
Why getting the Obamacare exchanges to work was difficult - RougeFemme
http://www.washingtonpost.com/blogs/the-switch/wp/2013/10/04/heres-why-getting-the-obamacare-exchanges-to-work-was-so-difficult/
======
hdctambien
Did anyone expect a bunch of "lowest bidder" contracting firms to build
something for someone else that works perfectly on day one when companies like
Blizzard[1], EA[2], and SquareEnix[3] don't get it right when they are
building something for themselves.

Especially considering how the lowest bidder has worked so well in the
past[4].

[1]
[http://www.pcmag.com/article2/0,2817,2404481,00.asp](http://www.pcmag.com/article2/0,2817,2404481,00.asp)
[2] [http://arstechnica.com/gaming/2013/03/clogged-streets-
simcit...](http://arstechnica.com/gaming/2013/03/clogged-streets-simcity-
launch-plagued-by-server-problems/) [3] [http://gamerant.com/final-
fantasy-14-launch-issues-servers-s...](http://gamerant.com/final-
fantasy-14-launch-issues-servers-square-enix-reponse/) [4]
[http://www.boston.com/news/specials/big_dig_problems/](http://www.boston.com/news/specials/big_dig_problems/)

------
mikestew
Maybe it's difficult to scale and there were some hard deadlines, but there
was some shear incompetence, too. As evidence I present WA's system that is
storing passwords in plain text, has off-by-one errors, and reveals system
details when you encounter an error. That's what I found by creating an
account and trying to log in (which I still can't do). Who knows what I'd find
if I were trying.

------
shuzchen
I'd have to say some of that is likely incompetence on the people in charge of
developing the exchange. In Hawaii (hawaiihealthconnector.com) the whole
extent of the online marketplace is a web form where you have to give up the
SSNs of your entire family just to have someone _call_ you later with quotes.
Not exactly what I think of when I think of an online marketplace.

There are many problems with the form too (e.g., can't sign up if your family
has more than 4 people). To make matters worse, the form is down for
maintenance. Apparently they couldn't figure out how to scale a single form.

It's hard being a supporter of Obamacare when the execution is being done so
badly.

------
ianstallings
The CA website costs $313M: [http://www.latimes.com/health/healthcare/la-fi-
obamacare-cal...](http://www.latimes.com/health/healthcare/la-fi-obamacare-
california-launch-20131002,0,4856547.story)

Did they have to build a new data center? Hire specially trained astronauts to
run it from it's location on the moon? Sitting in special chairs made from
exotic materials they reverse engineered from UFOs? I mean JFC where did that
money go? It makes the dotcom days look like an era of fiscal responsibility.

~~~
cjdavis
See the previous discussions, here's one:
[https://news.ycombinator.com/item?id=6492127](https://news.ycombinator.com/item?id=6492127)

It wasn't simply the website - it's the entire exchange including call
centers, advertising, etc.

~~~
ianstallings
Ah, yeah. That makes sense. I can't imagine the call center for that program.
Probably looks something like mission control or a war room. Then all the
surrounding stuff. When you throw in facilities plus all that surrounds the
program it makes sense.

------
kjackson2012
Isn't it strange that one arm of the government, ie the NSA, can get PRISM and
all their extremely complex surveillance and correlation programs up and
running but these much simpler and more straightforward web sites are
generally failures? If anything it speaks to the quality of work that Palantir
does, and the government should get them to do all the work as opposed to IBM
Global Services or Accenture. Imagine if IBM or Accenture developed PRISM? We
would have nothing to worry about then since it would be a complete failures.

~~~
fnordfnordfnord
How many failed projects do you think the NSA has suffered? The NSA aren't
immune to reality (even though they are well insulated from it). As for why
you don't hear about the failures, we know of at least one very big IT
disaster project called Trailblazer. Thomas Drake, a former NSA executive blew
the whistle on this particular project, and was rewarded for that favor with
Espionage charges.

------
jessaustin
_...some of your larger companies, your Twitters, your Googles, your Amazons,
these are things they do to be able to scale up, scale down their servers as
needed to handle the traffic. I 'm not exactly sure what's in place in terms
of the federal government infrastructure..._

If only Amazon provided some sort of "Web" services, or Google offered some
sort of application "Engine". Imagine, if new projects could rent computing
resources from these companies, and make use of their scaling expertise?

(Actually, AWS is the default for federal contracts now.)

------
pbreit
This account makes me want to become a republican.

