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Keep It Simple, Stupid !!

Three guys from San Francisco have built it. Pulled 100% of the logic out of and simplified the processing

Everything their site doesn't do, the insurance companies are going to do anyway. This includes verifying ID and income data for their contracts.

There was no profit motive. No scams. No contractors. No Wednesday night poker games with Federal Division salesmen.

Nothing but three good guys and their computers: Ning Liang, George Kalogeropoulos and Michael Wasser.

Query logic and filters pulled from the government's web site. Calculations for subsidies pulled from But by doing only the basic mission, this one works.

I said in the first week of the recent bloodletting that this is a 120-day problem. Anything more than 120 days building sets up failure.

Put HealthSherpa on a Sun 10K or any big "cloud" box or a typical Hadoop layout and you can handle 250,000 distinct customers an hour at a minimum. You come out of HealthSherpa in the insurance company systems -- where you belong -- with all the information they need to complete the contracting process.

Insurance companies will usually finish the process at call centers. Telephone is the best choice.

Keep It Simple, Stupid !!

Details on the who-what-where-how under the orange muffin.


Ning Liang, George Kalogeropoulos and Michael Wasser dug out the processing queries and filters from the site. Converted the logic to state machine algorithms. Put it all table-driven instead of the stupid-contractor mess of re-querying every damn item every time and trying to do conditional this-and-that.

And they got it up and running all by themselves.

A 120-day problem. A month to get the interfaces defined, main flow logic implemented, a start on subsidies. A month to prototype, plus converting flow points to state machine logic, plus unit testing. A month to smooth it all out. A month more, so's the local Captain Kirk don't get too damn spoiled.

These guys had the processing elements for HealthSherpa coded already. That's the guts of Their big problem was redefining the flow/"experience" so you get to what you're eligible for right off.

The complications of the ID work are put off to the actual contracting steps where it belongs. Insurance companies are going to redo that for themselves no matter what.

Obama's people are doing the data access work with PowerCenter and a data warehouse.

Our San Fran guys do periodic pulls for new data and make it tabular. Then pin it. Same difference, within a fraction of a second, considering how much memory an apps server gives you these days. (The DW builds fact tables, honestly a negligible advantage.)

Yeah, the boys pull what they need down into memory.


Absent profit, you can get first rate results by relying on personal integrity. "The quality of a product reflects the integrity of the production process" -- from W. Edwards Deming.

The more you know about Deming, the better. A genius.

Anyway, the evidence-based debate on using ObamaCare should be over. Fact is, Liang, Kalogeropoulos and Wasser knocked this problem out of the park.

But corporate media ain'ta gonna give up that easy. The Kochs are paying them not to give up. And the usual GOP creeps will be whining about October 2013 till October 2033.


From our Latter Day Confederate Gray brethren:

-- "Perhaps we're all missing The Goal of Barack Obama... that we must agree to the statement that we have no reasonable expectation of privacy... To the point, that is to cause such a disruption to the economic system because of Identity Theft that our govt will require that all persons must accept a mark on their persons so as to verify the unique identity of each person." [Tattoos from Hell, or concentration camp numbers ?????]

-- "Their solution is a single-user application that would never scale to the degree that HealthCare.Gov needs to." [Of course it does. Insurance company systems complete contracting and report everything back to the DHHS same as]

-- "The site requires JavaScript, a known security hole: Two thumbs down!" [Yeah, if you browse porn sites.]

-- "Obama is an idiot. He wasted 6 million paying a firm to do this" [and that code did 98% of the work to get HealthSherpa up and turning.]

-- "Obama: You didn't build it!
Private Sector: Yeah, we fixed it."

[Charity: No, we fixed it.]

-- "The NSA can intercept 7 billion communications globally on a daily basis from us peons to foreign leaders, sort, data mine and process that data, but our govt can't get this working. Priceless."

-- And many-many-many whines about subsidies. Which the insurance companies will calculate for you, no sweat. That's only a problem in the alternate-fantasy-whoop-dee-do world of GOPer hoaxes.

And sane observations:

-- "This, ladies and gentlemen, is how you build a website that works..."

-- From the team: "That's the great thing about having such a small team. You sit around a table and say, 'Okay, how does this work?' There's no coordination meetings, there's no planning sessions. It's like, 'Well, let's read the document and let's implement this.'"

