DuhBy Peter Galuszka

With all the bloviating one reads about the introductory failures of ObamaCare, a big, big point is being missed. It could very well be that the concept of ObamaCare is viable if not  admirable, but the government badly bungled how it hired an under-performing, private lead contractor for the system.

That raises an entirely new and different set of questions. The concept of ObamaCare  is solid. It seems to be so in California and Kentucky which are among 14 states that chose to go with their own state-based health care plan exchanges. Neither state had any problems signing people up. Demand is apparently there.

In the case of the federal exchange, there seems to be some uncertainty about how the Obama Administration handling bidding for the overseer of developing the so-called “Federal Facilitated Marketplace” exchange through which people could apply for health plans.

Some accounts claim there was only one real bidder, a Canadian firm named CGI Federal, while others say that the Department of Health and Human Services received four bids from 16 pre-qualified bidders. Problems have come up before with contractors handling government system design. One only look back a few years at Virginia state government’s debacle with Northrop Grumman, but more later.

CGI Federal is a wholly owned subsidiary of CGI Group based in Montreal. It has sales of about $4.8 billion and 72,000 employees, many in India and about 11,000 in the U.S.

It has had some experience designing health care website, some of it unhappy. CGI tried to design a health registry for diabetes sufferers in Ontario for $46.5 million but the province ditched the firm after three years of missed deadlines. The Washington Post reports that CGI did have more success with the U.S. government, notably helping with a system for the U.S. Environmental Protection Agency.

CGI Federal, based in Herndon, isn’t a big player – only the 29th largest IT contractor for the U.S. government – but it does a lot of lobbying, spending $800,000 since 2006. That’s peanuts compared to what Lockheed Martin or Raytheon do.

CGI Federal got the contract to lead up to 55 smaller contractors. The bidding history is murky. The Washington Examiner says it was the only bidder,  but The Daily Caller quotes an HHS source as saying that CGI was one of four companies that bid on the deal.

In any event, after working on the project since 2011, CGI was awash with big problems as late was last summer before the Oct. 1 launch date. Subcontractors didn’t talk to each other. No one wanted blame for the growing evidence that the site couldn’t work. There were rumors that IBM, which supposedly had also bid for the CGI work, would take over, according to the New York Times.

Well, the marketplace didn’t work and an army of geeks is trying unscramble it. A really serious analysis would have to come from someone more expert on this blog, (perhaps from that NOVA IT badass, Don the Ripper).

Back to the point. Is the issue here really ObamaCare, a highly complex entity unto itself? Or are we talking about something rotten in our own beloved NOVA-land?

Not to forget Northrop Grumman. Back about a decade ago, during the craze to outsource most government services, the Virginia Information Technologies Agency handed over management of its data centers to Northrop Grumman in a 10-year, $2.4 billion contract. The deal was assigned in 2005 through the efforts of Democratic Gov. Mark Warner who had made hundreds of millions of dollars in the state’s private IT sector and was a big fan of outsourcing public functions.

Under Northrop Grumman’s watch, state agencies saw massive outtages and delays which meant that Virginians could not renew their driver’s licenses for a while.

The ObamaCare site is supposed to be fixed about now. We shall see. Still, it is important to separate the issues of contracting and executing IT functions with private firms from the real intent of ObamaCare. Let’s not forget that it’s really a Republican (Mitt Romney) idea after all.


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16 responses to “ObamaCare: Sound Idea, Bad Private Contractors”

  1. DJRippert Avatar

    http://blogs.wsj.com/cio/2013/11/13/california-health-exchange-outdoes-healthcare-gov/

    “Federal officials chose to oversee multiple contractors and built much of their website from scratch. They also delayed testing until shortly before the exchange opened, and required visitors to enroll before they could shop, a time-consuming and balky process. The result is a bug-filled website that has been hard to use.

    By contrast, California officials hired AccentureACN -0.18% PLC, a seasoned systems integrator, to oversee development of its website, Covered California, and used off-the-shelf software wherever possible. The state also repeatedly tested its site and let users view and compare plans on their first visit.”.

    As a side note, I worked for Accenture for 30 years.

    1. having worked on software for govt – weapons systems – for a while in my life, let me say that I’ve seen many a screw-up.. both govt and contractor…

      it usually involves a programmer who does not understand nor cares to understand user interfaces … which are fundamental to the internet.

      In our case, programmers writing software for sailors to use – sailors who are often high school grads not college grads – but more than that – software programmers who do not understand how weapon system software is actually used in a real shipboard environment.

