The truth about Obamacare's rocky rollout

http://www.theguardian.com/commentisfree/2013/oct/11/truth-obamacare-rocky-rollout

Version 0 of 1.

The GOP's intransigence about the government shutdown and the debt ceiling have not given Democratic allies much to laugh about, so you can understand their ill-spirited snickering that came when shutdown headlines drowned out coverage of glitches in the Affordable Care Act rollout. Even some Republicans on the Hill counted missed headlines as a failure. As one consultant told Politico:

If there were no government shutdown, Republicans could train all their fire on the failures of the exchanges in a 'see, I told you so' approach.

The snickerers and the intra-party critics didn't take into account the media's willingness to cover only the problems with the rollout. While, sure, mainstream media (MSM) have focused more heavily on the shutdown, what attention has been paid to the ACA exchanges has centered almost entirely on its flaws.

And the public's reaction has been accordingly negative: 40% of those polled by AP said that the launch "hasn't gone well", while 20% said it's gone "somewhat well" and 7% said "very well". Thirty percent said that they didn't know what to say. The same poll found that only 7% had actual first- or even secondhand experience with online enrollment. So, really, 93% of the respondents should have declined to give an opinion. But hey, we're Americans and we have opinions.

To be fair, smooth transitions and effortless introductions are not "news". And of those who have tried to use the government websites, 75% said they had problems. But from a tech standpoint, many experts have allowed that the introduction of the Healthcare.gov portal is remarkable mostly because it didn't go worse: "Of all the terrible websites I've seen, Healthcare.gov ranks somewhere in the middle," wrote David Auerbach at Slate.

The nerdy curmudgeons at Reddit mostly raked it apart from the perspective of how the problems of implementation were not so much insurmountable failings, but the foreseeable result of a project that had to conform to political goals first, user experience second: "there are actually 51 or so separate IT projects here"; "the site has to have interoperable channels of communications with the department of health, treasury, social security, state agencies, employers, health insurance companies, and consumers"; "they didn't put thought into the sort of traffic they'd receive at all and it turned into a huge news event and honestly, talk about pressure!"

Many posted about bugs, just to re-post later that the problem had been addressed. And there was another perspective largely missing from MSM coverage:

Whatever. I've waited years for this. Another week or two won't hurt. They'll get the bugs worked out eventually.

This Sunlight Foundation post goes into detail to illustrate the scale of the operation the site's designers undertook. It uses analog of party-planning to explain, in part, why the problems were probably inevitable and largely have nothing to do with the essentially superficial problems that have gotten so much attention.

Put simply: there's only one birthday girl (a finished enrollment), but there are lots of tasks to complete before the party and during it. The Sunlight author concludes:

Fixing those sorts of bottlenecks can be easy or difficult, [but] the boring truth is that it's hard to say definitively from outside the system. Much harder than carping about uncompressed Javascript, at any rate.

Almost all the technical analyses I've read conclude the same way: the project was poorly tested and over-bureaucratized, but it'll probably straighten out. I am not sure conservative critics read to the end of these articles. One Ted Cruz staffer gleefully tweeted out a link to a piece about the site's password woes (headline: "Obamacare site hits reset button on passwords as contractors scramble"), but apparently didn't get to the second paragraph: "Now, a week later, the site appears to be stabilizing, with waiting times dropping dramatically for those who haven't been able to register before."

All in all, proper coverage of the rollout would treat it not as "man bites dog", or even "dog bites man", but rather, "dog displays indifference to man, but man will be back later with beef jerky and some toys, hopes to create bond with dog that will last a lifetime."

Of course, it's that lifetime bond that makes critics so nervous. Their real fear isn't that ACA and its attendant infrastructure won't work; it's that it will.

If its structure was really so deeply flawed, why would conservatives be so suicidally intent on preventing it from taking full effect? For that matter, why are they so sure that the rollout's problems aren't exactly what the administration wants, bwahahahaha? Don't put it past the architects of the Benghazi cover-up to put out a bad first draft just so they can impress you with the second iteration! No, really, that's one theory.

It's not really that crazy a theory – at least, in so far as the next version of the exchanges problem will work exponentially better. And more distressingly to conservatives, it won't be too long until the ACA isn't a new and scary socialist plot, but just part of American life – like social security, whose implementation had similar organizational headaches and a raft of bellicose critics whose complaints were quickly anachronistic and served mainly to scare off potential beneficiaries. (The SSA official history drily comments that by the time one set of muckracking stories hit the newsstands, the errors it trumpeted "were less than 1% of total wage reports, suggesting the articles reflected political differences rather than administrative inefficiency." Ahem.)

Conservatives, tech geeks, and comics had fun with the administration's attempt to smooth over commentary about the exchanges with a comparison to the introduction of Apples iOS7. The analogy does miss the mark – not because iOS7 is relatively stable (and prettier), but because iOS7 doesn't attempt to fundamentally change the way people think about their relationship to the world around them. iOS7 isn't even a significant change in the way we think about the technology it controls. To the extent that one can make an analogy between Healthcare.gov and consumer software or hardware, the ACA is the Apple Newton: a first attempt to get people to interact with their environment in a different way.

Print out and hold onto those ACA legacy passwords, folks. They're going to be in a museum some day.

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