Someone made healthcare.gov.

The tragedy of Healthcare.gov

Anyone that starts a new website or business or really anything asks themselves these questions:

  1. Who is my target audience?
  2. What are those people like?
  3. How will those people interact with my service?

Now imagine the answer to those questions are:

  1. Everyone.
  2. Everything.
  3. Everywhere with everything.

This is what the designers, developers, and IT folks at Healthcare.gov are dealing with. President Obama’s signature healthcare law, whether you like it or not, hasn’t had much praise for its ability to work. I used to work for state government in Indiana and one thing you quickly learn is that when you’re developing a website, there are a lot of barriers, roadblocks, and hurtles to jump through that most “other businesses” don’t think about. For example:

  • All websites have to be ADA compliant and preferably tested with a screen reader. You might not have many blind or visually-impaired visitors to your site, but when you’re the government, you’re still talking about millions of people.
  • The number of tech-savvy users is likely to be very low. Government by its very nature is designed to help the least affluent, the least capable among us.
  • Access to technology is still incredibly difficult. Your business might be able to zero in on a city, but imagine if you had to deal with the whole country. Sure, plenty of businesses do that, but Coca Cola wasn’t built overnight.

It’s estimated that Healthcare.gov needs five million lines of code re-written. Think about that staggering number for a moment: five million lines of code. If you had to rewrite a book, imagine rewriting every line of it … and imagine there are five million lines.

The government gets a lot of heat for being a terrible provider of services, as so many DMV-related jokes can attest. But recognize, too, that the government has a monumental task far above what even the largest companies like Apple, Google, or Amazon have to contend with. Amazon just needs to make sure your new copy of The Hobbit gets from one warehouse to your door through UPS. They never have to worry about what might happen if Betty from Missouri can’t access a computer, because that’s what Wal-Mart is for and Amazon has plenty of other customers. The government can’t just up and say, “Well, too bad that you don’t have a computer, a phone, or even a connection to the Internet or cell signal.” Or that they can’t read, which is another big problem for much of America.

It’s easy to pass blame and point fingers since this is such a politically-charged issue. But remember, too, that you can pretty easily ignore people who can’t read (whether from learning disabilities, visual impairments, or just plain laziness). It’s also easy to forget that it’s hard to know what will happen on the scale that government has a legal and moral obligation to operate.

Experience tells me that the people working for Healthcare.gov are not incompetent. They’re smart people just like you and they get up and go to an office everyday just like you. But they have to worry about politics to a degree most people do not. It complicates and permeates everything. With so many political egos and stakeholders, the advice of the IT people gets drowned out by the irrational demands of politics and agendas. And that’s how things break.

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