Mon June 9, 2014
HealthCare.gov's Next Version Is In The Hands Of Young Techies
Originally published on Mon June 9, 2014 7:14 am
DAVID GREENE, HOST:
The Obama administration is planning a revamp - well, maybe a re-re-vamp of the healthcare.gov website for this fall. A new enrollment period begins November 15 and after last years bungled launch, there is a lot of pressure to make sure this time goes smoothly. The flaws that plagued the site at its launch prompted a frantic tech surge. And in a new article on wired.com, senior staff writer Steven Levy details some of what the team behind the surge was able to do then and also what they have on deck for healthcare.gov 2.0. He joined us from Stanford, California. Stephen Levy, welcome to the program. Thanks for coming on.
DIANY LEVY: It's pleasure.
GREENE: Can we go back to last fall first? From an IT point of view, what exactly happened?
LEVY: It was an epic fail. This was a website which was supposed to connect people to health plans, but it was created by 55 different contractors that didn't talk to each other and they didn't have really experience in creating a mass-market consumer website. Basically it didn't work.
GREENE: Take us to this team that you have written about. Who are they? Where did they come from?
LEVY: So the team I wrote about in Wired is actually the second wave of people addressing themselves to this website. First came a group known as the ad hoc team, and these were outsiders who came in mainly because CMS, the Center for Medicare and Medicaid services...
GREENE: The agency that runs this, yeah.
LEVY: Yeah. They were desperate and they went outside and got people who are experienced in creating these sites. And they decided that instead of rewriting from scratch - there was no time to do it, the open enrollment period was already there - that they would do the best they could to patch it. But as they were working, they realized this thing would have to be rewritten, maybe piece by piece. And they recruited a second wave of even younger people, a lot of them came from startups here in Silicon Valley. And this team became known as the market place light team.
GREENE: One thing you wrote about was something of a culture clash. I mean, these younger techies coming in, they're used to doing things really quickly, experimenting, and suddenly they just ram into the federal bureaucracy.
LEVY: That's right. They're used to moving fast. And they're used to building infrastructure that moves really fast. And the government is very cautious. In Silicon Valley, failing is part of the game there. But in Washington, if you fail, even quickly, you get hold before Darrell Issa
in the congressional subcommittee.
GREENE: Republican congressman, yeah.
LEVY: Yes. So this was very much on their mind, especially since their working this cauldron were everyone is bashing healthcare.gov. So they said, OK, let's just go and let's fix this. And everyone says, well, we don't want to make things worse and we have to be careful. So there were clashes, particularly when they wanted to move some of the infrastructure to a third-party data center, Amazon Web services, which really isn't done in the government but it actually would've been a big boost to reliability.
GREENE: OK, so Stephen Levy this group comes in. They sort of are experiencing all these political pressures to get this right for the first time. They're running into a lot of the bureaucratic tangles that they weren't used to. They do convince the government to use this Amazon Web services, they get started. How were they doing so for?
LEVY: Well, they actually weren't able to convince the government to do a lot of the stuff in this previous open enrollment period. But they are building significant parts of the next version of healthcare.gov. It's called Marketplace 2.0. And we will all see this November 15 when we come back to the website to find our new health plans for 2015.
GREENE: Does it look like that's going to be markedly different than what we saw in the very beginning, that didn't work out so well with healthcare.gov?
LEVY: It's going to have a nicer interface and what's more, it'll be more efficient at helping us find a health plan. There's one thing called plan compare 2.0 where you can do window shopping for a plan without even having to sign in. This is particularly good for young people, who maybe don't feel they need health care and they can just go there without having to give their Social Security numbers and things like that and just say, is there something out there for me?
GREENE: Can I just ask why the government went to 55 different contractors who never talked to each other in the beginning instead of just turning to a small group of kids from Silicon Valley?
LEVY: There's a much larger problem lurking behind here. And that is the way the government traditionally does IT - information technology - to websites for all these agencies is pretty much broken. The contractors have gamed the system. So when you do a big system, whether it's for the FBI or Social Security, everyone gets a piece of it, and no one is in charge. And we hear again and again about these systems that take sometimes, like, a decade to build, and then sometimes they're not even finished. And they put the contracts out again because the technology is obsolete. And a lot of people in these teams were told by the lifers there that healthcare.gov was not unusual for the government. It's just that people paid attention this time.
GREENE: So maybe a failure was needed for the government to learn a lesson about IT.
LEVY: A lot of people who have long been arguing that the system should be reformed see this as an opportunity, and this might be the silver lining of healthcare.gov - that it might be the impetus to make things better.
GREENE: Steven Levy is a senior staff writer at Wired. Steven, always good to talk to you. Thanks a lot.
LEVY: My pleasure. Thank you. Transcript provided by NPR, Copyright NPR.