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Lessons From the Healthcare.gov Fiasco

samzenpus posted 1 year,10 days | from the better-luck-next-time dept.

United States 501

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."

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Website down? (-1)

Anonymous Coward | 1 year,10 days | (#45124333)

Thanks, Obama!

Re:Website down? (-1)

Anonymous Coward | 1 year,10 days | (#45124495)

Massive and costly boondoggle just like Obamacare, whoddathunkit? They're complementary; go hand in hand; like two peas in a pod. You didn't think a corrupt piece of legislation would have a clean website, did you?

"I knew Obamacare would be bad..." (5, Interesting)

Jeremiah Cornelius (137) | 1 year,10 days | (#45124803)

"...but I seriously had no idea it would be this bad."

How would you design a Healthcare Extortion Racket? [rall.com]

"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 [slashdot.org] .

... sounds familiar ... (1)

JWSmythe (446288) | 1 year,10 days | (#45124341)

    That sounds familiar.. I've said the same thing here and elsewhere. But it's not like my analysis is unique. There are lots of people who have done large implementations in the past. This one turned out with the expected results. They'll get it working right in a few months.

Re:... sounds familiar ... (5, Insightful)

khasim (1285) | 1 year,10 days | (#45124455)

And you have to realize that not everyone on the team has the same goals.

How much do the contractor companies get paid for overtime or change requests?

When I'm a contractor I will tell you what problems there could be that I can see. But if you tell me to do it your way I'll do it your way and collect my check.

Re:... sounds familiar ... (0)

Anonymous Coward | 1 year,10 days | (#45124897)

When I'm a contractor I will tell you what problems there could be that I can see.

But if you tell me to do it your way I'll do it your way and collect my check.

...and this is the difference between a software engineer and a computer programmer.

Re:... sounds familiar ... (-1)

Anonymous Coward | 1 year,10 days | (#45124689)

One can hope. I've been trying to sign up as a member of a death panel for days now, but still can't find the application anywhere on the site.

Maybe using BSD wasn't the best choice after all.

I wonder if (0)

mark_reh (2015546) | 1 year,10 days | (#45124363)

the govt shutdown helped create some of the problems.

Re:I wonder if (1)

Anonymous Coward | 1 year,10 days | (#45124447)

Considering testing was slated to BEGIN the day before launch, I doubt it.

Re:I wonder if (3, Interesting)

CrimsonAvenger (580665) | 1 year,10 days | (#45124571)

I wonder if the govt shutdown helped create some of the problems.

Hmm, they've been developing the software for the last two or three years, and the shutdown began the day the site went live, it's extremely unlikely that the one impacted the other.

Or are you suggesting that Obama decided to treat Healthcare.gov like the WW2 memorial, and deliberately sabotage it? Hint: making your biggest achievement as President look bad is NOT a way to build a legacy....

Re:I wonder if (0)

Anonymous Coward | 1 year,10 days | (#45124799)

well come to think of it - considering hostility of sizable minority I would have been surprised if the project would not have run into problems. In fact considering circumstances it actually works better than it could have been expected. This said I am neither republican nor US american, I come from Europe where we are all communists....

Re:I wonder if (2, Insightful)

alexander_686 (957440) | 1 year,10 days | (#45124883)

What hostile minority? It is the executive branch that was âoeexecutingâ the plan. Considering that this is seen as Obama's greatest achievement and Obama gets the pick the staff I can't think of a minority opposed.

If you are talking about the backseat drivers - the Republicans - well congress has oversight but no powers in this case. Sigh. No. This falls squarely on the shoulders of Obama.

Re:I wonder if (3, Insightful)

GodfatherofSoul (174979) | 1 year,10 days | (#45124887)

You really think the President is going around shutting down just vet memorials to make some kind of a point? A shutdown means government services are shut down. Just because a handful of congressmen stand outside of the most controversial ones, doesn't mean that's all that our government has stopped doing. Pretty clueless for people to start taking a strategy one wing of the Republican House has bragged about for MONTHS now and blame it on the President.

Re:I wonder if (0)

Tailhook (98486) | 1 year,10 days | (#45124593)

I wonder if the govt shutdown helped create some of the problems.

You wonder this because you'd like to find some rationale that lets you blame whomever you think is responsible for the shutdown. Not being ignorant, you're well aware that development of the site did not begin in September or October — what went live was developed long before the 15% shutdown of the government. You know this, but you're still looking for a way to tie the two together, because hey; maybe you and your kind can get stupid people to believe it.

Embarrassing problems... (4, Funny)

zooblethorpe (686757) | 1 year,10 days | (#45124367)

There's a cream for that.

But we can't tell yet if your insurance will cover it.

Re:Embarrassing problems... (0)

Anonymous Coward | 1 year,10 days | (#45124509)

Right now, we are SURE you don't have coverage, because the real problem is they botched this so bad nobody can buy coverage....

Lesson #1: (-1, Troll)

Anonymous Coward | 1 year,10 days | (#45124371)

Don't ever, ever allow a Democrat into a position of power. Lesson taut, lesson learned.

Re:Lesson #1: (1)

dex22 (239643) | 1 year,10 days | (#45124453)

I wrote a tasteful missive about the dangers of politicians of all creeds, stripes, colors. When it came time to click "submit" I just couldn't bring myself to do it. Modern politics is brought to us by the Seventh Circle of Hell. I laugh so that I do not cry.

