Let’s Pile on Healthcare.gov…My Two Cents

Many articles have discussed the travails of the new Federal healthcare marketplace, healthcare.gov. You can find them here, here, and here, just to name a few.


Essentially they all say that the Federal government was ill-equipped to handle a website of this magnitude. From what I gather, the Centers for Medicare and Medicaid Services (CMS) acted as the “lead” in the development of the site. These are the same people that administer Medicare (an agency that you can’t reach by phone to get preauthorization for a procedure) and Medicaid (an agency that provides very poor, incomplete insurance for the poor). That means that we gave a very complex web development project to an agency that’s not good at their regular day job of administering Federally funded health insurance.


Sure they will say that hindsight is 20-20. That we couldn’t know how bad CMS would be at rolling out healthcare.gov. But I’m confident that if you asked anyone here in San Francisco how best to develop this site, they would have suggested a private sector company that uses Agile software development methods that favors collaboration and working software as a primary goal, not fat negotiated contracts with a bunch of Federal contractors.


I think the most frustrating thing – aside from Americans’ inability to purchase healthcare despite repeated attempts – is that any opponent of ObamaCare will incessantly use this web failure as proof that increased accessibility to coverage is bad. I don’t mind someone making articulate, evidence-based arguments that ObamaCare is ineffective at reducing healthcare costs; that’s probably true. But to use a website’s failure as proof that the President’s attempt to provide healthcare to more Americans is just inaccurate and maybe even mean-spirited.


I’m no fan of more government bureaucracy in an already complicated healthcare system but a clueless agency that can’t build a website has nothing to do with the potential success of increasing our accessibility to health insurance. The bottom line is that websites today are not your older cousin’s website of yesterday (this is a reference to “this isn’t your father’s Oldsmobile”). There’s more interactivity with the user and more connectivity to multiple databases. This required someone, maybe anyone, other than CMS.


An excellent (unofficial) overview of the website can be seen here:




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