Barack Obama held a press conference in the White House press garden on Monday, October 21, to address major technical issues that have plagued the Affordable Care Act’s (ACA) website, www.healthcare.gov/. The president’s detractors have used this rash of recurrent computer glitches as evidence that the ACA is doomed to crash. Critics have even suggested that these technological challenges are his “Hurricane Katrina.” In reply, Obama has pointed to the fact that many people have accessed the federal healthcare website since October 1st in order to register for health insurance. The sheer number of people enrolling in plans has led to significant delays in enrollment and subsequent login; it seems being logged off the website in the middle of applying for coverage has been a common experience. Obama asked for patience from the American people and was determined to resource hardware experts to increase server capacity and software engineers to resolve programmatic issues. As he emphasized, “Nobody is madder than me about the fact that the website isn’t working as well as it should, which means it’s going to get fixed.” The last price tag to rectify the website through what Obama called a “tech surge” approached $400 million.
Realistically, websites do not always rollout smoothly. New businesses, especially entrepreneurial ventures, seek to publish their website as quickly as possible in order to generate income and create interest, or “buzz” as Douglas W. Hubbard calls it in his book Pulse: The New Science of Harnessing Internet Buzz to Track Threats and Opportunities. Unfortunately, in their efforts to establish their online presence, that is “go live,” some companies fail to resolve issues with their websites and these websites’ communications with their respective servers. Only after end users have engaged a website, at times maximizing its capacity for traffic, are software glitches and hardware challenges discovered. PC users who use Microsoft products know this experience well from their encounters with Windows 8, the Internet Explorer platform, 404 errors, or regular patch maintenance.
This way of launching websites does not excuse commercial enterprises from blame, it only explains the reality. In an ambitious effort to deploy the ACA website, comprehensive testing seems to have been non-existent or rather limited. The Washington Post indicates that the government knew perfectly well what they were releasing would be flawed. Compounding the problem, when it comes to the ACA website, is that we are talking not about an optional service that people have to engage, but one that is required by law. There is an urgency then in enrollment and, thus, the demand for a website easy to access, understand, and navigate free of any bugs. If a citizen is uninsured after March 31, 2014, tax penalties can accrue and would be applied when 2013 income tax returns are filed. A person may qualify for an exemption to the ACA’s mandate to purchase qualifying health insurance, but otherwise a financial penalty may apply.
As is well known, the United States Conference of Catholic Bishops (USCCB) offered a substantial critique of the ACA concerning conscience rights and religious freedom. However, given that the ACA was enacted as law (the recent government shutdown notwithstanding), without the full support of the USCCB, the Roman Catholic Church can still, and undoubtedly will, continue to challenge some of the demands the ACA is making of Roman Catholic healthcare institutions. At the same time, drawing from its wisdom of social teaching, the Roman Catholic Church can proffer a critique on some of the aforementioned technological problems associated with this recently launched, clunky ACA website.
There are two immediate concerns that emerge about the ACA website that need consideration in light of Roman Catholic Social Teaching:
1. Access. We who regularly engage the computer and enjoy the easy availability of our technology devices can overlook too easily that there are people in the United States, not to mention the global community, who are digitally handicapped. That is, either they do not have regular access to a computer or they are not keen on how to use the computer. It is not that they are Luddites, but rather that their fiscal budgets do not allow for a computer purchase or even a smart phone. While it may be hard to believe, there are some Americans who merely have a landline.
As of May 2013, 15% of American adults ages 18 and older do not use the internet or email. Asked why they do not use the internet:
– 34% of non-internet users think the internet is just not relevant to them, saying they are not interested, do not want to use it, or have no need for it.
– 32% of non-internet users cite reasons tied to their sense that the internet is not very easy to use. These non-users say it is difficult or frustrating to go online, they are physically unable, or they are worried about other issues such as spam, spyware, and hackers. This figure is considerably higher than in earlier surveys.
– 19% of non-internet users cite the expense of owning a computer or paying for an internet connection.
– 7% of non-users cited a physical lack of availability or access to the internet.
Having unfettered access to an optimized ACA website is a matter of distributive justice, central to the Christian theological tradition. The ethical principle of distributive justice is defined as that which society or a responsible body owes to its individual members, taking into consideration their proportionate needs, resources available, and a commitment to the common good. In this case of the ACA website, distributive justice further calls the government to accountability in creating the ACA website relatively free from bugs, which presently is not the case. To give credit where it is due, the ACA website does promote distributive justice in that it is available in seven other languages in addition to English. The ecclesial leadership at the Second Vatican Council saw this access as intimately connected to human dignity:
There is a growing awareness of the sublime dignity of human persons, who stand above all things and whose rights and duties are universal and inviolable. They ought, therefore, to have ready access to all that is necessary for living a genuinely human life: for example, food, clothing, housing … the right to education, and work… –Gaudium et Spes, #26
2. Education. President Obama has suggested that those without access to the internet could use the 800 number available. The president also announced that trained “navigators” are available for assistance in understanding the website, its array of plans, the signing-up process, and for registering appeals. Given that there is a segment of the population that is disconnected or with limited connection to the Internet, the phone agents and the navigators are going to be quite busy, as they should be for government serves as a positive force the promotion of human dignity, extension of human rights and the sustainability of the common good. The US bishops in their 1986 document Economic Justice for All, highlighted this positive moral function of the government:
Government…does have a positive moral responsibility in safeguarding human rights and ensuring that the minimum conditions of human dignity are met for all. In a democracy, government is a means by which we can act together to protect what is important to us and to promote our common values (no. 18)
If we were to think about working on the ACA website or calling the 800 number for assistance, it initially could overwhelm us. Even after attempting to understand the complexity of the website, perhaps after watching the instructional and promotional videos, a prospective insured might find her/himself quite bleary eyed. As the website is developed and telephone operators are trained, both need to be clear in their presentation and honest in their options. It cannot be a dizzying maze similar to the complexity of attempting to understand the series of annual updates associated with federal and state tax return forms. If that goal is realized, government could be cast easily as fraudsters peddling their wares using technology and telephony.
The ACA website is broken. As long as all or a part of it remains problematic, overall trust in healthcare reform will be threatened. The website needs to be fixed and in a manner whereby the patches applied and the software engineering restore confidence in the promise that the ACA holds for national coverage despite economic background. In the interest of equal access and clear education, citizens need to demand this overhauling of the ACA website. In his homily for the September 16th eucharist, Pope Francis said that being an idle citizen is not an option for Catholics, with an overture towards all people of the world. The pope preached that a person cannot say:
I have nothing to do with this, they govern. No, no, I am responsible for their governance, and I have to do the best so that they govern well, and I have to do my best by participating in politics according to my ability. Politics, according to the Social Doctrine of the Church, is one of the highest forms of charity, because it serves the common good. I cannot wash my hands, eh? We all have to give something!
Everyone has something to contribute to the promotion of the common good. In the case of the faulty ACA website, we can add our voices to the chorus of people calling for access for all to the ACA website sans any glitches and a clear presentation of choices.
Patrick Flanagan is an Assistant Professor in the Department of Theology and Religious Studies at St. John’s University in Queens, New York. Patrick’s research interests lie in studying the relationship between information technology and theological ethics, giving special attention to the import of Roman Catholic social teaching as a critical resource for assessing this intersection.