6 ms·

Doing Better: Making Improvements to HealthCare.gov

20 points by 001sky 13y ago

flippyhead 13y ago
I'd love to see a more in-depth explanation of what's gone wrong.
- jpinkerton88 13y ago
  same. pretty vague.
- coderaptor 13y ago
  Since the target is probably the general public, I wouldn't expect a technical write-up on problems faced and potential solutions (though it would have been nice) - but this write-up is devoid of any actual information whatsoever. I fear this is what we can expect in the future was well. At least give us the names of the folks you're bringing in to make this thing work! This is the reason those of us in the US were doubtful of this project in the first place - not a single one of my peers expected this site to stay up (we've all got experience with media company advertisement efforts, so we know what it means to go from zero to millions). As an aside - spewing this "with over 19 million unique visits to date to HealthCare.gov– confirms that the American people are looking for quality, affordable health coverage, and want to find it online" is ridiculous - it confirms only that Americans are now legally obligated to look for health coverage... There's more, but instead of pissing myself off further I'm just going to hit 'reply' and shrug away to my corner of indifference for the day.
iandanforth 13y ago
I just want to have access to the code again. I can only speak for myself but I'd love to contribute patches.
- cheald 13y ago
  The code that was public was just a Jekyll static site, which wouldn't have any performance problems to worry about.
cdoxsey 13y ago
> This tremendous interest – with over 19 million unique visits to date to HealthCare.gov– confirms that the American people are looking for quality, affordable health coverage, and want to find it online. Sadly the system can only work if healthy people sign up. This disaster of a website has made it so that only the most desperate of people will eventually sign up, thus ensuring the inevitable collapse of the whole system.
- ssharp 13y ago
  Isn't the point of the OP that they are actively working on fixing the site? I don't see how being active in repairing broken parts of the site is any indication on "inevitable collapse". There is no indication that these will be long term problems.
  - bpodgursky 13y ago
    The post is referencing a different problem. This is the scenario described: 1) since the exchanges can't discriminate on pre-existing conditions, many people with expensive pre-existing conditions in need of treatment will sign up. 2) because a high percentage of the new customers to the new plans need expensive treatments, insurance companies are forced to raise the rates on the new plans to cover costs 3) after seeing the higher insurance rates, healthy people quit the plan since their expected healthcare costs are lower 4) repeat steps 2 and 3 until very few people can both afford to be in the plan and have very pressing healthcare needs.
    - icebraining 13y ago
      It's an insurance death spiral [1]. NPR's Planet Money talked about it last month [2]. [1] http://en.wikipedia.org/wiki/Death_spiral_(insurance) http://en.wikipedia.org/wiki/Death_spiral_(insurance) [2] http://www.npr.org/blogs/money/2013/09/30/227468495/one-key-thing-no-one-knows-about-obamacare http://www.npr.org/blogs/money/2013/09/30/227468495/one-key-...
  - schaub435 13y ago
    Have you ever been involved in large complex applications? They're not pretty and does not simply involve "repairing broken parts".
keithwarren 13y ago
"...bringing in some of the best and brightest from both inside and outside government." Did any of you get a call? I imagine many of the best and brightest are on HN.
- niels_olson 13y ago
  They're currently somewhat busy. Don't take a non-response as proof of anything.
  - keithwarren 13y ago
    I think they are all busy prepping their applications for the YC application deadline tomorrow.
- coldcode 13y ago
  They're bring in Top Men. Who? Top. Men.
- nknighthb 13y ago
  I can think of several engineers I would consider "best and brightest" for something like this. To my knowledge, not one of them posts on HN. Get over yourself.
amalag 13y ago
Even if states are incentivized to create their own exchanges, they are not doing it.
- coldcode 13y ago
  Politics > money.
keithwarren 13y ago
I often wonder why something like this is not required to be open source from day 1. I think you still contract an agency to build it, but had the specification and code been open all along then this kind of thing would be less likely. Of course, that would make sense and since we are talking about government contracting...
siculars 13y ago
So who are these "best and brightest" they are bringing in? Surely they are HN readers or an HN reader knows them. Would love to hear about an in depth postmortem. Joking aside, if you are Obama & Co. and your entire administration is hinged on the success of this program, how do you not get the "best and brightest" from the outset to make what you can control about this - the technology component - work? Not to say there is that much complicated technology here. We've known how to make sign-up sheets for a long time. Also, surge protection is also somewhat of a solved problem - just use AWS or one of their competitors. Didn't the Democrats crush the Republicans in their pre-electioneering with a much better system built on AWS? Why didn't they get those guys to do this stuff? Oh well.
Xcelerate 13y ago
The fact that this little blog post stutters and jerks as I scroll down the page (using Chrome) on a fairly new RMBP means they've got a lot of work to do. I don't understand how these things become so complicated and expensive and still not work right.
carsonm 13y ago
I wonder if any of the members of this "surge" have read the Mythical Man Month.

