The Thinker

How healthcare.gov failed: the political aspects

(Also read parts 23 and 4.)

You know a federal IT manager has a problem when the President of the United States is dissing the very web site he was paid to manage. That’s what President Obama was doing today with the healthcare.gov site, the rollout of which was botched by any standard. Also botched was the obscene amount of money paid for the site, obscene even if it had worked. The Canadian contractor CGI Federal got the award, initially $93.7M, but with extra work is now at more than $292M. This is a crazy amount of money to pay for an interactive site and may be the most expensive site of its kind ever purchased with tax dollars.

I wrote a week or so back about my initial critique of the website. It is easy to criticize in hindsight. I can’t claim to know all of the site’s requirements. From news reports it is not too hard to infer a lot of them. There were a number of external data sources such as at the IRS and Social Security Administration that had to be queried to do things like figure out your eligibility for a subsidy, if any. There were many business rules that had to be followed. There were tight security rules to follow because Privacy Act data had to be stored. And there were accessibility rules required of any federal or federally funded website, to ensure access to the visually impaired. All this plus the site had to scale to meet demand.

As a certified software engineer (MS Software Systems Engineering, 1999, George Mason University) and federal employee with more than twenty-five years experience designing, maintaining and managing systems and websites, I can speak with some authority, in part because I have made many of the mistakes I will allude to, just not so spectacularly. I learned from my mistakes. There are many dimensions to engineering a site like this: political, programmatic, architectural and technical. I plan to take each of these in turn in various posts.

Today: the political dimension.

All work for the government is inherently political. This is true even in a science organization where I work. You can’t avoid it because politics are built into the rules and regulations you must follow, such as the Privacy Act and accessibility requirements (Section 508 of the Rehabilitation Act, to be specific). Projects of a certain size, like healthcare.gov, fall into the bucket of a program. A program is basically one or more projects that are interrelated which, because of their overall size, need to be packaged, managed and sold politically and which typically continue indefinitely. Managing a program requires a fistful of certifications. Having the certifications though is not enough. The effective program manager has to really understand all the power players at work and market to them. It’s probably the toughest job out there, particularly for very large scale or high visibility programs. I am sure the program manager for this project tried his or her best, but they got the wrong person. Someone with a lot of experience, a proven ability to manage a program this large successfully, and with the right political skills was needed.

The right program manager would have spoken truth to power, tactfully of course. There were red flags all over this project. Few things are more controversial than health care. He or she probably reported directly to HHS Secretary Kathy Sibelius. To start he or she should have mentioned the triple constraint. It affects all projects and it is basically this:  a project is naturally bounded by cost, schedule and scope. What this means in practice is that if the project was deadline driven, then scope would have to be reduced. This means not all the features of the website could be delivered by October 1, 2013. If the minimal scope was too big, it may have been technically impossible to deliver by the deadline. The typical political response is to throw money at the problem, which is probably why CGI Federal has billed more than $200M dollars so far. Unfortunately, at some point throwing more money at a project is counterproductive. It actually makes the project worse. This means there is an upper limit to what money can buy you as far as features for a given deadline. Someone was probably being dishonest to power by not laying these facts on the table because it was politically incorrect to do so. It was either that or someone in power refused to listen. If that was what happened then Secretary Sibelius should resign. If it was the program manager, he/she should resign.

The White House has some blame here too. This is the Obama Administration’s signature initiative. The Chief Technology Officer for the government should have been all over this project. He should have found the best talent inside and outside the government and brought these resources to bear for HHS, which doesn’t often handle projects like this. Instead, it was developed largely hands off. The CTO should have warned the White House of the high probability of failure, and recommended early on ways to preclude its possibility. Either he did not do this or his warning fell on deaf ears. The Federal CTO wields enormous political capital. It’s hard to imagine that if he squawked that the White House Chief of Staff would ignore him.

In any event, those in the chain of command must have largely acted in CEO mode. “Tut, tut, don’t bother me with details. No excuses, just get it done,” was probably their mentality. Given the prominence of this initiative, everyone from the president on down should have been engaged. They were not.

So a good part of the failure of healthcare.gov is simply an absence of the right kind of leadership. This was a problem that required getting out of the ivory tower and getting your hands dirty. Shame on all who acted in this way.

I don’t operate at the program level but I know enough about it to know I don’t want to. I don’t have the requisite people skills. But if I did I would have not taken responsibility for this work without written and personal assurances from these stakeholders that they would provide the resources to let the project succeed. I’d also want assurances that they would empower me and support me to the maximum extent possible to make it succeed.

Next: the programmatic missteps.

 

Leave a Reply

 

Switch to our mobile site