Steve Brill’s account of how some of the nation’s top tech talent turned HealthCare.gov from a frustrating bottleneck into a functioning gateway to health insurance is an entertaining read. I long ago lost track of the thread on who was doing what in site repair. I had thought there really wasn’t much of a “tech surge,” just the team of original contractors patching things to spare themselves further embarrassment. That’s far from the correct story, according to Brill.
But the fundamental problem seems to be as I thought. The trouble was due to a colossal and potentially avoidable failure of leadership.
What Abbott could not find, however, was leadership. He says that to this day he cannot figure out who was supposed to have been in charge of the HealthCare.gov launch. Instead he saw multiple contractors bickering with one another and no one taking ownership for anything. Someone would have to be put in charge, he told Zients. Beyond that, Abbott recalls, “there was a total lack of urgency” despite the fact that the website was becoming a national joke and crippling the Obama presidency.
David Cutler urged the Administration to make management changes back in 2010 and he repeated his concerns about leadership in December. That some talent and could turn things around within two months is remarkable and very lucky. As bad as it was, it could have been much, much worse. It also could have been much, much better. According to Cutler, with some management changes now, it still can be.