Healthcare.gov and the Inevitably Digital Future of American Governance

It's remarkable how inexperienced Washington is when it comes to developing complicated technology unrelated to national defense.
Reuters

The Obamacare blame game is in full swing, and without other news to fill pages and airtime, it’s likely to continue for some time. Attention is shifting from the myriad problems with the official website Healthcare.gov, and toward the health plans that are being canceled, even though President Obama promised that they would not be.

But the longer-term story isn’t the rollout and its many severe glitches. No one recalls whether the first batch of Social Security checks was sent on time in the late 1930s. The story that will matter, and linger, is that the Affordable Care Act was the first major law implemented almost entirely online. It’s the template for the future, and rather than using its launch as an excuse to renew attacks on the law, we need to learn what we can because, like this bill or not, it is part of the next wave of government.

The past two weeks have been filled with various individuals testifying to Congress about the design and implementation of Healthcare.gov, the web portal that allows individuals to access the new health plans and exchanges. The tenor of these hearings, convened by the Republican-controlled House, is that the design of the website exposed the fundamental failings of the law and government incompetence. But what’s actually been exposed is that the U.S. government has not yet made the transition to a digital age. While the administration could have and should have done far better, the reasons for its failure are less about a flawed process than a system currently ill-designed for this type of legislation.

It’s safe to say that Congress has never before passed a federal law whose primary mode of delivery is a web portal that will be used by tens of millions of people. And not just one portal, but a portal that serves as a gateway to numerous state healthcare exchanges along with the federal exchanges; a portal that must link up newly designed web pages and interfaces with legacy systems stretching from the Internal Revenue Service to the Veterans Administration to the Medicare and Medicaid systems, none of which are easily compatible or speak the same language.

Many in the tech community have tried to analyze what went wrong with the web launch. Some think the government shouldn’t have hired low-bid contractors, choosing agile development teams instead. There was also a lack of sufficient testing of the site before launch, but the site went live anyway because of political considerations. That the site’s code is not public has limited the ability of even savvy tech-heads to fully explain the many problems.

What is evident, however, is how inexperienced the federal government is when it comes to developing complicated technology systems unrelated to the defense department. Testing is certainly a major issue. Whenever a large or small tech company releases a new version of software, it is after months of assiduous testing of bugs and glitches in a beta version. Even then, the more complex the programs, the more problems there are. Microsoft for years has earned the reputation of releasing programs that are still flawed despite months of running the code through its paces. Some critics have faulted the administration for similar sloppiness, but in truth, the federal government didn’t have the option to do this kind of beta testing.

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Zachary Karabell is Head of Global Strategy at Envestnet, a financial services firm, and author of The Leading Indicators: A Short History of the Numbers that Rule Our World. More

At River Twice Research, Karabell analyzes economic and political trends. He is also a senior advisor for Business for Social Responsibility. Previously, he was executive vice president, head of marketing and chief economist at Fred Alger Management, a New York-based investment firm, and president of Fred Alger and Company, as well as portfolio manager of the China-U.S. Growth Fund, which won a five-star designation from Morningstar. He was also executive vice president of Alger's Spectra Funds, which launched the $30 million Spectra Green Fund based on the idea that profit and sustainability are linked. Educated at Columbia, Oxford, and Harvard, where he received his Ph.D., he is the author of several books, including Superfusion: How China and America Became One Economy and Why the World's Prosperity Depends on It (2009), The Last Campaign: How Harry Truman Won the 1948 Election, which won the Chicago Tribune Heartland Award, and Peace Be Upon You: The Story of Muslim, Christian, and Jewish Coexistence (2007), which examined the forgotten legacy of peace among the three faiths. In 2003, the World Economic Forum designated Karabell a "Global Leader for Tomorrow." He sits on the board of the World Policy Institute and the New America Foundation and is a member of the Council on Foreign Relations. He is a regular commentator on national news programs, such as CNBC and CNN, and has written for The Wall Street Journal, Newsweek, Time, The Washington Post, The New Republic, The Los Angeles Times, The New York Times, and Foreign Affairs.

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