At what point am I allowed to say healthcare.gov is a freaking nightmare

[BlueStreak]

150. If I were doing it

It would have actually been tested if I were doing it. And if I were doing it, it would have been well recognized that 95% or more of the traffic is people wanting to do research, not to actually enter an application. I would have provided a lightweight path for the 95% information-seekers, and because that is read-only with no accounts required and because the database is essentially static (the plans don't change until the next open enrollment period), it can be scaled virtually infinitely. That is how a competent IT professional would have done this. But that didn't happen, so here's what I would do if I were pulled into service as a crisis manager:

1) Let the President know how screwed up it is so he has an opportunity to frame his pitches in a more appropriate way. Encourage the President to acknowledge the problems openly and set national expectations for when a workable system would be available, and clarify that states with their own exchanges are not affected. That's a bit of humble pie, but it is much better to acknowledge the problems and reset expectations than to run around in denial as the majority here are doing.

2) I would immediately put up an entry page that splits off users who have company-provided policies, users who are on Medicare already, users who are on Medicaid already, and users in states with their own exchanges, sending them to their exchanges or to an appropriate information page that explains why they don't need to go into this site at all. I would hook that into IP lookups to further discourage people in state-run exchanges from using this site. That could be done in 8 hours and can be completely disconnected from the main site servers. I'd look at putting that on a highly scalable resource like the Amazon cloud.

3) I would consider ways of structuring the traffic so that people would have a reasonable expectation of when they could access the system, without allowing everyone to do it at the same time. For example, anybody could access from 2AM-7AM eastern time. But during the rest of the day, people 20-35 could have Monday, 36-50, could have Tuesday, 51-64 could have Wednesday and so on.

4) I would stop all entry of applications by the phone bankers. This takes them an hour per client and that is too long. Those people need to be 100% focused on helping people access the online system right now. That is the only way to handle the crush of demand. They could simply advise clients that phone application support will begin October 25 of whatever.

On the IT side, there are undoubtedly many things that could be done, but I would have to see the exact system architecture to determine that. 2 days with their top analysts and we would have a plan that was doable and had a high probability of success. I have done this before multiple times on systems of comparable complexity. It is difficult, but you have to do it.