Could Google have saved healthcare.gov?

posted at 11:31 am on November 2, 2013 by Jazz Shaw

For the sake of argument, let’s leave aside for the moment the many, serious problems with the actual implementation and execution of Obamacare and focus on the widely storied problems with the web site. Could it have worked out flawlessly – or at least with only modest roll-out problems common to any large launch – if it had been designed by someone competent? Clearly there’s only one person to ask, and as per Brian Fung at the wapo, that’s The Donald.

In an interview with the Washington Examiner, Donald Trump lashes out at HealthCare.gov and argues, somewhat trollishly, that a U.S. company such as Google would never have dropped the ball on such a project:

“I would have advised them to go to Google or one of our other great technological companies and get their act straightened out,” Trump told the Washington Examiner. “They should have done that before they did the roll out with a Canadian company with a bad track record.”

Since this is the Washington Post, they have to scoff at the idea immediately, but it’s an interesting question. I’m not saying they’d have done it for free as Trump suggests they might, but given a few years and a reasonable budget, could they have filled the bill? Fung brings up one of Google’s many, many tech initiatives over the years which I’d forgotten about. Back in 2007 they actually launched a product which aimed to do something very similar.

The initiative was called Google Health, and its vision was to produce a centralized database for electronic medical records. Users could log on, add their information — or get their insurer to do it for them — and wind up with one set of documents they could give to doctors and other health professionals. The service was up and running by 2008. But by 2011, Google had decided to shutter the service. Its audience was too limited, the company said in a blog post. The only people who used it were fitness nuts and geeky early adopters.

Why did Google Health fail, and could it have been adapted to serve HealthCare.gov’s purposes?

One big reason is that logistically, Google was hamstrung by some of the same forces that stymied CGI, the government’s lead contractor on HealthCare.gov.

The thing that killed Google Health, at least according to this analysis, was the myriad different interfaces used by individuals, government offices and health care providers of all stripes in fifty different states. Getting a single tool able to securely talk to all of them, collect data through those various tools and deliver it in a way that they could all usefully digest was a monumental task. Of course, they didn’t have a government mandate to do it or to gain cooperation from all the various parties involved, either. I suppose it’s possible that a giant like Google might have mastered the task if enough weight was thrown behind the effort, but we’ll probably never know.

This does, however, highlight one of the overarching problems with a government overhaul of and meddling in something as mind bogglingly huge and complex as the American health care system. The government has not historically been all that efficient at doing “big things.” And the bigger they are, the harder they are to get under control. This is true for experts in any field, to say nothing of the collection of boobs and bozos you find inhabiting DC. When their reach exceeds their grasp, bad things tend to follow. That’s why I’m immediately suspicious when I hear somebody on the Hill talking about a gigantic proposal for “comprehensive” anything.

Perhaps Congress should focus on passing specific, limited laws which focus on one individual situation at a time. That seems to be more in their skill range.


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Trump now. I didn’t think this could get more bizarre. It just did.

kcewa on November 2, 2013 at 11:41 AM

Ehealthinsurance.com has been around since the late 1990′s. They could have just asked them.

Charlemagne on November 2, 2013 at 11:42 AM

And if anyone is interested in supporting and promoting an actual free market in health care, visit Medibid.

Charlemagne on November 2, 2013 at 11:44 AM

Could Google have saved healthcare.gov?

Maybe if they put obama on one of their barges and left him in the middle of the ocean.

Ronnie on November 2, 2013 at 11:44 AM

Just googled “Donald Trump is an idiot”.

965,000 results

fogw on November 2, 2013 at 11:48 AM

Perhaps Congress should focus on passing specific, limited laws which focus on one individual situation at a time.

But then we’d have to pass it to find out what’s in it. Isn’t it much better to find out after enactment what some liberal, think-tank geek, navel-gazing about the problem in academia or a Soros non-profit for the past 20 years, has told a Democratic staffer to shove into a bill in the middle of the night? What’s the fun of legislating in the daylight under the public glare?

BuckeyeSam on November 2, 2013 at 11:51 AM

…Phuck Google!

KOOLAID2 on November 2, 2013 at 11:52 AM

as mind bogglingly huge and complex as the American health care system.

Mind bogglingly huge and complex is a good description of the federal bureaucracy, also.

(Mind bogglingly huge and complex + Mind bogglingly huge and complex) * Socialism = Disaster

kcewa on November 2, 2013 at 11:52 AM

This displays an ignorance of the FARs. You can’t just give the government something for free like this.

