…said Richard Nixon, famously. Comes now Joe Biden, with “I am not a geek.” Specifically, in responding to questions about the problems with the Obamacare website and its supporting systems, Biden said:
“Neither (the president) or I are technology geeks and we assumed that it was up and ready to run.”
I don’t think the main problems with this implementation have to do with a lack of geekitude–most likely, there are many quite competent software developers working on this project–but rather with a lack of effective management. (And if there is a shortage of competent developers on the project, well, that’s a management issue, too, isn’t it.)
Real managers, real executives, don’t assume that important things will be ready when they’re supposed to be ready, and they aren’t satisfied with superficial answers to superficial questions, either. These effective leaders are people who have developed effective questioning skills so they can find out what is really going on. They establish open, non-fear-based organizational cultures so that people with concerns feel able to bring them forward. As I noted in my post about Benghazi (excusing failure by pleading incompetence), it is the responsiblity of an executive to establish an information and decision-flow architecture…including clear assignment of responsibilities…to ensure that the right things are seen and acted upon by the right people at the right time. Failure to do this..and to maintain and tune the system over time…will predictably result in catastrophes.
Later in the interview with Biden, the Vice President also said he didn’t know the specifics of why the website isn’t working, but that he was told the platform “is fine, but they have to change an awful lot of the inputs.”
“Look, all I know is they talk about 50,000 lines of this and this, I don’t know the technical reasons,” Biden said.
”So I don’t know, I wish I could tell you, that’s why I became a lawyer,”
A pretty flippant response to a serious situation. Slow Joe might not be able to understand the technical reasons for the failure, but he should be able–if he were competent at his job–to investigate and understand the management reasons for the failure.
Some of the questions that come to mind about this debacle are: How were the contractors selected? Why was it decided to have the government (CMS) act as prime contractor, rather than choosing an external company for that role? What do the contracts with the outside contractors actually specify, in terms of deliverables? What remedies are provided in the contracts for failures in delivery? If these remedies are inadequate, why did the government not require that they be more stringent? What coordination vehicles were there between the government group writing and interpreting the Obamacare regulations and the separate group that was attempting to act as prime contractor? Was there a single individual in charge? What project scheduling and tracking methods were employed throughout this effort?
These are not issues that are specific to software technology–the above questions are ones that any good executive, whether his background is in construction or in theater or in wholesale distribution, would understand that he should ask.
A United States President is not elected as a philosopher king; he is elected to run the executive departments of government and to faithfully execute the laws passed by Congress. The members of the present administration have repeatedly demonstrated their utter incompetence to perform these tasks.
An administration that seeks endless expansion of government’s role–but is at the same time completely incompetent at carrying out basic executive tasks–will drive expanding circles of chaos throughout ever-broader reaches of American society and the American economy.
Biden gave up on geekhood after he tried to do his own brain surgery. We see how that worked out.
“I am not a geek” is the positive spin on the “I was told there would be no math” that SNL used to use to make fun of Gerald Ford. BTW, Ford was likely better at math than Carter.
The pattern should be obvious to all by now that this administration is designed by lawyers to avoid responsibility and criminal prosecution for all of its policies.Many of the scandals require the DOJ to prosecute individuals that were originally advised by the DOJ as to the legality of their actions.
So let me see if I understand: Biden became a lawyer so he wouldn’t have to read 50,000 lines of fine print?!?
Once again, we have proof of two things: every technocracy (or as it once as called “Scientific Socialism”) will be run by corrupt politicians, not, you know, actual engineers and scientists; and lawyers and politicians should be banned from elective office.
The situation by which politicians (that is, lawyers) believe they can hire technical expertise should be reversed. Legal expertise can always be hired. Judgment should be made by real experts, not legal experts who play real experts while in office.
We live in a society in which lawyers propose laws; lawyers write bills; a lawyer signs a bill into law; lawyers in regulatory agencies decide how to apply the law; lawyers sue regulatory lawyers to force changes in regulations; lawyers sit in judgment of which set of lawyer’s opinions is correct, and lawyers are talking heads explaining it all to what is laughably called the citizenry. And for some reason this is called “democracy.” As in “demos,” or “the people.” Well. Some people are better than others.
VI, Carter was trained as an engineer, Ford was a lawyer. I seriously doubt FOrd was better at math.
I have noticed a trend in government agencies in the last 6-7 years to ignore private prime contractors and assume that role themselves. TVA has done this at Watts Bar Unit 2 and has proven their incompetency at it.
