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Comparing the cost of healthcare.gov to spotify or linkedin, or comparing the user experience to Amazon, is completely irrelevant. The only relevant question to ask is this:

Is this better or worse than the way shopping for insurance online used to be?
Now you, like me, may have thought that when Obamacare went live with new rules and regs, simultaneously all the private sites operating on the old rules somehow went dark, rendering direct comparison impossible. Not so! We don't have to try to remember the bad old days and then try to compare -- we can do it side-by-side because those sites are still around!

(But rather than do it yourself, let the incomparable and hilarious John Green of Crash Course do it for you -- this is well worth your time.)

For those who can't view videos, here's my summation:

FIRST: John spends a frustrating 49 minutes trying to create a profile on healthcare.gov, getting kicked out multiple times, before finally making his way in (video shot and posted on October 8). He adds info about his wife and kids, confirms his email and driver's license, and is then ready to compare plans.
THEN: John spends a much more frustrating 2 hours and 16 minutes trying to get to a similar point with a private insurer. He is asked about his medical history. He is asked what doctors he and his family see. He is asked about traffic violations. He is asked if he's had surgery or has "discussed" surgery ("what, like mentioned it in conversation?"). He is asked how much he drinks alcohol. He is asked to provide written details on all these responses and advised that failing to do so completely will jeopardize his future coverage. The application is at least 25 pages long, a huge headache and super intrusive.
Healthcare.gov, flawed as it may be, still seems like a massive improvement over the old system. Yet no media is doing this comparison. Maybe that's why, despite the difficulties, the site keeps getting traffic and people are fighting the delays to get through. These people -- the ones actually signing up -- know what it used to be like.

That's a message we need to be repeating. And this video is awesome and deserves to go viral. It's been out over a week and has been viewed 625,000 times on YouTube. Let's make that 6 million views.

Disclaimers: I have never shopped for individual insurance myself nor have I tried to create a healthcare.gov profile. I am not saying Obamacare the law is perfect (it's not) nor that the healthcare.gov website is perfect (it's not). I am not a computer programmer. I am in no way affiliated with John Green or his stuff. But it is awesome, and here's a little more about him:

John Green is one half of the VlogBrothers, who do occasional video blogs and various topics in this style, as well as the growing educational series Crash Course, which is sort of like a high-intensity humorous-yet-educational Cliff's Notes video channel on a ton of different topics. There are 150+ videos available in topics like biology, history, literature and chemistry.

The duo has recently launched Subabble, a crowdfunded venture where they hope to be more sustainable in making future videos.

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Comment Preferences

  •  This is an excellent point. (11+ / 0-)

    Everyone criticizing the signup process for the ACA and commenting on how frustrating or how long it takes to sign up needs to stop and consider for a moment: "as compared to what?"

    Most people are used to getting insurance through their employer, a simpler process than one goes through in trying to buy insurance directly on one's own.  Yes, signing up through the ACA exchanges is hindered by a glitchy website rollout, but glitchy websites can be improved, and I have no doubt that over the next month the experience will improve substantially.

  •  About that glitchy website rollout (0+ / 0-)

    As an IT professional to the medical community, I am beginning to freak. HealthCare.gov coding is a disaster. It needs a complete rewrite on a world class open source PaaS (platform as a service), which will probably not happen. It's not scaling well, it abuses client/server broadband structure, and it's opaque.

    As Dems running as the technocratic compassionate party against the Reps fear and faith party, we have to get this right.

    The stakes are higher than most folks here know. I hope Rachel begins making very loud noise on the subject. And soon.

    I get it now. It's not the Tea Party. It's the Neo-Confederate Party!

    by DavidHeart on Fri Oct 18, 2013 at 07:48:59 AM PDT

    •  A complete rewrite? Must use PaaS? Abuses bband? (0+ / 0-)

      I find these subjective recommendations, not technological requirements for a successful service.

