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Medicine Government IT

Why Can't Big Government Launch a Website? 786

MarkWhittington writes "Glenn Reynolds, the purveyor of Instapundit, asked the pertinent question, 'If big government can put a man on the moon, why can't it put up a simple website without messing it up?' The answer, as it turns out, is a rather simple one. The Apollo program, that President John F. Kennedy mandated to put a man on the moon and return him to the Earth, was a simple idea well carried out for a number of reasons. The primary one was that Congress did not pass a 1,800 or so page bill backed up by a mind-numbing amount of regulations mandating how NASA would do it. The question of how to conduct the lunar voyages was left up to the engineers at NASA and the aerospace industry at the time. The government simply provided the resources necessary to do the job and a certain degree of oversight. Imagine if President Obama had stated, 'I believe the nation should commit itself to the goal of enabling all Americans to access affordable health insurance' but then left the how to do it to some of the best experts in health care and economics without partisan interference."
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Why Can't Big Government Launch a Website?

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  • Congress.... (Score:4, Interesting)

    by jythie ( 914043 ) on Monday October 28, 2013 @10:24AM (#45258205)
    While not uniquely and American problem, this seems to be a recurring issue with the way our government operates. Other countries have managed to put together similar sites with, well, I do not want to say 'little' difficulty since any such undertaking is going to have problems, but 'less' difficulty might work.

    Though it has mostly been smaller countries that have done such projects well, so what we might be looking at here is an artifact of having a large and diverse country with lots of competing philosophies, interests, and actual needs.
  • by jedidiah ( 1196 ) on Monday October 28, 2013 @10:29AM (#45258255) Homepage

    There is nothing complicated about knowing what the available options are and matching them to an individual. There's nothing complicated about computing a person's subsidy eligibility.

    If Kentucky can manage this kind of thing, then anyone can.

    This system doesn't have to manage the ENTIRE health insurance industry. It only has to manage a very small part of it and most of that isn't even visible to the end user.

  • by Bucc5062 ( 856482 ) <bucc5062@@@gmail...com> on Monday October 28, 2013 @10:34AM (#45258313)

    NASA had it easy. They only had to deal with Physics.

    Social Sciences are messy, Social programs are messy and when it involves large groups of people, politicians get involved which makes a services program almost impossible to get right. Given current technology (at the time) there were just a limited number of ways the Moon mission could be completed. Creating a web site in a fractious, antagonist political world had/has too many variables to "get it right". It took close to 10 years to get a man on the moon, and somehow we're suppose to build a complicated heath management system in a few months...It is not a question of expertise, both environments have talent, but it was/is a question of Management, goals, and commitment. NASA employees were vested and proud of their work for they were a part of the whole. CGI Federal *contractors* don't give a shit about the whole, just their slice of the dollar pie. That is why we can put a man on the moon, but can't write a complex web site. (IMHO)

  • Re:Sabotage (Score:4, Interesting)

    by alen ( 225700 ) on Monday October 28, 2013 @10:39AM (#45258379)

    never heard of walter mondale, have you? senator and one time presidential candidate tried to kill apollo.

  • by bondsbw ( 888959 ) on Monday October 28, 2013 @11:31AM (#45258971)

    the obamacare website the contractors had to build in a few months and code hundreds of pages of law and regulations into logical business rules and a database schema. and no time was there testing or a ramp up of opening up the site to a few people and then allowing more people access as they work out the bugs

    But the ACA has been law for 3 1/2 years.

  • by fuzzyfuzzyfungus ( 1223518 ) on Monday October 28, 2013 @11:44AM (#45259111) Journal
    The thing that's interesting about the 'blame the developers' position is that, in the run-up to the election, it was generally demonstrated that Obama's tech (management) chops were head-and-shoulders above his opponent's. (Obama's election-information-system-thing was called 'Narwhal', Romney's 'Orca'. Arstechnica has some good coverage of the two; but you can google around for other info. In short, though, 'Narwhal' was considered agile, cloud-architecture-oriented, etc, etc, etc, modern buzzwords, and brutally outperformed the competition.)