-- "While the GOP conducts ANOTHER of their witch hunts asking political aimed asinine questions ... some folks are trying to help ... Does the GOP know what cooperation means?????????"

-- Care to comment on their subsidy calculator? How many websites might that program hit? I understand the concept of streamlining with out hitting the servers part of your rationale and I do actually see the value of their approach, as simple is better in this case, but the perfect system has not yet been designed where average users can obtain the information they seek, maybe they can work on it again tonight. .... [Which is why it's all pulled down at once and put to tables in memory. And the final subsidy amount has to come from the insurance company. First rate question from a non-database person.]

-- "This is for all the morons who think private business can do everything better!!! ... the banks that went bust in 2008 weren't government run business, neither was Enron or Hostess."

[Charity + government = a KISS web site that works.]

Gotta love this. Cool as Occupy the first month of so.

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Comment Preferences

  •  wow - that was simple & FAST! (5+ / 0-)

    Faux News ruined my state

    by sc kitty on Sun Nov 10, 2013 at 03:52:43 PM PST

  •  There's a certain beauty to it (4+ / 0-)

    Now why did we sink 600 million to build the same site? It's almost like our procurement system is broken...

  •  Thank you for sharing (3+ / 0-)

    works great.  The administration should hire these guys.

    Power to the Peaceful!

    by misterwade on Sun Nov 10, 2013 at 04:15:19 PM PST

  •  Not really fair (2+ / 0-)
    Recommended by:
    waterstreet2013, Addison

    to compare this website and the government's. This is an informational site; that's a transactional site that needs to confirm identity and income across multiple departments while also protecting the same information.

    Having said that, I think the basic point is a good one: Simpler is better, more efficient. Just look at google or craigslist.

    •  Yes, this is perfectly fair. (5+ / 0-)

      This web site does exactly what the government web site should have done, first time around. This is what you get with no mission creep.

      Insurance companies are perfectly capable of doing identity validation. They've been doing it for more than a century.

      The income validation function should have been located at a back end, after the preliminary contracting stage. If it takes a whole hour at that point, No Problemo !! There was no pay-off from putting it in the front end online system.

      Putting income validation at the front was stupid. Mindless. Not in keeping with normal financial system procedures -- e.g. at loan processing.

      Sabotage ??? I didn't say that.

  •  Nice and simple but wrong. (4+ / 0-)

    It doesn't seem to recognize states that are not expanding Medicaid. Or something.

    This is what Kaiser says about my info -- no subsidy:

    Household income in 2014:
        64% of poverty level
    Maximum % of income you have to pay for the non-tobacco premium, if eligible for a subsidy:
    Health Insurance premium in 2014 (for a silver plan, before tax credit):
        $8,290 per year
    You could receive a government tax credit subsidy of up to:
        $0 per year
        (which covers 0% of the overall premium)
    Amount you pay for the premium:
        $8,290 per year
        (which equals 55.27% of your household income and covers 100% of the overall premium)

    This is the first page of what HealthSherpa says based on the same info -- subsidy available:

    BlueSelect Everyday Health 1443


    Premium: $1,281.59

    Subsidy: $1,281.59
    Florida Blue (BlueCross BlueShield FL)

    BlueSelect Everyday Health Plus 1443P


    Premium: $1,321.32

    Subsidy: $1,296.32
    Florida Blue (BlueCross BlueShield FL)

    BlueCare Everyday Health 1477


    Premium: $1,384.21

    Subsidy: $1,296.32
    Florida Blue HMO (a BlueCross BlueShield FL company)

    BlueSelect Essential 1439


    Premium: $1,387.59

    Subsidy: $1,296.32
    Florida Blue (BlueCross BlueShield FL)


    •  Say what ??? (1+ / 0-)
      Recommended by:

      The system recognizes this:

      Household income in 2014:
          64% of poverty level
      But you say there's no subsidy ??? No Medicaid info?

      Well, O.K. Then you/family may qualify for Medicaid with current rules. Not an expansion, current rules.

      -- Depends on assets for you personally.

      -- For children in your family, no asset test. At 64% they are automatic.

      -- Pregnant ? Same thing at 64%.

      -- And what's an asset ??? That can get tricky.

