The 80 Percent Solution to Healthcare.gov

Not only is healthcare.gov a poorly-packed parachute with an 80 percent likelihood of working for people who try to use it, the government that constructed the health care canopy knew it would fail to meet its promise for 20 percent of the certain-to-be disappointed insurance-shopping public.
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Sunday's Washington Post front-page headline, "Room for error in goal for health site," and its subhead, "1 in 5 could still be unable to enroll," led into a story that left me shaking my head... in disbelief and disappointment.

Let's rewind the www.healthcare.gov tape for a moment, run it back to 2011 when the Department of Health and Human Services contracting offices called for bids for the website's creation. Almost every federal contract has a statement of work -- ironically called a SOW -- that gives competing contractors a full description of what is expected of their finished product. A statement of work for a new airplane, for example, would include things like:

"Airplane must have wings (2 preferred); a tail; an engine capable of lofting the airplane skyward; a place (cockpit) for a pilot or pilots; instruments to help get it from one place to another, and so on, in a statement clear enough to ensure that the contractor not only knows what to build, but how it should work, too."

According to the Post story, the SOW for healthcare.gov that was given the contractors was a bit short on some performance details:

When HHS in 2011 invited contractors to bid on the chance to build HealthCare.gov, the department's "statement of work" did not include requirements typical of many IT contracts in which interested companies must spell out how the system would perform, according to an industry representative close to the project, who was granted anonymity in order to speak frankly. The agreement that CGI Federal, the company chosen as the main contractor, signed on Sept. 30, 2011, also did not contain specific performance criteria, success measures or response times.

At least three years ago, the companies competing for what should have been one of the most important websites in the history of the Internet -- not to mention what should have been the shining avatar for President Obama's healthcare legacy -- were not given key information about what was expected of the site, how to measure the operation of the site, or how to define the site's performance.

You can't make this stuff up.

On top of that, all along, the government was figuring that 20 of every 100 users would fail in their attempts to successfully navigate the insurance marketplace. As reported in the Post, "It [the administration] acknowledges that as many as one in five Americans who try to use the Web site to buy insurance will be unable to do so."

To put that into perspective, here are a few examples of a 20 percent failure rate:

You send out 100 Christmas cards -- only 80 are received; FedEx promises to successfully deliver 800,000 out of 1 million packages -- the other 200,000 never make it to the truck; for every 1,000 miles of interstate highway you travel, 800 are paved; you order a dozen roses for your sweetheart -- the florist delivers nine and the stem of one more; an aerial adventure company promises that eight of the 10 parachutes it provides to your skydiving club will work -- but they don't tell you that until after everyone has jumped from the plane.

So there you have it. Not only is healthcare.gov a poorly-packed parachute with an 80 percent likelihood of working for people who try to use it, the government that constructed the health care canopy knew it would fail to meet its promise for 20 percent of the certain-to-be disappointed insurance-shopping public. That may be fine the majority of users, but it's a long, long fall for those who are left with just a ripcord and an empty insurance pack on their back.

In the immortal words of "Captain," Strother Martin's chain gang superintendent character in the 1967 Paul Newman classic, Cool Hand Luke, " What we have here is failure to communicate!"

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