Obama's New HealthCare.gov: A Look at What's Inside
BY Nancy Scola | Thursday, July 1 2010
The day President Obama signed the Patient Protection and Affordable Care Act into law, the clock started ticking on 90 days for federal health officials to build out a way for the American public to get online access to critical information on the health insurance plans available to them, and the other health care options open to them under the new law. Those 90 days were up today. Presenting the brand-new HealthCare.gov, launched early this morning.
We'll take a quick look at what's inside the new site, but first, a word about context. The health care overhaul bill, was, of course, a landmark moment in the Obama presidency thus far. The opportunity that HealthCare.gov hands the Obama Administration is a chance to first, of course, help the American people, but also to implement, iterate, and sell a new way of doing health care in 21st century America, one informed by the principles of user interface design, information presentation, and a savvy negotiation of the Internet that was once thought to be a defining characteristic of the Obama way of doing things.
HealthCare.gov could, done right, improve the quality of life for millions of Americans. HealthCare.gov could make navigating the complexities of modern American life a little more manageable, a little less frightening. HealthCare.gov could, by empowering him or her with clear and transparent information, shift the balance of power a little bit away from the insurance industry and back towards the American citizen. But HealthCare.gov might also have electoral aftereffects, as a constant, living reminder of how the Obama brand politics is making things better for real people.
Enough with that. Let's look at what's inside.
The Department of Health and Human Services, charged with building out HealthCare.gov, under the direction of Chief Technology Officer Todd Parks, describes the site as "the first website to collect both public and private health insurance options across the nation in a single place." They go on. "Even better, our insurance options finder automatically sorts through this huge catalog of options to help you identify the ones that may be right for you." Elsewhere, HHS makes the case that "Healthcare.gov lets you take health care into your own hands." The corner stone of the site is the found under the "Find Insurance Options" tab. The entry screen is, by design, drop-dead simple.
Next, the HealthCare.gov user is asked for a few key piece of information; a healthy individual from New York, for example, is asked for her age, medical conditions, ability to afford insurance, and whether she's losing insurance or simply searching for a new plan.
From there, a user is presented with his or her best options:
A truly important bit, of course, is information on the private insurance plans available to him or her. Some of HealthCare.gov's more important work is taking place behind the scenes. Under the health care bill, HHS had until about a month ago to "develop a standardized format to be used for the presentation of information relating to...coverage options." In other words, the federal government has been building out a format for insurance choices that makes apples-to-apples comparisons possible.
A sample option delivered to our example New Yorker-based user of HealthCare.gov:
There's a good chance that your eye was drawn to the yellow box on the right end there, and there's good reason for that. A key piece of information is, at this point, missing. HealthCare.gov is slated to have pricing information on each plan option by October of this fall, but it's not there yet. Those prices will be estimates, so people will still need to check with the insurance offerer to nail down a final cost. Those involved with the site are well aware that it is beta, a first-draft, to-be-improved. That that end, the important parts of the site feature built-in feedback widget that make it trivial for Americans to let the government know where HealthCare.gov isn't living up to its potential.
And there are holes. A senior from New Jersey, for example, finds that his or her third of three options for coverage is simply a "Final Note" that directs them to contact their state department of insurance to see if there might be other relevant programs or protections, but there's no phone number, website, or other way of getting in touch with New Jersey's state insurance experts. Even more problematic is that plans with the very same name but different enrollment codes are offered up as separate options -- with no help on figuring out what's unique about each choice.
There's more to HealthCare.gov than the insurance plan finder. The site also includes updates on the implementation of the health care act and what comes next, resources on healthy living customized for individual circumstances, and details on how changes triggered by the act might impact your particular health care situation.
Ultimately, figuring out whether HealthCare.gov is a useful tool or window dressing requires people running their personal circumstances through its processes, and seeing if they do end up knowing more about their own health care options than they otherwise would. Which raises the question: if you build it, how do you get them to come? How does the White House and broader Obama Administration drive the American public towards making use of the new HealthCare.gov? Can the White House buy Google ads on health-care related trigger words? I've put the question to the White House, and have not yet heard anything back.
That said, HealthCare.gov's best chance at visibility and success is in simply proving itself useful to people as they navigate the health care landscape. The first Google result for "nursing home" is, for example, a link to the government-run Nursing Home Compare site, used by many make informed nursing home choices for themselves and the people they care about.
One thing to keep in mind is that a successful HealthCare.gov would be something that a President Obama leaves to history, or at least the next presidency -- a persistent structural change to the landscape of American life. Last summer, I interviewed Swarthmore psychologist Barry Schwartz, author of the book The Paradox of Choice about the intersection of user interface and government, in the context of a world overflowing with data, numbers, knowledge. He said at the time, "The challenge we have now is to shape how we navigate that information in meaningful ways." He went on. “The people who truly figure that out...are going to be the ones to run the world." My kicker, at the time, was "Perhaps they already are." Are they? Stay tuned.
More: The Department of Health and Human Services offers this video introduction to the new HealthCare.gov:
Update: Calling the site "slick" and "easy-to-use," Ezra Klein points out that much of the health reform bill doesn't kick in until 2014, giving plenty of time for folks to work out some of the more complicated bits. Though, I will stay, the purpose of HealthCare.gov isn't, under the law, just to help people make sense of the coming exchanges, but the current insurance landscape, too.