Tuesday, December 3, 2013

The Heroes of Healthcare.gov

Since the roll-out on October 1st, we've heard little more from the mainstream media than stories on how badly the Healthcare.gov website rolled out (OK, stumbled and staggered out), how long it's taken to get to working even badly (rather than mostly not at all), and how much this largely ineffective website has cost (certainly over $600 million plus by now).  Even now, after the deadline has come and gone for the site to be 'repaired', the best that anyone with an IT background will say publicly about it is that though partially incomplete, it still leaves a lot to be desired.  (What they say privately is largely in an obscene version of 'geek speak', that's wholly unintelligible and largely unprintable.) 

Now before we look too harshly on the code writers responsible however, it should be pointed out that they are mostly contractors given contradictory and constantly altering design parameters by politicians and bureaucrats who have no experience in insurance, less in administrating health care, and none at all in website design. To say that the resulting SNAFU was probably the best that could be expected would be an understatement.  So while all of the charges that you've heard about how bad things are with Healthcare.gov are apparently true, I believe that there's more to the story and that the website designers are getting a bad rap.

Like Washington DC bureaucrats who quietly (and regularly) attempt to perpetuate monumental governmental inefficiency to keep our leaders from 'saving us to death', these unassuming geeks have apparently done all in their power to keep a website that could do incalculable damage to millions from launching or operating successfully. And what do they get for throwing themselves under the bus in the nation's defense; constant ridicule from the media, and abuse both sides of the aisle.  Distracted by stories where the website is concerned, the greater tragedy potential in website success is all but ignored.  The media spends its time arguing about how badly the band on deck is playing, while largely ignoring the fact that the Healthcare ship is sinking under this law.  

Robert Heinlein used to speak in his novels about TNSTAAFL (There's No Such Thing As A Free Lunch).  Where Health Care is concerned, this 'Payment' includes, but it not limited to:  
  • Someone is going to have to pay for all those signing up who are being added to Medicaid rolls.  Whether it's Federal or State money, it's still taxpayer money.
  • These Medicaid additions will put a strain on the system creating cues for doctors far longer than those currently considered a problem on the website.
  • The lack of doctors will eventually force the government to raise Medicaid reimbursement rates to encourage greater doctor participation and ease the strain; further adding to the taxpayer cost of that program.
  • Insurance rates are already increasing for many of those going on the sites (Federal and State) more than expected, since the greater coverage mandated in the ACA naturally includes greater costs.
  • Small employers sooner, and eventually larger ones, will begin to drop employee coverage or likewise increase employee costs in order to reach ACA compliance.
  • Smaller network availability for those going through the website is likely to send it through the same fiscal spiral as Medicaid; quickly increasing rates and subsidies (and at the same time, debt and taxes). 
The day will come in the not-so-distant future when we will be forced to recognize the delaying action fought by these noble nerds for its true value.  (Can you say "Battle of Britain"?)  Sowing contention, confusion, and obfuscation; while fighting in the only way they knew how while fulfilling their limited contractual role, it's these efforts that may someday be recognized for providing us the time to create a winning strategy to seal a final victory over the ACA.  

I can see a shining day ahead, where some may even be awarded a coveted Presidential Pocket Protector of Freedom for their largely unheralded service.  All of them however, will have earned the thanks of a grateful nation for turning grossly ineffectual efforts into epically failing ones.

As a student of history and a libertarian who hopes that the ACA is a doomed bit of government overreach, I am humbled by the chance to salute the gallant geeks of Healthcare.gov for their heroic efforts in the current struggle.

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