Obamacare’s Virtual Fantasy Couldn’t Handle Messy Reality
Bloomberg View , October 23, 2013
The HealthCare.gov website is a disaster -- symbolic to Obamacare opponents, disheartening to supporters, and incredibly frustrating to people who just need to buy insurance. Some computer experts are saying the only way to save the system is to scrap the current bloated code and start over.
Looking back, it seems crazy that neither the Barack Obama administration nor the public was prepared for the startup difficulties. There’s no shortage of database experts willing to opine on the complexities of the problem. Plenty of companies have nightmarish stories to tell about much simpler software projects. And reporting by the New York Times finds that the people involved with the system knew months ago that it was in serious trouble. “We foresee a train wreck,” one said back in February.
So why didn’t the administration realize that integrating a bunch of incompatible government databases into a seamless system with an interface just about anyone could understand was a really, really hard problem? Why was even the president seemingly taken by surprise when the system didn’t work like it might in the movies?
We have become seduced by computer glamour.
Whether it’s a television detective instantly checking a database of fingerprints or the ease of Amazon.com’s “1-Click” button, we imagine that software is a kind of magic -- all the more so if it’s software we’ve never actually experienced. We expect it to be effortless. We don’t think about how it got there or what its limitations might be. Instead of imagining future technologies as works in progress, improving over time, we picture them as perfect from day one.
The most successful companies encourage that illusion. “We feel our job is to try to solve tough, difficult problems,” Jony Ive, head of design for Apple Inc., said in a recent interview, “but we don’t make the complexity of the problem apparent in its resolution.” His company regularly describes its products as “magic,” and the illusion of ease is essential to their glamour. They promise a world in which, contrary to the frustrations of everyday experience, computers “just work.”
Freed from real-world technical constraints, Hollywood amplifies that promise. “The police on the CBS show ’Hawaii Five-O’ have these amazing computer databases at their disposal where images, maps and photographs can be digitally thrown from a digital table onto a giant wall screen with the flick of the officer’s hand into space,” says Tom Simon, a special agent with the Federal Bureau of Investigation in Honolulu. In real life, “we work in a Microsoft Windows environment with all its benefits and limitations.”
Glamorous Hollywood visions make us forget that effortlessly informative, endlessly flexible databases represent the world as we wish it were -- or fear it might be -- not as it actually is. “TV computer hackers, especially those employed by the police, can instantly tap into any video feed, satellite imagery, internal database, or record ever created by man, even though the record exists only on paper and has never been digitized,” retired police officer Tim Dees wrote on a Quora thread about ludicrous crime-show conventions.
Audiences know such portrayals are fiction, but unless viewers are themselves professionals, they can’t be sure where the boundary between reality and imagination lies. The result is an alluringly unrealistic view of both what’s possible and what efforts even the possible might require.
In the case of the health-care exchanges, advocates emphasized how simple they’d be. “Getting insurance through the marketplace is as easy as applying for a plan, finding out if you qualify for subsidies and then comparing competing health plans,” declared ObamacareFacts.com. It was a seductive idea.
But, like other forms of glamour, it hid the tradeoffs and difficulties involved. Such artificial grace is what makes glamour so dangerous and so persuasive. By concealing anything that might break the spell, it leads us to feel that the life we dream of exists, and to desire it even more: “To provide affordable, quality health care for all Americans and reduce the growth in health care spending.” That sounds wonderful. As Captain Picard of “Star Trek: The Next Generation” would say, “Make it so.” But turning hopes into reality requires more than a command.
The health care law, the White House argues, “isn’t just a website.” True enough. But the software problems are representative of a larger rhetorical choice. Rather than argue that the new health-care law would require adjustments and sacrifices, and that the costs would be worth it to give more people health insurance, the president and other supporters assured the public that if they liked their insurance, they could keep it. There might be costs for industry, this rhetoric suggested, but individuals would be better off. It was a glamorous vision of reform, with the trade-offs -- in higher costs and less choice for some people, and the hardships of implementation -- concealed.
Glamour is a powerfully persuasive tool. Taken as a guide rather than the literal truth, it can lead to positive, sometimes life-changing, action. But it is also an illusion. In the real world, the hidden details matter.