Thursday, October 10, 2013

The Healthcare.gov Fiasco: Blame Bureaucracy - IT Clan Editor's Blog - Internet Evolution



The Healthcare.gov Fiasco: Blame Bureaucracy

The broken government procurement process shoulders the blame for the fiasco over the launch of Healthcare.gov, according to a blog for a company that designs government software.

The problem is that the federal procurement process gives work to a limited number of firms whose expertise is in navigating the procurement process, rather than doing the work, according to a blog post at The Department of Better Technology.

Healthcare.gov is the linchpin of the Affordable Care Act, which mandates, among other things, that Americans have health insurance. States set up exchanges to sell affordable insurance to individuals who don't get it through other channels, such as employers. Some 36 states have elected not to set up their own exchanges, instead letting federal systems handle the work for them. Healthcare.gov is the front door to that federal system.

On launch day Oct. 1, Healthcare.gov was plagued by slowdowns and outages. Site visitors saw a lot of this -- it's Healthcare.gov's fail whale:

Although the problems have been mitigated, they're not completely solved.

Bureaucracy is to blame, says the Department of Better Technology:

Healthcare.gov got this way not because of incompetence or sloppiness of an individual vendor, but because of a deeply engrained and malignant cancer that's eating away at the federal government's ability to provide effective online services. It's a cancer that's shut out the best and brightest minds from working on these problems, diminished competition for federal work, and landed us here — where you have half-billion dollar websites that don't work.

That cancer is called "procurement" and it's primarily a culture-driven cancer one that tries to mitigate so much risk that it all but ensures it. It's one that allowed for only a handful of companies like CGI Federal to not only build disasters like this, but to keep building more and more failures without any accountability to the ultimate client: us. Take a look at CGI's website, and the industries they serve: financial services, oil and gas, public utilities, insurance. Have you had a positive user experience in any of those industries?

The Department of Better Technology, which publishes the blog, makes government software, so of course it has a dog in this race. But, still, the blog makes good points. And the blog post is authored by Clay Johnson, who's had a substantial career in government, politics, and the Internet, including heading the digital presidential campaigns of Howard Dean (2004) and Barack Obama (2008). Johnson is CEO and founder of DBT, as well as a supporter of RFP-EZ, a federal project designed to make it easier for smaller companies to bid on federal IT projects.

Bureaucracy wasn't all there was to it. Healthcare.gov is also an incredibly complex problem. "Private companies sell things online all the time. Why is the government having such a hard time setting up an online health insurance marketplace?" writes The Washington Post.

Healthcare.gov's job was much harder than simple online commerce. "Much of the complexity comes from the fact that the exchanges are used to administer the complex system of subsidies the Affordable Care Act provides to low-income consumers. Figuring out whether a customer is eligible for a subsidy, and if so how much, requires data from a lot of federal and state agencies," the Post says. The site must also confirm that the applicant is an American citizen or documented immigrant, checking with the Social Security Administration and Department of Homeland Security. And so on. The Post reproduces a chart from Xerox that describes the problem:

Healthcare.gov was just plain badly built, according to The Wall Street Journal. It was overwhelmed by traffic, failing to cache frequently used portions of the website. Identity authentication broke down. And the site is susceptible to security vulnerabilities.

The White House knew since February that the launch was shaky, according to Forbes.com. But the White House was eager to get the site up and running fast. As Republicans combat the Affordable Care Act, proponents felt they needed to get the law implemented and get the American people using the system to make ObamaCare impossible to repeal. "The Obama administration was more afraid of delaying the launch of Obamacare, than they were of botching it," Forbes said.

This may prove to be a sound strategy. But the key is that the American people have to enjoy the benefits of the ACA. If the White House can't fix the law's Internet problem, there will be no benefits, only frustrations. And the ACA will go down.

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