Having been a program manager for one HHS initiative in the past, the experience provided enormous insight into the culture of the department that is enormously risk averse, while also attempting to be broadly inclusive. Those two things are somewhat contradictory, and the department seems to not want to come to grips with limits on its capacity to complete complex work. Its leadership changes frequently too, and that makes it hard to track accountability.
Now, the details of the Obamacare initiative are not known to this reporter, but there is sufficient evidence that there are way too many contractors involved, when central accountability and management are essential. HHS simply doesn’t have the technical bandwidth to manage systems like this one.
It appears that they went as far as they could and then threw it over the wall to the federal Centers for Medicare and Medicaid Services (CMS). In a manner that has become the US government culture and behavior, they will chip away at this iteratively until it works to some level of acceptable frustration.
All of this makes one wonder if Republicans had this one right.
- Establish the legislation to provide for affordable healthcare for all Americans
- Let the private sector and consumers sort out the delivery system
The trouble is that Republicans did not want to attend to the need at all. Therefore, the first step was missing and for the private sector that would have been business as usual and leaving 50 million Americans uninsured.
“The private contractors behind HealthCare.gov on Thursday blamed the Health and Human Services (HHS) Department — and each other — for the disastrous rollout of ObamaCare's enrollment website. At Congress's first hearing on the issue, industry witnesses denied responsibility for the system's problems and suggested that the HHS had failed to effectively coordinate the project. The executives, under sharp criticism from both Republicans and Democrats, had no answer for why the enrollment site debuted with massive flaws on Oct. 1.
Though few answers emerged about the recent triage efforts on the website, contractors did shed light Thursday on efforts to pull the system together in the weeks prior to Oct. 1. According to the witnesses, the federal Centers for Medicare and Medicaid Services (CMS) was made aware of all the problems encountered with each product in the lead-up to the launch. One company, Optum's QSSI, said it wished for more time to test the site end-to-end but was provided only a few weeks. None of the companies represented Thursday suggested delaying the launch to the CMS, witnesses said.”