18 Oct 2013

Avik Roy on What Went Wrong With Healthcare.gov

Health Legislation 32 Comments

If these quotes are accurate, this is a pretty damning article. But don’t worry, we’re going to tax rich people enough to make it all work out in the end:

A growing consensus of IT experts, outside and inside the government, have figured out a principal reason why the website for Obamacare’s federally-sponsored insurance exchange is crashing. Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping. This, in turn, creates a massive traffic bottleneck, as the government verifies your information and decides whether or not you’re eligible for subsidies. HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away.

“Healthcare.gov was initially going to include an option to browse before registering,” report Christopher Weaver and Louise Radnofsky in the Wall Street Journal. “But that tool was delayed, people familiar with the situation said.” Why was it delayed? “An HHS spokeswoman said the agency wanted to ensure that users were aware of their eligibility for subsidies that could help pay for coverage, before they started seeing the prices of policies.” (Emphasis added.)

Robert Pear and colleagues at the New York Times have a piece up today detailing the serious problems with the federal exchange, problems that may get worse, not better. They confirm what we already knew: that the Obama administration refused to delay the implementation of the exchanges, despite the well-known problems, because they were afraid of the political blowback. “Former government officials say the White House, which was calling the shots, feared that any backtracking would further embolden Republican critics who were trying to repeal the health care law.”

As I documented last week, IT and insurance experts have been saying for at least eight months that implementation of the exchanges was going badly, that as early as February officials were warning of a “third world experience.” The Times’ sources are just as blunt. “These are not glitches,” said one insurance executive. “The extent of the problems is pretty enormous. At the end of our [conference calls with the administration], people say, ‘It’s awful, just awful.’”

“We foresee a train wreck,” said another executive in a February interview with the Times. “We don’t have the IT specifications. The level of angst in health plans is growing by leaps and bounds. The political people in the administration do not understand how far behind they are.” Richard Foster, the former chief actuary at the Centers for Medicare and Medicaid Services, said last week that “so much testing of the new system was so far behind schedule, I was not confident it would work well.”

32 Responses to “Avik Roy on What Went Wrong With Healthcare.gov”

  1. Bob Roddis says:

    More evidence that social democracy is nothing but one gang voting to employ the government to set upon another gang, all the while the proponents try to hide the nature of the game from the victims.

    Oh, but it’s system that we just MUST have because it is so supremely moral and efficient compare to non-violent voluntary exchange. Right?

  2. Nick says:

    I’m shocked this happened. They must lack the resources to implement it correctly.

  3. Major_Freedom says:

    Well, at least with private insurance you are, more often than not, given the opportunity to at least discuss and agree to the price you pay before you sign the contract.

    “…officials were warning of a “third world experience”.”

    That’s an insult to the third world.

  4. Major_Freedom says:

    “The political people in the administration do not understand how far behind they are.”

    It was always about symbols and Obama along with his fanatics leaving a “legacy” for political history purposes (face). Quality was not the top priority by any stretch.

  5. Mike M says:

    “But don’t worry, we’re going to tax rich people enough to make it all work out in the end:”

    Going Galt becomes the new fashion statement

  6. Gamble says:

    Obamacare is the same as having 4 buckets of water, 1 of which has a leak. You then use the other 3 buckets to keep the leaky bucket full.

    You figure it out….

  7. Dyspeptic says:

    I wonder how long it will take the callow and ignorant youth of our fair polity to realize that they have signed up to be ripped off for the benefit of crack whores, chain smokers, the obscenely obese and the generally self destructive hordes of unhealthy America.

    Oh well, in the end it’s good intentions that matter, right?

    • Gamble says:

      I tried to be more polite, lol.

  8. Dyspeptic says:

    The beauty of all of this from Obama’s point of view is that at worse it means some short term political embarrassment for His Royal Excellency, but in the long run it just makes a socialist, government monopoly medical system all the more likely. Somehow the “Progressive” elites will convince doofus voters that this is all the fault of evil insurance industry executives and the free market.

    Heads they win, tails we lose.

  9. Dan says:

    Clearly, it’s the free market messing up another brilliant system set up by our sage politicians.

  10. joeftansey says:

    I too would like to register my generic outrage and scorn. I enjoy jerking off about how stupid is.

    Seriously. Politics is, at best, entertainment to you people. But then there’s all this pretense and bluster about being informed intellectuals. Heh…

    • joeftansey says:

      zzz… second sentence got cut because I used brackets. Lel.

    • Bob Murphy says:

      No wonder you’re so pissed off all the time. You figured out everything there is to know in your early 20s. I’d be bored too if that had happened to me.

      • joeftansey says:

        I’m going to let you take another shot at that one…

        Also, my post wasn’t directed at you. It was directed at all the above masturbatory comments. But this is par for the course – politics rewards you for being twitchy and hypersensitive.

        I’m glad I figured this out in my mid-20’s so I can begin dewiring now and not have to spend the rest of my life patting myself on the back for being chronically stressed about an endless string of lowest common denominators.

        • Dan says:

          Project much?

          • joeftansey says:

            Sorry.