      Healthcare.gov ran into the same issue.. programmers and managers who were not seasoned and successful developers.. but instead learning as they went along. The managers are responsible for this.

      you cannot turn over things like this to programmers .. they will screw it up.

  2. accurate Avatar

    Really Peter? Really? So Obamacare is in effect a huge disaster so rather than admitting to it, you’re going to blame the private contractors? Amazing, what’s next? Going to blame Bush too?

    I can just feel Larry coming on to this post. And in anticipated answer to his question – national health care should have been a government sponsored program to help those with pre-existing conditions (and pregnancy is NOT a pre-existing condition, things like epilepsy and MS are). It should cover a large portion of the costs for things like broken legs, a car accident in which there are several injuries. Instead we get a stupid program that covers maternity (which I won’t EVER use, being a male and because my wife is almost 60 and has had a hysterectomy). I HAVE to pay for birth control for the lady down the hall, be she 20 or 40 and has one or one hundred lovers, because she can’t afford the $20 or $30 a month? People get plans that cover a wellness check, but when something is found, they are staring at $2000 to $10000 of deductibles that they will have to cover before the insurance kicks in? Wanna guess what they will do? They’ll do without it (the operation or treatment). And for the privilege of getting birth control and wellness checks you want to charge people (people who didn’t have health insurance before) a fee of $150, $300, $500 a month and have the nerve to call it a good deal?

    Really? The WHOLE problem with Obamacare is the private party contractor? Wow – it’s very obvious that you and Larry carry Obama’s water, but you’ve hit a new high water mark with this one. The problem with Obamacare is the third party website developer – wow.

    1. actually my premise is pretty simple. Ronald Reagan signed the law that said we’ll give free medical care to those who are poor as well as those who choose to not buy insurance.

      Reagan did sign that law.

      from that point on – we committed ourselves to pay for others medical care.

      look at this chart and tell me Obama caused it:

      http://kaiserfamilyfoundation.files.wordpress.com/2011/04/health-care-spending-in-the-united-states-selected-oecd-countries_chart03.gif?w=675&h=396

      I don’t know about you Accurate – but until the last few years, I’ve seen some pretty bad websites for commerce. It’s take Amazon a decade to get their site optimised.

      there are other commerce websites that still suck.. and the govt has nothing at all to do with them.. they are bona fide crappy private sector systems.

      Obama and company pushed too hard and too far for such a fundamental change. It was arrogant and optimistic way beyond what common sense should tell you.

      On the other hand, the GOP are a bunch of feckless cowards who KNOW that our health care system was nosediving and they’ve done nothing – except oppose others efforts.

  3. Peter Galuszka Avatar
    Peter Galuszka

    Birth contrl?

  4. DJRippert Avatar

    The government doesn’t actually do much. The military doesn’t build the airplanes they fly. Lockheed Martin builds planes. The government doesn’t build hydroelectric dams. Bechtel builds hydroelectric dams. So it should come as no surprise that the federal government didn’t build the health care website. State government employees in California didn’t write Covered California. An Irish company named Accenture wrote that web site.

    OFraudmacare has worse problems than the web site. For one thing the system has essentially no security. It won’t be long before the private health data is leaking like a sieve. Then, the young and healthy are going to pay the fines instead of buying insurance. That will provide too little in subsidies so the older folks will have to pay more. You won’t get to keep your doctor any more than you can keep your health plan.

    Oh yeah – and the web site sucks because the federal government can’t even hire people to do the work that needs to be done.

    1. re: the govt doesn’t build stuff… well they do… but they also partner with the private sector.

      we have way too many who forget that the US – which includes civilian govt workers – puts GPS and Weather and Military communications satellites into orbit. They create Tomahawk missiles and world-class drones.

      every time you use Google Maps and Garmin GPS units, you are using govt-created stuff – all those maps are govt created maps.

      When the plane you fly comes into an airport – you are depending on FAA software… when you go through airport security – you are depending on US govt software for terrorists..

      when you go through a green light – your life depends literally on a govt worker.

      50 million people get their health care from Medicare… the bills get paid…

      many more get their health care from TRICARE – the military single payer system.

      others get their health care from FEBH – he Federal govt health care exchanges that serve 2 million govt employees from the guy who helped launch a NOAA weather satellite to the woman that works in an airport control tower to the border patrol guy who rounds up illegals to the Coast Guard lady that boards a drug smuggling boat to arrest criminals.

      1. DJRippert Avatar

        “When the plane you fly comes into an airport – you are depending on FAA software… when you go through airport security – you are depending on US govt software for terrorists..”.

