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Government Medicine United States

How 3 Young Coders Built a Better Portal To HealthCare.gov 499

Hugh Pickens DOT Com writes "Doug Gross writes at CNN that spurred by the problems that have surrounded the rollout of the official HeathCare.gov website, three 20-year-old programmers in San Francisco have created an alternative website to help people get health insurance under the Affordable Care Act quickly and cheaply. The result is a bare-bones site called Health Sherpa, which lets users enter their zip code, plus details about their family and income, to find suggested plans in their area. 'We were surprised to see that it was actually fairly difficult to use HealthCare.gov to find and understand our options,' says George Kalogeropoulos, who created the site along with Ning Liang and Michael Wasser. 'Given that the data was publicly available, we thought that it made a lot of sense to take the data that was on there and just make it easy to search through and view available plans.' Of course, it's not fair to compare the creation of Health Sherpa to the rollout of the more complicated government ACA site, which even President Obama has acknowledged as a horribly botched affair. 'It isn't a fair apples-to-apples comparison,' says Kalogeropoulos. 'Unlike Healthcare.gov, our site doesn't connect to the IRS, DHS, and various state exchanges and authorities. Furthermore, we're using the government's data, so our site is only possible because of the hard work that the Healthcare.gov team has done.' But it does cast light on the difference between what can be done by a small group of experts, steeped in Silicon Valley's anything-is-possible mentality, and a massive government project in which politics and bureaucracy seem to have helped create an unwieldy mess. The three programmers have continued fine-tuning the site as its popularity has grown. In less than a week, the site has had almost 200,000 unique visitors and over half a million page views. '"The Health Sherpa makes it ridiculously easy for anyone to compare health care plans covered under Obamacare in 34 states," writes Connor Simpson at Atlantic Wire. "The result is a simple, beautiful, remarkably responsive website that anyone could use.'"
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How 3 Young Coders Built a Better Portal To HealthCare.gov

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  • Just price? (Score:5, Insightful)

    by Anonymous Coward on Tuesday November 12, 2013 @08:50AM (#45399893)

    I'm looking at a zip code and it tells me the price for all the plans, but it doesn't even tell me the deductible or out-of-pocket?

    • Re:Just price? (Score:5, Informative)

      by icomefromtheinternet ( 3429517 ) on Tuesday November 12, 2013 @11:53AM (#45402045) Homepage

      I'm looking at a zip code and it tells me the price for all the plans, but it doesn't even tell me the deductible or out-of-pocket?

      Working on it. The details aren't in the main data set, so we've got to go get those elsewhere. We've identified a few sources and are working on integrating them.

      Source: I'm a member of the team.

  • Lipstick on a pig is still a pig.

    • by account_deleted ( 4530225 ) on Tuesday November 12, 2013 @08:56AM (#45399947)
      Comment removed based on user account deletion
    • by Thanshin ( 1188877 ) on Tuesday November 12, 2013 @09:04AM (#45400027)

      Unless you've got a magical lipstick of transfiguration.

      Lipstic of transfiguration on a pig is a standard action that provokes attacks of opportunity. And the pig may resist the transformation with a successful DC 17 Fortitude save.

      The change would only be instantaneous if the pig has a volume of one cubic foot or less (1h/cubic foot, for fatter pigs).

    • I just know there's a pork barrel joke hidden here somewhere...

