Health IT

Silicon Valley to Washington: Healthcare.gov should have started small

NPR got Silicon Valley’s take on Healthcare.gov, and asked what those tech entrepreneurs would have done differently with the federal healthcare insurance exchanges. Their answer? Start small. “It’s not as if Facebook says, ‘OK, here is our six-year plan for how we’re going to make Facebook.com,’ ” entrepreneur Ben Balter said. “They build one feature […]

NPR got Silicon Valley’s take on Healthcare.gov, and asked what those tech entrepreneurs would have done differently with the federal healthcare insurance exchanges. Their answer? Start small.

“It’s not as if Facebook says, ‘OK, here is our six-year plan for how we’re going to make Facebook.com,’ ” entrepreneur Ben Balter said. “They build one feature at a time, and take a step back, look at how the feature is be used, before they go on to the next feature.”

He went on to add the code should have been shared, so people could critique it and find the bugs before the launch.

But, in part due to the government’s propensity to “clamp up” and public frenzy (both in fear and fanaticism), this sort of sharing wasn’t feasible.

It’s a culture that is risk-adverse and terrified of public failure. You can’t learn from little failures or adjust course midstream. And instead of taking big jobs, breaking them down into small tasks and testing for success at each step, a project like HealthCare.gov becomes a giant all-or-nothing gamble.

(Michael) Cockrill says too often it’s a gamble taxpayers loose.

“You’ve made all these commitments about what you are going to build. What is it going to look like upfront,” Cockrill says. “And even if the market changes underneath you, and even if your customers need something different — which you know always happens — you made a commitment a big public commitment, and they’ve written it into budgets and law.”