Getting HealthCare.gov Out of Critical Condition

Yeesh, it’s been a rough few weeks for HealthCare.gov.

The federal website that is meant to provide an online marketplace for health insurance as part of the Affordable Care Act has proven dramatically unequal to the task. It faltered out of the gate. Over the weekend, it crashed for hours. Republicans have held congressional hearings about the mess. To fix things, there is now to be a “tech surge” led by Jeff Zients, a former business executive and economic advisor to President Barack Obama.

To those who were on the inside, sadly, many of the problems were predictable. “Confidential progress reports from the Health and Human Services Department show that senior officials repeatedly expressed doubts that the computer systems for the federal exchange would be ready on time, blaming delayed regulations, a lack of resources and other factors,” the New York Times reported earlier this month. “Deadline after deadline was missed.”

Yet White House officials considered any admission of stalled progress to be politically dangerous; acknowledging failure was not considered an option. Nor, given the political pressures, “was rolling out the system in stages or on a smaller scale, as companies like Google typically do so that problems can more easily and quietly be fixed,” the Times noted.

Viewed broadly, the problems of HealthCare.gov can of course be traced to ineffective government officials. “To be effective is the job of the executive,” Peter Drucker wrote. “‘To effect’ and ‘to execute’ are, after all, near-synonyms. Whether he works in a business or in a hospital, in a government agency or in a labor union, in a university or in the army, the executive is, first of all, expected to get the right things done.”

But, viewed more narrowly, the problems of HealthCare.gov were immensely exacerbated by the decision not to roll out the plan gradually, Google-style. Despite the politics involved, Drucker would have found this choice hard to forgive. “Nothing new is right the first time,” he wrote in Management Challenges for the 21st Century. “Everything improved or new needs therefore first to be tested on a small scale, that is, it needs to be PILOTED.” (Capital letters Drucker’s.)

On the bright side, Drucker would probably have approved of the appointment of Zients to fix things. When a project gets into trouble, wrote Drucker, “it needs a champion. It needs somebody who says: ‘I am going to make this succeed,’ and who then goes to work on it.”

Step by small step.

Do you think the problems of HealthCare.gov will largely have been solved by the end of November, as the administration is now promising, or will they linger much longer?