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What Healthcare.gov can learn from the Challenger shuttle disaster

Wes Fisher, MD
Policy
November 18, 2013
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By now, the Obamacare insurance exchange debacle is old news. Our attention spans are so short, we’re on to the next disaster.  So we sit before our TVs and enjoy the Humana ads with a smiling senior pointing to a whiteboards with their insurance plan name, or watch the news sponsored by UnitedHealthcare or Walmart’s pharmacy department. Everyone’s got a cheaper plan these days with more benefits than the other guy, and the good news never ends for you, according to our insurance companies.

Sign up people. No worries.

Even if they take you to the cleaners.

It was interesting reading the piece over at Kaiser Health News asking why a couple without kids has to buy dental insurance for children they don’t have.

Or the free colonoscopy “catch” never discussed in the Obamacare ads that promoted by the law’s proponents. More and more of these not-so-little details are not  as pretty and “free” as everyone had hoped, but it’s what we as a nation have approved, hidden in the new law we never read.

Shame on us.

Shame on our legislators.

But we must take a different perspective now that it’s becoming crystal clear what central control of health care delivery means.  I think most Americans have been incredibly tolerant of the rollout (and even appreciate the effort involved) since they have a rudimentary understanding of how complicated health care has become in America and how vital it is to our economy.

But I sense (like many others) that Americans’ patience is growing thin.  People are wondering how will things be fixed?  How long will it take?  Will I have to pay a penalty for something so fraught with problems?  Who’s responsible?  Whom can I call?  Can they be trusted?  Is this going to be how the rest of the health care coverage rollout happens?

Years ago, millions of people watched the US space shuttle Challenger explode into a million tiny pieces on a crystal clear day shortly after its launch.  We were shocked at first, then deeply saddened, for our idealized notion of the space program so advanced and amazing quickly evaporated before our eyes.  We grieved with the crew’s families as we watched in horror the events replayed on TV again and again and again.

But then what happened?  Investigations followed.  Video tapes were reviewed.  A root cause analysis was undertaken.  Ideas were tested, the O-ring problem identified, and slowly, carefully, changes were made to the shuttle program.  New parts were engineered, other parts scraped.  More thorough testing than ever before occurred.  Then re-testing.  And slowly, cautiously, the shuttle program resumed, one baby step at a time.

And no one ever took a complicated shuttle launch for granted again.

So, too, should it be with our new health care law.

We should remember these lessons we learned from the Challenger disaster.  The Healthcare.gov rollout debacle was no less anticipated and certainly no less spectacular.  We need a root cause analysis of this mess.  We need to identify the problems and fix them if they can be fixed or scrap what can’t.  We should stop and ask ourselves what of this law should continue, and what should be scraped.  We should ask the difficult questions and if it truly is in our best interest to proceed with certain parts, test and retest that which remains to make sure the systems are secure and the program functional.

And most of all, we should ask now if this whole grand health care idea is likely to be truly cost effective and sustainable for our nation before rushing ahead toward another disaster.

Because, like the Challenger, it’s people’s lives we’re talking about here, not some stupid website catastrophe.

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Wes Fisher is a cardiologist who blogs at Dr. Wes.

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What Healthcare.gov can learn from the Challenger shuttle disaster
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