Obamacare: What we have here is a failure to integrate
The blame game was in full force on Capitol Hill today. Legislators finally got a crack at some of the major contractors who worked on Healthcare.gov, the federal government’s troubled online health insurance marketplace, during a long hearing. And the contractors were quick to point the finger right back at the government. One thing everyone agrees on is that the healthcare exchanges are a mess. The larger question is who’s responsible?
In the world of complex government contracts, overseeing an effort the size of the Obamacare often falls to what’s known as a lead systems integrator. Think of a general contractor on a house — managing the painters, plumbers and electricians. In the case of Healthcare.gov, it was a very complicated house with some 55 contractors.
“It appears that, in this particular case, the Obamacare case, the notion was we’re going to do the contract integration in-house,” says Paul Light, professor of public service at New York University.
By in-house, he means at the Centers for Medicare and Medicaid Services.
“I am hearing repeatedly and repeatedly that this, the bottom line here is, CMS is responsible for this failure,” Rep. Renee Ellmers, Republican from North Carolina, said at today’s hearing.
There have been lots of questions about why the government didn’t bring in some A-List integration firm to begin with. That used to happen, says Stan Soloway, who represents government contractors at the Professional Services Council. Then came Deepwater, in the early 2000s. The massive Coast Guard modernization program was initially overseen by private firms.
“It was not terribly successful, and a lot of people have pointed to the use of the lead systems integrator as the root cause of the problem,” says Soloway, although he says that’s not clear.
But if the government wants that job?
“The first thing they’re going to need to do is buy some more people,” says Trevor Brown, who teaches public affairs at the Ohio State University. “They’re going to need to recruit, hire, train and retain systems engineers, program managers, integrators to perform these functions.”
And Brown says competing for those talented folks has become harder. Not only can they make a lot more in the private sector — they don’t have to worry about shutdowns and furloughs.
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