The first steps of progress in making things better would be if one party gained some competence, and the other turned off their Petty Hate Machine(tm). You, humble reader, can decide which party is which. Choose the one that makes you happiest and upmod accordingly ;)

Re:Lesson #1: (2, Informative)

Anonymous Coward | 1 year,10 days | (#45124871)

someone who doesn't know how to spell "taught" is in no position to give lessons of any kind.

* If your state didn't set up their own. (4, Informative)

0100010001010011 (652467) | 1 year,10 days | (#45124377)

Remember that this is only for people that live in states that tried to stall off the inevitable. I live in Kentucky and despite being a pretty red state we have a Democratic governor and he saw the writing on the wall. Rather than try and delay and delay it we have our own. Numerous other states did the same thing. I haven't heard anything about ours being down.

Re:* If your state didn't set up their own. (2)

intermodal (534361) | 1 year,10 days | (#45124469)

Your Democrat governor (and several others) did not see the writing on the wall. He was simply not opposed to the system itself the way some other governors were, and worked to build it at a state level. Other states have governors who fought the program and the result is those living in those states have to deal with the broken federal one.

The "writing on the wall" idea is nonsense. The reactions of governors have been political, not practical, as far as whether to set up state systems. One needs only look at a map of which states are doing what and compare to a map of which party each state's governor comes from to see it. The difference between the two is not particularly large.

Re:* If your state didn't set up their own. (3, Insightful)

jedidiah (1196) | 1 year,10 days | (#45124579)

The political rhetoric is irrelevant. The point is that states implemented their own systems and none of them have been declared a disaster. You don't hear about any of them because they are working as intended. All of these other systems are just too boring to make the news.

Each of them stands as an example of why the problem is not an insurmountable one and perhaps not even a terribly difficult one.

Each one of them shames the federal government.

Re:* If your state didn't set up their own. (0)

Anonymous Coward | 1 year,10 days | (#45124819)

The other thing is that none of them gave Booz Alen Hamilton and CGI group their business, they found people who can actually get stuff done. Also the process that the Federal Government uses for such projects gets in the way more than it helps.

Re:* If your state didn't set up their own. (5, Informative)

Obfuscant (592200) | 1 year,10 days | (#45124879)

The point is that states implemented their own systems and none of them have been declared a disaster. You don't hear about any of them because they are working as intended.

Sadly, this is simply not true.

Oregon had been running ads for CoverOregon [coveroregon.com] for months prior to Oct. 1. Cute ads, catchy music, but no indication of exactly what "Cover Oregon" was. Unicorns and pixie dust.

Come Oct. 1, the website went live. Unfortunately, they hadn't yet implemented the details of how to sign up, ignoring the basics of "how much will you have to pay" based on income, etc. That part of the website is, to this day "Coming Soon".

You can sign up, but you have to contact a "Community Partner" (new name for "Insurance Agent") on your own. They'll point you at one, but interestingly, the law doesn't require that "partner" to tell you about anything other than the plans his company sells. Lowest rate? Well, look here at my glossy brochure, ...

And no, this isn't how it was intended to be. It just wasn't finished, and still isn't. It did make the news, but only in Oregon media. Who cares about failures of the health care exchanges in someone else's state? BTW, Gov. Kitzhaber is a Democrat and a physician who is fully behind taxpayer-funded health care for all.

Re:* If your state didn't set up their own. (0)

Anonymous Coward | 1 year,10 days | (#45124841)

GP: "a Democratic governor"
P: "Your Democrat governor"

Re:* If your state didn't set up their own. (0)

Anonymous Coward | 1 year,10 days | (#45124639)

Yeah... I grew up in KY and miss the countryside, there was some awesome stuff down there.

Ohio is way too flat and election years in a "swing state," I'm finding, are sheer hell next to living in a state where everybody knows which way the big races are going to go.

On the other hand, I don't have to put up with freaking Southern Baptists very often any more, so that's a plus.

I was pleasantly surprised to find that KY actually set up a state exchange, but at the same time I'm still surprised whenever I realize that they elected a Democrat governor. How the hell did that happen? This is the same state that sent us one of the only Teabaggers to hold a Senate office, not to mention Mitch the Chinless Wonder.

Every time I read about my old home state I just get confused. KY politics are weird.

Alternatives? (2)

schneidafunk (795759) | 1 year,10 days | (#45124391)

I'm just curious if anyone knows of an alternative way to sign up without using the website. How many homeless have access to computers & the knowledge to use them anyway?

Re:Alternatives? (1)

iotaborg (167569) | 1 year,10 days | (#45124439)

There is a paper application supposedly, from what I've heard on the radio. There are people whose job it is to help those who are less knowledgeable sign up for the health care.

Re:Alternatives? (3, Informative)

bobdehnhardt (18286) | 1 year,10 days | (#45124603)

For states that set up their own exchanges, there are generally offices available as well as phone lines people can call. Many of the states that opted out are also trying their damnedest to block any perceived successes for the ACA, and have taken steps to hinder their establishment. How much help someone can expect in signing up depends entirely on what state you're talking about.