      Obviously this web site is not set up to do Medicaid. It's for the new insurance options.

      That's likely a good resource for you. The Medicaid offices are listed at the very bottom of that web page. They're not lightning fast, but they do know how to help you.

      •  Not the point (1+ / 0-)
        Recommended by:
        high uintas

        I know what we qualify for -- we don't -- but the two calculators came up with different answers.

        •  I don't believe it if you have children. (0+ / 0-)

          That's not the Federal law. You may have gotten bad advice. There's a lot of that out there.

          Here's how to check that out: go through the application process with an insurance company. Use telephone. The bottom line for subsidies is that there was a bug in the system, earlier, that kicked people out where they "should" have qualified for Medicaid.

          The insurance companies got this fixed. As with many things, Florida has been misgoverned to the point where the State of Florida has unique failings.

          The safest way to do this is to go in through the insurance telephone systems after you find a policy that matches you basic circumstances.

          Bugs are noted in special instructions to agents ast the call centers. That's kinda low tech. It works.

          •  Read what I wrote, please. (0+ / 0-)

   and your site give two different answers for the same information.

            KFF, correctly, comes back with the answer that my family is in the Medicaid gap.

            Your site tells me I am eligible for subsidies and lists a bunch of BC/BS plans.

            Your site is the one with the bugs.

            •  You do understand the instructions (0+ / 0-)

              to go to the insurance company site and go through the application process.

              That is where everything converges with the most recent information presented same day.

              Go to the BCBS site and test the offerings.

      •  So which of the three programmers are you? (2+ / 0-)
        Recommended by:
        high uintas, Nance
  •  Actually Helath sherpa was down (4+ / 0-)

    right after it was publicized on the CBS evening news.  Guess it got overwhelmed.

    Also the general information they provide about the plans has been easily accessible at the site for a while now, without even logging in.  

    Unfortunately neither site is accurate. since they give an average cost for everyone 49 or younger which is not very helpful when you are 47 and will clearly be paying more than a 23 year old.  But at least I can see which plans cost more than others.

    One helpful piece of info was the contact info for each company.  Since I do not get any subsidy I guess I will give up on going through

    •  The objective is to get you to those companies. (0+ / 0-)

      The insurance companies provide exact prices, exact subsidy calculations, and assist with ID and income validation.

      But that is not why you go here, anyway.

      You go to the insurance companies.

      Clicking through to the insurance companies after you see good policies for yourself -- that is the proper mission for a front-end site.

      Worried about whether you're 49 or 47 or a smoker ??? Go to the insurance companies. You knew that was good going online the first time. Do things the easy way.

      •  I spent hours with and Aetna today (1+ / 0-)
        Recommended by:
        Armor and Sword

        Unfortunately, this is not true. A supervisor at (HCG) told me today that all you have to do is pick out a plan (, then get the phone number for the insurance company offering that plan in your state, call them, tell them you want the insurance, give them your signup info, and pay over the phone. I wanted an Aetna catastrophic plan for Florida. When I called the number HCG gave me for the portion of Aetna HCG said was offering this plan (855-586-6960), this is what an Aetna supervisor told me:

        1. You have to fill out an application on
        2. After you pick out the plan you want in the Marketplace (which you cannot access until you fill out the application & the website accepts & approves it & the website allows you to get to the marketplace, which we could not achieve in multiple attempts with several different reps), the staff at must "upload" your application to the company offering the plan you want (in my case, Aetna in Florida).
        3. Once the insurance company has your application, they send you a bill via snail mail (US Mail).
        4. You pay the bill (hopefully you can do it online), and at the point they acknowledge receipt of your payment, you are officially insured.

        The big problem is that, unfortunately, there is no way to get around going through and the buggy site that is constantly crashing (at least three times in the past two days, and I was told it would be crashed until Tuesday p.m.). I dearly wish these alternate routes would work, but they do not.

        BTW, I was on the phone today learning all this bad news for four solid hours.

