HealthCare.gov: Resources and Invention

The NY Times piece examining the perilously flawed rollout of HealthCare.gov is balanced and detailed. It is worth a read. It deconstructs the mad scramble to fix a problem that never should have happened given the resources applied to this big, but solvable problem.

Some details are in the NY Times article and countless blogs, and of course only those engineers involved know the real story. And despite the many educated guesses about the real net cost of the project, perhaps we can all agree a lot of the budget is waste blown on consultants and processes that didn’t make an iota of positive impact. In fact, a lot of the cash likely introduced risk by adding layers of management and friction that tend to dilute engineering focus.

I’m basing this on years of observations of large companies, agencies, consultancies and quite a ton of startups. It comes down to how cash and people are deployed, paced and exhausted. In large teams with virtually unlimited resources, waste creeps in before you can say “SCRUM” or “lean” or “iterate.” This is why “Lean” and “Agile” consultancies can charge a premium to swoop in and make big organizations more efficient. Don’t take the quotation marks as sarcasm- they undoubtedly can and do build effeciency where is is most needed. When resources are limited, one uses them efficiently out of the gate and knows when they are too costly to sustain. And most importantly, one spends the scarce dollars to ensure measurable progress and feasibility of the end goal. It seems to me the massive Healthcare.gov teams did neither.

The Healthcare.gov software cannot have been complex enough to justify even the smallest of the expenditure estimates I’ve seen. Let’s call it an even $100,000,000.00 before the rescue missions began in November. Now let’s refine that with a gross oversimplification: staff the project with 200 engineers at a cost of $500,000.00 each. With these folks, I’m quite sure a v1 of nearly anything can be built, launched and adequately monitored. I’ll further guarantee that this team can build a Healthcare.gov that supports at least hundreds of simultaneous enrollments and displays useful error messages beyond its capacity. What happened instead is shameful; embarrassing to the administration and inflammatory to we taxpayers who shelled out for it.

Technology can be hard. Coupled with government regulations and supercharged politics it must be really hard. But necessity (scarce resources) is the mother of invention. Invention yields systems that work. Predictably. Healthcare.gov was given virtually unlimited resources, and judging by the HTTP 500 error I saw only yesterday, its architects still have quite a bit of inventing to do.