[NOTE: This column originally was written on November 1, 2013 — a month before the HealthCare.Gov Website was scheduled to be fixed.]
The biggest mistake the Obama Administration made when promising the government’s health care Website would be fixed by the end of November was making that promise. In a “Ready, Fire, Aim” approach, the Administration failed to take the time to assess what actually needed to be done to make the site work.
Obama’s decision to bring in some of the nation’s top computer talent to fix the Website would have been a brilliant move had it been made when the planning for the system began. Those with experience in the high technology world have seen the misery which occurs when a product’s design is seriously flawed and needs to be “fixed.” The cost of major fixes after release of a product can be ten times the cost of fixing them during the design stage.
In this case, the complexity of the effort appears to never have been totally appreciated by the Administration’s non-technical decision-makers. The biggest challenge was the new system needed to connect and interact with numerous, diverse, and often incompatible existing systems such as Social Security, Medicare, Medicaid, Internal Revenue Service, et cetera. This was similar to bringing people together to work as a team, each of whom spoke a different language and none of whom knew a language other than their own.
This lack of appreciation for the new system’s complexity was magnified by (a) the failure to properly test the new system and (b) the decision to require visitors to create an account prior to being able to see the Health Exchange’s offerings.
The failure to properly test the new system was inexcusable. That testing should have occurred more than half a year ago so there would have been time to make corrections. Instead it was only partially done and even that was at the last minute. Problems were identified with too little time to fix them before the system went “live.” Other problems went unidentified until the public began to use the system. This demonstrated an extraordinary degree of incompetence by almost everyone involved — from the top down.
Just as irrational was the decision to require visitors create an account in order just to see what was available. This countered the entire culture of shopping in America. Online consumers always have been able to view goods and see prices to determine their level of interest before providing any information. Retailers and other sellers understand a key principle in marketing — “Make it as easy as possible to buy our product or service.” The Administration, by making consumers work harder, put up a barrier which discouraged people from even exploring what was available.
By demanding highly confidential data, the Administration drove people away. Given the lack of trust in Government, magnified by revelations of Government abuse of private information, many citizens do not want to share their private information just to window shop. The Government’s failure to recognize this demonstrated how out-of-touch it was with the American people.
The problems with the new system discouraged those who logged on from completing the process. As word rapidly spread how broken the system was, others did not even bother to try. Failing to recognize how forcing users to spend an excessive amount of time on the system would discourage participants, the Government again erred egregiously.
Shopping should be simple. Users should have the choice of plugging in their income before they shop so they can see what the actual cost of a plan is going to be. And it should be stated upfront whether the user should enter Adjusted Gross Income or Taxable Income — which is not stated initially (yet another design failure). Users should be able to view all the plans at once but cannot today.
This begs the question that most plans are more expensive and that, too, discourages people from signing up at all. This will create further problems for Obamacare if as millions of healthy people — needed to subsidize those with greater medical needs — abandon the health care system.
The high tech geniuses who looked at the problem probably threw up their hands and recommended the Administration start all over but this could entail allowing the current system to limp along for many months while its replacement is built. Maybe on November 30th the Website will work smoothly but my guess is — no matter what the Administration does — HealthCare.Gov likely will be a mess for months to come.