Rolling Out Obamacare: Would Businesses Get It Right?

October 25, 2013  • Charles M. Firestone

Charlie Firestone has been the executive director of the Communications and Society Program at the Aspen Institute since 1989.

One of the advantages of the new information and communications technologies (ICT) as applied to government is to make it work faster, better, cheaper — like in business. So when we look at the web mess of the Obamacare rollout, we wonder, how did this happen? If it were a business that would never have happened. Well, (1) it is not a business, (2) it could have happened in business, but (3) it also should not have happened in government.

First, government is not a business. Even the business of government cannot be run like a business. For one thing, we don’t tolerate failure in government, whereas in Silicon Valley it is a badge of merit. For another, we require certain elements of fairness in the procurement process that businesses do not have to worry about as much. Of course, we do not tolerate corruption in either, but the need for transparency and fairness has taken the government procurement process to a whole different level. And the decision-making process in government necessarily involves far many more than even the most bloated of firms. These three elements, among others, can lead to extensive regulations, bureaucratic procedures, and undue delays in achieving results in government — what would seem to be a given in a substantial American business. So when one has to meet a deadline for a governmental activity, there are delays at the beginning in gaining the contract — often with political overtones in who gets the award, regulations to conform to during the period of developing the service, and changing decisions even late in the process, as there were with this project.

Second, plenty of businesses have failed in rolling out new products — I’m old enough to remember New Coke, but even Nasdaq’s mishandling of the Facebook IPO comes to mind. Costly computer flummoxes have occurred this year with Jet Blue, American and United-Continental Airlines, and RBS Bank, to name just a few. Again, in Silicon Valley, the approach du jour is to get it out as fast as possible, fix what needs fixing later. That doesn’t always work, but the mentality is certainly extant in high tech cultures today. I should point out, finally, that it was a business contractor, after all, that could not complete the Obamacare assignment in the time allotted in its contract.

Third, most important, this still should not have happened in a major government rollout. Comedian Andrew Borowitz laughs that we waited 40 years for health care coverage, and then we can’t wait a few minutes on the computer to sign up. I only wish it were just that simple. The rollout had to work, and it didn’t. As the president and many on Capitol Hill have intoned, there really isn’t any excuse for that.

So what can be done to prevent this kind of thing from happening again? The Aspen Institute Communications and Society Program has convened its Forum on Communications and Society for the past two summers on the topic of open governance. There we have heard from government officials, non-profit leaders, academics, and “makers” of digital products. The White House has produced a very impressive corps of computer-and-network-savvy people who have rightly touted the advances that the Obama administration have made in opening government data to the public. (On the other hand, others in the administration have led ferocious prosecutions of leaks in government and have challenged reporters’ claims of confidentiality more than any in recent times.)

With the strong force within the White House for open government, then, it is a bit remarkable that the president’s signature domestic accomplishment would be blown so badly.  Obviously there was a disconnect between the policies and approaches of the chief technology officer’s staff and the people rolling out Obamacare. That also happens both in government and in business, unfortunately.

Among the reforms suggested over the past two years at the FOCAS conference, funded by the innovative Knight Foundation, makers urged reforms in the procurement process to allow for smaller companies to solve software problems, especially at the local level. While this doesn’t solve the $400 million project, it is something to keep in mind for the many projects in digital governance to come. For example, I wonder how the successful process for state rollouts of health exchanges in states such as Kentucky, Washington, and California differed from the US government’s?

We should also honor and enhance the peer learning and recognition of government officials who do get it right, so that they can help others reach new heights and make a career of ICT within government. And finally, we can do more to identify citizen expertise at the local level and integrate them into advisory committees and other activities that would bring that expertise to governments at all levels.

Maybe by the time we do all that, those workers, advisors, and citizens will have access to wider health care online!