Slashdot Mirror
Lessons From the Healthcare.gov Fiasco
Nerval's Lobster writes "In theory, the federal government's Health Insurance Marketplace was supposed to make things easy for anyone in the market for health insurance. But fourteen days after the Website made its debut, the online initiative—an integral part of the Obama administration's Affordable Care Act—has metastasized into a disaster. Despite costing $400 million (so far) and employing an army of experienced IT contractors (such as Booz Allen Hamilton and CGI Group), the Website is prone to glitches and frequent crashes, frustrating many of those seeking to sign up for a health-insurance policy. Unless you're the head of a major federal agency or a huge company launching an online initiative targeted at millions of users, it's unlikely you'll be the one responsible for a project (and problems) on the scale of the Health Insurance Marketplace. Nonetheless, the debacle offers some handy lessons in project management for Websites and portals of any size: know your IT specifications (federal contractors reportedly didn't receive theirs until a few months ago), choose management capable of recognizing the problems that arise (management of Healthcare.gov was entrusted to the Medicare and Medicaid agency, which didn't have the technical chops), roll out small if possible, and test, test, test. The Health Insurance Marketplace fiasco speaks to an unfortunate truth about Web development: even when an entity (whether public or private, corporation or federal government) has keen minds and millions of dollars at its disposal, forgetting or mishandling the basics of successful Web construction can lead to embarrassing problems."
This
made me laugh.
I've been in the unfortunate situation of working for a government agency when Booze Allen Hamilton came in to help make changes and improve things. They did much of the former and none of the latter.
Typically, dealing with whoever was going to actually use the process they were changing was something the Boozers did just to check off an item on a list. They did not listen to users because they assumed government employees were all idiots and could tell them nothing they really needed to know about the processes they were about to change.
Personally, if I were going to change business processes that had been in place for decades I'd want to talk to the people who work the current processes and find out how they work before I started trying to think up better ways of doing things. BAH never did that. They brought in workers for planning sessions, listened for a couple of days, then distilled the results of those discussions into a document of findings that was obviously written before the research ever started and contained exactly zero input from the field workers who truly understood job requirements.
Boozers, in my organization, were almost universally so convinced that their shit didn't stink that they were worse than useless. In the course of years of contacts with them, I met exactly ONE who listened, learned, and improved things.
Based on those past experiences, I can only surmise that the folks responsible for this current fiasco simply said "Oh, we don't need to talk to anyone from the government about how they run web sites that stand up to incredible traffic swings. We know what we're doing."
And some idiot government executives trusted them.
I don't know who to be more disgusted with.
I don't know about you, but does the site really need links and JS from ad sites (like doubleclick, chartbeat), YouTube, and Facebook, as well as whatever googletagmanager and optimizely provide - as noticed by what I had to temporarily allow in NoScript - to simply make the site work to, you know, helps people get access to healthcare insurance?
It must have been something you assimilated. . . .
This happens every time a major new internet service is launched. And it _always_ will. See, here's the problem: at launch everyone is interested and wants in. After a few weeks/months the interest dies off and the site hits a BAU point. So if you're designing one of these sites you're stuck either:
a. Spending billions on infrastructure for 3 months tops of high volume and then getting ripped to shreds in the press for 'wasting' all that money. or...
b. Taking your lumps up front and waiting a few months for people to forget about it.
The guys running healthcare.gov opted for 'b.', and I would too. The kinds of people that just want to say bad things about the ACA would have a field day with 'a.', with 'b.' they'll have to acknowledge (or at least ignore) the fact that in a few months it'll be working more or less as intended.
Hi! I make Firefox Plug-ins. Check 'em out @ https://addons.mozilla.org/en-US/firefox/addon/youtube-mp3-podcaster/
"...but I seriously had no idea it would be this bad."
How would you design a Healthcare Extortion Racket?
"New York State's healthcare plans range from Fidelis Care's 'Bronze' plan at $810.84 per month to $2554.71 per month for something I didn't bother to look up because if I had $2500+ a month to spend on doctors, I'd buy a doctor and have him/her live with me and dole out pills like I was Michael Jackson. The deductibles - the amount you pay out of pocket every year before you the insurer has to give you anything at all - are outrageously high. Fidelis Care Bronze has a $3000/year deductible per person. I'm in pretty good health; it's a rare year I spend that much on doctors. After the $3000/year deductible, they pay 50% of your bills. So if you rack up $5000/year in medical bills, you pay $4000 and they pay $1000. Pretty damned crappy."
Repeat, from my JE.
"Flyin' in just a sweet place,
Never been known to fail..."