The Healthcare.Gov Glitches: What Happened?

Readers who saw my first blog this month, 'The Finer Details of Obamacare, 2', will note that under the header of Cautions, I listed as No.1: Signing up on Day One could be a bitch.

And quoted Bryce Williams (managing director of exchange solutions for Towers Watson) from the Sunday Wall Street Journal section of the Denver Post:

"Unless you are desperate for health insurance, our advice is to wait until November or December. It's kind of like not buying the first model of a car when it comes out - wait until the kinks get worked out."

This has turned out to be good advice, especially for those who tried to get onto the healthcare.gov site. Some estimates in the media, indeed, claim maybe only 20,000 have actually physically managed to sign up without getting the spinning "symbol of death"  indicating the server is kaput.

So what happened? How did it all go wrong? According to Christopher Weaver and Louise Radnofsky, writing in a piece in the WSJ, most of the problems - according to policy and technology experts, occurred because of a design element that requires users of the federal site (which serves 36 states)  to create accounts before shopping for insurance.   Of course, this is exactly opposite to human nature, because typically people want to know what they're getting into, and all that's available before they sign onto anything or create an account. (An "account" normally translates into 'money' and people will wish to know what the options are before they spend any)


The decision to move ahead without that feature proved crucial because, before users can begin shopping for coverage, they must cross a busy digital junction in which data are swapped among separate computer systems built or run by contractors including CGI Group Inc., the healthcare.gov developer; Quality Software Services Inc., a UnitedHealth Group Inc. unit; and credit-checker Experian PLC.

Sadly, healthcare.gov was initially going to include an option to browse before registering, but that tool was delayed, people familiar with the situation said.  The upshot was.....havoc. People naturally insisted on browsing first, then likely stymied when they registered - found things went amiss - then perhaps didn't complete the process. This may explain why, according to a CBS News report this morning, many insurance agencies have complained about duplicate registrations, errors littering other registrations.... and other problems.


If any part of the web of systems fails to work properly, it could lead to a traffic jam blocking most users from the marketplace. That’s just what happened on Oct. 2, and officials identified a bottleneck where those systems intersect at a software component sold by Oracle Corp. that still hasn’t been cleared.  This bespeaks a modularity problem in the overall software operation. Many of the sort of internal software deviations highlighted can be traced directly to the modularity applicable to a given software program. Modularization allows the software designer to decompose a system into functional units, to impose hierarchical ordering on function usage, implement data abstractions and develop independently useful subsystems. As pointed out by the techies in further examination of the healthcare,gov modules, there occurred some breakdowns in mutual exclusion – an attribute necessary to preserve modularity. Basically, “ME” is needed to ensure multiple processes don’t attempt to update the same components of the shared processing state at the same time.

That may well be a hard bugger to fix and bring up to expectations, with likely million waiting to get access to health care. It may well be necessary for the government to redirect prospective buyers to the sites of the insurance companies themselves - wherein the selection or choice will already have been made, and hopefully the companies will already be on the exchange sought.

Tech experts Brett Norman and Jason Millman, highlight further bugbears to do with the likely "ME" problem, i.e the consumer end of the website, designed by one contractor, is not “talking to” the back end of the website, developed by a different company. This communication impasse then leads to breakdowns in mutual exclusion .


A further article by Robert Pear, Sharon LaFraniere and Ian Austen in The New York Times, notes that as one tech expert has observed, this software "wasn't even ready yet for beta testing". 

Confidential progress reports from the Health and Human Services Department show that senior officials repeatedly expressed doubts that the computer systems for the federal exchange would be ready on time, blaming delayed regulations, a lack of resources and other factors.

Deadline after deadline was missed. The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process. As late as the last week of September, officials were still changing features of the Web site, HealthCare.gov, and debating whether consumers should be required to register and create password-protected accounts before they could shop for health plans.

 

Meanwhile, Craig Timbert and Lena Sun of The Washington Post have observed that ordinary glitches in the course of software use would be expected to be magnified in the case of a government run interface. Most government agencies have a shortage of technical staff and long have outsourced most jobs to big contractors who, while skilled in navigating a byzantine procurement system, are not on the cutting edge of developing user-friendly Web sites.  Thus, the original modularity problems would be compounded.

These companies also sometimes fail to communicate effectively with each other as a major project moves ahead. Dozens of private firms had a role in developing the online insurance exchanges at the core of the health-care program and its Web site, working on contracts that collectively were worth hundreds of millions of dollars, according to a Government Accountability Office report in June. At the heart of the federal IT crisis is a complex system of regulations that rewards contractors that are better at bidding on giant federal contracts than at building software.

In hindsight, it surely would have been better to postpone the inaugural date for healthcare.gov than to trot out a product not likely to pass a proper beta test for a proper software company. It would have been better to be late than to have a roll out that has now become a laughing stock, and which the ever predatory Reepos are likely to want to exploit as a vehicle for more attacks on "Obamacare".

Let's hope they get this thing fixed and soon!