Oct 1, was the day that the Affordable Healthcare launched the Healthcare marketplace website. This was the website where people could browse and find plans.
Day 1 was a disaster. No one could get to the website. In the meanwhile the Government was shutdown and the focus shifted to the Government shutdown. Day 2 to 7 was equally bad and by now the focus was shifted to Congress not increasing the debt ceiling and the risk of a US Government default. Oct 17 was when finally there was a deal, albeit temporary and kicking the can down the road by around 3 months.
And the website and its accessibility was as bad as ever. With the other major news out of the way, the focus was back on how the website still wasn't working and how millions of people had frustrating experiences in finding or comparing plans, let alone sign up.
Initially President Obama and the administration blamed the issues on the traffic, i.e. the number of people who were trying to access the website. They continued to use this as the main cause of the issue until it has now become obvious that its simply not true. The media was able to eliminate this as the root cause by a very simple experiment. Trying to use the website even in the middle of the night, early morning, 4 a.m. Nothing worked. And there's no way there could be more than a few hundred people trying to access the website.
I tried using the website on several occasions. On most occasions I had similar experiences to most people, but because of the sheer number of attempts, I was able to proceed several steps into the website. Several states (13) had put up their own marketplace, including Connecticut and New York. Whilst these had some issues, they were relatively minor and overall they functioned relatively well. It was the Federal government website, applicable to States that did not have their own marketplace, which had the major glitches.
The Government according to media estimates has spent over 600 million dollars on this effort over a 3 year period. And it doesn't work. I'm confident that the administrator will be able to fix most of the issues in a few weeks, but there are several things that could or should have been done, which could have resolved most of the issues in a couple of days. And would be as effective as the several hundred million dollar fixes.
Here's a list of the top 5 things I would do to improve the same. It would cost under $10,000 and would resolve over 95% of the aggravation. No that was not a mistake. Ten Thousand Dollars. That's it. Not 100s of millions, not 10s of millions not even a couple of million. Just a few thousand dollars. And not even that, as the people required to make these changes are probably on staff and being paid anyways.
Fix 5
Redirect to State Home on Fed Home page
The Fed website gets traffic from all the 50 states. And then after asking several questions, redirects you to either the State's healthcare website where applicable or continues with the process. By making this the point of entry, you are reducing a significant load of those whose States already have their own health marketplace. And by having multiple sites, 1 for each State, the ability to manage the load as well as make State specific changes becomes simple.
Fix 4
Create a quick reckoner calculator of Healthcare options
At the end of the day, the healthcare options are a factor of a few basic factors.
1. No. of persons
2. Sex of each person
3. Age of each person
This is the Law. It does not allow the insurance companies to use other factors that may impact premiums such as health, race, family history or any of those zillion things. That's it. A simple ready reckoner can give you the options available when you input these basic values. And most of the millions who were frustrated and want to know their options would have it in minutes. Automatically reducing the number of people accessing the website.
Fix 3
Minimal details required to compare
The current website requires loads of data to compare plans. After the previous steps, those who want to go further and want a formal proposal can be made to input the personal data. Such as Name, Address, Date of Birth and other required data. Again this can be reduced and restricted to under 10 parameters per individual.
Fix 2
No need to register
The current system required every visitor to register before they could get any info. Considering that the large majority of these visitors aren't likely to purchase the plans, its a waste of time and resources. Both of the individual and of the portal. Make as much info available outside of the registration. That way, only those who want to take the next steps towards purchasing healthcare need to register. Automatically reducing loads and resources by over 90%. Think of the impact a single road accident has on traffic. Its a cascading impact. Get the accidents off the road, and give a separate lane for fast traffic, and the traffic moves smoothly.
Fix 1
No server side validation of data at application
And finally get rid of all of the validations at the application stage. All you need to do is have a 1 line disclaimer that says "The policy is subject to all data provided being accurate". The same can be verified offline in a batch process at a later stage by the insurance companies issuing the policies. And the benefits can be verified by the Government when they are submitted by the Insurance company for verification. This will speed up the process and give the exact same accuracy as the current cumbersome system that uses interfacing with several systems including Credit Rating Agencies for verification of an individual. The Government is collecting money upfront. The payer (Beneficiary) needs to worry about the data being correct and accurate.
And the reason, all of this can be done in a coupe of days at low cost is that you're getting rid of all the complicated systems that have several bugs, issues, flaws, holes,... and replacing with a simple yet robust, scalable and equally or rather more effective system.