      • I can see 88 million jokes. And here's the kicker, if the kids put on a credit card plugin, they could move ACA product. This overhead that CGI threw in with Experian, and Medicare in shear nonsense. Go to any other Health Care business model, to verify it. Also, don't limit it to just Health Care, check Auto, and Home Insurance. First they get the minimal amount of information, then they get your money; NOW they clear up any questions. And those industries units of measure are in the Billions.
  • by Lech Rzedzicki ( 2828773 ) on Tuesday November 12, 2013 @08:52AM (#45399915)
    This only shows why it's important that organisations, especially public ones publish open data - even if the software is broken, as long as the data is open and accessible and in a known format, someone else can pick up the slack and process it as necessary!
  • by Andover Chick ( 1859494 ) on Tuesday November 12, 2013 @08:53AM (#45399923)
    This proves the old adage that no more programmers should be involved on a project than you can fit into a VW Bug with pizza and beer.
  • by Pr0xY ( 526811 ) on Tuesday November 12, 2013 @08:53AM (#45399929)

    This is a nicely done website, there is no doubt about that. And certainly the people who implemented healthcare.gov could learn a thing or too from it.

    But I do have to ask, how would thehealthsherpa.com hold up when 100,000's of people try to use it at the same time? My guess is that the site is hosted on a single, relatively small server and wouldn't hold up very well. I could be wrong, but I think that scale is worth considering.

    • Agreed.... (Score:5, Interesting)

      by SerpentMage ( 13390 ) on Tuesday November 12, 2013 @08:59AM (#45399979)

      IMO and I will probably get downgraded because of this comment... WOOOPEEE DOOOO! So you did a nice job, like you said. However, a UI is only a detail. The backend and getting that work is often much more difficult. I get really annoyed by some Silicon Valley types that think I can rewrite an entire enterprise system over a weekend. It involves a bit more than just fancy UI and greenfield database storage.

      My guess what went wrong of the the original healthcare website is that it was designed with enterprise in mind and became bogged down in enterprise details. Would not be the first time, and will not be the last time something like this happens.

      • Re:Agreed.... (Score:5, Insightful)

        by MozeeToby ( 1163751 ) on Tuesday November 12, 2013 @10:45AM (#45401159)

        Healthcare.gov tried to be too complex and serve too many people right out of the gate, both things that these three developers get to completely and totally sidestep.

        What they've built is a database query engine with a decent GUI. What healthcare.gov is supposed to be is a software implementation of a several thousand page law, which probably becomes 10s of thousands of pages of requirements and design constraints. Just getting the dozen or so data sources to talk nicely with each other and sanitizing the initial data load is half the work on a project like this.

    • It doesn't matter how many servers it's hosted in today, but how many servers they could scale it to tomorrow. The techniques to become scalable are fairly well known, as hundreds of sites get hammered like that every day. Reactive programming and all that.

      Anyone building a website today that has a design relying on components that can't be easily scaled should look for a different line of business.

    • by OakDragon ( 885217 ) on Tuesday November 12, 2013 @09:26AM (#45400267) Journal
      One of the major sticking points about HealthCare.gov was that you had to create an account. This was done so that information could be gathered to provide you with pricing after subsidies . The idea was to lessen the sticker shock. I haven't read it explicitly in regard to this site, but I'm assuming it does not calculate your subsidy for you.
      • by OakDragon ( 885217 ) on Tuesday November 12, 2013 @09:31AM (#45400299) Journal
        Hush my mouth, I tooled around their site a little, and they do estimate your subsidy, based on income and number of people in your household. So right now, this is much more useful that HealthCare.gov - at least for information purposes.
      • by catfood ( 40112 )

        You are correct. Sherpa does not calculate subsidies. It simply says they exist and you should go find out on healthcare.gov.

        I think a nice new feature would be to ask a few questions to project your expected subsidy and calculate it for you. That adds complexity, but not as much complexity as the verification that the government site puts you through. (That's where all the IRS stuff comes in.)

      • by T.E.D. ( 34228 ) on Tuesday November 12, 2013 @10:15AM (#45400785)

        One of the major sticking points about HealthCare.gov was that you had to create an account.

        ...and that is precisely where they failed. Commercial websites that have to do this kind of thing let you shop around all you want and only force you to create an account when its time for money to change hands. Yes, prices of some things are based on personal info like income. But when a person is shopping around, it doesn't hurt anyone but them if they are wrong/lying about that. You just do your checking when its time to "check out", and if you find out the user was wrong about something that affects price, you present them with the updated price for them to accept or reject and go back to shopping.