      "So, please stay where you are. Don't move and don't panic. Don't take off your shoes! Jobs is on the way."

      by wader on Fri Oct 18, 2013 at 07:57:41 AM PDT

      [ Parent ]

      •  I design medical clouds (0+ / 0-)

        and have more than a subjective clue in these matters.

        Let's just say that I'm not feeling complacent about the inevitable success of HealthCare.gov

        I predict this issue will get plenty noisy for good reasons pretty soon.

        I get it now. It's not the Tea Party. It's the Neo-Confederate Party.

        by DavidHeart on Fri Oct 18, 2013 at 08:31:24 AM PDT

        [ Parent ]

        •  You're not the only one with I/T experience (2+ / 0-)
          Recommended by:
          Catte Nappe, kerplunk

          here.

          Your prescription does not sound like a solution to current issues, but an alternative way to develop the system - from scratch, apparently.  For example, PaaS is not a requirement for infrastructure scalability.  "Rewrites" of things not fully broken are overkill and can simply recreate what went wrong in a different fashion.

          Project management methodologies, scalability built into the design, synchronization of service levels/availability across back-end systems, etc. are often more important aspects of ensuring reliable,correct performance than technology, per se, IMHO.

          I doubt that anyone at CGI is feeling complacent about handling the startup issues of their system.  I'm not sure what you men by "noisy", but I think the situation and internal pressure is already there when the President has already mentioned the situation publicly.

          Most of the problem mentioned with the federal site thus far sound like back-end synchronization issues under load, to me.  I'm sure it's more complex than that, but given the issues with what appear to be partly-saved profiles, messed up sessions and the like, I'd say that they are having timing issues that were not encountered in test, at the very least.

          "So, please stay where you are. Don't move and don't panic. Don't take off your shoes! Jobs is on the way."

          by wader on Fri Oct 18, 2013 at 09:59:36 AM PDT

          [ Parent ]

          •  Pick one: platform or application. (0+ / 0-)

            Unless you have unlimited time and funds you shouldn't bet the farm on a project that does both.

            I get it now. It's not the Tea Party. It's the Neo-Confederate Party.

            by DavidHeart on Fri Oct 18, 2013 at 10:45:02 AM PDT

            [ Parent ]

            •  Do we know from what they built this system? (0+ / 0-)

              I've worked projects that have built successfully from scratch and others that are able to reuse + grow existing programs - via some combination of infrastructure/hosting, application(s), support, processes, etc.

              In my experience, you don't have to choose only one or the other to find success - but, you should still make a decision up-front based upon expected needs multiplied by a reasonable growth factor, etc.

              Until we hear more, I can't offer a prescription for their ails besides suggesting processes to assess their issues and relative severities of such - as I mentioned above, it's likely an issue from the combination and synchronization of systems that only one area.  That doesn't imply we necessarily should throw all of their platform or application out the window to solve the problems.

              "So, please stay where you are. Don't move and don't panic. Don't take off your shoes! Jobs is on the way."

              by wader on Fri Oct 18, 2013 at 12:02:38 PM PDT

              [ Parent ]

              •  Have you ever picked up on someone else's code? (0+ / 0-)

                If so, multiply that by 50 different contractors on the same project. Imagine the spaghetti code, the lack of documentation, the utter hopelessness of trying to make sense of design by committee.

                And what do you mean by "synchonization" and "timing" issues? The internet is a set of protocols, not some RS232 handshake.

                And those garbled records? Christ on a pogo stick. How can you be complacent about that? World class backends never drop records because their T-SQL based. Transactions either complete, or they don't.

                What kind of Mickey Mouse bullshit is going on?

                Every IT professional in the US should sitting up taking notice. And then demanding action.

                I get it now. It's not the Tea Party. It's the Neo-Confederate Party.

                by DavidHeart on Fri Oct 18, 2013 at 05:56:57 PM PDT

                [ Parent ]

                •  For one thing, they didn't get the initial set of (0+ / 0-)

                  requirements until last Spring.  Due to politics.

