The Manhattan Project, The Apollo Space Program, and Healthcare.gov

Today the Obama Administration announced that 106,185 people have “selected” health insurance since the Affordable Care Act took effect on October 1, about 20 percent of the Administration’s stated goal for October.  The much-maligned Healthcare.gov website performed even worse than expected — fewer than 27,000 people used it to sign up for coverage.

In an odd way, the Affordable Care Act seems to be knocking down some of the political barriers between Americans.  Democrats and Republicans, liberals and conservatives, tea partiers and progressives alike are scratching their heads about where things went wrong.  I don’t diminish the technological challenges of developing a website for the Affordable Care Act — I couldn’t do it — but commercial entities manage to develop websites that are nimble, easy to use, and capable of handling far more volume than has been handled by Healthcare.gov.  Why couldn’t the government do so?

Some people are suggesting that maybe the Affordable Care Act is showing that government simply is not well suited to managing massive and sprawling projects.  That notion, I think, is completely belied by history.

During the 1940s, the United States somehow managed to successfully fight a two-front overseas war, raise and equip the largest army in the nation’s history, and turn a depressed economy into an awesome engine that produced staggering amounts of planes, tanks, jeeps, battleships, and other implements of war.  It topped off the World War II years by single-handedly, and in great secrecy, unlocking the destructive force of atomic power and figuring out how to use that power in weapons capable of leveling entire cities.

Two decades later, in response to a challenge from a new President, the United States built a space program from the ground up, conquered countless engineering problems involved in protecting humans unscathed from the unforgiving environment of space, and devised the rocket systems, docking systems, computers, space capsules, and space suits necessary to send men to the Moon, allow them to romp on the lunar surface, and return them safely to planet Earth.

The Manhattan Project and the Apollo space program were far more complicated and challenging than building a functioning website that would allow people to shop for health insurance coverage and sign up when they have found a plan they like.  Are people who wonder whether our government is capable of handling large-scale tasks really saying that intrinsic limitations in the capabilities of our government mean we couldn’t successfully complete the Manhattan Project or the Apollo program these days?

I just don’t buy it.  The history of America shows that government can perform admirably on big jobs, and I don’t think Americans or their capabilities have changed for the worse since the 1940s or the 1960s.  The problem isn’t the government or its structure, the problem is who was running the show and managing the effort.  Could the President’s falling approval ratings be a reflection of the fact that more and more people are coming to that conclusion?

Public Sector Vs. Private Sector

You’ve got a new product that you want to roll out to the American public.  It’s hugely important, and hugely controversial.

You’re trying to appeal to young people.  You want them to sign up for your product.  You know that their participation is crucial if you want your product to be a success.

You also know that most of the people in your target demographic are tech-savvy folks.  If they are going to sign up, they are going to do so through a website.  After all, it’s how they buy music, and concert tickets, and other things that they want.  If your new venture is going to be successful, it’s essential that you have a website that is user-friendly.

So, who do you select to manage and supervise your roll out and website development?  A computer geek who has developed successful, accessible websites for google, Amazon, and other lucrative internet businesses?  A tech wizard who is intimately familiar with cutting-edge technology and user interface concepts?

Or, the ex-governor of Kansas?

Toto, I don’t think we’re in Kansas anymore!

First-Day “Glitches”

Today was the first day Americans could try to access health care exchanges under the Affordable Care Act — known to some as “Obamacare.”

It’s fair to say that the process didn’t go smoothly.  The Chicago Tribune reported, for example, that consumers seeking information encountered “long delays, error messages and a largely non-working federal insurance exchange and call center Tuesday morning.”  It’s not entirely clear how widespread the problems were, and are, but the prevailing theme of the news stories was about difficulties, failures, and frustrations.  As the video above shows, one MSNBC anchor tried to obtain information about options on-line, to try to help viewers understand how the process worked, and was hit with error messages, inability to resolve the issues through an on-line chat session, and finally being put on hold for more than 30 minutes before hanging up because her patience was exhausted.  

The President says there will be problems and “glitches” because we are trying to do something that hasn’t been done before.  I’m not sure that is quite right — there are commercial websites that handle significant volumes of traffic without problems — but his reaction, I think, misses a fundamental point that would not be lost on a businessman.  One of the selling points for the Affordable Care Act was that people could quickly and easily get information about competing health insurance options with a few clicks of a mouse.  Given that pitch, a business would never roll out a website without being absolutely certain that it worked well, because businesses know that consumers can quickly become frustrated — and a frustrated consumer is one that is not likely to come back.  It says something about the government mindset that they would go live with websites that clearly aren’t ready.

The people implementing the Affordable Care Act missed a real opportunity today.  The negative publicity about the websites and their problems are the kind of thing that could become fixed in the minds of the American public, with people coming to accept as conventional wisdom the notion that the websites, and exchanges, are an enormous hassle fraught with delay and failure.  When you’re trying to convince people who aren’t insured to become insured, and you’re trying to overcome the drumbeat of Republican criticism of “Obamacare,” a disastrous first-day roll-out just makes your job immeasurably harder.