This is what an online health care exchange looks like:
The federal health-exchange marketplace, architecturally, is a mess. That, at least, is the consensus of IT experts explaining to reporters why so few people were able to sign up online for health insurance last week.
- In the Wall Street Journal: "Such a hastily constructed website may not have been able to withstand the online demand last week."
- On Reuters: "Five outside technology experts interviewed by Reuters, however, say they believe flaws in system architecture, not traffic alone, contributed to the problems."
- On Wonkblog: "Most of the problems like these are in the software. Hardware is the easy part. You can add more hardware and do it easily. Software takes more time."
Health and Human Services officials admitted to The Wall Street Journal that the website has coding issues, and that they "can do better and we are working around the clock to do so."
National Journal's Margot Sanger-Katz predicted this outcome. In July, she wrote about the logistical difficulties of opening the exchanges, especially in creating an information hub that ties disparate streams of data from various government agencies. The chart at the top of the page tries to simplify what that looks like.
"In an ideal world," she reported, "the exchange websites need to be able to talk to several federal agencies—IRS to verify an applicant's income and employment status, the Department of Homeland Security to determine her citizenship, and the state government to see if she qualifies for Medicaid, to name a few—all in real time."
She continued: "It is increasingly clear that the kind of Amazon.com, one-stop shopping that was once described ... will not be available in most parts of the country."
Well, Amazon it is not. But time might fix the online marketplace. Speaking to The Switch, an IT expert involved with its implementation said the first rocky week may not be indicative of larger Obamacare infrastructure problems. But if it is, problems could continue to trickle down, for instance, when people get the bills for their new insurance plans.
While the design complexities don't absolve the administration from blame, they do put the exchange problem in some perspective. If and when healthcare.gov is up and running smoothly, it will be considered an accomplishment of information technology in government, which tends to lag far behind the private sector.
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