                  If you have never had to deal with the fact that one click on the front-end system may depend on multiple back-end systems to have their data in-synch for successfully returning what is required to form the content of a response, then I'm not sure why you are even commenting here.  These systems are bringing together data from all sorts of sources and the front-end likely expects all the data to be available on-demand.  From what I'm reading, multiple requests at a certain level of load seem to be hanging up and sometimes returning a completed requests (e.g., for a registration of a family member), but later attempt to retrieve that record from the credentials originally provided are not returning correct data - or, returning any data at all.  Those are examples of timing and synchronization issues under load, most likely.  This has been a rush job since the beginning, so I'm assuming they are reusing as much as possible to make it work - which likely led to back-end service interface redesigns and a gazillion BDAs scratching their heads in parallel with the UA teams.

                  Some of the end use issues reported sound like problems trying to match identities/profiles with credentials from prior registration attempts.  This could be caused by anything from corrupted database entries to a hard reliance on persistent cookie information and so forth.  So many other things at possible causes - much of them likely related to the fact that people gave up when systems took too long to visually respond and the system is handling so many incomplete flows that it wasn't fully designed to correct for.  This is not something you or I can prescribe an answer for without knowing more of what's actually happening in the system flows.

                  Nothing I've heard implies that the entire thing needs to be thrown out at all: registrations are going through, issues are being worked and I hope that they are seeing a path through the next few months to alleviate most of the Sev 1 and 2 issues in a realistic manner.  I've seen far worse move-to-production issues for large systems and great recovery for most of them (not all).

                  Unlike you, I don't presume to know all of what's going on or at fault - I'm just looking at symptoms and making guesses, based on my history from smaller to immense electronic and web-based transaction systems.

                  "So, please stay where you are. Don't move and don't panic. Don't take off your shoes! Jobs is on the way."

                  by wader on Fri Oct 18, 2013 at 07:57:07 PM PDT

                  [ Parent ]

                  •  Think asynchronous. Get queued. (0+ / 0-)

                    "one click on the front-end system may depend on multiple back-end systems to have their data in-sync"

                    At this time, HealthCare.gov should not aspire to be a real time medical records provider. Right now it's best function is that of serving ACA. That is, to be a facilitator for Insurance Exchange. For now, don't even think of being a medrecs provider.

                    HealthCare.gov system does not have to provide services in real-time to achieve first generation success.

                    I get it now. It's not the Tea Party. It's the Neo-Confederate Party.

                    by DavidHeart on Fri Oct 18, 2013 at 08:56:18 PM PDT

                    [ Parent ]

                    •  It's offering registration with rates based on (0+ / 0-)

                      information both provided by users and queried from the backend.  We aren't aware of the heuristics involved in such calculations - I've seen plenty of cases where existing "fulfillment" systems also hold the pricing routines, for example.

                      That could very well require some real-time flows, depending upon the architecture that they had to hurriedly put in place.  I'm willing to bet that since Spring they didn't have time to do much more than hook up a bunch of legacy systems and hope the front-end could handle the waits, minimizing asynchronous/isochronous calls in their design as best possible and caching whatever they could closer to the front end.  This would imply possible design of new service interfaces for backend systems, service level upgrades for systems not previously requiring realtime access, etc.  At the same time, I'm sure there's much which is being replicated for easier access and use by the front-end system, but would easily bet money it's far more complex than that.

                      No idea if we'll ever find out what the internal architecture looks like, though I'd be interested to take a look.

                      "So, please stay where you are. Don't move and don't panic. Don't take off your shoes! Jobs is on the way."

                      by wader on Fri Oct 18, 2013 at 09:22:03 PM PDT

                      [ Parent ]

    •  Apparently the healthcare.gov site (0+ / 0-)

      was created by a republican-supporting company (at least what I have read).

      So no wonder it is buggy - it was designed that way so the republicans could prove how horrible ACA is.

      I reject your reality and substitute my own - Adam Savage

      by woolibaar on Fri Oct 18, 2013 at 09:22:07 AM PDT

      [ Parent ]

    •  I Sent Programmers Back To Their Desk When (0+ / 0-)

      they would come to me claiming that the computer system change they were assigned required a total rewrite of the entire system in order to make the change.

