12 March 2013

ObamaCare vs IT

Asymmetric Information | Megan McArdle | Administration Extends Obamacare Deadline Yet Again

At some point—some point very soon, I think—it will simply no longer be possible to get a state-based federal exchange up and running in the required time. It's not clear to me why HHS is running the risk of a major, catastrophically embarassing delay, rather than simply acknowledging that they're probably going to be running exchanges in at least half the states, and moving forward accordingly. So far I have three possible theories, all of them unsatisfactory:

1. HHS has a crackerjack squad of IT Ninjas who can parachute into a state on March 1st and deliver a fully working data application, securely integrated with local agencies, insurance companies, and the IRS, less than nine months later.

2. It will be less complicated than I think to build this system, or it does not require nearly as much procurement or integration with local agencies and companies, so that functionally you can just stamp out 25 or 30 identical copies of the exchange in very little time.

3. HHS has wildly underestimated what is involved and is going to badly slip its deadline in the desperate hope of coaxing a few more states on board, most of whom would anyway badly slip the deadline.

As I say, I don't find any of these entirely convincing. But one of them must be true.
I think I can resolve this. Which is more likely to be true of the decision makers at HHS who are doing this: are they (a) acutely aware of software engineering difficulties and IT processes, or (b) are they focused on political problems and processes?

If you ask a software engineer if it will be easier to deal with a technical roadblock or a beauracratic one, he'll tell you the latter is easier. Technical problems require real man hours hunched over a keyboard; political problems are solved by clueless people blathering at each other across conference tables.

If you ask the beauractrat the same question, he'll tell you the former is easier. Technical problems are things you can hire geeks to deal with; political problems require him to have uncomfortable conversations that may lead to his reputation taking a hit.

So who did HHS put in charge of rolling out these exchanges? I don't know, but I'll eat my shoes if that person knows their way around a Makefile.

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