Concept of Obamacare “Failures” Overhyped
There seems to be an increasing mention of the “failures” of Obamacare, which largely come down to failures in the computer systems. Ezra Klein’s Wonkblog piece is even titled “Five Thoughts on the Obamacare Disaster”, which seems overly broad since it does largely address computer system problems. But lots of the talk about the problems try to paint the entire ACA with a broad brush based on these IT failures.
But things are consistently left out of some of these stories to make it look like it’s something unique to government officials and/or Obamacare. First, the actual implementation of the computer systems was, of course, done by private contractors and not government employees. Secondly, there is a long history of large computer systems having failures including deadlines being missed, massive cost overruns and complete failures to deliver. The Financial Times recently had an article examining the problem. It’s a well known problem in the field. I’m part of a very small IT department for a small company. I’m still aware of how common these are. I can think of one example of a 7 figure project that melted down completely for a large company. Klein’s article talks about how Apple would have been firing people. He writes about accountability and all those wonderful things that the private sector supposedly provides. But the Financial Times article quotes one of the authors of a 2011 study of 1471 IT projects as saying
“The private sector is just much better at hiding these things,” says Mr Budzier. He points out that large blue-chip companies continue to operate failing IT systems because they are unwilling to write down the expense.
If you want to read what I consider to be a very good article that honestly examines the issues there’s this one from the Washington Post. It gives a good feel for the complexities involved in what it takes to do all the things that these systems have to do without going into technical details. It provides this graphic from Xerox that gives a basic idea of the complexity of the system.
I love that the graphic uses only one icon to represent the thousands of health plan carriers and their systems. Somehow I doubt that the contractor used nearly enough manpower or time for the initial research and design phases. These contractors need to be doing a lot work on fixing what’s gone wrong and the taxpayers shouldn’t be on the hook for any of it.