Thursday, October 10, 2013

HealthCare.gov: Boat of Gloat v.5

Ten days after the open enrollment started on the ACA (Obamacare) HealthCare.gov web site, Politico describes it as a "train wreck" (full disclosure: the piece was written by a National Review editor). News organizations of every political slant can plainly see the disaster it has been and continues to be. From the Politico link:
The rollout of Obamacare has been so disastrous that even “Daily Show” host Jon Stewart was plainly mystified and unconvinced when Sebelius came on his show the other day to offer soothing explanations and reassurances. Stewart gently expressed his frustration that there is “a level of incompetence that is larger than what it should be,”
and...
Nancy Pelosi infamously said that we had to pass the law to find out what’s in it. But the then-House speaker erroneously assumed, evidently, that people would be able to get onto the government-run exchanges created by the law. So far the law’s implementation has been as ugly as its passage.
As a professional software developer (among other things) with 28 years of experience in both private and public sectors, I happen to have expertise in this field. In fact, four years ago, I wrote an open enrollment system for a public agency with complex flexible benefits covering health insurance, dental insurance, vision insurance, health and dependent savings accounts, deferred compensation, long term disability insurance, and life insurance. The system is still running today, and while the scales are not comparable, my system has enrolled more people this year that the states of Maryland (326), Iowa (5), and Hawaii (0) combined. I understand system development, analysis, design, testing, tuning, documentation, and deployment from conception to production. Creating good software is very hard. If you haven't done it for a living, it is easy to underestimate and hard to appreciate.

I've had the unfortunate experience to be pulled into a large failing government project (Blue Cross and Blue Shield of Florida, Medicare Part B) many years ago. I witnessed amazing incompetence, especially at the management level, that torpedoed the 90 hour/week efforts the programmers were suffering. In that project, out of 9 different virtual systems, no one could identify which was production. There were 6 test systems, all out of sync with each other, and 3 remaining systems, any of which "might" have been the production system. Programmers would apply their updates to the 3 possible production systems, frequently overwriting updates from other programming teams. The ticketing system worked intermittently and databases went down without warning. It was chaos when I started the engagement, and chaos when I left. The firm I worked for at the time collected huge consulting fees for the effort, but very little got permanently fixed over that 6 month period.

This kind of scenario might be playing out behind the scenes at Healthcare.gov. There are probably numerous contractors that built various pieces of the system (I know Experian is one of the culprits) at a cost, so far, of over $600 million. But contractors sometimes have little control or incentive to get the get the whole system working. They are focused on their part and collecting time and materials on a can't lose contract. What I'm suggesting is that it could easily be 6-12 months before the system is stable and performing as expected. Bringing in outside experts at this stage won't help and might even be counterproductive. Blame is being passed around and the work environment is probably toxic.

Obama might have saved himself a huge embarrassment if he had allowed the individual mandate to be delayed a year as the Republicans first wanted. Instead, he forced America to use the half baked, wheezing, hot mess that is the current system. For that, the President and Department of Health and Human Services have earned the Boat of Gloat.



Other opinions:

Obamacare Disaster Predictions Coming True - Even Howard Dean Agrees

Why Obama’s tech-savvy team couldn’t make Obamacare glitch-free

Obamacare Is a Disaster and Democrats Own It

Another Democrat Calls ObamaCare Implementation a "Real Disaster"

Obamacare ‘disaster,’ or routine maintenance?

Will glitches derail Obamacare?

4 comments:

  1. Creating good software is very hard.

    Amen.

    I will share the story of one of my first jobs out of college. I started work at a small contracting company that designed computer systems for others. There were just 3 of us in total.

    One of my tasks was to take over for the previous person who was no longer there. It was a program to help a small marketing company track all the homes in the Seattle area, which amazed me to no end since there were just 2 people in this marketing company (real estate).

    There was no end to the problems. We had to switch databases because the first database could not handle all of the data. We had a person from the database company on the line. My boss was telling him how slow the import process was going. It had crawled to a halt. They asked how many records were being imported? My boss said 50,000. You could hear the guy telling his coworkers and then we heard what sounded like laughter, lol. Gallows humor at my end let me tell you.

    Oh oh!

    That project had so many problems and many of them stemmed from not having a design document. It was just mostly on the fly. One day I'm told that I need to generate a closest homes report. It was just assumed that the database could kick one of those out for marketing purposes. I had to explain that the database has no idea where the 50 closest homes are, nor would I without a good map and some time on my hands. This was totally unacceptable of course. The entire reason to create the database was to generate that very report!

    They had to settle for the 50 closest homes down a given street (assuming there were even 50 of course).

    As was often the case, there was no testing. Just cross fingers and hope for the best. Glad to have that out of my life.

    I have not signed up for the Affordable Care Act's insurance yet. Big shocker. ;)

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  2. Stagflationary Mark,

    Yeah, expectations often exceed capabilities unless it is all documented in the scope before hand. I had to do a similar closest addresses feature recently, but the database had northing and easting locations so I could do a radius calculation against other parcels.

    I think the specifications for the ACA were changing as much as six months ago. Hard to hit a moving target. I also had the unfortunate experience of coding some HIPPA transactions for a dental claims system back in 2003. The nasty 837 transaction with variable length records and different values required by different insurance companies and about a 4 foot high stack of HIPPA documentation (immediately out of date).

    Let's see how this system looks in a few months.

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  3. Here's another you might like.

    We were just a week or so away from our ship date. We were making a typing tutor game. The game was on two different platforms (PC and Mac) and we were releasing on both simultaneously. The General Manager asked me how long it would take to add the ability to print a certificate. Other products did something similar.

    I told her that it would take anywhere from 3 days to a month.She couldn't believe the range was so big. I told her that if the feature was important, I'd know more after we'd worked on it for a day. Until then, I had no idea how hard it was going to be to get it running on two different platforms and what kind of interface we'd need within the game to make it work (pop up windows were right out as my ego would not allow an ugly screen like that to pop up in our game, nor would the artists). We'd never printed a thing in the past. This was all new.

    In hindsight, it took about 3 days but only because we did not offer any interface for setting up the document. We gave them a print button and that was it. Whatever state the printer was in was the state the document would come out. Never got a complaint to my knowledge, thank goodness. Perhaps that was best anyway. It was for kids after all. Who can say?

    That happened a lot to us. Management would look at the competition at about the same time they were thinking up the box design (at the end of the project). One thing the box design needed was a list of things the product did. Heaven help us if management thought up more things it could do at that point.

    One of the best shipping stories ever was when management spent some time working with one of the games and only had one change that was needed. One of the character's sweaters shouldn't be red. It should be green. Green is a healing color.

    The artist involved wasn't nearly as happy about that one change as I was. That didn't require me to change a line of code, lol.

    From then on, "green is a healing color" became our euphemism for change is happening! I'm guessing there's an amazing amount of "green is a healing color" going on right now in regards to the healthcare websites! Makes me cringe even. Big time.

    I sure hope they didn't outsource to Bethesda, lol.

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  4. Stagflationary Mark,

    I have lots of horror stories that are similar. Business systems are rarely as stressful as working at game companies, but large government projects can be. One of the biggest problems, even when you don't have a dozen large vendors working on a project is figuring out who is in charge and who makes final decisions. Then you get conflicting and frequently changing specifications and stuff ends up broken or half coded.

    I have a feeling the HealthCare.gov roll out will end up as a Harvard business school case study of what can go wrong with large system development. The mythical man month still applies.

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