    Given that healthcare reform is Sort of A Big Thing (even if the result he got is basically Romneycare, as it exists in MA from before Romney's conversion to the idea that it threatens the fundamental underpinnings of America), I would have expected that an IT project in support of it would have been running in skunkworks mode from pretty much the moment of the election, if not before, and that absolutely every effort would have been made to assure success.
  • by ShanghaiBill ( 739463 ) on Monday October 28, 2013 @11:48AM (#45259151)

    they don't know of other ways to solve problems and they think the only way to do this is changing the law.

    The other problem with lawyers is that they come from an adversarial profession. They tend to think in terms of winning and losing, rather than mutual benefit. Courts are in the business of slicing up the pie, not making the pie bigger, and certainly not planting some wheat and apple trees so more pies can be made in the future.

    So what can we do about it? Many ballots and voter guides list the profession of the candidate. When in doubt, vote for the non-lawyer.

  • by oh_my_080980980 ( 773867 ) on Monday October 28, 2013 @11:55AM (#45259231)
    Except contractors were used for this. The same one that screwed up the UK's project.
  • by ColdWetDog ( 752185 ) on Monday October 28, 2013 @11:58AM (#45259263) Homepage

    OK, if it's not so complicated, then how come my small hospital has FOUR people that JUST deal with weird ass details of various insurance companies? Companies who insist that you format the information in one way for them. Each of them. All thirty of them (and counting).

    Insurance is a simple concept. Health 'insurance' (and it really isn't insurance in the classic sense) is a complicated mess. And the ACA made it worse. Much worse.

    The biggest failing of the ACA is that Obama didn't think he could go up against the insurance companies (and he was likely correct). So they got pretty much what they wanted, their whining notwithstanding. The losers are pretty much everything else. Patients got a few bones. The government got some loopholes and access to information (lovely, just what they needed). Small employers either got a big break or got screwed big time - nobody can tell just yet.

    If Congress had written NASA's enabling legislation like the did for the ACA, all of the engineering talent and expense would have gone towards figuring out what the hell was crammed into several hundred thousand pages of internally inconsistent documentation. There would have been enough money left over to buy a couple sets of Legos and some Estes rocket engines.

  • Re:Single payer (Score:5, Interesting)

    by ebno-10db ( 1459097 ) on Monday October 28, 2013 @12:09PM (#45259379)

    Single payer means the government has 100% control of all health care, regardless of what anyone says differently.

    Forget your ideological fantasies and stick to the facts. Name a country with universal health care where you can't get what you want by paying for medical services yourself.

  • by satch89450 ( 186046 ) on Monday October 28, 2013 @12:25PM (#45259571) Homepage
    Everyone is missing the point. The space program was done one step at a time, finishing each step before moving on to the next. Yes, this is "waterfall" thinking, but in the space program it was the right way to do it. Properly done, the agile approach could also have been used in the moon program, as long as the result is that the final push is composed of fully-tested and vetted pieces. (Could it be that the agile approach was indeed used? People closer to the facts can answer that.)

    The reason to have multiple contractors is to allow development of different parts to be done in parallel. The key to success with broad development is a really, really good architect specing the interfaces, and each people/group showing that their stuff works as specified at the interfaces. Then integration testing becomes a manageable exercise. This includes performance metrics -- at the interfaces. Was that done here? I highly doubt it.

    And the Affordable Care Act missed a number of elements that would have made health care affordable. It's isn't about insurance, it's about the total experience. And Congress bungled it. At least, those people in Congress who were allowed to contribute did. What was wrong with stepwise refinement?

  • by sycodon ( 149926 ) on Monday October 28, 2013 @12:37PM (#45259725)

    This bill didn't need a filibuster proof majority because it was passed as a reconciliation bill, which only needs a majority.

    Which, incidentally, may be it's downfall because Constitutionally speaking, all revenue Bills, which this is according to the Supreme Court, must originate i the House. We'll see how that goes because these days, the law pretty much is just a suggestion.