Re:Alternatives? (1)

jlechem (613317) | 1 year,10 days | (#45124627)

How many homeless file a tax return to begin with? I bet most of them don't have a drivers license or know their SSN number. You have to some kind of mailing address or permanent residence for these things. The people I think it would hit hardest by being online are the elderly and working poor. But they can always call the toll free number and talk to a person.

Re:Alternatives? (0)

Anonymous Coward | 1 year,10 days | (#45124845)

Sheltered much? If this is how you view the homeless, you really need to get out more.

Re: Alternatives? (0)

Anonymous Coward | 1 year,10 days | (#45124825)

All of them. Libraries.

Re:Alternatives? (0)

Anonymous Coward | 1 year,10 days | (#45124853)

No, this is a really good question. It's as if the federal government passed a law mandating that citizens use a website to purchase health insurance health insurance from a private company or face a penalty. What about folks who don't have or don't want internet? What about folks who don't want to upload their personal info to the internet?

"unlikely you'll be the one responsible?" (1)

Tanman (90298) | 1 year,10 days | (#45124399)

"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."

Going by budget, even if you are the head of Facebook and Twitter, you are still not going to be responsible for a project on the scale of the Health Insurance Marketplace.

This farce is wholly, completely, and unarguably inexcusable.

Re:"unlikely you'll be the one responsible?" (2, Insightful)

ebno-10db (1459097) | 1 year,10 days | (#45124675)

Facebook and Twitter started out small and grew. That's also true of Google, Amazon, and just about any other very high volume site. This is different because they had to build a site and then, on the first day, turn on the fire hydrant all the way. I'm sure there are plenty of things they did wrong, and it was probably very badly organized. Nevertheless I'm curious what the best way to handle something like this would be. How many people have worked on a project where they had to go from zero to millions of users one day? Obviously massive test capability would be part of doing it right, but often that doesn't wring out all the unforeseen cases.

"Prone to glitches"? (1)

Anonymous Coward | 1 year,10 days | (#45124421)

"Prone to glitches"?? That's being rather generous... it doesn't f'ing work! I still can't get it to create an account, let alone actually use it for anything.

Re: "Prone to glitches"? (2, Informative)

Anonymous Coward | 1 year,10 days | (#45124893)

You can't seem to get Slashdot to create an account, either. Maybe the problem is just you?

It's about letting the system scale (0)

Anonymous Coward | 1 year,10 days | (#45124443)

1) choose management capable of recognizing the problems that arise
2) test, test, test.

Sorry, but this is pure bunk. The website should have been designed to scale. Both of the experiences learned are reactionary responses (recognizing the problems and testing). If the website would have been designed to scale by simply creating more server instances then this would have never been an issue.

I learned that most people fail to understand the importance of a good software architect.

Re:It's about letting the system scale (3, Interesting)

bobbied (2522392) | 1 year,10 days | (#45124821)

I learned that most people fail to understand the importance of a good software architect.

The problem is worse than that. Most folks don't understand how hard and expensive good software is to develop and deploy.

Remember, most folks only see the stuff that works. Nobody remembers Yahoo, Google or Amazon when they where struggling to keep the servers alive. We barely hear about Netflix when they are down... This stuff just works and most don't have a clue the effort that goes into making that happen.

Obama's administration was in *WAY* over their heads trying to put the infrastructure in place for the marketplace. NOBODY tries to field a complicated website at full capacity on a single day, at least nobody who's actually been successful at this. You ALWAYS soft start and ramp up to production goals. The whole idea is as unworkable as the website implementation turned out to be. But that's politics. Make confident assertions about things you have no clue about.

But that's government for you. Doing STUPID things in a big and expensive way then throwing money at the problem to fix it.

Impossible circumstances (2)

djbckr (673156) | 1 year,10 days | (#45124483)

I don't see how anybody could build a semi-complicated system from scratch in a few months. A system this big would take at least a year to get right, and that's if everything was spec'd appropriately, and the coders were good, and the project was managed well. Since the project actually got under way only several months ago, I knew it would be - at the very least - quirky. If it ran at all.

Re:Impossible circumstances (1)

motorhead (82353) | 1 year,10 days | (#45124607)

You can't!

Re:Impossible circumstances (2, Insightful)

jedidiah (1196) | 1 year,10 days | (#45124633)

It's essentially an e-commerce site with a government subsidy element added to it. There are any number of similar sites that already existed. They were created to fill the same basic market need by people interested in making a buck.

Since this whole thing was a gift to the insurance industry, perhaps the feds should have considered that the industry may have made a useful partner. Let all of the insurance sales men out there be honorary do-gooders helping themselves while helping Obama's agenda.

Re:Impossible circumstances (0)

Anonymous Coward | 1 year,10 days | (#45124653)

Actually the project has been underway for well over 2 years.

Re:Impossible circumstances (1)

wisnoskij (1206448) | 1 year,10 days | (#45124753)

From what I heard you pretty much just register on the site, other than needing to support a rather large number of concurrent users, there are already suits of programs that do everything that this projects needs.

You could set up a Drupal forum in a week with the required content, and then just buy some ultra plan on Amazon cloud servers.

Obama should agree to delay the individual mandate (1, Troll)

blue trane (110704) | 1 year,10 days | (#45124487)

Agree to delay the individual mandate, in exchange for a repeal of the debt-ceiling laws.