        •  P.S. on Prices (1+ / 0-)
          Recommended by:
          Armor and Sword

          I forgot: the price thing is the most incredibly frustrating of all. I begged, pleaded and almost wept trying to get something other than an "estimated" cost for the plan I wanted from Aetna. The supervisor flatly refused. She insisted over and over that only personnel could give me that answer. Here's the problem: the Aetna website says the plan I want would be $835 for me and my husband, and says it would be $398--and since we do not qualify for subsidies (which only happen if you have an income to get tax rebates from), it's not because of some sort of government subsidy, so it's a pre-subsidy rate. That is an enormous difference between these two quoted rates. I told Aetna that as a consumer I could not possibly be expected to be deprived of the actual price of the plan I had chosen until I got their bill, but the person I talked to was utterly unconcerned: "I'm sorry you don't like what I'm telling you, but that's just the way it is," she said in a cold, hard voice.

  •  KISS (2+ / 0-)
    Recommended by:
    waterstreet2013, Maverick80229

    When I was a computer science student over 40 years ago, one of my professors there, Dr. George Gorsline, brought up the KISS rule whenever it was appropriate.

    Over my long IT career, I haven't forgotten it, and I see reminders every time I come across a web site that over-uses Javascript or uses a template that looks fine with IE but hideous with Firefox.

    The simple fact is, the more complicated a piece of software is, the more bugs it's going to have. is just one more site that was over-designed.

    The developers of haven't gone out and bought new BMW's yet, but they are well justified in gloating over their achievement.

  •  Their info wasn't even close to the actual.. (3+ / 0-)

    exchange prices for me (a smoker) in Indiana.

    "Detective, if ignorance was a drug, you'd be high all the time." Sam Tyler, 'Life on Mars'

    by Kokomo for Obama on Sun Nov 10, 2013 at 04:54:09 PM PST

    •  Could you quote examples ? (0+ / 0-)

      The first priority was getting states that do not have exchanges.

      Since you have an Indiana exchange, of course, you don't have a real need for

      Report the page addresses and the info and I'll see what the bugs are. Assuming you're accurate with the description.

      •  Indiana is on the federal exchange (1+ / 0-)
        Recommended by:

        I can't compare it with the numbers from (Called in four times simply to get registered, still waiting on the packet to arrive in the mail two weeks later.)

        But, if Healthsherpa is right, this is very good for me.  33, non-smoker, Delaware County-IN, and I'm looking at a number of bronze plans where the subsidy leaves me with $0.00 for a monthly premium.

        I've had to self-insure for a while (adjunct instructor) and the rates that I see on Health Sherpa are broadly comparable with what I was quoted before, except the coverage is actually much better. It's the subsidies which are going to make a huge difference for me.  

        by ManfromMiddletown on Sun Nov 10, 2013 at 07:29:38 PM PST

        [ Parent ]

      •  The news clips have Indiana relatively expensive (0+ / 0-)

        compared to other states.

        But of course the 2013 policies would reflect that already. So I guess it's all comparative.

        Pence and Zoeller are santorum-spewing holes. Anything to sabotage HeritageCare / RomneyCare / ObamaCare.

      •  Here's an example of Zoeller's sicko mind: (1+ / 0-)
        Recommended by:

        Zoeller is proudly unsympathetic to the tens of millions he would block from PPACA health coverage:

        “The fact that many citizens lack health insurance is an issue for policymakers, and my office takes no position regarding the congressional debate over funding the ACA. I never complain when private plaintiffs file lawsuits to challenge the state authority that my office defends; but now our role is reversed and Indiana has initiated this lawsuit asking the court whether the IRS has exceeded its federal taxing authority over state governments. This respectful challenge is an appropriate role for the Office of the Attorney General to vigorously assert the ability of the State and its political subdivisions to manage their workforces in our American system of federalism.”
        Da Hole filed a law suit on behalf of Indiana trying to block cooperation between PPACA implementation and IRS.
  •  It worked for me in California (2+ / 0-)
    Recommended by:
    waterstreet2013, Maverick80229

    I got the same results as, the official website.

    These guys are on to something.

    Daily Kos an oasis of truth. Truth that leads to action.

    by Shockwave on Sun Nov 10, 2013 at 05:17:31 PM PST

  •  Yes, I had to pretend I'm from Delaware (1+ / 0-)
    Recommended by:

    Since they don't have the Maryland exchange modeled.

    But it was fast and the interface is astonishingly clean given the crap we see on the web nowadays.