~~~
seanmcdirmid
Romney really messed up royally on his IT during the election. It would have
probably been much worse under him.

~~~
briandear
Considering Romney's success in actually managing businesses as well as
public-private partnerships with the Olympics judging his abilities in this
context based on campaigning IT isn't really a relevant comparison. Let's look
at the Bain Capital and Olympics track record as a better metric. Also given
that the cost of just the California system was almost half of Romney's entire
campaign budget, we're comparing apples to oranges. Part of Obama's campaign
successes were due to volunteer engagement not necessarily because he was
better at managing IT. Also campaign IT is light years different than
healthcare IT. Given the administrative behemoth, it isn't IT leadership
that's needed at the top but administrative competence. I'm not knocking
Obama, I'm just challenging the assumption that "Romney would be worse because
his campaign technology had some issues.."

~~~
mercurial
I think this was meant as a joke.

------
cantbecool
Is there any states so far where the rollout was seemless? I work in the
public benefit industry as a developer and all I have hearing are nightmare
accounts.

------
coldcode
And yet the static part of the site, written in Jekll, is available on github,
has barely any issues at all. Of course it's easier to write read-only static
systems but I have rarely ever seen big enterprisey consulting firms get
anything right.

------
DennisP
I haven't been able to get into healthcare.gov yet, but you start with a
button labeled "apply." Did they not expect anyone to just curiously browse?

Because for browsing, it doesn't seem to be much data. My state has about a
dozen regions, and the only other variables are age and smoking status. You
could do the whole thing with a static site, using a little javascript at the
beginning to direct to the right folder.

You could handle huge traffic with a few nginx servers. Put it on AWS with
Cloudfront and you're not even hitting the servers for a lot of requests.

Then send people to a database-backed webapp when they're actually signing up.

~~~
mkr-hn
You sound like you know all the legal, technical, and regulatory issues they
faced in designing the system.

~~~
jrockway
I doubt there is a legal issue that would prevent the site from being
statically served with ngnix.

~~~
mkr-hn
> _legal, technical, and regulatory_

Three things.

~~~
jrockway
Regulatory issues are legal issues. Why do people comply with regulations? To
avoid the ire of the law.

~~~
mkr-hn
I think I'm just frustrated with this whole ordeal of _Silicon Valley Knows
Best_ that we see when any kind of problem comes up. People get hung up on
their pet theories and solutions and never stop to consider that they might be
wrong.

It's impossible to solve a problem before knowing what the problem is. How can
anyone here even begin to consider a solution before we know the problem? It's
ridiculous. Maybe they're not _allowed_ to use your favored solution. The
solution is probably political, not technical. You can't fix an
outdated/flawed policy with nginx.

It's just...weird. Half the posts in any politics thread at HN is people
complaining about politicians coming up with pet theories and pet solutions
for problems before understanding the problem, but they're so eager to do the
same when the roles are reversed.

~~~
DennisP
I wouldn't presume to suggest a solution to the larger problem of getting
people signed up for plans.

But the problem right now is, people are very curious about what plans are
available. It's public information that doesn't require personal data. The
whole point of the exchanges is to give the public clear data on the available
plans. Distributing public information is a problem that has been quite
thoroughly solved.

The technical people didn't seem to realize that they had two problems to
solve, not one. And my frustration right now is that part of Congress is
trying very hard to defund the whole program before people are able to gain
access to that information, and it should be too late for that.

If someone has screwed up the regulations so badly that this information
intended for the public is not actually public, then of course that's where
the problem is, but that seems unlikely to me. It would make for a very
interesting news story, if true.

~~~
mkr-hn
> _If someone has screwed up the regulations so badly that this information
> intended for the public is not actually public, then of course that 's where
> the problem is, but that seems unlikely to me. It would make for a very
> interesting news story, if true._

Healthcare.gov is covered in HN-popular libraries, software, and toolkits
(like Bootstrap, jquery, and Drupal[1]), so the problem is apparently not that
they just don't know any better.

It appears they went as far as they could with the latest and greatest tech.
Someone somewhere along the chain of command failed to include a "provide any
kind of useful information on the plans" provision in the design document. All
signs point to this being either politics or negligence, not technology.

[1]I'm assuming on this one since WhiteHouse.gov has been covered in Drupal in
the HTML and JS since the Obama administration took it over.