Give republicans what they want: they don't have to sign up for health care if they don't want to, and there will be no penalty. But in exchange, get them to admit what they know, that Reagan proved deficits don't matter. Just let the government create money (as banks do) to fund services.

A healthier population will create more. The argument should be about the desirability of universal health coverage, not about how to finance it. The Modigliani-Miller theorem of Finance says that if you have a good idea, it doesn't matter how you finance it. Let's stop arguing about finance and concentrate on the important things: the desirability of universal health care and its positive effect on continued innovation.

Re:Obama should agree to delay the individual mand (3, Interesting)

lgw (121541) | 1 year,10 days | (#45124547)

Just let the government create money (as banks do) to fund services.

So we don't need any taxes, then? Heck, we don't even need any government bonds for funding! Why half-measures, why not send $1M to everyone? I wonder how that would end: "since we adopted the leaf as the currency, we're all rich!". I can see no flaw in this plan.

Re:Obama should agree to delay the individual mand (5, Informative)

Todd Knarr (15451) | 1 year,10 days | (#45124629)

The reason for the mandate (and for the original single-payer system) is that currently the cost of health care for the uninsured is hidden in the "uncollectable debt" category in the hospital's accounts receivable. It's all the bills for ER visits and emergency care for people who can't pay. I was taught a basic rule back in high school business classes: you can't manage costs until you've got them laid out where you can see them. The idea was to get all health care being paid for and accounted for so we can see where the money's going and do something about the areas where it's costing more than it should. It was also to help with shifting the costs from expensive emergency care to much cheaper preventative care, the idea being that when people know they're covered by insurance they're more likely to go to the doctor before things get critical instead of putting it off and hoping they get better so they don't get nailed with a doctor's bill and ending up at the ER in critical condition. If you have no insurance the bill's going to be a killer either way so it makes sense to go for the chance to avoid it, whereas if you do have insurance the bill won't kill you either way so why wait and suffer more than you have to?

Re:Obama should agree to delay the individual mand (2, Informative)

CrimsonAvenger (580665) | 1 year,10 days | (#45124647)

Agree to delay the individual mandate, in exchange for a repeal of the debt-ceiling laws.

After all, Obama has already delayed the Employer Mandate part of the ACA by executive fiat.

Re:Obama should agree to delay the individual mand (-1)

Anonymous Coward | 1 year,10 days | (#45124649)

You are so far behind in the conversation that I'm not sure you'll ever "get it". Universal Healthcare isn't desirable. It only helps the weak survive longer, creating a larger burden on society. Do I want everyone to be at the top of their health, absolutely. Do I want to pay for it? Nope. Buy your own Asprin or ask for charity, just stay away from the Federal Purse. If it's so important to you then pass the law at the state level. Personally the ACA is the same thing as the UN coming in and telling the people of France they have to either buy 'insurance' for a product they don't want or pay a fine, I mean a tax, I mean a fine (which one is it?). Do you think the people of France would welcome that? Do you think they'd be happy to have some Giant Governing Body looking out for them? Do you think they'd blindly follow knowing that nobody at the UN had even read it and one of the big leaders said they'd have to pass it just to know what's in it. Let's stop arguing about finance and concentrate on the important things; FREEDOM, LIBERTY AND THE RIGHT TO CHOOSE OUR DESTINY.

Re:Obama should agree to delay the individual mand (0)

Anonymous Coward | 1 year,10 days | (#45124823)

That implies that everyone who doesn't have health insurance is choosing not to.

Re:Obama should agree to delay the individual mand (0)

jedidiah (1196) | 1 year,10 days | (#45124663)

> Agree to delay the individual mandate, in exchange for a repeal of the debt-ceiling laws.

The Republicans were the ones to add the personal mandate. Offering to remove or delay this will be of no value to them. It's their bad idea to begin with.

Not a good bargaining chip.

Re:Obama should agree to delay the individual mand (1)

rotorbudd (1242864) | 1 year,10 days | (#45124765)

Do you realize the Repubs. Had zero input to the bill?

Re:Obama should agree to delay the individual mand (1)

Bartles (1198017) | 1 year,10 days | (#45124831)

That's the stupidest thing I've ever seen on this site. Not a single republican voted for the individual mandate, and had zero input on writing this bill.

Re:Obama should agree to delay the individual mand (3, Insightful)

NoNonAlphaCharsHere (2201864) | 1 year,10 days | (#45124713)

So ~30 hostage-takers get to override the other 500 House and Senate members? We have a first-past-the-post system, which guarantees a 2-party system. If we had a proportional system, we could have these kind of splinter groups in a coalition government, much the way Israel runs. But when one faction holds its breath until it turns blue, the whole government can fall. We HAD a national referendum on Obamacare, i.e. the last presidential election, where the Republicans were the ones who wanted to make the election about it - AND THEY LOST.

Re:Obama should agree to delay the individual mand (1)

fahrbot-bot (874524) | 1 year,10 days | (#45124737)

Agree to delay the individual mandate, in exchange for a repeal of the debt-ceiling laws.
Give republicans what they want: they don't have to sign up for health care if they don't want to, and there will be no penalty.

