Why Politicians Shouldn’t Manage Projects – Affordable Care Act Lessons Learned

Greetings Leaders…

I cringe every time I hear of a government run IT project gone bad. I watch in amazement as project after project, especially in the IT arena, goes down the tubes when run by the government. I’m not talking about IT Infrastructure, things like servers or networks but about true software development. Over my career in Project Management, I’ve worked on many government projects and also been around many others who have… and it is very easy to see why they fail, and yet the trend continues despite many studies and hundreds of millions of dollars spent to fix the problem. The problem is not project management, it is the politicians. The Affordable Care Act is just another example of why politicians shouldn’t run IT projects.

As I read the news about the “failed” ACA website, it is pretty obvious politicians are absolutely clueless about managing projects. Any experienced project manager saw this coming about 2 years ago and the performance of the website shouldn’t have surprised anyone. Here is the very predictable road map to how this all occurred.

Lack of Cohesive Vision

With Republicans and Democrats fighting from day one about the ACA, it is not surprising that a cohesive vision did not exist. You can give President Obama some kudos for laying the vision out there, but while the democrats were able to ram the ACA through because of numbers in the House and Senate, they never got buy-in from the Republicans. There is blame on both side of the isles though, as the Republicans also had a choice, and they chose to fight from an absolutist position, rather than trying to make the ACA work. A question to my colleagues in project management, what are the odds of a project succeeding if the project owners are in disagreement over the vision of the project? Right… not very good. From Day One, the stage was set for failure.

Lack of Concrete Requirements

Lack of Cohesive Vision, leads to lack of concrete requirements. When the Republicans were falling on their swords back in September and October of this year, I shook my head. It was clear that they didn’t understand a thing about how projects are run. Regardless of your position on the ACA, trying to cancel it at the last minute was just plain stupid. Millions, if not Billions of dollars were already spent getting ready for it. To just cancel it, or even just postpone it, was impossible. The healthcare industry does not have an on/off switch. The complexities of healthcare administration would require at least a year to back out all the changes that were put in. There were system changes, benefit plans, communications, market analysis, provider contracts and so much more that would need to change before you could just turn off the ACA.

The infighting over the past two years caused changes to the requirements that the healthcare industry had to try to accommodate. Another question to my project management colleagues, what are the odds of a project succeeding if the requirements are continuously changing up to the date of implementation? Again… not very good. If the Republicans had a clue about how healthcare really worked, they would have just kept their mouths shut and waited for the ACA to implode.

What could the Democrats done to help prevent this from happening? Well, any good project manager knows it is about setting expectations. The Democrats should have been talking with the healthcare industry, looking for health indicators about how things were going. In healthcare, the Centers for Medicare and Medicaid have done this somewhat successfully with HIPAA and ICD-10. The Democrats set an unrealistic deadline without checking back in with the industry to see how it was doing. It is not surprising that the ACA website was not ready given the changing requirements and a deadline that was set without checking back in with the industry.

Groupthink

After the Challenger accident back in 1986, and the studies that indicated that groupthink was a very large contributing factor to it, I am amazed that politicians think that just ramming something through and throwing money at it will ensure its success. Groupthink occurs when a group loses sight of reality based on misperceptions about the groups strengths and weaknesses. One of the reuslts of groupthink is that those outside of the inner circle (democrats), begin to use self-censorship to avoid being percieved as not supportive of the group. In the case of the ACA website, I’m sure the consultants felt that they needed to deliver a message in-line with their political sponsors. On the other hand, even if a true status of the project was delivered, those running the project for the government may have not heard the message because of the effects of groupthink, or worse yet, may have altered the message as it was pushed up the chain. I don’t have enough information to know which one of these things happened, but am willing to bet that groupthing was prevalent and a very high contributing factor to the ACA website failure.

Lack of Change Management and Project Control

The last factor that bears mentioning here is inadequate change management and project control. I am certain that the government had oversight on a project as big as the ACA website. Yet, the controls they had in place were not adequate to predict the success or failure of the project. A very common falacy surrounding change control is that if you monitor and document the changes to a project, that you’re doing a good job of managing it. This is true to a certain extent, but if project stakeholders were not making decisions about what could realistically get done by the resources in place, within the given timeframe of the project, then tracking the changes means almost nothing at all. What should have happened, is that as changes were being made to requirements, the impact to the overall project would be assessed and timeframes moved as necessary to accomodate them. What the democrats should have fought for, was a stick in the ground, or a line in the sand that was set back in the spring of 2013. Any changes after that, should have come out in phase 2, perhaps in mid 2014.

There is so much more that could be written about why the ACA did not meet expectations on October 1, 2013. I hesitate to use the word “fail” because that is such a relative term. On a closing note, I was disappointed that President Obama threw in the towel yesterday and allowed Insurers to extend policies currently in place beyond 1/1/14. This is not based on a political bias, but on a project management perspective. He made the situation worse, by throwing more uncertanity and yet another changing requriement into the mix at the last minute. What he should have done, was look out six months down the road, and ease the requirement of what kinds of benefit plans that health insurerers could offer, and use the “try it first” approach. If after trying the benefit plans for six months you don’t like it, allow people to move to another benefit plan similar to the one they were on in 2013, if the health plans chooses to offer it.

All the best,
All the time,
JT

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