The sober reflection on the healthcare.gov website is … really sobering.

superman brandBy now, nearly everyone has read or heard news reports about the “slow-motion train wreck” that is the newly minted Federal healthcare exchange.

It’s not only late-night comedians who are piling on.  It’s people like a senior technology officer at one of the major social media sites who texted, “It was a uniquely incompetent team that worked on their website.”

“Uniquely incompetent”:  Now there’s a sound-bite for you.

Those two words may do more to bury the notion that government-managed healthcare is a good thing than all of the political opposiion’s ideological arguments put together.

But as I often do with domestic policy challenges, I turn to my brother, Nelson Nones, who has lived and worked overseas for years – for an outsider’s perspective.

Here’s what Nelson wrote to me:

healthcare.gov landing pageFrom what I’m seeing, it’s going to be a long, long time before the Federal healthcare exchange website (healthcare.gov) works properly.

To see why, take a look at this article just published by Forbes magazine: http://www.forbes.com/sites/anthonykosner/2013/10/21/obamacares-website-is-crashing-because-backend-was-doomed-in-the-requirements-stage/.

If the article’s diagnosis is true, then the entire back-end may need to be re-architected.

That’s not something one can do quickly with a “tech surge” of “the best and brightest from both inside and outside government to scrub in with the team and help improve healthcare.gov,” as the Department of Health & Human Services put it on Sunday and President Obama reiterated on Monday.

According to the various news articles I’ve seen, the cost of designing and developing the website was initially estimated at $94 million and had risen to $292 million by last May. This seems like a lot of money, but you have to put things in perspective.

A personal observation:  I was recently involved in the testing of an enterprise resources planning (ERP) and manufacturing execution system implementation for a large multinational manufacturing company.  The total cost of this project was slightly north of $200 million.  This was the price-tag for an application used by about 6,000 people at a single manufacturing site (albeit a large one).

It, too, was plagued with problems when we went live, and it took almost a year to fix the problems – in fact these problems and their impact on supply chain performance warranted a note in the company’s annual report.  

Just like in what the Forbes article reported, the great majority of the problems traced back to the requirements stage – as I warned the senior management at this company (repeatedly) during the design phase.

For the healthcare.gov website, it seems to me that even $292 million is a low-ball figure considering the site has to support tens of millions of users (not 6,000) in a whole country (not just a single manufacturing site).  The Forbes article suggests that the $292 million was invested primarily on the front end, without attempting to consolidate the databases that sit on the back end.

This implies that the back-end design and development were woefully shortchanged — and as a result the front end doesn’t work.

Perhaps things would have gone better if $1 billion had been invested properly the first time around.

Unfortunately, from (painful) experience I can tell you that it’s almost impossible to invest wisely in architectural improvements while you’re in the middle of a crisis, so I’d bet the final price tag is likelier to hit $2 billion.

And … because that $2 billion won’t be invested wisely either, the problems will take longer to fix.

My prediction?  Two years.

In distilling all of this down to its essence, you can’t do much better than the famous words of Michael Dukakis, former governor of Massachusetts and one-time presidential candidate:

“It’s not about ideology.  It’s about competence.”

2 thoughts on “The sober reflection on the healthcare.gov website is … really sobering.

  1. Launching by the deadline, for political reasons, was more important than making sure that it worked.

    Everything in the “Affordable” Care Act is symbolism over substance. The money hasn’t been well-spent because there was a fictitious maximum number that they couldn’t exceed and still get it passed in Congress — even with pure one-party majorities.

    The complexity is completely unnecessary, but bureaucracy knows no other way.

    If there are three plans and all insurers have to meet minimum criteria, why not just have a place where visitors can go to see rates from insurers in their state and access the particulars of those plans through the insurer’s portal?

    But of course it could never be that simple, because the intimate data collection for IRS and HHS use is necessary to lay the foundation for the real goal: universal, government-run, single-payer healthcare.

    … So when the “consumer misery index” reaches a certain level, the people with cry out for government to “do something”!

  2. Did you hear the point made by House Speaker John Boehner? More people are losing their health insurance than are getting it through Obamacare.

    We have a healthcare system that supports a population of about 350 million people. It is too complex for the government to be able to run better than in the private sector.

    As an alternative, why not allow more medical health savings accounts … allow people to buy insurance over state lines … institute some much-needed tort reforms.

    At the very least, get it down to the state level where the bureaucracy is not quite as likely to “muck it all up.”

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