Yes and I'm sure it will all end there. [/sarcasm] No, giving in to extortion only leads to more extortion. What Republicans want it to get something they could not get through the normal legislative process, so they're throwing this tantrum and holding their breath until they get what they want. As any parent knows, condoning this type of behavior only reinforces such behavior.

No one *has* to sign up for healthcare and the penalty in 2014 is $95 (ninety-five).

The rest of your post is okay by me... :-)

slashdot MOTD (0)

Anonymous Coward | 1 year,10 days | (#45124489)

Always leave room to add an explanation if it doesn't work out.

Patient Protection and Affordable Care Act (0)

Anonymous Coward | 1 year,10 days | (#45124491)

not trying to troll, but i thought insurance is already affordable in the United States of America? my cousin in USA has health has Blue Cross and Blue Shield for $75.00 USD a month. what's the problem? surely people make more than $100 a week in USA?

maybe healthcare.gov can take lessons from Blue Cross and Blue Shield website? i got a quote in one minute but i had to type my cousin's postal code.

Re:Patient Protection and Affordable Care Act (2, Informative)

mbkennel (97636) | 1 year,10 days | (#45124541)

"but i thought insurance is already affordable in the United States of America? my cousin in USA has health has Blue Cross and Blue Shield for $75.00 USD a month. what's the problem? "

$75 a month doesn't get you insurance that's worth anything or almost nobody is eligible.

More like $750 for a single person for coverage even partially comparable to single payer.

Re:Patient Protection and Affordable Care Act (2, Interesting)

Bartles (1198017) | 1 year,10 days | (#45124885)

I buy individual insurance for $165 a month. That is with a $500 deductible, and 0% coinsurance. My plan will be illegal on jan 1st, because it does not cover maternity care amongst other things. My plan is the equivalent of a platinum plan on the exchange. I just got quotes for a platinum plan with the same deductible, and quotes ranged from $420-$700 a month. Fuck you, and everyone else who thinks this law is a good thing. It just destroyed my ability to buy insurance. BTW, I am not even eligible to use the exchange. I applied, and my application was denied because my income was too low. I was told my only options for healthcare, was to enroll in medicaid or buy insurance on my own outside the exchange. It just so happens my income is very low right now, because I am starting a business and living off a capital loan.

Re:Patient Protection and Affordable Care Act (0)

Anonymous Coward | 1 year,10 days | (#45124717)

That's likely $75/bi-weekly pay period for his contribution to his group coverage through work. That's about what staff here pay for single coverage after our 80% employer contribution is taken out. Unless he has a particularly generous employer.

Why "Plan to throw one away" was a chapter title (2)

NoNonAlphaCharsHere (2201864) | 1 year,10 days | (#45124499)

Those who fail to learn the lessons of history are doomed to repeat them in summer school.

Typical government... (1)

msauve (701917) | 1 year,10 days | (#45124501)

they should have just sold policies through eBay and/or Amazon.

Re:Typical government... (3, Interesting)

lgw (121541) | 1 year,10 days | (#45124601)

You may be joking, but I think you're right.

Most states have this worked out pretty well for car insurance. There's a great market, you buy it just like anything else with no exchanges needed, it's just another service. If you're especially high risk, the insurers are required to take you as a customer at government-limited rates, but in return everyone is required to buy insurance. Seems to work well for all involved, and for 90% of customers the government is just not involved in the purchase process (nor is your employer, nor any other third party).

Typical idiot... (0)

Anonymous Coward | 1 year,10 days | (#45124655)

Using GOP stereotype followed by reference to a some sort of private business no matter how irrelevant it is to point being discussed. Does any product sold by amazon and ebay has to comply with HIPAA, ACA and any other relevant state and federal laws regulating insurance and patient privacy?

Re:Typical idiot... (1, Flamebait)

jedidiah (1196) | 1 year,10 days | (#45124715)

The regulations surrounding insurance products are dealt with by the relevant insurance providers just like any other industry. Amazon doesn't have to bother with insurance regulations any more than they have to deal with the FCC regulations on your phone or computer.

The problem of privacy is not even interesting. It's purely a matter of policy and whether or not you are willing to enforce a certain set of rules.

There is nothing special about health insurance.

YOUR attitude is precisely the problem here. Idiots like you are making this situation far more complicated than it needs to be.

Contractors (5, Insightful)

Todd Knarr (15451) | 1 year,10 days | (#45124521)

Part of the problem is the usual problems with large-scale IT projects: it's not until you're well into it that you really get a grasp of what's involved. Nothing government-specific there, that plagues all large IT projects in private industry. Part of the problem, though, lies exactly in the fact that contractors were used. Contractors are mercenaries. They're here to deliver this project, and once they get their paycheck they're on to other work. They won't be around to deal with the fall-out and maintenance headaches from their work, and they don't have any vested interest in the quality of their work as long as it's good enough to pass review and get their payment check cut. In fact, poor quality is actually an opportunity to get paid twice since fixing the problems is a new project. Full-time permanent employees may not be as efficient as contractors, but on the other hand they've got a vested interest in making sure the system doesn't create any more problems than necessary because they know they're the ones who're going to have to clean up the messes. Long-term employees also have a better grasp of what's already involved in the current system, which translates directly into a better grasp of what the new system will need to do. They're less likely to miss major complications because they already have to deal with them.

