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The healthcare site problem, let me take a whack at this

I have about 7 minutes to knock this one out before the bus comes. The editorial board at the nytimes weighs in this morning on the healthcare site. But if you’ve never worked in corporate America on an project that requires IT, you may miss the subtle nuances of that kind of experience.

From what I’ve seen, there are usually a couple people waaaaaaaaaaayyyyyy down on the totem pole who know what’s going on and how to fix it, or want to take a new approach and have spent 6 months carefully identifying bottlenecks and opportunities.

The problem is that no one will ever hear from these people. That’s because they have to fight two management structures. They have to fight the IT management structure, which is full of borgs and vogons, and they have to fight the executive structure, whose business appears to be positioning on a status and power ladder.

To make any effective changes, the person who knows the answer has to get his expertise percolated up to the point where these two structures meet, and that is about 6 or seven levels up from where he or she sits. The borgs aren’t going to do anything without a change log thingy and the most political person in IT is, well, political. So, it’s his business to tell his mirror in the executive side that everything is peachy keen and people are working on it. The person on the executive side is covering his ass.

No one is going to put their necks on the line for the poor schlub in the trenches. Ell have meetings and tasks will be assigned but the real problems will likely not be addressed any time soon. Mostly, people just learn to live with it and find workarounds until a new contractor is brought in to design a whole new system.

The problem may very well be that there are too few full time employees ensuring the continuity of the code and coherence of the system and the MBAs are getting in the way because without systems to manage, they would have no purpose in life.

Gotta go.

21 Responses

  1. Without getting too specific about where I work, this sounds completely right to me and confirms something I’ve observed over the last 10-15 years – the increasing divorce between management and subject-matter expertise. It used to be that your managers, although they weren’t worker bees, knew what you were doing and could listen to you talk about it and act on it. Now we’ve got folks who are good at “management” as an MBA-style abstraction where the theory is that you can manage anything without really knowing anything about it. Obviously, you can’t But what it means is that these folks are so out of it that they not only don’t know what they need to know, but they seem to disdain the idea of even listening to anyone who would know. They only listen to people like themselves who have good social skills and can give good meeting, but don’t want to pay attention to anything else. Sorry about the rant, but you made a great point and really touched a nerve.

    • I managed our school’s IT assets by default years ago and did quite a bit of programming for various admin work. I was eventually replaced since I didn’t have the “appropriate” degree. I did all the computer stuff between and classes since I also taught a full load. I was keeping up around 50 computers at the time and was replaced by a manager who knew next to nothing and three full time employees. The dept now manages around a thousand computers and has 12 full time employees,so the old 60’s era IT departments have returned in a new form and the democracy of the PC has been replaced by the tyranny of the Priests of the Internet. And just as RD intimated, the Peter Principle is alive and well in these Java-driven theocracies. The private contractor who built the site should be getting torched instead of paid for rolling out a system that couldn’t handle the load– that’s straight-up an issue of spending dollars for capacity.

  2. Once more, with Obama office politics trumps “real” politics. He needs to surround himself with the Kool Kidz (TM) which means they may be smart but are hardly knowledgeable when it comes to subject matter.

  3. Deadlines set before scope will kill projects every time. They don’t know what they will build but they know when it has to be done.

    They also know how much money will be “available” for release 1 – that is staffing level and equipment – still without scope. Only then do they find out the project will take 6 months to complete the scope required AND by that time the project timeline has 3 months left since the front office (MBA’s) took 3 months to create the roles and responsibility swim-lane chart.

    Then, through the brilliance of more MBA’s, the only on-site staff is an architect/programmer, a business analyst and 10 project managers reporting to 5 program managers – with the rest of the development team outsourced. India has 10 major holidays during that 3 month remaining time frame, the programmer in charge of India team is getting married (at least 1 month off) and the underling programmer in charge during marriage just had a major family emergency.

    Been there, done that – still have the numerous t-shirts given as consolation prizes for pulling all-nighters to have “face-time” with India while all the project managers call 3 daily stand-up status meetings to interrupt any possible “flow”.

    You don’t even want to see the resulting code.

    Not that I’m bitter.

    • I always loved getting the specs for the program, spending months on the job, then right before the roll-out being told that somebody wants a change that will cause me to have tear the house down and start from the foundation again. Even object-oriented programming couldn’t save us from that horror, though that was the C++ pitch.

  4. What I want to know is when will our govt be asking for our money back from these bozos?…because while they had no say over the deadline, they did have a say on calling the timeframe bogus and unrealistic and refuse it.

    Of course, when you understand that the contract was payola, you realize that we’ll never see any of that worthless money again.

  5. I agree with everything in RD’s post and all comments…. And have my own questions & comments:

    Looking back, it’s almost like it was deliberately designed to fail. The HHS issued “Final” regulations in February that changed the situation significantly (one that I remember is that “affordability” for employee plans is based on the cost of the Employee-only policy, not the cost of kids & spouse…. and that IF the Employer offers a policy (at any price) to kids (which they have to by law) and spouse (optional) then Kids and Spouse can’t purchase on the exchange.