        Not so much ….

        https://faaco.faa.gov/index.cfm/announcement/view/15278

        A lot of federal government software is written by contractors these days – often in turn-key contracts where the vendor pretty much runs the project.

        1. The Govt develops the CONOPS and the Requirements Document and they usually select a second, independent contractor to perform the IV&V.

          The government retains the authority and the responsibility for the final product once they accept the delivered product.

          the interface between the govt and the contractor is called a Cotar.

          Contracting Officer’s Technical Representative

          http://en.wikipedia.org/wiki/Contracting_Officer's_Technical_Representative

          The Government writes the Requirements and is responsible for insuring the product performs according to the requirements.

          changes to requirements are fraught with risks and often lead to delays and increased costs and sometimes a bollixed CF.

          There are virtually no major govt contracted products that don’t have issues.

          A Contractor I once interfaced with used to kid me by saying I could have only 2 of 3 of 1. fast 2. good 3. cheap.

          You can bet the FAA software has substantial govt influence on the functionality of the product just as they do with GPS or NOAA weather satellites, drones, military communications satellites, air craft carriers, etc….

  5. Breckinridge Avatar
    Breckinridge

    Obamacare is so many things. It is a big time income redistribution scheme, soaking the rich with a list of new taxes to provide subsidies for lower and lower-middle income families. It is a federal regulatory takeover of the health insurance industry, setting national standards where before there was a patchwork of state standards, and by controlling the money it is a de facto take over of the entire industry. It allows for a massive expansion of the Medicaid welfare program, which was already sucking most state budgets dry (meaning expect more state tax increases in time.)

    It has popular provisions, such as allowing parents to keep their un- and under-employed kids on family coverage until age 26 (fine with me, as they are usually quite healthy — why cut them off at all?) It has popular provisions that are also raising rates for everyone, such as requiring coverage for pre-existing conditions (also fine with me because I have a couple of doozies.) The bottom line is it is way too much way too fast and I think the problems are just going to multiply.

    Imagine if they had done this — just passed the mandate provision, with the financial penalty/tax for people who refused to go find some basic coverage on their own set high enough to truly make them do it.

    No, the website is an annoyance, a technical glitch. The real fun is just starting.

    1. I just think we should recognize the current realities also.

      Recognize the VA – which IS govt doctors. Why in the world if the spectre of “govt doctors” and “rationing” is so terrible, it is what we give to our injured warriors?

      Recognize that we provide seniors with 85K in retirement income with full coverage, guaranteed health insurance for 100.00 a month.

      Recognize that 1/3 to 1/2 of MedicAid is providing people with half million dollar homes with free long-term care.

      recognize that people with employer-provided insurance receive it tax free while the person who pays out of pocket pays with taxed money.

      recognize that hospitals get funding from the govt to pay for uncompensated ER care AS WELL AS are allowed to charge those who are insured .. $10 aspirin to help pay for the uncompensated care.

      I’m not advocating that since we already have subsidies that we extend them to others… I’m asking if someone who makes 85K in retirement income should not pay more than 100.00 a month for health insurance or someone who has a half million dollar home should get taxpayers subsidies for long term care.

      how fair is our system when we provide tax breaks and subsidies to some of us and deny it to others?

  6. Peter Galuszka Avatar
    Peter Galuszka

    B
    This is laughable. The problem with aca is that it is a sop to vested managed care. Half assed. Need universal coverage

  7. I have to disagree a little with Peter. The failure of the website is not that unusual with version 1.0 efforts – both private and public. We’ve seen many, many websites go belly up during the dot.com era and since then. It’s not uncommon. At one point in the past, Amazon.com was not good.

    and who among us has not received a notice from some company that has our personal data where they inform us that there has been an “incident”?
    I mean even the NSA can get your data, right?

    the problem with the website is that in order to quiet the crescendo of opposition, it desperately needed to have a tremendous immediate success in signing up people… a desperate and unrealistic expectation on the part of the administration and it played right into the opposition’s strategy because they do not expect the website to be dorked forever.. they just needed another hurdle so they could line up the next and far more potent argument which is that ObamaCare as a health insurance problem is fatally flawed .. aka.. the “LIE”.

    There was no way that changing so much of the health care system so quickly with so many people being affected – that it was not going to be a dangerous gamble.

    It’s also true ( I believe) that our current system is such a convoluted and dysfunctional system that attempts to change it are fraught with risk.

    This chart is also undeniably true:
    http://b-i.forbesimg.com/danmunro/files/2013/05/MMI20132.png

    and it’s hard to believe that ANYONE would argue that keeping the status quo is the better path.