            “Obamacare is the same as having 4 buckets of water, 1 of which has a leak. You then use the other 3 buckets to keep the leaky bucket full.
            You figure it out….”

            Does this person sound well adjusted to you? What about my comments is likely to be inaccurate?

            • Dan says:

              You seem cranky.

              • joeftansey says:

                It’s easy to seem relaxed in your own echo chamber.

            • Rick Hull says:

              He sounds fine to me. It’s an analogy. But I guess if the analogy makes you feel unpleasant, you need to lash out and make personal attacks. Stay classy.

              • joeftansey says:

                ^This itself is a personal attack, but that’s cool.

                I know it’s an analogy. But it has no content. It may not even be true. It’s just a cheap-shot declaration of superiority.

                It was safe for him to make that comment here because everyone already agrees with him. I guess it doesn’t matter how toxic someone’s brain is as long as they come to a conclusion you approve of.

                These same people could have sold their souls to any number of fringe ideologies. I guess, wherever they were in life, libertarianism seemed like the best way to feel like a big man.

                It’s just a shame that no one else sees the average libertarian for what he is – a bully and a coward.

              • Rick Hull says:

                @joeftansey

                Come on with the false equivocation. I know you’re smarter than that. Making analogies is not bad behavior. Personal attacks are bad behavior. I called you out for bad behavior.

                Never Stop Posting.

              • joeftansey says:

                I am not equivocating. Stop grasping at straws. You’re better than that, right? See I can be patronizing too.

                Since when is pointing out that someone is a pathological douchebag bad behaviour?

                You folks also really should clarify your position on ad homs… An ad hominem is only irrelevant from a deductive standpoint. It’s a perfectly reasonable inductive argument to dismiss someone for personal reasons. It’s why you don’t expect homeless people to to have an accurate understanding of differential equations.

                Or did I go too far for you… Are you really going to sit here and tell me I shouldn’t attack the hobo’s credentials, and instead should waste my time looking at the content of millions of uneducated vagrants before I assign a 99.9% probability that they don’t know what they’re talking about.

                Question mark.

              • Rick Hull says:

                Uh, who claimed ad hom?

                > Since when is pointing out that someone is a pathological douchebag bad behaviour?

                Perhaps just for the pretentious, informed intellectuals among us.

              • Dan says:

                You need a nap.

              • Rick Hull says:

                Re: ad hom

                Were you really saying that *because* he is a pathological douchebag, you can dismiss his analogy? I read the implication the other way.

              • joeftansey says:

                @ Rick

                ad hom means “to the person”. You claimed I was making personal attacks.

                Also, nice rebuttal of my points. I’m never going to get an acknowledgment of the initial issue, am I? It’s just going to be you missing the point and sniping in cheap shots wherever you can.

                “Perhaps just for the pretentious, informed intellectuals among us.”

                … I think you screwed up your sarcasm there.

                Or do you make a habit of tolerating uneducated douchebags as long as they conform to your opinion?

                >> Obamacare is like Sisyphus trying to push a boulder up a hill. You can keep trying, but it won’t work! Ahahah. Those clods in Washington…

                Libertarianism4lyfe.

                @Dan

                Feel safe in your echo chamber?

              • Rick Hull says:

                @joeftansey

                I gotta hand it to you — you’re definitely picking up on the pretentious intellectual lingo. Just work on your application a little bit.

                It’s not enough to claim “ad hominem!” any time you feel attacked. “ad hominem” is just shorthand for the “ad hominem fallacy”, essentially according to the implication from my last comment.

                Keep it up, you’ll get there one day!

        • Tel says:

          Actually, as an IT professional myself (seems lots of readers here are) I’m kind of interested in the way half a billion dollars can be spent on a flub.

          I might need to go into a meeting and cite this as an example of what not to do. I might also need a pithy and easy to understand story when my great grandchildren ask me what happened to the United States that they hear about in old movies.

          • Rick Hull says:

            Which would you honestly expect more from, coming from the government:

            a) $1M website “hey we built you guys a million dollar website!”

            b) $10M website

            c) $100M website

            d) $1B website

            • Tel says:

              Once upon a time I would have put forward an opinion on that, but now after studying economics online, I have no idea whatsoever.

  11. Tel says:

    Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping. This, in turn, creates a massive traffic bottleneck, as the government verifies your information and decides whether or not you’re eligible for subsidies.

    OK, this is perhaps a bad idea in terms of process design, but it doesn’t give any excuse for the developers to bollox it right up on top of that.

    Think about a web shop, you place an order. It says, thank you for your order, we will notify you by email when it is ready for shipment. It doesn’t leave the browser hanging in a partial refresh while the warehouse staff go out the back and start picking your items into a basket.

    If there’s a slow part of the backend, then sensible user interface design can deal with that… every commercial entity has some example of this already. This includes wholesale suppliers where they don’t publish their prices, and where you do have to sign up with them (possibly a lengthy process, involving approvals) and those guys can still make it work with their website. They simply tell you, “Approval takes a few days, we will get back to you.”

    Everyone can deal with this. They might grumble a bit, but they deal with it. They do something else for a few days, and check their email. Simple.

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