Healthcare: You Need It To Live


I know: it’s an uninspired illustration, but what it says in the picture.

I find the controversy around Healthcare.Gov to be infinitely boring, stupid and uninteresting. A matter of supreme unimportance. As important as a new suggestion algorithm on Amazon or a tweak in the google PageRank system, yes — and also just as boring. It is one of those things which are really important in shaping our lives, but which it is obvious to absolutely everyone will — eventually — become fixed. And then the important thing happens, which is that the US, as the last industrialised nation, gets universal healthcare. Which, you know, is kind of amazing and a lot more important than a server rollout failure.

And the idea that anyone would be queuing up to fight against the idea of universal healthcare, using these tiny server outages as some kind of bullshit excuse to undermine a project that will end untold human miseries? Yeah, they’re sort of idiots. And if there is a tiny part of you listening even a little to the arguments from “website design fail = stop healthcare reform now!”, squash that part of you down into the dirt. It’s not your friend. The servers don’t matter. If it happens now or next year or the year after that, it doesn’t matter. As long as it comes it is amazing. And a huge improvement in the life and health of the US.

But there is one person who has written one interesting piece of writing about Healthcare.Gov, and I think you should read it. It’s Clay Shirky, and he’s written a great blog post generating a number of interesting and transferable lessons from the zeppeliner-down-in-flames-failure of Healthcare.Gov (for now, until it gets fixed and becomes unimportant because it works, at which point millions of people will not have to not got to the doctor and risking death from toothaches and pneumonia). is a half-billion dollar site that was unable to complete even a thousand enrollments a day at launch, and for weeks afterwards. As we now know, programmers, stakeholders, and testers all expressed reservations about’s ability to do what it was supposed to do. Yet no one who understood the problems was able to tell the President. Worse, every senior political figure—every one—who could have bridged the gap between knowledgeable employees and the President decided not to.

And so it was that, even on launch day, the President was allowed to make things worse for himself and his signature program by bragging about the already-failing site and inviting people to log in and use something that mostly wouldn’t work. Whatever happens to government procurement or hiring (and we should all hope those things get better) a culture that prefers deluding the boss over delivering bad news isn’t well equipped to try new things.

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