Part of the problem with contractors is also the fact that large organizations like governments limit themselves to Tier 1 contractors. And there aren't a lot of those. So it rapidly becomes a situation where the Tier 1 contractors aren't really concerned about quality and results, because they know their customers will by policy refuse to consider any alternatives outside a small set and those others aren't any better about quality. If the government switches from contractor A to B, that means B can't take on another customer who takes their business to A (because A and B are the only Tier 1 firms and the customer can't consider anyone who isn't a Tier 1 firm) and it's a net wash for A.

Re:Contractors (2)

BenEnglishAtHome (449670) | 1 year,10 days | (#45124727)

Contractors are mercenaries. They're here to deliver this project, and once they get their paycheck they're on to other work. They won't be around to deal with the fall-out and maintenance headaches from their work, and they don't have any vested interest in the quality of their work as long as it's good enough to pass review and get their payment check cut. In fact, poor quality is actually an opportunity to get paid twice since fixing the problems is a new project. Full-time permanent employees may not be as efficient as contractors, but on the other hand they've got a vested interest in making sure the system doesn't create any more problems than necessary because they know they're the ones who're going to have to clean up the messes. Long-term employees also have a better grasp of what's already involved in the current system, which translates directly into a better grasp of what the new system will need to do. They're less likely to miss major complications because they already have to deal with them.

I've already posted so I can't mod you up but I'm sure you'll hit 5, anyway.

Government software should be written (and subequently further developed and supported at every level) by full-time, long-term government employees.

Thank you for outlining so concisely some of the major reasons this is true.

The problem with full time employees is... (1)

MikeRT (947531) | 1 year,10 days | (#45124835)

The federal government doesn't have the culture to actually create and run something like this and just stamping your feet while insisting it much change won't change it. The civil service system itself militates against what you want because it makes it hard for the government to actually hire the right people, fire the wrong people and reward people based on performance. There is nothing intrinsic to government work that says this cannot happen, but our system as it actually exists all but ensures that you'll not have the ability to build this sort of team. Add on top of that even if you did, you'd need looser rules of procurement to let these employees take risks, try new things, etc. You know like when someone on staff says "hey let's buy 500 small servers instead of 50 REALLY expensive blades" and the experiment gets caught up in procurement kabuki until the whole purchase order is, well, OBE...

Actually, what you really need (1)

MikeRT (947531) | 1 year,10 days | (#45124859)

Is to let federal project managers directly hire their own contractor teams and have them report to the government. Federal managers need more latitude in how they spend money with their evaluation criteria being primarily on how effective the team's delivery actually was. If responsibility and authority were both in their hands, and federal managers could be fired based on how poorly their teams executed an initiative you'd suddenly find a lot more federal contract teams working together smoothly.

Alpha? Beta? Rolling release? (1)

ReallyEvilCanine (991886) | 1 year,10 days | (#45124525)

Why the FUCK was this broadly released instead of tested and stepped? Even people firing up PrestaShop sites aren't this cavalier.

I can hear someone screaming about how to choose to/for whom and where to release first: how about by acceptance/ratification/support of the program?

It does work however (1)

Anonymous Coward | 1 year,10 days | (#45124533)

I used the site and managed to get through. It was buggy. Really all it asks you for is a username/password your name and address your age and if you smoke. Why they spread this over several pages is beyond me- amazon could have done it on one form. However I have also tried to get insurance the normal way which requires much more information (health history etc). I think the exchange is much much easier.

Re:It does work however (1)

jedidiah (1196) | 1 year,10 days | (#45124769)

They also don't validate data until the end of the process forcing you to enter data multiple times. It almost seems like it is specifically designed to harvest data rather than be a functioning registration process.

Before you're even registered, you should be able to get some idea of what products are available, what they cost, and what kind of subsidy you can expect. It should be easy to see what your likely options and not require (or appear to require) that you send private identifying data to some 3rd party data aggregator.

If the media and fundies weren't distracted with the shutdown, the whole "number of the beast" aspect of this thing would be much more widely perceived.

In that respect, the timing of this launch could not have been better. Senator Cruz is the perfect distraction here.

The irony is that the republicans... (0)

Anonymous Coward | 1 year,10 days | (#45124545)

...actually had to do nothing to stop this - they made the mistake in thinking that the government could actually do something right.

Oversight or devious plot? (1)

Umuri (897961) | 1 year,10 days | (#45124555)

Now I'm not saying incompetence isn't plausible, or even likely. But I also wonder if this wouldn't be somewhat intentional on the part of a few people as a political maneuver, whether via who the contracts went too, artificial delays, etc etc, in order to make the project become politically embarrassing. Sabotaging a co-workers project is not unheard of in the corporate world to get ahead or inhibit their credibility, so why would the government be any different...

Where did the money go? (3, Interesting)

GGardner (97375) | 1 year,10 days | (#45124557)

As a software engineer, I'm very curious about where this $400 million went. In all the articles about this project, I've never seen a breakdown of where the money was spent, at least at the granularity of people/hardware/software. Typically software projects spent most of their budgets on people, but a $400 M project that is basically a year old implies on the order of thousands of employees. That can't be right? Did they get dinged by ridiculous licensing fees from the usual suspects? Where did the money go?

