Healthcare.gov Problems and It’s Effect on the US Governments Online Reputation
October 1st 2013 marked what was supposed to be a triumphant day in the history of our nation. After years of political infighting and sordid debates, Healthcare.gov – a healthcare exchange website operated by the US government in conjunction with the Affordable Care Act (Obamacare) – went live.
Or at least it attempted to.
Unfortunately, due to poor planning, even worse technical design and a myriad of technological glitches, October 1st 2013 will better be remembered as the day in which the US government let its citizens down – a day when it tried to cash a check that would ultimately bounce. And to this day the problems that plague Heathcare.gov have still not been resolved. Which leads many to wonder: Has the US government’s reputation been irreconcilably damaged by the recent mess?
A Brief History of the Affordable Care Act
Healthcare reform was a major focal point of Barack Obama’s presidential campaign. America’s healthcare system is one of the least value-for-money in the developed world and has one of the most confusing billing systems. Access to basic treatments is often inaccessible for many Americans on the lowest income tiers.
This bled into many different areas of life. Whilst seniors could have senior home care costs covered by Medicare, medication was only partially covered. People diagnosed with severe illnesses like cancer often saw their entire savings eaten up within a short amount of time. This made changes to healthcare legislation a very important topic for America.
Upon being elected into office, Obama began working with Congress on a bill that would provide healthcare to all uninsured Americans. Within six months of election the House had approved a plethora of bills that would pave the way for reform. Unfortunately, Republicans vehemently opposed the idea of an individual mandate that would require all Americans to purchase health insurance. Republicans, who once supported the idea of universal health coverage, began calling the mandate unconstitutional and an attack on personal freedom.
Regardless, on November 7, 2009 the House would pass the Affordable Health Care for America Act by the slimmest of margins, 220 – 215. During the same time period, the Senate was busy working on their own version of the bill, one that would pass by a 60 – 39 tally in December 2009.
On March 21, 2010, after four more months of debate and compromise, the House of Representative adopted the Senate’s version of the bill by a 219 – 212 vote. After pushing for healthcare reform ever since being elected into office two years earlier, Barack Obama finally signed the Affordable Care Act into law on March 23, 2010. Reform was coming.
Healthcare.gov would open for the first time in July 2010, albeit without the enrollment feature. Over two years later, the revamped and expanded site would open enrollment to the public – and subsequently crash for the first time shortly thereafter.
What Went Wrong Technically?
Although the minimalist front end of the site appeared pleasant enough, users began to discover clues as to why the site wasn’t working properly almost immediately. Most notably, upon attempting to register an account, users would hit a bottleneck, forcing them to either abandon their efforts or to risk waiting it out until the proper database lookups were performed – if they were performed.
See, Healthcare.gov required users to register an account before they could begin comparison shopping for a healthcare plan – hence the bottleneck. That wouldn’t be such a big problem if either the site was well designed or not heavily trafficked, but unfortunately such was not the case.
On its first day, the site was bombarded by over 250,000 simultaneous users, leading some to believe that the site’s problems were caused by scaling issues, and that it would have functioned properly if only say, 50 or 60 thousand concurrent users were online. The issues that users are having are as follows:
- Delivering the content to the website user
- Receiving the account creation information from the users after signup
- The database generating new user accounts
Officials from the White House would ultimately concede that software and development issues were the problems, and not the immense amounts of traffic. Considering that the government probably anticipated a high volume of traffic on Day 1, it was definitely in their best interest to admit blame and protect their own rapidly deteriorating online reputation over the entire healthcare.gov website debacle.
But despite its claims that the issues would be addressed, the site continued to be plagued by crippling crashes and other strange errors. For instance, users noted careless spelling mistakes, sloppy error handling checks and indicators that the engine driving the site’s database was down more than it was up. A combination of Software glitches and not adequate hardware to handle the anticipated traffic load from day 1.
One Site: Two Contractors
Hiring one team to handle the front end aesthetic and another to write the back end code has become a relatively common web development practice. However, when working on a site as massive as Healthcare.gov, it would have helped if the two contractors were actually communicating with one another on at least a somewhat consistent basis.
Instead, back end developers CGI Federal and front end architect Development Seed apparently worked in isolation. In an interview conducted several months before the site’s failed launch, Development Seed praised their use of innovative open-source technologies that would, in their estimation, pave the way for clients to maintain sites without further assistance from the developer. A great idea in theory, but it appeared that Development Seed’s cutting-edge methodology didn’t jive with how CGI Federal was building the back end.
It was this fundamental lack of communication that ultimately doomed Healthcare.gov. Both contractors went to great lengths to test their own code, but failed to perform the crucial cross tests necessary for a successful launch. Careless bugs riddle the site, some of them easily detectable by even the most casual non-programmer.
The lesson learned: Simply assuming that just because what you’re working on is functioning properly, doesn’t mean that the entire product will work without issue.
Working out the Bugs of Healthcare.gov
The real problem is accountability: Which group is responsible for fixing which bugs? And it appears that after weeks of finger pointing, outrage and excuses, the government, in tandem with its hired contractors, have yet to figure that out.
That’s because the issues with Healthcare.gov transcend simple bug fixes. The real problem is how the site was designed from the start, and because of that it may take months for its severe architectural flaws to all be ironed out. That’s not good news for the millions of Americans hoping to receive affordable health coverage by January 1st, 2014. If you have ever worked in IT or tried to create a complex website from scratch then you understand the headaches and complexities that will arise. The general public on the other hand is probably not as understanding.
Well at least the legal deadline for applying to get health insurance without incurring a penalty has been extended to the end of March, 2014. If anything, it proves that the government is assuming partial ownership for its mistakes.
As of the time of this writing, Healthcare.gov is little more than a clean, savvy, high-profile site that lacks the functionality of the average WordPress blog. Registration is still next to impossible, crashes are relatively commonplace and the site is taken down for maintenance more than its left online ( I do not have stats on the actual hours up and down but please share them if you do). And although Director of the National Economic Council Jeffrey Zients assures us that the site will be mostly operation by the end of November 2013 only time will tell.
The State of the US Government’s Online Reputation
Healthcare.gov is more than just a buggy site. To many Americans, it’s a concrete example of the US government’s ineptitude to create something that simply works.
Recall that on the very same day Healthcare.gov was launched, the federal government ceased operations. For sixteen days, Healthcare.gov was one of only a few government controlled websites still in operation. Consider the ramifications of this two week period on the government’s online reputation. They’re astounding.
Thanks to Healthcare.gov’s troubles critics of the Affordable Care Act had a new reason to voice their opposition, many of them insisting on knowing what went wrong. Within days of the site’s maligned launch, Republicans and some members of the media called for Secretary of Health and Human Services, Kathleen Sebelius – otherwise known as the primary overseer of Healthcare.gov – to be fired immediately. Unsatisfied users flocked to social media sites such as Reddit and Twitter, voicing their anger, confusion and frustrations to anyone who would listen.
The effects thus far have been devastating. Some of the original proponents of healthcare reform are now shaking their head, questioning why they ever supported it in the first place. In fact, according to a joint poll between ABC and the Washington Post, 53% of Americans disapprove of the way President Obama is “handling implementation of the new health care law.” Even more staggering, 56% feel that the problems with the website are indicative of “broader problems in implementing the health care law.”
Based on these results, a moderately large sampling of Americans feel that Healthcare.gov is a decisive red flag of issues to come, which doesn’t bode well for its future, nor for the future of the government’s online reputation – not without a ton of damage control.