20 points by 001sky 13y ago

flippyhead 13y ago

I'd love to see a more in-depth explanation of what's gone wrong.

jpinkerton88 13y ago
same. pretty vague.
coderaptor 13y ago
Since the target is probably the general public, I wouldn't expect a technical write-up on problems faced and potential solutions (though it would have been nice) - but this write-up is devoid of any actual information whatsoever. I fear this is what we can expect in the future was well. At least give us the names of the folks you're bringing in to make this thing work! This is the reason those of us in the US were doubtful of this project in the first place - not a single one of my peers expected this site to stay up (we've all got experience with media company advertisement efforts, so we know what it means to go from zero to millions). As an aside - spewing this "with over 19 million unique visits to date to HealthCare.gov– confirms that the American people are looking for quality, affordable health coverage, and want to find it online" is ridiculous - it confirms only that Americans are now legally obligated to look for health coverage... There's more, but instead of pissing myself off further I'm just going to hit 'reply' and shrug away to my corner of indifference for the day.

iandanforth 13y ago

I just want to have access to the code again. I can only speak for myself but I'd love to contribute patches.

cheald 13y ago
The code that was public was just a Jekyll static site, which wouldn't have any performance problems to worry about.

cdoxsey 13y ago

> This tremendous interest – with over 19 million unique visits to date to HealthCare.gov– confirms that the American people are looking for quality, affordable health coverage, and want to find it online. Sadly the system can only work if healthy people sign up. This disaster of a website has made it so that only the most desperate of people will eventually sign up, thus ensuring the inevitable collapse of the whole system.

ssharp 13y ago
Isn't the point of the OP that they are actively working on fixing the site? I don't see how being active in repairing broken parts of the site is any indication on "inevitable collapse". There is no indication that these will be long term problems.
- bpodgursky 13y ago
  The post is referencing a different problem. This is the scenario described: 1) since the exchanges can't discriminate on pre-existing conditions, many people with expensive pre-existing conditions in need of treatment will sign up. 2) because a high percentage of the new customers to the new plans need expensive treatments, insurance companies are forced to raise the rates on the new plans to cover costs 3) after seeing the higher insurance rates, healthy people quit the plan since their expected healthcare costs are lower 4) repeat steps 2 and 3 until very few people can both afford to be in the plan and have very pressing healthcare needs.
  - icebraining 13y ago
    It's an insurance death spiral [1]. NPR's Planet Money talked about it last month [2]. [1] http://en.wikipedia.org/wiki/Death_spiral_(insurance) http://en.wikipedia.org/wiki/Death_spiral_(insurance) [2] http://www.npr.org/blogs/money/2013/09/30/227468495/one-key-thing-no-one-knows-about-obamacare http://www.npr.org/blogs/money/2013/09/30/227468495/one-key-...
- schaub435 13y ago
  Have you ever been involved in large complex applications? They're not pretty and does not simply involve "repairing broken parts".

keithwarren 13y ago

"...bringing in some of the best and brightest from both inside and outside government." Did any of you get a call? I imagine many of the best and brightest are on HN.

niels_olson 13y ago
They're currently somewhat busy. Don't take a non-response as proof of anything.
- keithwarren 13y ago
  I think they are all busy prepping their applications for the YC application deadline tomorrow.
coldcode 13y ago
They're bring in Top Men. Who? Top. Men.
nknighthb 13y ago
I can think of several engineers I would consider "best and brightest" for something like this. To my knowledge, not one of them posts on HN. Get over yourself.

amalag 13y ago

Even if states are incentivized to create their own exchanges, they are not doing it.

coldcode 13y ago
Politics > money.

keithwarren 13y ago

I often wonder why something like this is not required to be open source from day 1. I think you still contract an agency to build it, but had the specification and code been open all along then this kind of thing would be less likely. Of course, that would make sense and since we are talking about government contracting...

siculars 13y ago

So who are these "best and brightest" they are bringing in? Surely they are HN readers or an HN reader knows them. Would love to hear about an in depth postmortem. Joking aside, if you are Obama & Co. and your entire administration is hinged on the success of this program, how do you not get the "best and brightest" from the outset to make what you can control about this - the technology component - work? Not to say there is that much complicated technology here. We've known how to make sign-up sheets for a long time. Also, surge protection is also somewhat of a solved problem - just use AWS or one of their competitors. Didn't the Democrats crush the Republicans in their pre-electioneering with a much better system built on AWS? Why didn't they get those guys to do this stuff? Oh well.

Xcelerate 13y ago

The fact that this little blog post stutters and jerks as I scroll down the page (using Chrome) on a fairly new RMBP means they've got a lot of work to do. I don't understand how these things become so complicated and expensive and still not work right.

carsonm 13y ago

I wonder if any of the members of this "surge" have read the Mythical Man Month.