~~~
DennisP
Drupal generates pages dynamically, usually from a database, which is the
exact opposite of what I just suggested. Static pages are the way to go for
very high volume. (And as dynamic frameworks go, PHP didn't actually do that
well in the techempower benchmarks, though Drupal wasn't one they tested.)

Certainly the design is the root of the problem. You have to "apply" before
you get any information. When I say that the team screwed up, I definitely
include the people who designed it, not just the programmers who implemented
it.

~~~
mkr-hn
I was right:
[https://news.ycombinator.com/item?id=6514775](https://news.ycombinator.com/item?id=6514775)

Poorly-implemented technology was at the core, but it happened because of a
flawed and entirely political process.

------
lifeisstillgood
As a Brit, who quite understands the failings of Government IT (#) I still
think it must be an awful lot simpler just to ask "Are you an American? Yes -
then get cover"

really guys, we all know technology cannot fix foolish requirements.

(#) www.oss4gov.org

------
Misterburns
I used to work in government IT. A lot of people are wondering why the
projects so pricey and why there are so many issues.

1) The RFQ/bidding process isn't as logical as you'd imagine.

2) There are layers on top of layers on top of layers of bureaucracy. The
government is its own regulator, not the market. There are no shareholders or
VCs that can curtail the government's power. Elections and recalls are slower
signals by orders of magnitude.

3) government projects fail all the time. You just don't hear about it because
then heads would roll, which is faux past in the public sector.

------
scribblemacher
I work for a IT government contractor right now. We don't do work even close
to the size of these exchanges, but even in our work the amount of bureaucracy
and overhead involved is mind-numbing. To put a simple form on our web page
requires an FRS, SDS, binder of validation documents, review and approval from
several managers. It could take months just to make a simple change. Lots and
lots of wasted time and grant money.

------
dpweb
Nice PR. Anxiously awaiting the article of how Facebook goes down all the time
because its handling 600 million users a day. How bout this approach, which
can work..

1\. We F.d up 2\. Were sorry 3\. Heres what were doing to fix it

------
DanielBMarkham
_"...Even though in this type of setting the development teams are using what
you might call agile methods, there's still a huge layer of requirements and
review and sign-off..."_

Aieeee! Brain explosion.

If there's a huge layer of requirements, review, and sign-off, to the point
that it's impacting value creation, then they're not using agile methods.

Agile doesn't have a unique, firm definition. Best I can come up with is "best
practices around iterative and incremental development"

There's no best practice I know of that requires spending tens of billions in
new IT infrastructure to service 350 million Americans with some fairly simple
data needs. Sure, they may be using _some_ agile methods, like having nice
chairs that have those cool ergonomic options, but they're missed the forest
for the trees. Reminds me of the old joke "Aside from that, Mrs. Lincoln,
how'd you like the play?"

I found the article most uninformative. Nice example: _"...These projects so
big is that there is a very rigorous security oversight involved and layers of
audit, layers of rules. The kind of thing that small start-up companies who
are just winging it [don't deal with]..."_

No, lots of startups deal with high-security situations. These are known
problems and have hundreds of existing players with known solutions. The real
issue here is the way the environment for the work was structured, not the
nature of the work itself. Such comments are misleading at best, duplicitous
at worst.

The problem here is that this is a reporter talking to some industry schmuck
all too willing to make apologies for "that's just how things are" instead of
actually answering the questions. Since the reporter doesn't know any better,
there's no context or follow-up.

My money says the reason there were problems is directly related to a large
political system dividing up the spoils of new work and insulating itself from
being blamed for any disasters. Since lots of folks made money, and nobody in
particular is to blame for any of the issues, looks like the system performed
as it should.

The real lesson here for startups -- and it is an important one -- is that you
can't use people to solve problems that are so far inside the existing system
as to have created lots of excuses and barriers for why things have to be done
a certain way. Identifying risk is fine, giving up and saying that there's no
other way to accomplish things is not.

The larger problem here is using reporters and MSM outlets to analyze how
large groups of people perform complex tasks in nuanced environments. Most of
the time they're the wrong tool for the job. They're great for telling
_stories_ , how one person perceives the way things are, but not so much at
_analysis_. Most of the time what passes for analysis is simply an assemblage
of stories, either on deep background or assembled piecemeal from phone
interviews.