        Healthcare.gov instead forces you to create an account immediately and then does all its checking and remote database accessing up front. That's a massive PITA for those "just shopping", overloads the remote databases with unnecessary accesses for people who aren't planning on deciding this session, and front-loads the biggest sources of possible delays and failures.

        • But it pretty effectively prevents transparency. Journalists can't go on the site and report prices, and describe scenarios.
    • by mwvdlee ( 775178 ) on Tuesday November 12, 2013 @09:35AM (#45400353) Homepage

      Looking at the code, it seems they are using Amazon and make use of it's CDN services.
      It's mostly simple HTML, interaction in JS and a lot of advertising, social media and tracking scripts, which are hosted outside their scope.
      My gut feeling tells me they'd have no problem scaling up at all. At worst they'd just clone the virtual server a few times.

  • It is simple (Score:5, Insightful)

    by fermion ( 181285 ) on Tuesday November 12, 2013 @08:55AM (#45399941) Homepage Journal
    I recall when web pages began to become popular technology. Everyone would ask me how I could possible be paid so much money to develop software when anyone with GoLive could put up a website in an evening.
    • Re:It is simple (Score:4, Interesting)

      by Lumpy ( 12016 ) on Tuesday November 12, 2013 @09:52AM (#45400567) Homepage

      I still get idiots asking for me to build them a company website and only expect it to cost a couple hundred bucks.
      Most shit themselves when I qoute "$50 an hour, you can buy 10 hour blocks and I estimate the website will take 40 hours IF you make no changes at all from the scope of work you just gave me. Any changes are billed at hourly rate, minimum 2 hours, if it takes me 2 hours and 10 minutes, you pay for 4 hours

      This eliminates the idiots that thing they can get a cheap website and only the customers that understand business

  • Re: (Score:2, Insightful)

    Comment removed based on user account deletion
    • Re: (Score:3, Insightful)

      by Anonymous Coward

      Exactly.

      "Our site doesn't connect to the IRS, DHS, and various state exchanges and authorities"

      So they put a new front end on the part that works, and completely left out the part that didn't work.

      Next they should take their little PHP widget and connect it to dozens of federal agencies, 33 state governments, 400 insurance companies, and 4000 insurance plans. All in real time. Then throw in congress, the white house, and 4,000 pages of functional requirements.

      Seriously folks, the "glitch" isn't in the sou

    • Re:Oh vomit (Score:4, Insightful)

      by icomefromtheinternet ( 3429517 ) on Tuesday November 12, 2013 @11:50AM (#45402005) Homepage

      No, it really is thanks to Healthcare.gov. The open access to their data is what made it feasible to build HealthSherpa - getting that data otherwise would have been an absolute nightmare. You're right that there are a few pre-existing sites to help people buy insurance, but even those mostly aren't offering ACA plans - and it's a lot harder to estimate premiums on non-ACA stuff.

      Source: I'm a member of the team.

      • I'm guessing this has given you a better informed perspective on the problems that Healthcare.gov has to solve. So what's your opinion on the struggles, do you feel like Healthcare.gov really screwed up a doable task or was the problem a lot more technically challenging than most people realize?

        And do you think HealthSherpa or other 3rd party sites have the potential to eventually offer signups and fill the role of the Federal Exchange?

  • by biodata ( 1981610 ) on Tuesday November 12, 2013 @09:02AM (#45400001)
    The principle I see in action here is that if you break every task down into easy-to-implement components that do one simple thing well, then you can have three young coders build each component for you and each will probably work well. If you try to build a system which is more complex than that, the effort grows something like exponentially with the complexity, and the likelihood of early success shrinks correspondingly. If only we could get by with simple things and not bother with complex integrated online services.
  • so in my book; that's much better than good enough. The original site should be nuked from orbit and this one should be put up instead. Pure and simple.

