“But I just want to remind everybody, we did not wage this long and contentious battle just around a website.”
– Barack Obama, “Remarks by the President on the Affordable Care Act,” Oct. 21, 2013
The disastrous launch of HealthCare.gov gives an opportunity for everyone invested in digital media and learning initiatives to reflect critically about what we do and to ask some hard questions. Although it may be “just” a website, according to the president, the flawed federal Internet portal intended to enroll millions of consumers into a system of affordable healthcare coverage exposes a number of troubling aspects about how technological innovation, corporate influence, the credibility of online sources, civic participation, privacy, and the well-being of individuals interact.
As someone who has written a book about the design of government websites and has actually given awards in the past for particularly notable .gov failures, I am now frequently asked what I think of the HealthCare.gov debacle and how we can understand it as a learning opportunity.
There has been a lot of great reporting on this story from The New York Times and The Washington Post about government mismanagement and corporate lobbying, but tech blogs have also done impressive journalistic work to unpack the impact of specific technical glitches and prognosticate about potential fixes. Unfortunately the public relations materials from government agencies have been much less informative in repeating the administration’s desire to avoid nonspecific “issues” of various sorts.
My contention is that there are lessons to be learned far beyond the White House and that we need to get beyond a narrative of party politics to understand why traditional institutions have difficulty managing distributed networked technologies and why Silicon Valley’s self-interested moralizing may add heat rather than light to the narrative.
A Failure Story
Obviously, this is a kind of cultural narrative that plays a big role in the storytelling done about technology. Spectacular tech snafus are beloved chestnuts in geek culture; whether the lore concerns the Microsoft Zune flop or the doomed Atari E.T. videogame, those that make “smart” decisions can take pleasure in the failure of others. Of course, in a world of iterative design and rapid prototyping, the “f-word” of failure should be an important area of inquiry, and dot.com competition that pushes an ideology of survival of the fittest inevitably requires a gory body count of the vanquished in the background of any success.
In the case of a U.S. Chief Executive surrounded by tech gurus, many also see this story as a tale of hubris worthy of a tragic hero unaware of his own fatal flaw. For a Commander in Chief who had promised to deliver a high-tech government that was more “user-friendly” three times in the same speech, such a catastrophic failure in a supposed area of strength is particularly humiliating. It is excruciating to re-watch the demo video of HealthCare.gov, in which Obama tools around the site navigation on his Mac and promises “to put Americans in control.” It is painful to read the early optimistic blog posts from the White House, which are peppered with positive reviews written in anticipation of a successful launch, with the knowledge that screencasts full of error messages or embarrassing logs from the online chat sessions soon became YouTube memes. Internet culture loves a #fail, and the Obama administration has given them one.
The atmosphere of ridicule wasn’t helped when White House updates focused on the statistics of mere site visits rather than the evidence of successful enrollment, which only intensified suspicions about a lack of transparency, and officials urged Americans to redirect queries to call centers. From the perspective of serious consequences of failure, actuarial statisticians argued that a malfunctioning website could skew enrollment away from younger web-savvy people who tended to be healthier and toward older and sicker participants more likely to prefer traditional telephony.
A Mismatch of Cultures
Others have focused on a narrative about the supposed clash of cultures between bloated and inflexible Washington bureaucracy and the creative class of digerati that was supposedly excluded from decision-making. Government officials at the Office of Information Services for the Center for Medicaid & Medicare Services were depicted as clueless about software engineering, and the bidding system for government contractors was poorly suited for finding efficiencies in web development. As one Reuters story pointed out, “hitting ‘apply’ on HealthCare.gov causes 92 separate files, plug-ins and other mammoth swarms of data to stream between the user’s computer and the servers powering the government website,” the kind of mistake covered in elementary programming classes. The damning McKinsey Report boiled the fiasco down to a grim PowerPoint presentation, which showed that the normal design/build/test stages weren’t sufficiently articulated to optimize prototyping and iteration and that what should have been an initial phase of determining policy and requirements expanded to dominate the entire process.