  • Re:Ask Doctors ... (Score:2, Interesting)

    by Anonymous Coward on Monday October 28, 2013 @12:40PM (#45259769)

    The Doctors don't like it because their payments are limited to what most people would consider "reasonable".

    Note that nowhere in your argument do the actual costs to the Doctors factor in. Doctors dislike Medicare because its payments are less than their costs. Patients with insurance are charged higher prices to subsidize the Medicare patients. Medicare can't work unless there is something else to subsidize it.

  • Re:What ? (Score:5, Interesting)

    by bluefoxlucid ( 723572 ) on Monday October 28, 2013 @12:44PM (#45259819) Homepage Journal

    Actually what was said was, "The constituency doesn't understand legislation. You can't read a bill and understand it. When it's passed, you will understand because you will see what happens."

    In other words: Pelosi said you're all too stupid to understand the law until you see what you actually get from welfare and what people get arrested for. Essentially it's the same as saying that women don't know how to read and so need to be shown--an accurate statement hundreds of years ago in many societies--and thus that the women should butt out of government because they can't understand all the important things going on, which are mostly argued in small breaths over vast things that are written down. It's so much the same because the argument is that the lay person is illiterate to legalese and cannot understand written law--or at least cannot carry out the written law in thought to what its consequence will be (i.e. oversight, agencies, forms to fill out, benefits paid out, costs to the government, tax impacts, etc.).

    The government does not do "crafted in secret." They do "the common man is too stupid to self-govern; we are the shepherd, the watchful big brother."

  • by davidannis ( 939047 ) on Monday October 28, 2013 @01:00PM (#45260025) Homepage

    Obama and his people delayed the rules for Obamacare so they would not come out before the 2012 elections. That delayed the writing of the code for the website and they continued to issue changes right before the site was about to be released.

    Actually, a lot of that delay was to try to accommodate Republican state legislatures and Governors in the hopes that they would step up to the plate and create state run exchanges. In my state (Michigan) the Republican Governor fought the Republican Legislature to be able to build our own exchange but lost.

  • by I'm New Around Here ( 1154723 ) on Monday October 28, 2013 @01:32PM (#45260407)

    That is just too bad for the admiistration. When over half the states declared that they were not going to implement their own exchange, and the federal government would have to do so, the federal government had two options: build the exchange sites for those states, or rescind Obamacare as being too burdensome for them to handle.

    They chose the first option, and then completely botched the job. Don't blame people who didn't agree to play ball in a rigged game.

  • Re:Ask Doctors ... (Score:5, Interesting)

    by radtea ( 464814 ) on Monday October 28, 2013 @02:12PM (#45260861)

    You should talk to Doctors. They seem to have a quite different opinion of Medicare

    You should also look at world-wide comparisons. Medicare and other public healthcare programs in the US account for more dollars per capita spent than all or almost all universal health-care systems in other countries, and deliver lousy results comparatively.

    Canada--with our nominally single-tier, public, single-payer health care system--has longer life expectancy, lower infant mortality, and better outcomes by any number of other measures. Critics (sometimes justly) focus on input measures like wait-times, but at the end of the day what matters is that we are getting health care and getting good outcomes. We aren't even the best in the world--just middling-decent as these things go.

    So the real question is not "why can't government launch a website" but "why can't the US Federal government, alone amongst all governments in all developed nations, provide a reasonable level of basic, universal health care at costs comparable to those in every other developed nation on Earth?"

    This isn't a "government" problem. It is a uniquely American problem, and the solution does not lie in any general ideological fix, but in the detailed structure of the specifically American, particularly broken, Federal government.

  • by Jane Q. Public ( 1010737 ) on Monday October 28, 2013 @03:35PM (#45261857)

    "Requirement changes due to red states not implementing exchanges and their legislatures making any state assistance illegal constituted the majority of the development issues."

    No, they didn't. Repeat: I *SAW* some of their code. (In was from the registration page, in fact.) And it was just plain bad. Quite literally terrible, inept programming. You would actually have to consciously try in order to do worse.

    There may have been other contributing factors, but the plain truth is that they did a very poor job on the website.

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