    Thump! Bang. Whack-boing. It's dub!

    by dadadata on Sun Nov 10, 2013 at 05:53:26 PM PST

  •  Deming. One "m." (1+ / 0-)
    Recommended by:

    Who would be lynched today because he understood hat quality problems are management failures, not employee failures.

    Thump! Bang. Whack-boing. It's dub!

    by dadadata on Sun Nov 10, 2013 at 05:57:45 PM PST

  •  Really does nothing.... (1+ / 0-)
    Recommended by:
    Everything their site doesn't do, the insurance companies are going to do anyway. This includes verifying ID and income data for their contracts.
    That's great, except computing the subsidy (income data) and I.D. are exactly what is clogging up

    Not clear how plans bought like this will qualify as "enrolled in through an exchange established by the state".....

    See following exerpt from I.R.C. Sec. 36B which creates the subsidy:

    (2)  Premium assistance amount  
    The premium assistance amount determined under this subsection with respect to any coverage month is the amount equal to the lesser of—

     (A) the monthly premiums for such month for 1 or more qualified health plans offered in the individual market within a State which cover the taxpayer, the taxpayer’s spouse, or any dependent (as defined in section 152) of the taxpayer and which were enrolled in through an Exchange established by the State under 1311  [1]  of the Patient Protection and Affordable Care Act, or  

     (B) the excess (if any) of—  
     (i) the adjusted monthly premium for such month for the applicable second lowest cost silver plan with respect to the taxpayer, over  

     (ii) an amount equal to 1/12 of the product of the applicable percentage and the taxpayer’s household income for the taxable year.

    •  Insurance companies take care of federal paperwork (0+ / 0-)

      That's why you want to do the ID and income verification through the insurance company, anyway.

      Arguably..... there's no reason for the complicated federal website. Mission Creep is it's most important feature.

      Insurance companies have trade organizations and lawyers and consultants who have evaluated the subsidy law.

      Implementation is also available to the insurance companies with off-the-shelf software that runs with the standard ERP processing packages.

      No problem ! And posting a section of the legalese ??? That's simply useless.

  •  I am betting its a scam! (1+ / 0-)
    Recommended by:
    high uintas
  •  simpler solution (1+ / 0-)
    Recommended by:

    There is a simpler solution:  

    Tell everyone to buy their insurance on the existing website.  For the subsidy, add a line on the 1040 tax form that calculates the amount of the tax credit.  done.

    All of the existing insurance plans on the government website can be purchased elsewhere at the identical price.  Why is the government website even needed?

  •  Varying price quotes & accessing the marketplace (3+ / 0-)

