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Healthcare.gov is Merely a Preview of Obamacare
I don't often feel sorry for the Obama administration, but in the case of the massive technical problems plaguing the Healthcare.gov website, I almost do. It has to be awfully embarrassing, after all of the heated opposition to the Affordable Care Act and the Democrats' impassioned defense of it, to have the program's technological interface completely crap out from the very onset.
I suppose my sympathy stems from my background in systems development. I've certainly worked on my share of complicated web-based systems over the years, and the truth is that not all of them ran smoothly at first. Heck, not all of them ran smoothly weeks later. I remember all too well those automated text messages that would occasionally wake me up at three in the morning, signaling that something was wrong with a server. It meant that I needed to quickly get dressed, throw on a hat, and drive to the office building where I worked, all while more and more text messages tortured my cellphone. When I got there, I'd meet with one or two other analysts and we'd spend the next couple of hours feverishly running diagnostic checks, rolling back updates, and debugging code in order to fix the problem before our customers on the East Coast began logging in.
Those were not fun times. Thus, I feel for the developers who are working hard to get the system working properly while the world is watching. I really do.
On the other hand, the vast problems with Healthcare.gov are far more than just simple "glitches" as the Obama administration keeps telling us. The problems have stemmed from poorly written code that can't handle the heavy volumes of traffic that anyone older than the age of five should have seen coming.
Some people are citing the debacle as evidence that Obamacare itself is a failure. I tend to think that's a premature conclusion. There are plenty of reasons for why Obamacare will fail. It's an ill-conceived monstrosity. The least of its problems is website navigation.
Yet, one can't help but look at what's going on with the Obamacare website and find a metaphor for exactly why the Affordable Care Act itself won't work.
Both were painfully naive undertakings. You can't just take over 1/5 of the U.S. economy with a brand new entitlement program whose success relies on a desperately flawed funding system, and think that massive problems won't come from it. Likewise, you can't mandate that all uninsured Americans sign up for that program (or face a government fine) and direct them to do so through a website that can't even handle heavy Internet traffic.
The cost of both was grossly underestimated. A few years back, when president Obama was selling the Affordable Care Act to Americans, he repeatedly stated that the program would cost $900 billion over 10 years. However, the Congressional Budget Office projected earlier this year that the actual cost of the ACA will be $1.8 trillion in its first decade. That's double of what we were told. Likewise, the original cost of Healthcare.gov was projected to be no more than $93.7 million. The actual cost of the website, however, was well over $600 million. Yes, a whopping $600 million for a website that doesn't even work.
To give you a little context for how truly obscene that dollar amount is, let me cite a paragraph from a recent column written by Andrew Couts of Digital Trends:
"Facebook, which received its first investment in June 2004, operated for a full six years before surpassing the $600 million mark in June 2010. Twitter, created in 2006, managed to get by with only $360.17 million in total funding until a $400 million boost in 2011. Instagram ginned up just $57.5 million in funding before Facebook bought it for (a staggering) $1 billion last year. And LinkedIn and Spotify, meanwhile, have only raised, respectively, $200 million and $288 million."
Of course, no one in Washington cares about such costs because they aren't the ones flipping the dime. We are. To them, its like Monopoly money.
Also like Obamacare, there's no real concern with quality assurance when it comes to the Healthcare.gov website because the motivation just isn't there to make things better.
When I was a full-time systems analyst, my coworkers and I understood that a failure of service and repeated usage problems would lead to a loss of customers. A loss of customers would mean less company revenue. Less company revenue would mean less company investment, including employee salaries. Less money available for employee salaries meant that our ability to provide for ourselves and our families was on the line.
So, we were always highly motivated to put forth our best effort, do everything we possibly could to please customers, and make every cent that was put into a system count. That's is how the private sector works.
When the government's in control of something, however, no one really cares about pleasing the customer (who is the American public). There's little motivation to be efficient. It's the reason why the DMV is such a nightmare. It's the reason why no one in their right mind would ever choose to use a public restroom over a private one.
Private ventures are driven by success. Public ventures are driven by dependence. Which do you think are most likely to factor in quality and ease of use?
Speaking of ease of use, how many people do you think gave up on Healthcare.gov and the health care exchanges over the past week and seriously considered just paying the federal fine to avoid all the hassle? After all, according a recent AP poll, three-fourths of Americans who tried to register for health insurance through the ACA experienced problems. That, along with all of the reports from different states revealing how shockingly few people have actually signed up, suggests that people just don't want to deal with the complexities.
That's the same concern that medical professionals have with the Affordable Care Act. In a Deloitte survey of U.S. physicians taken a couple of months ago, 60% expect an exodus of early retirements among doctors over the next three years. The reason? Doctors don't want to deal with another bureaucracy that requires them to fill out even more forms, write more letters, and respond to more inquiries. They don't want to deal with the additional hassle of government reimbursements, less control over how they run their clinics, and less take-home pay that is all associated with the increasing costs and regulations that come with the ACA.
When a process becomes too complex, people abandon it. And that's just another reason why Obamacare will fail.
The good news for the Obama administration is that websites can be fixed, typically without having to start over. The Affordable Care Act, on the other hand, really can't. It's fatally flawed, resembling a computer virus more than an inefficient system. And maybe, as some have suggested, that was the point all along - a way of getting us switched over to the ultimate liberal dream of a single-payer system.
If that's the case, I'm not sure even a system reboot in 2016 could save us.