"Glitches" are least of Obamacare's worries

Ezra Klein has posted to his "Wonkbook" a piece entitled Obamacare's Website is really bad. Klein writes:

[A] few screens after that, the site crashed on me entirely. ... [And yet, t]he fact that the site is buckling under the traffic is not a reason to defund or delay the law. Indeed, it's perverse to use the overwhelming demand as a reason to take the law away from the people who so clearly need it. And even if it takes a few more days or even weeks until the site is working as well as it should be, the open enrollment period still has another five months and 27 days (or so) to run. These are fixable, not fatal, problems.

The fact that Klein thinks the technical problems with the Obamacare web site can be remedied in "a few more days or weeks" (heck, just spin up a few more servers to handle the excess traffic) is an indication that he has no understanding whatsoever of enterprise software development. (BTW, Ezra, just exactly how do you define the SLA "working as well as it should be?")

Even worse, my intuition tells me that the "glitches" (new favorite Democrat buzzword) encountered so far in the website will be the least of Obamacare's worries. What I really worry about is the "business model" the system is based on. How well has this business model been defined? Is it really a model for producing a net benefit for the American people? We are being asked to believe not only that the meaning of the 2000-plus pages of the Affordable Care Act is perspicuous and void of any ambiguity, but also that all these pages have been translated without misinterpretation into specific software business rules that will improve the health care and reduce the health costs of all Americans.

Klein seems to fail to understand the basic fact that, when customers click on buttons in the Obamacare portal, backend business processes will be set in motion. It is one thing for software to capture data in a form, send that data over a wire, and store that data as a transaction in a database. It is quite another thing for the backend business processes to operate in such a way that all the transactions taken together aggregate and add up to a net benefit.

Contrast Obamacare with Amazon, for example. Every quarter, Amazon files financial statements with the SEC. All the various transactions initiated through Amazon's website are rolled up into an income statement, and Amazon's financial status is summarized in a balance sheet. These financial statements are created in accordance with strict accounting rules defined by FASB and under the supervision of an independent accounting firm. Thus, at the end of every quarter, we have a reasonably good idea of whether Amazon made a profit in the preceding quarter and whether its financial health is good. In other words, we know whether Amazon's business processes for that quarter have resulted in a net benefit for Amazon's stockholders.

How will the net benefit (if any) from Obamacare be measured? What accounting methodology is going to be applied to all the transactions under Obamacare to determine if the benefits of the system outweigh the costs and if the system is having a positive impact on America's balance sheet? Will government accounting (contradiction in terms) be employed? Will we encounter the same kind of accounting shenanigans and obfuscations that we grew so accustomed to at Fannie Mae and Freddie Mac? Will the benefits be simply what Mr Obama and other Democratic politicians assert they are (just as Barney Frank asserted to the bitter end that Fannie Mae was solvent)? Or will there be any hard and impartial measurement, any metrics? Furthermore, if there are metrics and these metrics show that the system is operating "at a loss," will the Democrats have the political courage and integrity to acknowledge the system's shortcomings and fix them? Or will a malfunctioning health care system become simply another example of a government program run amok, rolling up huge costs, further inflating American debt, but preserved for the benefit of various politicians and special interest groups?

Given the "glitches" we have seen in the rollout of the various exchanges, I am not confident that the underlying business processes have been given anywhere near the amount of thought that they should have been given. My experience as a software engineer tells me that it's fairly easy to create a UI for a web app that gives the illusion that something beneficial is happening in the backend. Yes, the system can display a message that says: "Congratulations! You have successfully enrolled in Obamacare!" But, what should really concern us is whether all the various clicks and user actions, once the exceptions and error messages begin to die down, will prove to add up to a real, objectively measurable net benefit for the American people.