A lack of leadership, not technological prowess, doomed the healthcare.gov launch

posted at 9:21 am on February 24, 2016 by Jazz Shaw

Anyone with even a smidgen of interest in politics or government affairs recalls all too well the disastrous launch of healthcare.gov when it finally went live, behind schedule and way, way above budget. The initial results became fodder for late night comics and conservative bloggers for months on end. We were told repeatedly of the staggering technological challenges involved, the difficulty in retrieving data from disparate sources and the strains of handling the flood of people trying to log into the system. But according to one recent report it wasn’t a lack of geek squad support that doomed the project, but an abject failure in leadership. (Government Executive)

Management really does matter. That’s the takeaway message of a case study of how the Centers for Medicare and Medicaid Services fumbled the implementation of HealthCare.gov, the website through which people may purchase health insurance under the Affordable Care Act, President Obama’s signature domestic policy initiative.

“Most critical was the absence of clear leadership, which caused delays in decision-making, lack of clarity in project tasks, and the inability of CMS to recognize the magnitude of problems as the project deteriorated,” Daniel Levinson, the Health and Human Services inspector general, wrote in the 92-page case study.

If you glance through that case study it becomes clear that there was plenty of blame to go around. There was poor communication from the top down to the many agencies involved in the developmental process, as well as a failure to prioritize the various required tasks in an order which would have allowed problems to be detected and corrected in a reasonable time frame. Perhaps even worse was the finding that supervisors up and down the chain essentially put their fingers in their ears when difficulties were encountered, refusing to take any bad news up to the boss. In an environment such as that, you’re pretty much setting yourself up for failure.

In a rather clinical fashion, the report describes the management chain as being plagued by a series of structural, cultural, and tactical deficiencies. That sounds about right. As I frequently said during the roll out, this was obviously a big project which wasn’t going to be tossed together by a handful of inexperienced hacks, but by the same token, what they were trying to accomplish wasn’t exactly new territory in the computer science field. Their goal was one which should have been readily achievable by the right team with the right tools. The fact that it failed so spectacularly couldn’t simply be written off to deficiencies in technology.

In the end, this was an engine which was running on high test hope and change. There was the will to do this thing and a fervent belief that it was the right thing to do. Therefore, the White House clearly believed that the beast could be willed into existence since it was essentially preordained. Sadly, that’s not the way the world works. Big goals require big solutions, and those involve hard work, competent management and the flexibility to adjust when things don’t go just as you envisioned them in your hopes and dreams. On that score, the Obamacare website effort failed utterly.

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