The spin, like the web site itself, isn’t working:
Seven
percent of Americans report that somebody in their household has tried
to sign up for insurance through the health care exchanges, according to
an AP-GfK poll.
While that’s a small percentage, it could represent more than 20 million people.
Three-fourths of those who tried to sign up reported problems, though, and that’s reflected in the underwhelming reviews.
Overall, just 7 percent of Americans say the rollout of the health exchanges has gone well. Far more deem it a flop.
Overall,
the poll found, 40 percent of Americans said the launch of the
insurance markets hasn’t gone well, 20 percent said it’s gone somewhat
well and 30 percent didn’t know what to say. Just 7 percent said the
launch had gone “very well” or “somewhat well.
Opinions
are sharply divided on the overall framework of the law: 28 percent of
Americans support it, 38 percent are opposed, and 32 percent don’t have
an opinion either way, the poll found. When asked specifically whether
the government should be able to require all Americans to buy insurance
or face a fine, only about 3 in 10 Americans agreed, and 68 percent were
opposed.
The
front-end static website and the back-end servers (and possibly some
dynamic components of the Web pages) were developed by two different
contractors. Coordination between them appears to have been nonexistent,
or else front-end architect Development Seed never would have given this interview to the Atlantic
a few months back, in which they embrace open-source and envision a new
world of government agencies sharing code with one another. (It didn’t work out, apparently.)
Development Seed now seems to be struggling to distance themselves from
the site’s problems, having realized that however good their work was,
the site will be judged in its totality, not piecemeal. Back-end
developers CGI Federal, who were awarded a much larger contract in 2010 for federal health care tech, have made themselves rather scarce, providing no spokespeople at all to reporters.
Their source code isn’t available anywhere, though I would dearly love
to take a gander (and so would Reddit). I fear the worst, given that CGI
is also being accused of screwing up Vermont’s health care website…
The poor, confusing error handling indicates that there was no ownership of
the end-to-end experience—no one tasked with making sure everything
worked together and at full capacity, not just in isolated tests. (I
can’t even figure out who was supposed to own it.) No
end-to-end ownership means that questions like “What is the user
experience if the back-end gets overloaded or has such-and-such an
error?” are never asked, because they cannot be answered by either group in isolation. Writing in Medium in defense of Development Seed,
technologist and contractor CTO Adam Becker complains of “layers upon
layers of contractors, a high ratio of project managers to programmers,
and a severe lack of technical ownership.” Sounds right to me.
Likewise, the bugs around username and password standards—for example, the fact that the username required a number
but the user interface didn’t tell the user about it—are not problems
of scale. They’re problems of poor cross-group communication.
Oh, and the administration was warned.
“A week into it, still a lot of glitches,” CNN correspondent Brian Todd reported
to Blitzer. “People not able to create accounts, just to get
information to possibly enroll, much less not being able to enroll in
the plan.”
“We’re also hearing now that the administration was warned about these potential problems months in advance,” Todd continued. “We
spoke to a health care consultant who has clients who are insurers. He
says his insurers, who dealt with the administration in the months ahead
of time, had contentious meetings with people at [Health and Human
Services] and other health care officials who were in charge of this,
warning them, ‘This isn’t working, it’s not going to be smooth, don’t do
it.’ He says those warnings were ignored, they went full speed ahead,
and said we’ll work these problems out. There’s been a bit of pushback
from the White House, we’ll hope to get more later from them.”
“If
they had three years to get this ready—if they weren’t fully ready,
they should accept the advice that a lot of Republicans are giving them,
delay it another year, get it ready, and make sure it works,” Blitzer
said. “There are government health care-related websites that work
great. Socialsecurity.gov, a whole bunch of others. They know how to do
it. But if they didn’t get it ready on time, then maybe fix the problem,
make sure people don’t have to worry about it.”
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