      It is common for an inexperienced computer professional to claim "a total rewrite is needed".

      What it really means is that the employee is incapable of understanding the system in order to make a change to it and instead wants to rewrite the system so he understands it because he rewrote it.

      Get back to work understanding the systems you are assigned DavidHeart and quit trying to cover your inability to study a system and make appropriate changes.

      "I think that gay marriage is something that should be between a man and a woman.” - Arnold Schwarzenegger 2003

      by kerplunk on Fri Oct 18, 2013 at 12:16:23 PM PDT

      [ Parent ]

  •  i * promise * i'll * be * back ... (1+ / 0-)
    Recommended by:
    FloridaSNMOM

    i'm just not awake enough just yet to give proper attention, and hope the coffee will present me with the proper hum to view and recall the "good old days."

    thank you so much.

    Addington's perpwalk? TRAILHEAD of accountability for Bush-2 Crimes. @Hugh: There is no Article II power which says the Executive can violate the Constitution.

    by greenbird on Fri Oct 18, 2013 at 07:55:43 AM PDT

  •  I happen to know a few young people (5+ / 0-)

    who with dread are procrastinating the whole application process for ACA.  I think this video is a hoot and so I'm sharing this video with hopes they will find it as funny as I did and that they will finally just get to the actual process for themselves.  

    Really, this is quite funny.  That "dude" is going to help sell ACA.  Ya think?  Well, share the video.

    Thanks for sharing this with all of us!

    I would rather spend my life searching for truth than live a single day within the comfort of a lie. ~ John Victor Ramses

    by KayCeSF on Fri Oct 18, 2013 at 08:16:19 AM PDT

    •  makes sense (1+ / 0-)
      Recommended by:
      Catte Nappe

      If it were me that's probably what I'd do -- put it off, like taxes and bill paying and everything else that's boring and confusing -- even without the news reports on bugs. That's why the hysterical call for OMG OMG HOW MANY PEOPLE HAVE SIGNED UP ALREADY WHYWON'TTHEYTELLUSWHYWHYWHY? are kind of annoying. They won't prove anything.

      I know it sounds like I'm in denial but I'm not.

      by Save the clock tower on Fri Oct 18, 2013 at 09:42:42 AM PDT

      [ Parent ]

  •  This is an excellent point! Valid comparisons, (2+ / 0-)
    Recommended by:
    OrangeMike, kerplunk

    rather than hype, irrelevancies, and stone-throwing.

    Ayn sucks. Please know I am not rude. I cannot rec anything from this browser. When I rec or post diaries I am a guest at some exotic locale's computer.

    by Floyd Blue on Fri Oct 18, 2013 at 08:41:59 AM PDT

  •  Now If We Could Only Get Even One Democrat To (0+ / 0-)

    stand on the House or Senate floor and defend the Affordable Care Act as readily as Ted Cruz trashes it with his "Obamacare And Healthcare.gov Is A Disaster Routine".

    They could simply sum it up by saying if you want to sign up for insurance not found on the Obamacare Exchange, here are the questions you should be ready to answer:

    Insert a list an assortment of all 250 questions here:

    1. List all the healthcare providers (doctors, nurses, pa, chiro, specialists, etc., ) you have seen in the last ten years by name and dates.

    2. List every medical procedure and lab test you've had in the last 10 years, describe and date.  List results of every lab test.

    3.  List every disease you have or may have based on discussions with your health providers.
    .
    .
    .
    250.  List every prescription you have ever taken.  Over the counter and well as doctor prescribed.

    ... and emphasize that prior to Obamacare all questions had to be answered without even one tiny mistake because if you make a mistake your insurance company would not pay any of your future insurance claims at all and would cancel your policy.

    And then list the question you need to answer for Obamacare Insurance:

    1.  Do you smoke?

    "I think that gay marriage is something that should be between a man and a woman.” - Arnold Schwarzenegger 2003

    by kerplunk on Fri Oct 18, 2013 at 12:38:43 PM PDT

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