Over the years -- in this publication and elsewhere -- I've reviewed software, hardware, movies, music and even an Oscar telecast. Today I'm reviewing a process. Namely, the process involved with signing up for health care under the ACA, the Affordable Care Act.
As someone who works as an independent writer and consultant, I'm one of the millions of Americans who must get their own health insurance. The experience has been nothing short of nightmarish for me, and I've been paying ridiculously high premiums on top of that. Again, like millions of others, I've been eagerly looking forward to putting an end to the nightmare once and for all, while saving some serious bucks.
Being the Tech Daddy, I am familiar with high-profile rollouts on the web. Anyone who has tried to download the latest operating system from Apple or Microsoft on the day it's released knows what I'm talking about. I had anticipated there would be problems, and chose to wait a couple of weeks for the dust to settle before diving in. No one likes getting dust up their nose!
And there have been problems. A lot of them. A couple of recent USA Today articles outline just how flawed the system is. The most shocking revelation is that, out of about 10 million people who have tried to enroll since the system went live on October 1, only 36,000 have managed to successfully complete an enrollment application. That's less than 1 percent!
The articles lay the blame on a massive system using 10-year-old tech that was already out of date on Day One, plus its reliance on interfacing with other government websites that "don't play nice" together. While I can understand those arguments, my personal experience while signing up tells me something different. The real culprit? Bad design from a totally out-of-touch website team that apparently never bought anything on the web.
Since I live in California, my experience was with the Covered California site; I never had to do anything involving the main HealthCare pages. I'm sure, however, that other states are facing similar problems. As a Macintosh user, Safari 6.0.5 is my browser of choice, but the Covered CA site didn't work well with it. I switched to Firefox 24 for Mac, which is what I used for the remainder of my application. That didn't surprise me, as other government sites seem to work better with Firefox on the Mac side.
One nice thing about Covered CA: The graphic elements are nicely done, with big, easy-to-read icons and a simple page layout. I appreciated that, as my eyesight isn't always what I'd like it to be. A nice touch is that, once you start an application, it'll remember where you are in the process so that if something goes wrong, or you have to sign out, you can pick up where you left off.
The downside of that is it's almost impossible to change something if you make a mistake. And you will make a mistake! My first of two phone calls to the Covered CA call center in Rancho Cordova involved just that: Where is the "START OVER" button? Turns out you have to go all the way back to the very beginning and look for a very small link on the right-hand side that says "withdraw application." Trust me: If you don't know it's there, you'll never find it. And that's common on the site: Some things that are big should be smaller, and some tiny things need to be a lot bigger.
"Bob," the guy I spoke with, was polite and professional but had to check with an "expert" in the office to see if withdrawing my application meant I'd possibly be locked out of the system for a week or two. Thankfully that was not the case. I said, "You may want to change this and put a big START OVER button on every page." Bob liked that idea.
Have you ever used a website that has small "question mark" icons or help buttons that give you more info or advice while trying to fill out a form? There are none to be found on the Covered CA site, and they are sorely needed. Many of the things you are asked to provide are cringe-worthy. Here's one: "Have you had a medical incident in the last 3 months?" Huh? Does that mean I went to the doctor's office for something simple, or the hospital for something major? There was no definition of what a "medical incident" means. For fields involving phone numbers, there were no nearby guidelines as to what format to use while entering them. These kinds of disconnects are on almost every page.
Confusing is one thing; glitches are something else. And, just as the USA Today article mentioned, the glitches on the site were legion. One example: I got asked for my address about a dozen times, even though I already provided it on the very first page. Worse, the site kept trying to change my address, suggesting a "better version" that was totally wrong. FedEx and UPS and the Post Office have no problem with auto-verifying an address, so why can't this site do it? Head-scratchingly weird.
Another glitch came when I listed myself as the primary contact, yet later on the site decided my wife was now the primary contact. "Bob," the guy in Rancho Cordova, could not figure that one out at all. That's never a good sign.
That auto-save feature was ultimately a good thing, as the site logged me out suddenly for no reason at all. Three times!
I was heartened to see there was an online chat feature to help with questions during the process. I initially tried using it, figuring it would be better than calling and being put on eternal hold. I was wrong. I clicked on LIVE CHAT and was informed that I was No. 15 in the chat "queue," and waited patiently for 35 minutes while watching the number count down to 1. Finally it was my turn, but instead of talking with someone, I got this message: "chat system down; please try again later, or click the email button to send us an email." When I clicked the email button, I then got a "no such page exists" error. Did no one actually vet this site before it went live? If a for-profit enterprise had such a laughably inept site, they would go out of business quickly.
After calling the first time (after being on hold for only a few minutes), I got back on the road and was able to complete my application. I triumphantly clicked the SUBMIT APPLICATION button, and got this: "ERROR! /hix/enrollment/showesignature Status: 200 ... please call the support team." If Douglas Adams -- the gleefully twisted creator of Hitchhiker's Guide to the Galaxy and the classic text-based game "Bureaucracy" -- were alive today, he would very much appreciate this aneurism-inducing ending!
In all it took about 90 minutes and two phone calls, but I prevailed. If the insurance company accepts my application as submitted, my reward for almost two hours of torture will be a better policy than what I have now, at one-tenth the cost. I'd say that was worth whatever I had to go through... including getting some dust up my nose.