The mismatch is made more complicated by the fact that to be a modern technology user is inherently unpresidential rhetorically, as I argue in this article that contrasts Obama’s multitasking plugged-in persona from the campaign trail with his more staid performance of traditional authenticity and attention that he adopted after assuming his role in the Oval Office.
Certainly the mismatch of cultures is much more complex than the vision of government inefficiency, ineptitude, and secrecy presented in Eric Schmidt and Jared Cohen’s The New Digital Age, because there are problems on the tech side as well. These two Google executives assure their readers that connectivity will solve all the problems of modernity and that digital technologies will erase the need for intermediaries and for publicly owned infrastructure, but I am not so certain. When government provides the backbone of so many public goods, and the consumer electronics industry creates so many invented needs, the holier-than-thou pose of tech evangelists might seem disingenuous. My colleague Siva Vaidhyanathan argues that we should be wary of “the Googlization of government” that relies on narratives about “public failure” that push insidious forms of privatization. He would likely say that the failure of HealthCare.gov shouldn’t lead us to the wrong moral about government obsolescence.
Should the Social Contract Be Like Online Shopping?
For some reason technology has been depicted as the ally of direct democracy but the foe of representative government. There are many hard political problems that computation could address, such as electronic voting and algorithmic redistricting, but these are too unpalatable for our winner-take-all system of governance, even if all the security vulnerabilities could be addressed. So the temptation is to try to use digital technologies to make politics more “user-friendly” rather than a realm of hard choices and irreconcilable conflict.
The experience of online shopping for health insurance was supposed to be analogous to the way “you’d shop for a plane ticket on Kayak or a TV on Amazon,” according to the President in a speech made on October 1st. He was repeating the same assertion about comparing prices that he had made a few days earlier, where he also praised Kayak and Amazon as efficient service providers that epitomized the ideals of private sector efficiency.
Obviously no one is praising the tech companies involved with the HealthCare.gov site. The new general contractor, Quality Software Services Inc., was purchased by UnitedHealthcare group, and may be tainted by potential conflicts of interest. The old company in charge, CGI Federal, chose to depend on a NoSQL approach to unstructured data propounded by a company called MarkLogic, which differed radically from the database design widely in use by stalwarts such as “IBM, Microsoft, and Oracle.” Despite its high-profile problems, the company’s stock price has continued to rise, and it doesn’t seem likely to lose face in future government bidding.
Making Sense of Hacktivism
The revelation that right-wing activists have participated in attempts to bring down the site by launching distributed denial of service attacks makes the story even more complicated as a narrative about civic engagement and individual rights, even if the tools of electronic civil disobedience that they are using aren’t particularly sophisticated or likely to be effective. Figuring out the relationship between new forms of activism that enrich civic culture and those that undermine it can be complicated, as I argue in this article about “hacktivism.”
Certainly, hackers pointing out the site’s vulnerabilities could be seen as performing important civic duties and should not be seen as anti-government agents working in bad faith. For example, Ben Simo’s blog has become a treasure trove of examples of the site’s bad navigation and potential security flaws, which has helped government watchdogs ask the right questions of government contractors.
A New Sovereignty
The idea of “the care of the self” theorized by the philosopher Michel Foucault has taken on a new life thanks to the critical efforts of new media theorist Wendy Chun. As we interact with blackboxed computational devices that share data much more promiscuously with each other than we might imagine, Chun argues, we need to understand our own imagined situation of freedom and control differently. Consequently new configurations of individuals and collectives may transform our politics in ways that don’t match the rhetoric of either party politics or of entrepreneurial Silicon Valley.
It is easy to throw stones at HealthCare.gov without thinking about our own glass houses. Those who build websites that attempt to speak to the public good and to represent knowledge accrued in traditional institutions should see this story as more than a cautionary tale and ask questions about how we see our own service to users, consumers, and citizens who send messages across shared networks.
Banner image credit: DenisGiles http://www.flickr.com/photos/denisgiles/4273241062/