And I know people who work for Google and other big name tech companies. I’m also a federal contractor.
My friends would quit on day 1 if they had to be a government contractor or work for the Feds.

They innovate. They don’t sit in meetings for months to determine a configuration management policy.
Look up the Integrated Defense AT&L Management System chart and 1. marvel that anything ever gets bought and all and 2. ask yourself how many google types want to work with crap like that. And that’s just DOD, I’m sure HHS has their own chart of crap.

Spade on November 2, 2013 at 11:54 AM

Could it have worked out flawlessly

I believe it has worked out Flawlessly.

Bmore on November 2, 2013 at 11:55 AM

Perhaps people need to examine their asinine desire to find a hero to save them from themselves. Nothing in the universe can save us from a gigantic government except ourselves.

NotCoach on November 2, 2013 at 11:59 AM

And I know people who work for Google and other big name tech companies. I’m also a federal contractor.
My friends would quit on day 1 if they had to be a government contractor or work for the Feds.

The first thing they would do is reject the 10,535 pages of Obamacare regulations and ask for a project that was feasible.

kcewa on November 2, 2013 at 12:01 PM

A Google rollout would’ve been about as effective as spray painting a cat turd.

Regardless of how ComradeCare looks, it’s still a cat turd.

OhEssYouCowboys on November 2, 2013 at 12:02 PM

Google would have used the site to mine for information then turned it over to any government agency (and democrat campaign) that requested it.

agmartin on November 2, 2013 at 12:03 PM

Could Google have saved healthcare.gov?

Maybe if they put obama on one of their barges and left him in the middle of the ocean.

Ronnie on November 2, 2013 at 11:44 AM

There are now 3 Google barges…One for Preezy 404…One for the pederast Reid…and one for the idiot from CA Pelosi.

workingclass artist on November 2, 2013 at 12:07 PM

Spade on November 2, 2013 at 11:54 AM

But every one of them blindly votes Democrat.

Charlemagne on November 2, 2013 at 12:09 PM

If I remember, when Sam Palmisano was CEO of IBM he offered to build the system for $1, but of course, the government would not accept his offer.

daveinthevillage on November 2, 2013 at 12:16 PM

Good to see the crystal ball being used in action against the Democrats. Usually it’s just used by the statist GOP to tell me things like we could have won NV without Angle or DE with Castle. It’s an absolute certainty. Just because. That’s why.

besser tot als rot on November 2, 2013 at 12:17 PM

Spade on November 2, 2013 at 11:54 AM

But every one of them blindly votes Democrat.

Charlemagne on November 2, 2013 at 12:09 PM

I’ve worked for several tech companies in Seattle. Very few people in tech bother with voting.

The owners of the companies do give dollars to democrats, though. Because they fear the bad publicity they’ll get if they support the Republican stand on social issues.

kcewa on November 2, 2013 at 12:23 PM

I can attest personally to the fact that government databases often don’t play well with each other, even when they’re run by the same agency. I frequently reminded my co-workers about the problems arising from the realities of the Fed that we face on a daily basis, especially whenever they raved about how well Obamacare was going to “take care of the people.”

That said, telling them “It told you so” to them doesn’t feel very satisfying anymore.

NorthernCross on November 2, 2013 at 12:25 PM

So did Google Health fold because of lack of interest or different interfaces? Does the NSA harvest info from different interfaces? Just how efficient is this spying?

Cindy Munford on November 2, 2013 at 12:26 PM

NorthernCross on November 2, 2013 at 12:25 PM

It would only be “fun” if someone else was paying, unfortunately it’s us. It’s always us.

Cindy Munford on November 2, 2013 at 12:27 PM

Wasn’t the no-bid contract for this mess given to Valerie Jarret’s child and their spouse? If only a journalist would follow the money…IMO…that’s a bigger scandal than the website.

fortcoins on November 2, 2013 at 12:38 PM

Sounds like the plot for the interns 2!

jhffmn on November 2, 2013 at 1:04 PM

Considering how many issues ive had with my chromecast….

jhffmn on November 2, 2013 at 1:06 PM

So did Google Health fold because of lack of interest or different interfaces? Does the NSA harvest info from different interfaces? Just how efficient is this spying?

Cindy Munford on November 2, 2013 at 12:26 PM

I was thinking about the same questions.

I think the Obamacare website could be successful and reasonably priced, but for government procurement rules, administrative incompetence, and time constraints created by Obama’s re-election campaign need to avoid any decisions be made before the election. A comparison website for consumers would be most useful. (Whether it is something a federal government should do is a different question.) The problem is Obamacare itself and not the website.

thuja on November 2, 2013 at 1:13 PM

It would only be “fun” if someone else was paying, unfortunately it’s us. It’s always us.

