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How The Healthcare.gov Implementation Got Lost

If The Rest Of America Pretty Much Works Like 404-Care…..

Maybe The Navigators Could Use One Of These

Maybe The Navigators Could Use One Of These

14 Let them alone: they be blind leaders of the blind. And if the blind lead the blind, both shall fall into the ditch.

Matthew 15:14 – King James Version (KJV)

I work on a large, complicated US Army Weapon System program. It’s a veritable rabbit-warren of bureaucratic complexity and confusing interdependencies. That’s just our org chart. I haven’t mentioned the WBS down to Level 4 yet. I state this not to brag, but more to clarify the fact that I get ObamaCare missing by a small margin. It was destined to have a bug or three in the vacuum tubes* even if the guys in charge of implementing it were as good as they bragged about being. What scares me are two aspects of this.

1) They didn’t miss by a wee-smidge. They missed the way Ayn Rand’s caricaturized failure characters missed towards the end of Atlas Shrugged.

2) The Obama Administration handled the development and its consequent failure in a way that no long-tenured professional would ever have handled it. They set themselves up to fail in both their contracting and their administration, they ignored adverse data that could have saved their rear-ends, they did none of the risk reduction that major acquisition projects require to insure success and they have no viable off-ramp or plan B to salvage this mess before the February 15th Individual Mandate Witching Hour.

Pace Point Number 1: Megan McArdle gives us a good bomb damage assessment. I need not say much more than this.

My best guess is that by the time HHS officials realized that they hadn’t left enough time, the only possibilities were: 1. Ask Republicans for a delay; or 2. Launch a not-very-well-built-or-tested system upon an unsuspecting public…..if they launched a nonfunctioning system, at least the state exchanges would hopefully work, and if enough people in the states signed up, it would be too late for Republicans to demand a rollback. They’d get the system working in a few weeks, and then everything would be fine. I’m guessing that even at the end, the senior officials didn’t realize just how bad this was.

Point Number 2 concerns me way more and about things far beyond the realm of ObamaCare. The troubles for ObamaCare started far earlier than when Luke Chung sat down to register at the internet portal Healthcare.gov. The contracting plan was a recipe for disaster. There was only 1 considered bid for the entire project. Meaning no market research occurred and nobody had to compete in a “bake-off” to demonstrate their competence prior to contract award.

Federal officials considered only one firm to design the Obamacare health insurance exchange website that has performed abysmally since its Oct. 1 debut. Rather than open the contracting process to a competitive public solicitation with multiple bidders, officials in the Department of Health and Human Services’ Centers for Medicare and Medicaid accepted a sole bidder, CGI Federal, the U.S. subsidiary of a Canadian company with an uneven record of IT pricing and contract performance.

This leads me directly into my comment regarding risk-reduction. A “Bake-off” would have given the industry and the government a treasure-trove of data to evaluate the feasibility and adaptability of current technology to the problem at hand. The government could have selected a best value offer to award with a contract and have a set of data on file to know which problems needed to be ironed-out throughout the test-fix-test process utilized to bring any difficult engineering project to success. Oh, Wait…Luke Chung gives us insight to how closely they followed the Good Old “Systems Engineering V.”

What should clearly be an enterprise quality, highly scalable software application, felt like it wouldn’t pass a basic code review. It appears the people who built the site don’t know what they’re doing, never used it, and didn’t test it….As a taxpayer, I hope we didn’t pay a premium for this because it needs to be rebuilt. And fixing, testing, and redeploying a live application like this is non-trivial. The managers who approved this system before it went live should be held accountable, along with the people who selected them.

And just who managed this development anyway? According to Megan McArdle, it was close-hold, stove-piped management by secretive cabal. Details of this particular facet of the fuster-cluck follow below.

The Centers for Medicare & Medicaid Services inexplicably decided to take on the role of central project manager itself, assuming responsibility for integrating all the various software pieces they’d subcontracted, rather than assigning that role to a lead contractor. CMS is not known to maintain a pool of crack programming talent with extensive project management experience that can be deployed to this sort of task..

So all of these early failures put the designers and coders behind the 8-ball a wee bit. But weren’t there warnings? Someone had to be briefing these people. The people who were, just got blown off. Henry Chao, an ally of Obama who wants this law to work as advertised, tried to bring some ratiocination into play 200 days before launch date.

Chao was frank about the stress and tension of the compressed time frame involved in setting up the exchanges. “We are under 200 days from open enrollment, and I’m pretty nervous,’’ he said. “I don’t know about you,” he added, to murmurs from the insurance industry audience.…..Chao said the main objective is to get the exchanges up and running and signing up the uninsured. “The time for debating about the size of text on the screen or the color or is it a world-class user experience, that’s what we used to talk about two years ago,” he said. “Let’s just make sure it’s not a third-world experience.”

So given all the problems that plagued this developmental effort from Day One, I assure you that any professional developer with the doctrinal objective of opening a functional, reformed insurance market by 1 October would have a portfolio of back-up plans. Too bad Kathleen Sibelius was driving this train instead. Only The State of California even consider doing a soft launch as a back-up to full, blind roll-out on 1 October. Nobody else even cared to contemplate the need for a parachute in case the plane went down.

In conclusion, the development and deployment of the $600M Healthcare.gov website was a classic example of what happens when the blind lead the blind. We learned 2000 years ago where that would get us. Australian Rock Group “The Church” gives us a more contemporary vision of how The Obama Administration lead us to fall into this particular ditch.

The pursuit of adulation is your butter and your bread.
It’s an exquisite corpse and its lips are red
And its teeth are glistening.
But you are lost, but you are lost.
Now hang up ’cause the lines are all crossed,
You are so lost.

Let us all pray that this particular failure is not indicative of what we can generally expect out of our government and our technology for the next few years going forward.

*-A bit of nerd trivia: the tendency of insects to short vacuum tubes in 1st gen computers gave rise to the terms bugs and debugging in Computer Science.

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