Whatâs
Wrong Today:
Most Obama
supporters are shaking their heads at the mis-management of the roll out of www.healthcare.gov. Here is a quick
summary of the problems: delayed funding; delayed procurement; rushed
development by multiple contractors; poor program coordination; insufficient
and late quality assurance; severe problems not bubbling up to decision-makers;
lack of accountability; and more.
We
learned from CNN that the Obama administration was
given clear warnings in August that the federal healthcare site was not ready
to go live. The caution came from the main contractor CGI, who warned of a
number of open risks and issues for the healthcare.gov web site, even as
company executives were testifying publicly that the project had achieved key
milestones.
In their August
status report marked âconfidentialâ, the CGI
document describes “top risks currently open” and
“outstanding issues currently being mitigated”. It said the testing
timeframes are “not adequate to
complete full functional, system, and integration testing activities”
and lists the impact of the problems as “significant”.
One
comment was that “hub services are intermittently unavailable”. That
is techie for: “the site’s not working
sometimes“. A concern, listed as “severe” warned: (brackets
and emphasis by the Wrongologist)
access to necessary tools to manage envs [environments] in test, imp [implementation],
and prod [production]. Specifically (1) we don’t have access to central log
collection/view (2) we don’t have access to monitoring tools. We have
repeatedly asked CMS [Centers for Medicare and Medicaid Services] and URS (URS Corp) but have not been granted this access
When your main contractor says they need
debugging information to get the web site up, wouldnât you give it to them?
When you
hear that there is ânot enough time in schedule to conduct adequate performance
testing”, wouldnât you make sure that it happened, even if it caused a
roll-out delay?
Letâs
look at what professionals are saying about the healthcare.gov rollout. Here is
Tony Byrne of the Real Story Group, who thinks that the specifications
for healthcare.gov were extraordinarily complex. In fact, he says that they hit
the web application trifecta. Their task was to:
1. Distill a highly
complicated customer journey on the front end into a usable experience
2. Apply a diverse set
of business rules to back-end transactions, involving myriad external partners
3. Support huge
volumes of traffic, including intense spikes
Byrne,
who has had the US Treasury as a client, explains why the task was very
daunting:
one of these requirements demands quite specialized expertise. Two of those
will put a web application project at high risk. All three, and you have to be
very, very good (and possibly lucky) to pull it off. Of course, others have
done it. Like, say, Amazon.
Byrne
concludes:
lesson here for web and IT leaders is: be forthright with your colleagues. If
something is hard, tell them early and often, but educate them as much as
possible, rather than just pushing them off. And for business leaders, remember
that the most magical experiences are the most difficult to create.
On the
plus side, the term HealthCare.gov could become part of the techie
vernacular, including usage as a verb. “This has all the makings of a HealthCare.gov,”
or, “We need two more weeks of QA or this is going to go all HealthCare.gov
on us.”
Given
the leaked CGI document, it’s unimaginable that senior Administration officials
didn’t know there were major implementation issues with the website and that big
trouble was ahead. The
DHHS and the Administration just seem to have been terrible clients.
So, here’s another crisis that the White House has handled badly. On the other
hand, the ruckus the Republican Party is raising about the website is a thing
of beauty. The calls for heads to roll, the lamenting that no apologies were offered, etc. are simply not
believable given the party that is asking for them.
From Ezra
Klein in Wonkblog:
child who kills his parents and then asks for leniency because he’s an orphan.
But in recent weeks, we’ve begun to see the Washington definition: A party that
does everything possible to sabotage a law and then professes fury when the
law’s launch is rocky. On
Tuesday, Rep. Paul Ryan (R-WI) became the latest Republican to call for HHS Secretary
Kathleen Sebelius to step down because of the Affordable Care Act’s troubled
launch. “I do believe people should be held accountable”
If accountability is back
on the table, how about House Republicans who refused to appropriate the money
the HHS said it needed to properly implement Obamacare?
- How about Senate
Republicans who tried to intimidate Sebelius out of using existing HHS funds to
implement Obamacare? Sen. Orrin Hatch demanded at one hearing:
authority under which you believe you have the ability to conduct such
transfers?
It’s difficult to imagine the scale of the disaster
if Sebelius hadn’t moved those funds.
- How about Republican governors
who told the Obama administration they absolutely had to have the right to build their
own health-care exchanges (you may remember that the House Democrats’
health-care plan included a single, national exchange). And they then refused to
build them, leaving the construction of 34 insurance marketplaces up to HHS?
- How about the Republican
effort to get the law declared unconstitutional, an effort that ultimately
failed, but that delayed program implementation as government and industry waited for
the uncertainty to resolve?
- How about the Republican
governors who refused to take federal dollars to expand Medicaid, leaving about
5.5 million low-income people who’d be eligible for free, federally-funded
government insurance to slip through the cracks?
Republicans made clear that any
issue with ACA and the rollout would be exploited rather than fixed, including
shutting down the government because the funding bill contained money for
Obamacare.
The Obama administration
deserves all the criticism it’s getting for the poor start of the health care law.
Their job was to implement the law effectively, even if Republicans were
standing in their way. So far, it’s clear that they weren’t able to deal with
either the complexities of the law or the technical tour de force that the roll
out required.
But the GOP’s complaints
that their plan to undermine the law worked too well and someone has to pay,
borders on the comic. If Republicans actually believe Ms. Sebelius is responsible for the
law’s poor launch, they should be pinning a medal on her.
Neither
side escapes; there is plenty of blame to go around.
On one
side, we have incompetence. On the other, we have obstruction.
And what do the people have? Nothing.
They have nothing for all of the effort, nothing for all of the emotion, nothing for all of the dollars spent.