  8. Being in New Zealand when much of this story broke, I missed several particulars — no doubt — but what truly frustrated from a distance was the Administration’s inability to “see” that they were forcing a disaster, which President Obama has now tried to back away from by postponing a couple aspects of the health care law. Since Peter and LarryG seem to have deep understanding of the need for and particulars of the Administration’s program, can I ask ya’ll a question which I haven’t seen addressed since I’ve returned?

    Why didn’t President Obama take Boehner’s “offer” (bargaining chip, delaying tactic, whatever) of a year’s delay on starting the health-care program when the Administration obviously needed that time to work out the massive issues, regardless of whether contractors or bureaucrats caused them? Since consultants had told his staff in plain English that the web issues were intense and that the program would not be ready for prime time last spring, the President cannot claim he didn’t know, can he? Conversely,, if he actually can claim that he didn’t know there were problems, why haven’t any heads rolled in the Administration? If no one told him when Boehner made the “offer” that it would likely be to his benefit to take it, then he should realize — shouldn’t he? — that his people are scared of telling him the bad news (which is always a recipe for disaster). One interpretation for his lack of action — either working with Boehner or later firing people who hadn’t told him the inconvenient truth — is that the President had to “win” in the political pissing contest (which is usually another recipe for disaster).

    Why didn’t President Obama take Boehner’s “offer” and then use the second-chance to actually manage what the world calls his “signature program?”

  9. ” Why didn’t President Obama take Boehner’s “offer” (bargaining chip, delaying tactic, whatever) of a year’s delay on starting the health-care program when the Administration obviously needed that time to work out the massive issues, regardless of whether contractors or bureaucrats caused them? ”

    Because he believed that Boehner had no interest in fixing the program but was merely buying more time to undermine it. Not once, has Boehmer indicated that he wanted to fix ObamaCare but instead get rid of it.

    “Since consultants had told his staff in plain English that the web issues were intense and that the program would not be ready for prime time last spring, the President cannot claim he didn’t know, can he? ”

    who says this? that’s important.

    “Conversely,, if he actually can claim that he didn’t know there were problems, why haven’t any heads rolled in the Administration? If no one told him when Boehner made the “offer” that it would likely be to his benefit to take it, then he should realize — shouldn’t he? — that his people are scared of telling him the bad news (which is always a recipe for disaster). One interpretation for his lack of action — either working with Boehner or later firing people who hadn’t told him the inconvenient truth — is that the President had to “win” in the political pissing contest (which is usually another recipe for disaster).”

    I’m not convinced that the POTUS knew of the status of the website but I’m also not convinced that it cannot be fixed by competent people fairly quickly. Software is notorious for first version issues.. both public an private… it’s not surprising nor unique.

    “Why didn’t President Obama take Boehner’s “offer” and then use the second-chance to actually manage what the world calls his “signature program?” ”

    Because Boehner had no intention to use that delay to fix the program. He wanted the delay to buy more time to figure out other ways to kill it.

    this is the problem. Neither Boehner or Cantor or any GOP has any intention of trying to develop a better health care program. They are opposed to the basic concept of the govt having any role in health care.

    This is the same philosophy they had back when Medicare was created. There were tales of govt doctors, rationing,death panels, etc.. as the GOP did everything it could to kill Medicare…

    and this is no different. The GOP is fundamentally opposed to the govt being involved in health care for ordinary citizens though they have no problem at all with the VA and TRICARE for the military apparently.

    they have no solutions… because they believe health care should be done by the “free market”.

  10. Peter Galuszka Avatar
    Peter Galuszka

    I agree with Larry. In the best of world’s, taking a year or so more to prepare for such a massive change would be entirely reasonable, but the political atmosphere at become so polarized with the Tea Baggers et al turning Obamacare into the new communism for the new MyCarthyites. ACA has morphed from a complex, needed yet flawed program into an emotional hot button icon for both sides.

    I gather it isn’t the first time a huge social program changing things has been so hot. My Republican grandfather despised FDR and social security. My own Dad, a doctor, had grave misgivings about Medicare back in the 1960s and then with managed care’s arrival in the 1980s. It think he was wrong overall, but a lot of his criticisms are still relevant today.

    If you want to see what the current system brings us, check out the NY Times last installment on medical expenses. A California hospital charges something like $140 for a Tylenol with codeine pill when the market price is 50 cents. The list goes on and on. This is WHERE WE ARE COMING FROM, pre-Obama.

    So, do you want to stick with this? If you don’t like Obamacare, what DO you like?

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