    I am a big supporter of ACA, an avid progressive, & I have 3 main issues with getting health insurance through the ACA marketplace health-insurance exchange (HE) that people might want to be aware of, and try and work around very carefully:
    (1) I am from Florida and have priced the policy I want--the only one my husband (dh) & I can afford--for catastrophic-coverage, which is what we both have right now. My dh & I are both over 50 which, along with smoking, seems to be all you are now asked on an HE application (app). Currently dh pays $865/mo to United Health Care & I pay $165/mo to Aetna. I have gotten 3 different figures for what it will cost us for a comparable plan on HE for us as a couple (which is cheaper than doing it separately) for the Aetna Basic PPO Catastrophic plan offered in zip 34747 Florida. The quote page at (HCG) says $398. Aetna website says $835. The website you list,, says $784. Huge variation & obviously, I hope HCG has the correct figure. (Note: HCG says that, individually, it would be $265 each for that plan, which is a big savings for dh, and a $100/mo increase for me--a common occurrence, the healthy and the young will see their rates go up; but if you have a sick family member, you will be helped a lot.)
    (2) I set up an account at HCG in Sept, and I started an app 12:01 AM Oct 1. I got as far in the app as proving my identity & it said I needed to upload a PDF of an identity doc, then refused the upload.  When I went back to try again next day, it said, in red, "application in process," & I could not access the app to try again to upload the identity doc. Day after that, I could not log on at all. Nov 8 we did an account & app for dh & got through to an acceptance letter stating the app was approved, go to HE. Clicked back to page where should have been a hyperlink to HE but, instead, it said, in red, "application in process," which I now see as a bug/error message. I sought help, starting with my current health ins agent from AAA, who said AAA is having nothing to do with ACA. I called a certified navigator from a list generated by HCG. She said navigators are in the same position as consumers--they can not do an end run around the faulty HCG website to access HE. She said to call the 800-318-2596 number & get them to put me through to the HE. Called & rep got as far as the approval letter, but HCG would not let her go straight to HE. She said some of the time it will, but I was not lucky & it forced her to go through the app, page by page, completely unnecessarily since it was already approved. Before she could get to the end of the app, she said HCG crashed. I asked her to verify if it was the whole website crashing or just my defective app. She verified it was the whole site. She said this happens a lot, and there is no way of knowing when it will be back up again or if it will crash again while the next rep is helping me the next time I try & call. She said the next rep would have to start from the beginning & there is no way to know yet if anyone will be able to help me if my app has a bug in it that will make it impossible to get to the HE using the app--& no way at all to go to HE w/o an app.
    (3) Some have said that a paper app avoids all these problems. Sadly, not true: (a) People who call 800 no & request a paper app report it takes weeks--to never--for them to arrive & individuals may make mistakes filling them out, which will result in further delays as that person will have to be called back by HCG reps. (b) If you fill out a paper app with a navigator, there is a better chance it will be filled out properly, but still the interminable delay of snail mail & reps having to scan the info into HCG. (c) Once anyone's app is completed & approved by HCG, there is still the issue of getting out on the HE and picking out a plan. I highly recommend knowing exactly what you want before you even go on the HE, to get things moving faster before the next crash of HCG while you are in the midst of purchasing a plan. (d) I'd love to know how you pay for a plan, if it is done instantly on choosing one would be ideal, because the only true, legal proof of owning a policy is a written proof of payment. (e) It takes insurance companies weeks, not days, to process health ins apps. Having worked many years for insurance-defense attorneys, I foresee a huge legal thicket upcoming. If consumers do not think to save screen prints of any proofs they have that they were approved for insurance and, ideally, paid for it, they will have a great problem getting insurance coverage if they don't get through this app process within the next week or so. It can take ins co's 4-6 weeks, under ideal circumstances, to process an app. Until they do, if you have to go to the hospital early in 2014, they will tell the hospital you are uninsured when it calls to verify your ins coverage. Which means when you try to collect later to pay your hospital bill, ins co's will have every motivation to try and get out of paying for people in that position who have little or no documentation. I'm keeping incessant documentation myself. It's the best legal protection you can get against malevolent ins co's who will inevitably take advantage of the proof-of-insurance disarray to screw as many people out of payment as possible.

    •  Thanks for your first comment, KateDM. (0+ / 0-)

      I'm sorry you're going through all this. I can't imagine how someone less savvy and well informed than you could get even as far as you have.

      Welcome from the DK Partners & Mentors Team. If you have any questions about how to participate here, you can learn more at the Knowledge Base or from the New Diarists Resources Diaries. Diaries labeled "Open Thread" are also great places to ask. We look forward to your contributions.

      Shop Kos Katalogue ❧ Help Okiciyap at Cheyenne River reservation.

      by belinda ridgewood on Tue Nov 12, 2013 at 12:39:25 AM PST

      [ Parent ]

    •  Interesting diction. (0+ / 0-)

      For example:

      -- use of initials HE, dh, app (not the phone "app" type of app), HCG, AAA
      -- "the faulty HCG website" after the new data warehouse was implemented ???
      -- ""application in process," which I now see as a bug/error message" where the sending page is where the User should remain until the system gets back
      -- "Some have said that a paper app avoids all these problems. Sadly, not true" -- but how would this person know that ???

      Really ? Problems from October 1st - 15th are reported as current.

      Also, Aetna's $685.17 for two 55 year olds who smoke off the web site. That's what changes -- Sherpa misses that smoker adjustment.

      How's about stopping smoking ??? Use hypnosis and the patch.

      Since the person reports paying $1,030 a month now for catastrophic coverage, saving a mere $344.83 a month ain't worth putting in 4 hours schlepping her way through Online Hell ???

      $4,137.96 a year, dear. Saving if you stop smoking.

      Plus the &^$%^& price of cigarettes. What, another $20 a week ????? $40 a week ??? $2,000 a year.

      Wanna save $6,000 a year ??? K.I.S.S.

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