  • by jamesl ( 106902 ) on Tuesday November 12, 2013 @09:05AM (#45400043)

    A search for insurance for a 65 year old single person with an annual income of $35,000 returned a "Market Young Adult Essentials" policy and a link to the insurance company's start page for finding available policies. This is not "A better portal to HealthCare.gov"

    And then, there's the warning ... "The information provided here is for research purposes. Make sure to verify premiums and subsidies on your state exchange or healthcare.gov, or directly with the insurance company or an agent."

    This is not good to go and less functional that even the real HealthCare.gov.

    They left all the hard stuff out.

  • In less than a week, the site has had almost 200,000 unique visitors and over half a million page views.

    And now that it's linked on slashdot, I'm sure that number will plateau and taper off.

  • by canadiannomad ( 1745008 ) on Tuesday November 12, 2013 @09:10AM (#45400095) Homepage

    Seems to me that the government ought to be in the API business, making all their tools open to developers that can then take the information and the forms, fill them out get details, etc. Make life easy for developers and then let the public create the interfaces.
    I could see a lot of great things coming out of such a model.

  • by catfood ( 40112 ) on Tuesday November 12, 2013 @09:58AM (#45400631) Homepage

    Even with the Sherpa team's disclaimers, they've provided a really valuable service. How many people are going to go to the Sherpa site, quickly get information about what's available to them on the exchange, and decide that the exchange is not their best option? It has to be some double-digit percentage of people who would have wasted a lot of time being frustrated on healthcare.gov.

    Basically, the Sherpa team has given us a great heuristic optimization, in which part of the load problem is handed off to where it can be handled easier, more effectively, and more cheaply. Nicely done!

  • by RogueWarrior65 ( 678876 ) on Tuesday November 12, 2013 @10:12AM (#45400763)

    Interesting. Punched in my stats and selected Gold, which is what I have now. My current provider doesn't appear. That said, there are seven plans less expensive than what I have now. I guess the real question is: what are the requirements to get one of these? Do they require a physical and if so, do those results factor into the rates?

  • by neurovish ( 315867 ) on Tuesday November 12, 2013 @10:16AM (#45400799)

    Even though this site takes only the easiest task of healthcare.gov, which completely works from healthcare.gov BTW...the "how much are these plans" thing is not what's broken, but the results are wrong. From health sherpa, the cost of a humana bronze plan is 194.72, but from healthcare.gov it is 166.99.

    Since the price is relatively close, I guess this site does *something*, but it looks like it is not accurate, in which case it's kinda useless.

    Can an editor change the title to "How 3 Young Coders Built a Broken healthcare.gov Portal"?

  • by BetaDays ( 2355424 ) on Tuesday November 12, 2013 @10:33AM (#45401047)
    But it doesn't send data to 57 agencies does it? I read somewhere that they have 57 different agencies that are sharing in all the data and information that people put in and search on the website and also the goverment has to follow the 503 rule (I think it's called that the one that calls for disability features and such) also all the diffrent languages is these guys website in? only english? what about Spanish? and so on that the goverment one has to have. I know the article says "bare bones" I'm sure the Healthcare.gov site worked when it was bare bones to. I'm not defending how the site is right now but I'm guessing when it was first frameworked without all the added layers of what the goverment has to have in it could be causing some of the issues. I'm not part of the site just my thoughts on it.

    Oh and when I went though both sites the goverment one gave me diffrent cheapter plans than this one did. So the question is how up to date are the databases are or is it just the search Algorithms or maybe even the time of day since I did my Obama search last night and this one right now?
  • by HycoWhit ( 833923 ) on Tuesday November 12, 2013 @04:34PM (#45405639)
    For my zip code and household--Shrepa worked like a champ. Confirmed what I already knew in less than a minute. i.e. the information is accurate and came quick. Took the better part of three weeks to get the "official" word.

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