represent more than 20 million people.

Three-fourths of those who tried to sign up reported problems, though, and that’s reflected in the underwhelming reviews.

Overall, just 7 percent of Americans say the rollout of the health exchanges has gone well. Far more deem it a flop.

Wait, there’s more:

Overall, the poll found, 40 percent of Americans said the launch of the insurance markets hasn’t gone well, 20 percent said it’s gone somewhat well and 30 percent didn’t know what to say. Just 7 percent said the launch had gone “very well” or “somewhat well.”

Opinions are sharply divided on the overall framework of the law: 28 percent of Americans support it, 38 percent are opposed, and 32 percent don’t have an opinion either way, the poll found. When asked specifically whether the government should be able to require all Americans to buy insurance or face a fine, only about 3 in 10 Americans agreed, and 68 percent were opposed.

David Auerbach, writing in Slate, examines the contracting process behind this Frankenstein:

The front-end static website and the back-end servers (and possibly some dynamic components of the Web pages) were developed by two different contractors. Coordination between them appears to have been nonexistent, or else front-end architect Development Seed never would have given this interview to the Atlantic a few months back, in which they embrace open-source and envision a new world of government agencies sharing code with one another. (It didn’t work out, apparently.) Development Seed now seems to be struggling to distance themselves from the site’s problems, having realized that however good their work was, the site will be judged in its totality, not piecemeal. Back-end developers CGI Federal, who were awarded a much larger contract in 2010 for federal health care tech, have made themselves rather scarce, providing no spokespeople at all to reporters. Their source code isn’t available anywhere, though I would dearly love to take a gander (and so would Reddit). I fear the worst, given that CGI is also being accused of screwing up Vermont’s health care website . . . 

The poor, confusing error handling indicates that there was no ownership of the end-to-end experience — no one tasked with making sure everything worked together and at full capacity, not just in isolated tests. (I can’t even figure out who was supposed to own it.) No end-to-end ownership means that questions like “What is the user experience if the back-end gets overloaded or has such-and-such an error?” are never asked, because they cannot be answered by either group in isolation. Writing in Medium in defense of Development Seed, technologist and contractor CTO Adam Becker complains of “layers upon layers of contractors, a high ratio of project managers to programmers, and a severe lack of technical ownership.” Sounds right to me.

Likewise, the bugs around username and password standards — for example, the fact that the username required a number but the user interface didn’t tell the user about it — are not problems of scale. They’re problems of poor cross-group communication.

Raymond Pritchett points to the public disclosure of the contract. If I’m reading this correctly, the U.S. taxpayer paid CGI something around $634 million to build this thing.

Oh, and the administration was warned.

“A week into it, still a lot of glitches,” CNN correspondent Brian Todd reported to Blitzer. “People not able to create accounts, just to get information to possibly enroll, much less not being able to enroll in the plan.”

“We’re also hearing now that the administration was warned about these potential problems months in advance,” Todd continued. “We spoke to a health care consultant who has clients who are insurers. He says his insurers, who dealt with the administration in the months ahead of time, had contentious meetings with people at [Health and Human Services] and other health care officials who were in charge of this, warning them, ‘This isn’t working, it’s not going to be smooth, don’t do it.’ He says those warnings were ignored, they went full speed ahead, and said we’ll work these problems out. There’s been a bit of pushback from the White House, we’ll hope to get more later from them.”

“If they had three years to get this ready — if they weren’t fully ready, they should accept the advice that a lot of Republicans are giving them, delay it another year, get it ready, and make sure it works,” Blitzer said. “There are government health care-related websites that work great. Socialsecurity.gov, a whole bunch of others. They know how to do it. But if they didn’t get it ready on time, then maybe fix the problem, make sure people don’t have to worry about it.”

Other than that, the site’s great.


Tags: Obamacare


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