“VI, Carter was trained as an engineer, Ford was a lawyer. I seriously doubt FOrd was better at math.”
Carter’s qualifications have been greatly overstated. He was NOT a nuclear engineer. He was an Annapolis graduate and qualified as a deck officer. He did not finish nuclear school. The whole Rickover thing was a myth.
Here are a few simple questions that any lawyer who was competent at management should have asked early in the process:
1. What is our track record (in the federal government) of bringing large software projects in on time and under budget?
2. What are the chances that this technology is going to work right off? What’s plan B if it doesn’t?
3. If things go wrong, how will we know we are in trouble and how early will we be able to tell?
None of these questions require the slightest bit of technical know how. There are other questions that could be added given a modicum of awareness but these don’t even need the smallest bit of technical knowledge.
For the record the answers are:
1. Poor
2. Poor, and Plan B traditionally is to cut features and put off deployment
3. We will know based on milestone slippage and we’ve got milestones every few months.
From memory (I gave away at least half a dozen copies):
“The Mythical Man Month” by Fred Brooks had a chapter titled “Milestones as Millstones”. The front piece was a picture of a menu from a New Orleans restaurant. On the menu was the statement: “An omelette takes three minutes to prepare. We could make it in two but you would not like it”.
No management team could have delivered Healthcare.gov in the time allotted. For example, SABRE, the airlines reservation system, was designed in 1957 – more than 50 years ago.
Just can’t do it, folks. Not even with magic.
A budget of about a trillion dollars and you guys expect prez and vp to be much concerned about a specific coding effort?
I bet if this was a Republican administration you wouldn’t take shots at prez and vp competence, butinstead focus on the companies which did a poor job, at Sebelius – or ignore it, claiming that Democratic critics of the issue are whining.
Or ore the blog archives 2003-2007 full of complaints about the many displays of incompetence of the GWB administration?
S O – actually, they are.
A budget of about a trillion dollars and you guys expect prez and vp to be much concerned about a specific coding effort?
Yes, because the success of the coding project is critical to the success of the enterprise as a whole, and because the management of the coding project is a proxy for the management of the enterprise as a whole. The President and his subordinates have failed all tests of managerial competence yet have no intention to revise or scale back their grandiose plan to put the federal govt in charge of American medicine.
I bet if this was a Republican administration you wouldn’t take shots at prez and vp competence, butinstead focus on the companies which did a poor job, at Sebelius – or ignore it, claiming that Democratic critics of the issue are whining.
Or ore the blog archives 2003-2007 full of complaints about the many displays of incompetence of the GWB administration?
You bet wrong. The blog archives are full of complaints about the incompetence of the Bush administration in handling the Iraq and Afghanistan wars, to mention just one example. And even if we were inconsistent, so what? Our criticisms of the Obama health scheme stand on their merits. Your accusation of partisanship comes across as an indication that you lack better arguments.
Roy Lofquist..the SABRE system contract was signed in 1957. The system was fully operational by the early 1960s. The issues involved in developing this system were far more difficult than those faced by healtchare.gov…SABRE was the first commercial on-line system, and the developers did not have any available appropriate operating system or transaction processing monitor to draw on; they had to create their own. Terminal hardware also had to be developed, and a telecommunications network had to be created from scratch.
http://en.wikipedia.org/wiki/Sabre_(computer_system)
(On the other hand, the passenger reservations process, while complex, was at least well-defined, unlike the chaotic situation with regard to the interpretation of the Obamacare legislation.)
Another early large-scale computer system was the SAGE air defense system, which I wrote about here. Computer technology was still in its infancy when this project started, to the point that magnetic core memory was a new and untried technology. Data communications was being created for the first time. The decision to build SAGE was made in 1953, initial deployments were in 1958, and the full system was in place by 1962.
After 25 years or so of online businesses: my auto insurance company’s is able to process my data and vet me in minutes, I’m applying for and banking online, Amazon, thousands of business…..the examples of online data interfacing/processing with the public are almost endless. Surely the administration could have obtained a system that was practically “off the shelf” (a framework, a skeleton, that would only require, if not minimal, rather modest detail changes).
Collecting information, giving the “customer” a message “Your data has been recorded and will be processed ASAP….we’ll get back to you in the near future.”, or something of the sort, should have been an easy task.