Cindy Munford on November 2, 2013 at 12:27 PM

In fact, someone else *is* paying. I happen to work for one of few federal agencies not paid for by tax revenues. But my point about federal gov’t dysfunction stands.

NorthernCross on November 2, 2013 at 1:16 PM

Could Google have saved healthcare.gov?

…nope!….they have to pay Mooches friend…and JugEars bundler…why at this point…worry about it now!

KOOLAID2 on November 2, 2013 at 1:21 PM

With evil google involved, I expect that if you confided in your doctor about a health problem, you’d be inundated with phone calls and junk mail to help to address the problem the next day.

God help you if you ever run on a Republican ticket anywhere, because the DNC would have total access to your files.

slickwillie2001 on November 2, 2013 at 1:24 PM

Hell, with all of the spying Google does on everyone, they probably could have submitted applications for 3/4 of the country without asking a single question.

RoadRunner on November 2, 2013 at 1:29 PM

If the question is, is it possible to get “the myriad different interfaces used by individuals, government offices and health care providers of all stripes in fifty different states. Getting a single tool able to securely talk to all of them, collect data through those various tools and deliver it in a way that they could all usefully digest was a monumental task” working? The answer is yes. Not easy, but not uncommon on very large projects either.

To strip it down to the most basic level, you:
(1) Perform data analysis on each interface
(2) Generate an XML file for each system interface
(3) Map all XML files to a common XML schema

At that point it is basic ETL (extract-transform-load).

The core technical buzzwords involved in doing this involve:
(a) an Enterprise Service Bus (ESB)
(b) using a Service Oriented Architecture (SOA) design pattern
(c) using XML (eXtensible Markup Language) to manage the data mapping

For performance, scalability, and reliability you would use many servers in parallel with load balancers to coordinate the traffic. Database technology would involve real application clusters and in memory database functionality.

Finally, you would duplicate the functionality regionally in probably four separate data centers with failover capability between centers in case of fire, earthquake, etc.

So can a competent technology crew handle something like this? Yeah no sweat — at the architectural level. What could not be handled is all the changes in requirements related to the processing of the data, and the impacts of the requirements changes on the application code, the UI, and the impact on performance. No tech crew could handle that, not even using a Agile approach (like Scrum).

Sorry for all the buzzwords. Feel free to google them all and use wikipedia (for the nonpolitical technical stuff wikipedia is pretty accurate to give a high level overview).

SunSword on November 2, 2013 at 1:35 PM

If the healthcare.gov website actually worked the disaster would be even bigger, as many more would discover how unaffordable ObamaCare really is. Higher premiums, and much higher deductibles. Some as high as $12,000 or more.

A bigger problem is the website security and privacy. The site is attempting to simultaneously access data from healthcare.gov, the IRS, SSA, HHS (Medicaid).

Whether that data can be kept private is a real problem. We have already witnessed partisan activists are rampant within the the IRS, and likely throughout the various agencies. We have only seen the tip of the iceberg on these issues. Under this corrupt administration these will only get worse.

Dasher on November 2, 2013 at 1:36 PM

If Google is called in I am sure they will plant a back door so they can mine data so much easier on everyone.

Dasher on November 2, 2013 at 1:40 PM

The thing that killed Google Health, at least according to this analysis, was the myriad different interfaces used by individuals, government offices and health care providers of all stripes in fifty different states.

Be careful what you wish for. More centralization and data mining equals less freedom.

bofh on November 2, 2013 at 1:54 PM

If the healthcare.gov website actually worked the disaster would be even bigger, as many more would discover how unaffordable ObamaCare really is. Higher premiums, and much higher deductibles. Some as high as $12,000 or more.

A bigger problem is the website security and privacy. The site is attempting to simultaneously access data from healthcare.gov, the IRS, SSA, HHS (Medicaid).

Whether that data can be kept private is a real problem. We have already witnessed partisan activists are rampant within the the IRS, and likely throughout the various agencies. We have only seen the tip of the iceberg on these issues. Under this corrupt administration these will only get worse.

Dasher on November 2, 2013 at 1:36 PM

Yep. I’m shocked that otherwise intelligent people, having seen the depth of the political corruption in the IRS, think that it just can’t happen in DHS, or the NSA. Such naivete will kill us all.

slickwillie2001 on November 2, 2013 at 2:05 PM

What could not be handled is all the changes in requirements
SunSword on November 2, 2013 at 1:35 PM

What could not be handled is the need to change the requirements. The requirements are law, and buried in 10,000+ pages of federal regulations. Assuming you could define them you couldn’t change them to make the project feasible. And that’s just the healthcare law itself.

kcewa on November 2, 2013 at 2:14 PM

Obama says to an old lady “NO, you’re not eligible for a hip replacement but you’ll be covered for birth control”.