Re:Where did the money go? (0)

Anonymous Coward | 1 year,10 days | (#45124695)

I too am curious of this. 400 million is a lot for a year. I assume 100 million for a CEO's yacht, 100 million in licencing to his friends (who also get sweet yachts), 1 mil for 20 developers for a year, 1 million in cloud servers, 48 million for developing the monitization strategy for selling your personal info, and 150 that goes into a black budget.

Re:Where did the money go? (0)

Anonymous Coward | 1 year,10 days | (#45124733)

The whole thing is open source, so there's no licensing fees. Although they had to spend money on training developers on how to program in Ruby for the project. So you have devs on the project for whom the site is their first production level Ruby project.

Making it better (0)

Anonymous Coward | 1 year,10 days | (#45124575)

I don't know how the government could have required it under contracting law, but the contract should have required that all involved, from corporate CEO's on down would have to use the system to get their own health care insurance for the next five years or so. It would have come out a lot better if they'd had to eat their own dog food.

We called 'em "Boozers" (5, Interesting)

BenEnglishAtHome (449670) | 1 year,10 days | (#45124595)

This

...experienced IT contractors (such as Booz Allen Hamilton...

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.

Are there any positive examples... (1)

PhantomHarlock (189617) | 1 year,10 days | (#45124619)

It seems like many times when a large government entity spends billions of dollars on a large IT project to consolidate or make more efficient the handling of lots of data, it frequently ends up in massive amounts of wasted money and failed projects, with lots of pork doled out to consultancies and middlemen, and in the worse cases ends up with the project abandoned entirely with all the money down the toilet. Many examples have been posted to /. in the last 10 years.

Are there some good cases of where the money was well spent, and a solid, cohesive working product came out of it?

Some of the root cause may be the politicizing of the contract process in the first place (beltway bandits and congress critters mandating a piece of the work go to their district) and the letting of cost-plus contracts. Other times may be the requirement to take the absolute lowest bidder, which ends up with someone who lowballed the job and cannot possibly execute it properly within the promised budget.

How does one properly motivate and direct a team under these conditions? The actual production of the software needs to be isolated from the politics above, and act as if they are working for a small company developing a new commercial website. With lack of competition - it's not like people can go to all those other government healthcare websites - a replacement incentive needs to be put in place if one wishes to tread down that path. In a monopoly situation, these are common problems. Highly centralized services do not take into account basic human nature.

Earlier in the last decade, there was a famous powerpoint slide that made the rounds within Aerospace circles. It was titled "SLI - The Work of a Nation" and showed which pieces of the Space Launch Initiative* were to be built in which congressional districts. It was the butt of many jokes as de-centralizing the production of such a complicated item always results in ballooning costs as it makes it extremely costly and difficult to integrate the various components. That may not be the case here but it's definitely seen in other federal projects.

* the then-current name for the over-bloated, impossibly expensive shuttle replacement heavy launch system now known as SLS - Senate Launch System as goes the joke.

How about making it simpler? (4, Interesting)

fahrbot-bot (874524) | 1 year,10 days | (#45124621)

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?

Campaign team (3, Insightful)

curunir (98273) | 1 year,10 days | (#45124635)

I find it interesting that the team behind the technical aspects of Obama's presidential campaign were so capable (more here [theatlantic.com] ...it's a great read) and yet he still chose the tried and false alternate model of outsourced government contractors to handle this.

A methodology more similar to what was used on his campaign would have been far more successful and cost significantly less.

Re:Campaign team (2)

yankeessuck (644423) | 1 year,10 days | (#45124875)

Pretty sure campaign contracts don't have to run through the gauntlet of the governmental bidding process. That eliminates a lot of capable contractors who don't want to or can't deal with that.

Republican DOS attacks (1)

Anonymous Coward | 1 year,10 days | (#45124651)

It's obvious. I'm Serious.

Millions of dollars = the real problem (1)

xxxJonBoyxxx (565205) | 1 year,10 days | (#45124661)

>> when an entity (whether public or private, corporation or federal government) has keen minds and millions of dollars at its disposal

Not sure there's any evidence of "keen minds" here, but I'd suspect that the root of the problem is that there were millions of dollars allocated to the project. With that kind of money, the incentive is probably to put as many billable bodies on the thing, regardless of qualifications or result.

What fiasco? (4, Interesting)

rsilvergun (571051) | 1 year,10 days | (#45124669)

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.

Re:What fiasco? (1)

mfwitten (1906728) | 1 year,10 days | (#45124759)

Why? I would opt for:

c. Failing gracefully (i.e., having a plan for the suspected onslaught).

d. Growing a new service incrementally from old, proven parts.

I'm sure a smarter person could figure out `e', etc.

Uh? (1)

rotorbudd (1242864) | 1 year,10 days | (#45124699)

"Keen minds and millions of dollars".
Maybe millions of dollars (ours), but keen minds? Not so much.

Like this doesn't happen in Corporations (2)

justcauseisjustthat (1150803) | 1 year,10 days | (#45124703)

It's funny all the finger pointing, how the government screws up IT, etc.
I've seen dozens of major web site projects and many other major IT projects totally screwed up. It's not government, it the human people involved and they are everywhere!

Central Planning (1)

mfwitten (1906728) | 1 year,10 days | (#45124711)

Central Planning does NOT work.

