Much of the criticism of HealthCare.gov, the government-designed “Looking Glass” into Obamacare land, has fallen, rather unfairly, on the heads of the private IT companies with whom the Center for Medicare Services (CMS) contracted. The real source of the problems that beset the website today, and which will undoubtedly plague Obamacare for years to come, is the hubris of the politicians who wanted to transform nearly one-fifth of the U.S. economy and of the bureaucrats and regulators who thought they could control the behaviors, values and choices of hundreds of millions of Americans.
From the beginning, there were problems typical of every large-scale, innovative IT program where the government (specifically CMS) acted as the project integrator. First, the contract was awarded only a little more than two years before its intended rollout. Because of the magnitude and scope of the exercise, requirements were ill-defined at the time of contract award and repeatedly altered during the development process. Different contractors were responsible for parts of the overall system with insufficient time for integration and testing of the different modules much less the end-to-end system.
The President himself recently acknowledged that government is a poor customer even for simple IT services. “What is true is that . . . our IT systems, how we purchase technology in the federal government is cumbersome, complicated and outdated.” He contrasted the ease with which his campaign could address IT problems, call the best people together, put them all together in a room and give them the freedom to devise solutions with the federal acquisition system.
“If you’re doing it at the federal government level, you are going through 40 pages of specs and this and that and the other. And there’s all kinds of law involved. And it makes it more difficult — it’s part of the reason why chronically federal IT programs are overbudget, behind schedule.”
It must be pointed out that the Obama Administration has made this situation worse. It has intensified the paperwork requirements for proposals, added oversight processes, increased the weight and complexity of government regulations and inhibited the ability of government and the private sector to collaborate. HealthCare.gov was hoisted on a petard of the administration’s own making.
Also, it should be recognized that what the federal government was seeking to build was not just a consumer-friendly service portal such as that provided by Amazon, Walmart or Best Buy. A senior corporate officer from CGI Federal Inc. observed in testimony before Congress that, “the Federal Exchange, including the Federally-Facilitated Marketplace (FFM) is not a standard commercial website. Rather, the FFM is part of an integrated platform that completely transforms the process of selecting and enrolling in insurance and determining eligibility for government subsidies.”
The FFM must gather information on millions of healthcare shoppers, perform multiple assessments across dozens of government agencies and departments (integrating disparate data) and hundreds of private insurance companies. The idea that it would be possible to achieve this in the time allotted was ludicrous. Organizing and conducting the Normandy invasion was an easier task and took less time.
The private companies involved in HealthCare.gov did heroic work. Unfortunately, in view of the way their customer/boss behaved, the fact that significant problems arose with the unfinished and untested product is neither surprising nor their fault.
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