Schadenfreude on November 2, 2013 at 2:15 PM

I’m shocked that otherwise intelligent people, having seen the depth of the political corruption in the IRS, think that it just can’t happen in DHS, or the NSA. Such naivete will kill us all.

slickwillie2001 on November 2, 2013 at 2:05 PM

People have been lied to about the political corruption in the IRS. They’ve been told by the people they voted for and the press that their was no political targeting.

And the president and the press have demonized the Tea Party and conservative Republicans to the point that no one cares about them being targeted. Similar to what was done to the Jews in Nazi Germany.

kcewa on November 2, 2013 at 2:24 PM

Since ‘The Donald’ has a background in real estate, let’s look at the ACA from the aspect of it being a building.

This is a building that was designed by a far left committee – and rushed through construction by companies that built sections of the building largely in a vacuum from other companies that were building sections. The plans for those sections were being drawn up not only as the sections were being constructed, but in many cases after the sections were nearly three quarters complete.

Everyone was told that a proper foundation was dug and prepared for the building – but all of these assertions and promises were little more than lies. The foundation was only semi-cleared before the building was built upon it. Now we are finding that the sections do not fit together, that there are even more lies in the assertions of the design and construction of the building.

When the building opened, looking up all 150 floors, we saw that the floors, walls, doors, elevators, stairways, and windows didn’t line up. The building leaned and shook in even the slightest breeze. No one wants to get in it because it looks like it will collapse on them any minute.

When faced with that, you don’t ‘fix’ it. It cannot be ‘fixed’.

You sack those responsible, tear the thing down, and build a proper building for the right reasons following best practice methodologies.

Athos on November 2, 2013 at 2:29 PM

So did Google Health fold because of lack of interest or different interfaces? Does the NSA harvest info from different interfaces? Just how efficient is this spying?

Cindy Munford on November 2, 2013 at 12:26 PM

Google Health failed due to the bureaucracy and difficulty in interfacing with dozens of federal and state government systems. Having done some IT work on state projects, I can imagine the impossibility of those herculean tasks.

No, I don’t think Google could do it… because they already tried and failed. Could they have done it with the full force of federal law behind them? Doubtful. Government workers don’t move for anyone… not even a contractor with the force of their employer behind them… because they KNOW they cannot be fired and thus see no sense of urgency or empowerment.

dominigan on November 2, 2013 at 2:51 PM

“The thing that killed Google Health, at least according to this analysis, was the myriad different interfaces used by individuals, government offices and health care providers of all stripes in fifty different states.”

What we need is an Obama Executive Order commanding all of these disparate computer systems to work together so that Obamacare doesn’t see the same fate.

That should be a walk in the park compared to making “… the rise of the oceans began to slow, and our planet began to heal.”

I mean if you got the power flaunt it, right.

Nomas on November 2, 2013 at 6:37 PM

It does not matter if Google could have made the website work. All that would have accomplished is for more people who ended up with their premiums jacked up, their deductibles raised, and their choice of care providers limited. The problem is not the signup process, it is what people are being forced to sign up for.

Exit question: The whole justification for Obamacare was to provide access to health care for the about 15% of the population that was not covered by private or public programs. Just how many of these people could have have insurance bought for them with the money that was wasted on the website?

bartbeast on November 2, 2013 at 7:06 PM

Exit question: The whole justification for Obamacare was to provide access to health care for the about 15% of the population that was not covered by private or public programs.
[...]

bartbeast on November 2, 2013 at 7:06 PM

Hint: it’s got nothing to do with “care” and even less to do with “health”. Worth a read: “ObamaCare: Illegal Voter Mine for the Democratic Party?

bofh on November 2, 2013 at 9:14 PM

Any competent tech company could have saved it. The issue here is not who could or could not save it. The issue is that creative control was in the hands of idiots. It doesn’t matter who the engineers are when that is going on. You can have literally the best engineers possible and your project will still fail if you keep changing direction every two seconds or contradicting yourself endlessly.

A successful project requires a lengthy planning phase where you map out everything you want the program/website to do in detail. This can easily take half the development time for really complicated projects.

Then you ruthlessly follow that plan to completion.

That is pretty much how every BIG project happens in software. You do that or you fail.

Karmashock on November 3, 2013 at 5:37 AM