
 Doing Better: Making Improvements to HealthCare.gov  - 001sky
http://www.hhs.gov/digitalstrategy/doing-better-making-improvements-healthcaregov.html
======
keithwarren
"...bringing in some of the best and brightest from both inside and outside
government."

Did any of you get a call? I imagine many of the best and brightest are on HN.

~~~
niels_olson
They're currently somewhat busy. Don't take a non-response as proof of
anything.

~~~
keithwarren
I think they are all busy prepping their applications for the YC application
deadline tomorrow.

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siculars
So who are these "best and brightest" they are bringing in? Surely they are HN
readers or an HN reader knows them. Would love to hear about an in depth
postmortem. Joking aside, if you are Obama & Co. and your entire
administration is hinged on the success of this program, how do you not get
the "best and brightest" from the outset to make what you can control about
this - the technology component - work? Not to say there is that much
complicated technology here. We've known how to make sign-up sheets for a long
time. Also, surge protection is also somewhat of a solved problem - just use
AWS or one of their competitors. Didn't the Democrats crush the Republicans in
their pre-electioneering with a much better system built on AWS? Why didn't
they get those guys to do this stuff? Oh well.

------
cdoxsey
> This tremendous interest – with over 19 million unique visits to date to
> HealthCare.gov– confirms that the American people are looking for quality,
> affordable health coverage, and want to find it online.

Sadly the system can only work if healthy people sign up. This disaster of a
website has made it so that only the most desperate of people will eventually
sign up, thus ensuring the inevitable collapse of the whole system.

~~~
ssharp
Isn't the point of the OP that they are actively working on fixing the site? I
don't see how being active in repairing broken parts of the site is any
indication on "inevitable collapse". There is no indication that these will be
long term problems.

~~~
bpodgursky
The post is referencing a different problem. This is the scenario described:

1) since the exchanges can't discriminate on pre-existing conditions, many
people with expensive pre-existing conditions in need of treatment will sign
up.

2) because a high percentage of the new customers to the new plans need
expensive treatments, insurance companies are forced to raise the rates on the
new plans to cover costs

3) after seeing the higher insurance rates, healthy people quit the plan since
their expected healthcare costs are lower

4) repeat steps 2 and 3 until very few people can both afford to be in the
plan and have very pressing healthcare needs.

~~~
icebraining
It's an insurance death spiral [1]. NPR's Planet Money talked about it last
month [2].

[1]
[http://en.wikipedia.org/wiki/Death_spiral_(insurance)](http://en.wikipedia.org/wiki/Death_spiral_\(insurance\))

[2] [http://www.npr.org/blogs/money/2013/09/30/227468495/one-
key-...](http://www.npr.org/blogs/money/2013/09/30/227468495/one-key-thing-no-
one-knows-about-obamacare)

------
flippyhead
I'd love to see a more in-depth explanation of what's gone wrong.

~~~
coderaptor
Since the target is probably the general public, I wouldn't expect a technical
write-up on problems faced and potential solutions (though it would have been
nice) - but this write-up is devoid of any actual information whatsoever.

I fear this is what we can expect in the future was well. At least give us the
names of the folks you're bringing in to make this thing work! This is the
reason those of us in the US were doubtful of this project in the first place
- not a single one of my peers expected this site to stay up (we've all got
experience with media company advertisement efforts, so we know what it means
to go from zero to millions).

As an aside - spewing this "with over 19 million unique visits to date to
HealthCare.gov– confirms that the American people are looking for quality,
affordable health coverage, and want to find it online" is ridiculous - it
confirms only that Americans are now legally obligated to look for health
coverage... There's more, but instead of pissing myself off further I'm just
going to hit 'reply' and shrug away to my corner of indifference for the day.

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keithwarren
I often wonder why something like this is not required to be open source from
day 1. I think you still contract an agency to build it, but had the
specification and code been open all along then this kind of thing would be
less likely.

Of course, that would make sense and since we are talking about government
contracting...

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Xcelerate
The fact that this little blog post stutters and jerks as I scroll down the
page (using Chrome) on a fairly new RMBP means they've got a lot of work to
do.

I don't understand how these things become so complicated and expensive and
still not work right.

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iandanforth
I just want to have access to the code again. I can only speak for myself but
I'd love to contribute patches.

~~~
cheald
The code that was public was just a Jekyll static site, which wouldn't have
any performance problems to worry about.

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carsonm
I wonder if any of the members of this "surge" have read the Mythical Man
Month.

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amalag
Even if states are incentivized to create their own exchanges, they are not
doing it.

~~~
coldcode
Politics > money.

