Obamacare - Incompetence or Sabotage?

Government IT is hard. I say this from experience, being an IT contractor with government agencies on the client list. Big IT projects failing is if course a sign of incompetence, but not necessarily of any extreme variety. However, now that more details are coming out about the fiasco of HealthCare.gov, the online interface of Obamacare, I think the problems we are hearing about goes beyond the usual. In this article from the Washington Post we supposedly get some additional inside information, and some of it is fascinating:

[...] the president emphasized the exchange’s central importance during regular staff meetings to monitor progress. No matter which aspects of the sprawling law had been that day’s focus, the official said, Obama invariably ended the meeting the same way: “All of that is well and good, but if the Web site doesn’t work, nothing else matters.

So it seems that Obama had the right kind of focus for a long time, at least since one and a half years ago. How then could things go so wrong, despite the best of intentions? Here are some clues:

“They were running the biggest start-up in the world, and they didn’t have anyone who had run a start-up, or even run a business,” said David Cutler, a Harvard professor and health adviser to Obama’s 2008 campaign

Inside the Department of Health and Human Services’ Centers for Medicare and Medicaid, the main agency responsible for the exchanges, there was no single administrator whose full-time job was to manage the project.

The Medicaid center’s chief operating officer, a longtime career staffer named Michelle Snyder, nominally oversaw the various pieces, but, as one former administration official put it: “Implementing the exchange was one of 39 things she did. There wasn’t a person who said, ‘My job is the seamless implementation of the Affordable Care Act.’ ”

But the problem was not only neglecting to put a proper management structure in place. There was also direct interference to block critical parts of the projects. Here is one example out of several mentioned:

According to two former officials, CMS staff members struggled at “multiple meetings” during the spring of 2011 to persuade White House officials for permission to publish diagrams known as “concepts of operation,” which they believed were necessary to show states what a federal exchange would look like. The two officials said the White House was reluctant because the diagrams were complex, and they feared that the Republicans might reprise a tactic from the 1990s of then-Sen. Bob Dole (R-Kan.), who mockingly brandished intricate charts created by a task force led by first lady Hillary Clinton.

In the end, the White House did not allow the diagrams to be published. Ostensibly, they were protecting the project against potential sabotage, but what they were in fact doing, time after time, was sabotaging the project themselves!

Finally, being a software contractor, this makes my stomach churn:

CGI was issuing warnings of its own. On Aug. 17, about six weeks before the launch date, a company employee sent an e-mail to a CMS staffer — with copies to more than a dozen other CMS staff members — detailing an “updated schedule” for work on the exchange. The e-mail, obtained by The Post, said that, for the tasks that CGI was responsible for, the exchange was 55 percent complete.

Note carefully what is actually being said here: Less than two months before release date, the contractor reported being barely more than half-way done. If this was indeed the case, standing by the original release date was madness.

These anecdotes are line with many other stories from inside the Obama administration - the environment seems to be one of paranoia and insularity. The president has a few advisors that he places an enormous amount of trust in, and these people are the only ones who get to run things, regardless of what skills are needed. t is amazing and somewhat frightening that Obama and his staff could not break out of their bunker mentality even when their greatest signature achievement was at stake. If they act with such recklessness when their own core interests are at stake, how could we possibly trust them to look out for ours?

Some have suggested that the whole Obamacare project might have been designed to fail. I don't buy it, since I think lack of competence is a sufficient explanation, but I see where they are coming from. And I think some of these actions are clear examples of self-sabotage, intentional or not.

2 responses
Agree, this is not at all off-the-charts incompetence, neither in software project estimation nor in goverment contracting, and most definitely not in a project involving the two of them working togeather. In fact, if the project was more than half way done it that would mean success above the standard of the software industry (less than a factor of 2). It is just silly and embarrasing for both the whistle-blower and the blowee when a supposed conspiracy is actually just incompetence. It does however proove that incopetence is very widespread on both sides of the fence. Thank you for the article. I think that you are right on the spot. I will remind you to investigate the Försäkringskassan-case as another interresting case of stunningly expensive incompetence in a very similar project.
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