Successful giant endeavors evolve organically out of small, working endeavors.

Re:Central Planning (1)

Animats (122034) | 1 year,10 days | (#45124805)

Central Planning does NOT work.

Oh? Check out Walmart, McDonalds, Apple...

Firm Grasp (2)

jamesl (106902) | 1 year,10 days | (#45124775)

Nerval's Lobster has a firm grasp of the obvious.

A successful project requires ...
1. A detailed and unchanging specification.
2. Experienced and qualified managers.
3. Incremental releases.
4. Test.

He forgot ...
5. Realistic schedule.

Smells fishy to me (1)

sl4shd0rk (755837) | 1 year,10 days | (#45124783)

Seems to me someone like CGI Group "multinational information technology (IT) consulting, systems integration, outsourcing, and solutions company" and Booz Allen Hamilton "Client service. Innovative ideas. Exceptional people. Core Values. Solid performance" could have handled designing a simple website which takes user input and stores it in a back-end database. Ask for our tax dollars back and move forward with another vendor. Perhaps a 16 yr. old high school kid who knows Javascript.

Dems want website up quickly, doesn't have to work (1)

Anonymous Coward | 1 year,10 days | (#45124809)

Any talk about technical reasons why the ACA website does not work is irrelevant. The problem is the Republicans trying to eliminate the ACA. The aim is to get as much ACA 'infrastructure' in place as soon as possible, and get as much public support, as soon as possible, so that repealing the ACA is as difficult as possible. Whether the website actually works is unimportant. There will be plenty of time and money to get the web site working later if the Republicans can be stopped.

Hell, Ted Cruz was talking about this back in July, “Moreover, we have, I believe, the best opportunity we will have, and possibly the last good opportunity we will have to defund Obamacare with the continuing resolution.” and, “If the subsidies kick in, the prospect of full repeal of Obamacare diminish dramatically,” This is what the government shutdown is all about.

Is there any way to "de-scale" these projects? (4, Insightful)

rbrander (73222) | 1 year,10 days | (#45124857)

It's pushing 20 years since I first saw an academic study showing that IT project failure probability increases dramatically - the latest was 2005:

The Challenges of Large-Scale IT Projects [waset.org]

You're darn right I won't be put in charge of such - not without a gun to my head. I'd want to de-scale anything down to a size where you could reasonably spec and test it. As the article says, "test, test, test". A formative experience in my programming was FORTH, a language that strongly rewards small incremental experiments, compiling as you go, building from small functions up to large ones. I'm not saying use FORTH, but the philosophy of getting the basics working and building up has really worked for me for a whole career.

By contrast, all the large-scale projects I've worked on have all taken a philosophy like building a skyscraper or 747 - no one person can comprehend it, design everything before the first screwdriver is picked up, so the design process goes on for months and years, etc. And then you have "crunch time" from then on as the fond beliefs of the design team smack into reality, and the specs are proven to not match needs. Incremental building and testing tends to reveal these problems.

The fear that drives these philosophies is that you'll have the thing mostly built...and discover it doesn't meet every need and can't without some huge rebuild, because you didn't think of everything up front. Rather like an old system that's been patched to death and has to be tossed because it just can't keep up with changes. I think the fear exaggerated, particularly if the design-build team is at least roughly aware of the whole project dimensions.

The advantage of more-incremental projects that are never large because you take one part at a time is you develop in priority order. The 80/20 rule suggests that 80% of the clients will want about 20% of the options available - so get 20% of the offering working, and working well, first.

Canada has this story of medical records: http://news.slashdot.org/story/09/10/10/0124227/open-source-could-have-saved-ontario-hundreds-of-millions [slashdot.org]
As /. covered it, "open source" would have saved 95% of project costs, but I think it was also about the open-source development was in small increments, no large projects.

what should have happened... (1)

buddyglass (925859) | 1 year,10 days | (#45124873)

They should have told Intuit, "Design the healthcare exchange website for us or we'll pay someone else to build an 'official' TurboTax competitor. Also we'll pay you $400M."

Contractors - Self-selecting from the bottom (0)

Anonymous Coward | 1 year,10 days | (#45124889)

Contractors win by being low bidders, and they take their cut off the top, and use what's left to hire their programmers. This self-selects programmers from the bottom. The result is obvious - if you pay peanuts, you get monkeys - one fiasco after another. The system itself is terminally dysfunctional.

Lessons from the healthcare.gov fiasco (2)

sumergo (2510518) | 1 year,10 days | (#45124895)

Sadly nothing new here in terms on government "understanding" of the need to: 1. Freeze the specs. 2. Have your Lawyers look at the contract for the tiniest of loopholes and then hold the contractors to it. 3. Be aware that contractors (especially the big ones - no acronyms supplied here) will indeed be like Lawyers and say "ooh you didn't specify that - it's a change request" 4. Test early, test often - and then test, test & test again. 5. Pay good attention to usability. Check this out: http://www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn [theguardian.com] Sixteen billion US expended so far (and still counting) - negligible returns.

Goverment Related News? (4, Funny)

Merk42 (1906718) | 1 year,10 days | (#45124905)

Clearly this is all because of {current President} and all the rest of the {President's affiliated party}. If only this were done by {opposing party to that of the President} instead none of this would have happpened!
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