It’s hard to believe that the software is the problem but IF the interface is truly the problem we can look forward to a corrected interface working with the morass of the law itself (nice pic of actual act: http://www.washingtonpost.com/blogs/fact-checker/post/how-many-pages-of-regulations-for-obamacare/2013/05/14/61eec914-bcf9-11e2-9b09-1638acc3942e_blog.html). That task (to the extent it’s not the real problem already) will likely dwarf interface/programming glitches.
One problem that healthcare has, which other types of systems don’t have, is that it has a near infinite number of variables. You can do studies that limit the variables, as I have done, but then you will find a limited number of answers.
For example, I was a vascular surgeon and, when I retired, I decided to study quality measurement, and hopefully improvement. I spent a year at Dartmouth. They had been heavily involved in the design of Hillarycare and were the best place in the country to learn about measurement. They were developing The Dartmouth Atlas of Healthcare when I was there and it came out about a year after I finished.
Their studies, and the Atlas, were based on the concept of variation. Jack Wennberg , an epidemiologist, first got interested in this when he was the state health officer for Vermont. He did a study of tonsillectomy and found the rate varied all over the state. He investigated and found that the rate of tonsillectomy was not based on any real data but was a matter of opinion of the local doctors. If a well regarded doc liked the procedure, that was the common practice of that community. He studied the incidence of ear infection, the rationale for tonsillectomy in kids, and found it did not follow the tonsillectomy rate. There was no relationship. Some towns had high rates of tonsillectomy but high rates of ear infection, too. Eventually, as a result of his studies, tonsillectomy fell out of favor in this country.
It’s a long story and has little to do with politics but the concept of variation is basic. If a condition has an obvious treatment, like broken hip, there is little variation. If the treatment is not well established, there is lots of variation. The number of factors involved is enormous as there are almost as many variables as there are people. The combinations are nearly infinite unless there is an obvious treatment, like appendectomy, or penicillin for syphilis.
A bunch of politicians are not likely to get this.
MikeK…as Rose Wilder Lane put it:
Nobody can plan the actions of even a thousand living persons, separately. Anyone attempting to control millions must divide them into classes, and make a plan applying to these classes. But these classes do not exist. No two persons are alike. No two are in the same circumstances; no two have the same abilities; beyond getting the barest necessities of life, no two have the same desires.Therefore the men who try to enforce, in real life, a planned economy that is their theory, come up against the infinite diversity of human beings. The most slavish multitude of men that was ever called “demos” or “labor” or “capital” or”agriculture” or “the masses,” actually are men; they are not sheep. Naturally, by their human nature, they escape in all directions from regulations applying to non-existent classes. It is necessary to increase the number of men who supervise their actions. Then (for officials are human, too) it is necessary that more men supervise the supervisors.
Quote:”Real managers, real executives, don’t assume that important things will be ready when they’re supposed to be ready, and they aren’t satisfied with superficial answers to superficial questions, either. These effective leaders are people who have developed effective questioning skills so they can find out what is really going on.”
But, that implies that there is concern that the task be accomplished successfully. To date, there is little to no proof that those in power want the exchange to work. Perversely, if it fails, then the fall back position, after the insurance companies have been bankrupted and run out of business, is the government single-payer solution. As desired, and expressed to be the ultimate goal by the current POTUS.
They do not care if it fails as that just accelerates motion towards their stated goal. Plus, Mochelle got her friends some plum FedGov dollars for a product teenagers could design and code in their garage…
” We don’t have to care, we are the Federal Government.”
I do not believe it is possible to centrally manage the US health care system using command direction. The more complicated a system, the worse the central command system works. I found Rose Wilder Lane’s quote most appropriate. It isn’t about information technology. It is about choice and differences. Using decentralized, competitively decentralized decision making by individuals renders the best chance for individuals to get more of their desires in a world of scare resources. This requires and encourages each to efficiently gather information, assume risk and learn from experience. Outcomes will generally be uneven and less than optimal given scarcity, unequal skill and diligence and resources, but static results will be superior for the large majority and dynamic results will be superior for the vast majority. Given human charitable motivations, I don’t think it is any stretch to predict that the outcome will be superior for virtually all. The only disadvantage (from the ruling class perspective) for the decentralized system is that it limits the opportunity for the power elite to control the outcomes for others (which they blissfully continue to assume they are better able to choose for them, regardless of repeated catastrophic but artfully rationalized failures) while assuring themselves the most favorable outcomes.