    Whew. Code that.

    Then the IRS issued their final Regulations the Friday after the fourth of July. More changes … More code changes.

    All the while, Sibelius is assuring us that everything is on schedule and testing is being done. HOW is that even possible. She made one of these speeches at the End of April. Months before the IRS released it’s final regulations.

    And this doesn’t even touch the Insurance end. Policies that still haven’t a final list of Doctors or hospitals. HOW the heck are people supposed to sign contracts for that?

    OK. Back to the Plan.

    If the President was really in charge, shouldn’t he have insisted on final regulations at some reasonable point … like a couple of years before the “Launch” date? Whose idea was it that this stuff could be designed, coded, tested, fixed, tested, adapted, tested and Launched in a matter of weeks?

    Who let them get away with pretending it was possible?

    Why are we still hearing about problems with the front end when the back end has to be as pretty as scrambled eggs?

    • I don’t think he *gets* the insurance problem. Not only did he not get the seriousness of the problem back in 2009, he doesn’t get that there are a hell of a lot more formerly health insured middle class people now. When I think about how many people in nj were laid off during Pharmageddon who are now seeing their COBRA expire or never got it at all, I shudder.
      The reason this program is FUBARED is because he minimized the tragedy, the tragedy that existed and the tragedy that was to come.
      In a way, he represented the uninsured about as well as he did his former constituents in Chicago. He was too busy tooting his own horn to realize that with great power comes great responsibility.
      Yep, we saw it all unfold before our eyes. I still can’t get over it.

      • I can’t get over it either. Not him. And not the local Congressmen who LIED right to my face about their commit to Universal Healthcare for Everyone. It was a lie because they never spoke up in ANY way for it when they had the chance to make a difference.

        I listened to most of Obama’s “speech” yesterday and it didn’t make any sense at all. They had to have that woman faint because listening to his speech was like listening to a foreign language. It was pure gibberish. He acted like he was reading a teleprompter but, no one could have written that out ahead of time.

        We all knew it was useless when they started talking “Health Insurance Reform” in place of “Health Care Reform” but, it’s been a long sad tragedy to watch it unfold.

  6. And if/when the exchanges problem gets fixed, then people will discover over time if the insurance is as bad as some predict. If it is, there will be rolling waves of bitterness. But the only way it would ever be repealed is if the Tea Party got veto-proof supermajorities in the House and Senate.

    • And by the way, Obama sounded just like a home appliance salesman on late nite TV, desperate to make the sale.

    • The repeal is just as terrifying. Obamacare did horrible things to the individual insurance market, ballooned premiums, screwed up networks. You just can’t put that toothpaste back into the tube. Someone who wants to REFORM the system is the only hope.

      Won’t be Obama, won’t be anybody in Washington DC.

      • Well, swap out Obamacare, swap in universal Medicare in the same law. Or swap out Obamacare, swap in Single Payer CanadaCare in the same law.

  7. I saw something very ordinary today that made me stop and wonder what Bizarro World I’m living in.

    A young lady pre-payng $5 worth of gas with crumpled bill and a handful of change obviously from her tip jar. I though to myself what kind of Democrat president dips into server’s and busser’s tip money so his Wall Street cronies can keep their yachts?

    I answered myself, the same kind of Democrat president that put a gun to their head and forces them to buy worthless health insurance they can’t afford on their less than minimum wage job.

  8. This ObamaCare disaster has the same qualities I felt when Katrina was ongoing. Bodies floating in the streets for days while the government was paralyzed by spin, incompetence, lack of leadership and accountability. This man-made disaster could be more devastating to more Americans than Katrina was. We lost a city for a long time. This time it could be millions affected in the whole country. And we can’t just be bussed to Houston to start over. Heck of a job, Barack!

  9. Just wanted to say that i enjoy what RD does here and the long-time commenters too. It would be nice if our leaders cared what happens in the real world and reached out for the kind of insight here that’s way better than anything they can get from their closed social circles. Just saying that y’all seriously rock!

  10. The level of incompetence is staggering. They’ve had years to get this system operational and it’s not even close to operational. I find it funny that one week after risking default to defend his “signature accomplishment” from the Tea Party, the ACA is FUBAR.

    The post and the comments perfectly encapsulate the situation in corporate America. Apparently, the Federal Government has caught the same disease. Posturing and telling easily digestible lies is a lot easier than actually running a company or, in this case, a large bureaucracy.

  11. Can you say: Criminal enterprise
    Can you say: Follow the Money
    Can you say: Another Operation Cakewalk
    Can You say: Health Care…Hell

  12. Well, in all fairness, name a gov program (or corporate one for that matter) that was this big and had a glitch free rollout.

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