Healthcare.gov: There’s NO app for that.

 In the beginning of an automated system project, business owners envision all of the automated features that they’ve seen before, and even some that they’ve just imagined. Some, if not all of the White House pols and speech writers “let” the president compare the Exchange to buying things from Amazon and the price comparison experience to Travelocity.  Was this an intentional over-simplification for sound-bites and “talking points”, or was it a gross underestimation of the complexity of the undertaking?

After pouring over left and right media accounts, internal emails, memos, a red team briefing and several progress reports, I’ve concluded that the administration at the high levels were close to clueless as to the technical complexity and the time required to develop as system with complex and difficult technical requirements.  Among these 'difficult technical requirements' are:

•     Identity Proofing: associating an internet-based transaction with a real person and validating that association with little-to-no doubt.  This is required for both privacy and subsidy/tax purposes.  There’s no app for that.

•   Agency Interfaces: to validate identity and to determine eligibility and amount of tax subsidy the Exchange has to compare information submitted to it by the prospective customer to The Social Security Administration, Internal Revenue Service, The Department of Veterans Affairs, The Department of Homeland Security and others as a part of determining eligibility (citizenship, eligibility for other insurance programs. Annual income, and other eligibility criteria. This means that the Exchange needed to interface with existing, OLDER agency systems.  Or it meant that these agencies needed to build a new system to provide such information to the Exchange’s data format and content specifications. There’s no app for that.

•        State and Insurance Company Interfaces: All 36 states, and some 170 insurance companies also need to interface with the Exchange.  The states that built their own web-marketplaces need to use the part of the Exchange that performs the Identity Proofing and Agency Interface capabilities.  The insurance companies need to upload information about their offerings and pricing of some 4,500 plans, There’s no app for that. 

•   Volume:  The idea that tens of millions of customers might show up at one time even scares Amazon on “cyber monday”…. and they’ve been in the business since they went online in 1995.  There’s no capacity or precedent and definitely no app for that or even for calculating it.

So it appears that the political folks and the policy folks that were ‘in charge’ of this complex undertaking did not obtain or trust technical and management staff, expertise or advice from proven sources.  Instead it seems that they relied on gross technical oversimplification, hubris, mismanagement or misinformation.  At this point it almost doesn’t matter which, and it was probably a mix of all of those.  On Dec 1, we’ll see if their attempts to recover will work.  Unfortunately there is no RECOVER app either.