Tuesday, October 29, 2013

A SIMPLE EXPLANATION WHY HEALTHCARE.GOV WILL FAIL

One of my smarter liberal friends brought up this really good question, and it also came up at my IT dinner tonight: If NASA can do massive, incredible projects with multiple contractors, why is it so hard to get the ACA website working?

Me: I'm glad you asked. You do know that you can go to the Amazon.com website, and look to see everything you ordered 4 years ago, with hardly a delay? Well, try to do that at IRS.gov today- do a simple inquiry about the how much in taxes you paid 4 years ago.

Let me break it to you gently: you can't. Even though you might think that such capability would be obvious by now, it's simply not there. Try digging up if you are a naturalized citizen, or when you became a citizen, at the national immigration service website. Look to see how much is set aside for you at the social security website, and what your expected income will be. How much money has been collected for your Medicare account. To be sure, the data is actually there, at all these agencies; it's just not available at a moment's notice, nor is there an effective interface to retrieve it.

Now, healthcare.gov is supposed to be able to access ALL this information, from at least a dozen Federal agencies, and then combine that information with data provided by the states (eligibility pools, state mandates), and THEN with the insurance data entered by the individual companies - for EACH state(!). All this must be done in near-real-time. The fact is, our core systems are so antiquated, behind the times, with poor, silo-ed interfaces that make collection, reconciliation and presentation of this data virtually impossible.

This is just a massive undertaking, which failed outright because of the hubris of people who thought, "isn't it JUST bringing all this data together?" without thinking through what all was involved. To just START to be able to achieve the goal of Obamacare, these core systems need to be cleaned up and made available to the public in a manner that can THEN provide accurate data for insurance pricing, not to mention the ultimate collection of your medical records. Maybe the systems will be better integrated in 10 years. It definitely won't be ready by Jan 1, 2014.