Lawyers are perfectly suited for the role of central managers (as are many academics). They are trained to be adept at arguing both sides of any issue without needing any conviction of what the truth is by selecting or presuming facts as appropriate. They are generally quite convinced that outcomes are based on words, especially the effects of words on other’s opinions, not on actions. They believe they are much better at getting outcomes for their clients because they are smarter and better able to convincingly use words. In the case of academics, they often see themselves as both smarter than their students, and possessing more enlightened values. Their goal becomes much more to instill these special values into their students rather than promoting critical or independent thought based on inductive and deductive reasoning based on unbiased inquiry tested against reality for outcomes. Neither group seems to be to be held to effective accountability for ultimate results. Lawyers are paid no matter the outcome and academics have tenure. Both operate in highly closed structures. Both have clients with asymmetrical knowledge so continued practice is generally assured.
I’m not sure that engineers or scientists would be much of an improvement. They could be expected to succumb to the fallacy that being smart enables you to make choices for others better than they can do so for themselves. The crux of the issue is the egotistical belief in centralized power and access to that power. I may think I know what my neighbor should be doing, but I limit my attempts to influence him to social interaction. Political power is coercive and most often counter productive to him learning to conduct himself in his own best interest. This includes externalities. There is no system that is perfectly optimal, even if we could know what that would be. It is about what generally works best.
The only way I see to avoid the cancer of centralized planning and coercive control is to eliminate the possibility of political power being used in this way. Well, it seems to me that the very specific prohibitions contained in our founding documents were breeched at least a century ago and the progressive (pun intended) ballooning of centralized political power and control are increasing at an increasing rate. This cancer may be incurable as the constituencies supporting the “free” stuff grow . Perhaps it can be slowed by the abject failure of this healthcare application. Or perhaps this failure will simply mean another doubling down by amending it to greatly increase government supplied healthcare. Already the expansion of Medicaid enrollments seems to be much larger than the exchange private plans.
If those of us who have no faith in the long term viability of central command run economic systems are right, we ought to be thinking that this system will fail. How much it takes with it is a very good question. Perhaps some of those opting out of this system using more individual and market based healthcare arrangements will show the way.
Mike
“A budget of about a trillion dollars and you guys expect prez and vp to be much concerned about a specific coding effort?”
YMMV, but if that coding effort was to implement something NAMED AFTER ME and was supposed to be one of the signature accomplishments of my administration, then I’d be very interested in how well it was going.
Yes Mike K. Imagine if tonsillectomy were codified, in vogue, and found their way into Obamacare. How much time would be required to change the coded behavior? Would the practice ever stop? It boggles the mind.
The interesting thing is that middle ear infections, the original rationale for tonsillectomy, have been increasing. We now see mastoid surgery, which had nearly disappeared after antibiotics became available, becoming more common. The current treatment for middle ear infection is putting tiny tubes in the ear drum. It’s pretty common. Between PE tubes, mastoidectomy and mild hearing loss, the improvement after the reduction of tonsillectomy is not that large. Lots of 18 year old kids have to have tonsillectomies and the pain and disability at 18 is ten times that at age 3.
No IPAB is going to figure out the perfect path through that maze of data and contradiction.
Now we see the beginning of an attempt to force doctors to serve the state. The decline in reimbursement plus the increase in female doctors who work reduced hours, have resulted in a marked reduction in work volume by doctors. This was exactly what admissions committees were worried about in the days when women applicants were discriminated against.
We are approaching the state of chaos theory in medical care. Too many variables. The left ALWAYS turns to coercion. My generation of physicians says good luck !
I am SO HAPPY that I had my children’s tonsils and adenoids both removed from both kids (we had both done at the same time so we only had a couple of terrible nights sleep instead of one kid at a time). They sleep WAY better at night, and their general health is WAY better. The damned things were the size of golf balls practically. The trauma of little kids with this procedure is minimal. They even received amnesics so they don’t remember a thing.
Both my wife an I had ours out at an early age and to us it was a no brainer. But many parents tried to talk us out of it and one doctor had the nerve to put some undue pressure on us (he wasn’t the surgeon) not to do the procedure.
It’s remarkable how this administration flaunts its haplessness and incompetence, over and over. What is this, the fourth scandal this year alone? Now that we’re getting into its twilight hours, Pretty Hair and Sexy Voice are getting pretty blatant about signalling it. They weren’t told about this, and weren’t told about that, and don’t have the competence to work out the third thing. Time to move on to next week’s apologies. What’s next, holding a “call 911 please help me” sign while reading from the teleprompter?
I dunno, whip smart media, are the two figureheads trying to tell us something?