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Healthcare.gov – Yes, Yes, and Yes

Healthcare.gov was rolled out on October 1.

Since then there has been lots of bashing of the site and finger-pointing between government overseers and contractors executing it.

Some have called for improvements down the line through further reform of government IT.

Others have called for retribution by asking for the resignation of the HHS Secretary Sebelius.

Publication after publication has pointed blame at everything from/to:

– A labyrinth government procurement process

– Not regularly using IT best practices like shared services, open source, cloud computing, and more

– An extremely large and complex system rollout with changing requirements

And the answer is yes, yes, and yes.

Government procurement is complex and a highly legislated functional area where government program managers are guided to hiring small, disadvantaged, or “best value” contract support through an often drawn-out process meant to invoke fairness and opportunity, while the private sector can hire the gold standard of who and what they want, when they want, period.

Government IT is really a partnership of public and private sector folks that I would image numbers well in the hundreds of thousands and includes brand name companies from the esteemed defense and aerospace industries to small innovators and entrepreneurs as well as a significant number of savvy government IT personnel. Having worked in both public and private sector, I can tell you this is true–and that the notion of the government worker with the feet up and snoozing is far from the masses of truth of hardworking people, who care about their important mission serving the public. That being said, best practices in IT and elsewhere are evolving and government is not always the quickest to adopt these. Typically, it is not bleeding edge when it comes to safety and security of the public, but more like followers–sometimes fast, but more often with some kicking and screaming as there is seemingly near-constant change, particularly with swirling political winds and shifting landscapes, agendas, lobbyists, and stakeholders wanting everything and the opposite.

Government rollout for Healthcare.gov was obviously large and complex–it “involves 47 different statutory provisions and extensive coordination,” and impacted systems from numerous federal agencies as well as 36 state governments using the services. While rollouts from private sector companies can also be significant and even global, there is often a surgical focus that goes on to get the job done. In other words, companies choose to be in one or another business (or multiple businesses) as they want or to spin off or otherwise dislodge from businesses they no longer deem profitable or strategic. In the government, we frequently add new mission requirements (such as the provision of universal healthcare in this case), but hardly ever take away or scale back on services. People want more from the government (entitlements, R&D, secure borders, national security, safe food and water, emergency response, and more), even if they may not want to pay for it and seek the proverbial “smaller government” through less interference and regulation.

Is government IT a walk in the park, believe me after having been in both the public and private sectors that it is not–and the bashing of “cushy,” federal jobs is a misnomer in so many ways. Are there people that take advantage of a “good, secure, government job” with benefits–of course there are some, but I think those in the private sector can look in the offices and cubes next to them and find quite a number of their colleagues that would fit that type of stereotype as well.

We can learn a lot from the private sector in terms of best practices, and it is great when people rotate from the private sector to government and vice versa to cross-pollinate ideas, processes, and practices, but the two sectors are quite different in mission, (often size and complexity), constituents, politics, and law–and not everything is a slam dunk from one to the other. However, there are very smart and competent people as well as those who can do better in both–and you fool yourself perhaps in your elitism if you think this is not the case.

Are mistakes made in government IT–definitely yes. Should there be accountability to go with the responsibility–absolutely yes. Will we learn from our mistakes and do better in the future–the answer must be yes. 😉

(Adapted from my blog at AndyBlumenthal.com)

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Jaime Gracia

As I have previously mentioned here on GovLoop, this is a classic failure of big federal IT, a textbook version actually. However, politics were in the thick of it, adding unnecessary delays to the schedule and a lack of focus on requirements and effective software development due to the infighting between the White House and HHS (CMS, in particular).

Apparently no one was really in “charge”. Communications between the government and industry, not to mention government to government, were poorly executed. Further, lessons learned and valuable knowledge from the states and companies who have already created and implemented these exchanges was never captured.

When are federal IT managers and leaders going to get it through their thick skulls that “Big Bang” approaches to software development do not work. Anyone ever hear of Agile development? System for Award Management should have been a breeze compared to Healthcare.gov, and even that was a predictable disaster.

Healthcare.gov is an abysmal failure of IT execution and program management, and it should never have happened. It is not like Healthcare.gov needed to get built overnight, although that seems to have been the outcome. It really is a wonder how this Administration touts itself as tech savvy, and then launches one of the worst botched federal IT programs in recent memory.

The “technical surge” will cost how much more? How much has already been spent on the same formula that federal IT loves to follow (e.g. garbage in = garbage out)?

I wonder who is laughing all the way to the bank. Not the taxpayers…

Kathryn David

Thanks for posting about this, the failures of the website have been discussed a lot in the media but there has not been (at least that I have seen) a substantive discussion of the systematic factors that led to the glitches with the site. Will this highly publicized failure be enough to change the procurement process of government IT or will the glitches be fixed and we will all return to the status quo?

Lori Winterfeldt

I just posted about this myself. I agree with Kathyrn on this one. Until we examine and address the systemic issues which have caused such a failure, it will happen again with the next big launch of any digital government initiative that is launched.

David B. Grinberg

I agree with your awesome insights and analysis, Andy.

I’m wondering if it would have made more sense for the Administration to bypass the traditional procurement and federal IT processes for such a colossal new government program affecting millions of Americans and the overall economy?

For example, I’ve heard some observers say the Administration should have hired one major and proven private sector high-tech company from Silicon Valley or elsewhere to do this mega-job — Google, Yahoo, Apple, Microsoft, etc.

Do you think this would have resulted in a smoother roll out of HealthCare.gov, which would have benefited all parties involved, especially taxpayers and those in desperate need of affordable care?

Thanks for sharing your thoughts on this.