Gee, what a co-inky-dink. A new report on the rumblin’, stumblin’, fumblin’ rollout of Vermont Health Connect was released on Friday afternoon.
Before Labor Day weekend.
When Governor Shumlin was hundreds of miles away, at his vacation home in Nova Scotia.
The report is pretty damning, and should have been tackled head-on by the Governor instead of being shuffled quietly out the door on a holiday weekend. It’s not too late; he could come back to work, express dismay at the report’s conclusions, take repsonsibility for administrative failures, promise to learn lessons and do better in the future, and maybe even fire a few people.
Now, that would be leadership. And it would allow the Governor to launch his re-election campaign next Monday in a strong, purposeful, and accountable manner. Do I think that will happen? Eh, probably not. But it’d be nice.
The report was written by Optum, the consulting firm that’s trying to fix the mess left behind by former contractor CGI. Topline, per VTDigger:
A lack of leadership at Vermont Health Connect left the tech firm CGI unaccountable for work it was supposed to complete on the state’s health care exchange, according to a consultant’s report released Friday.
The state “ceded” responsibility for the project’s success to CGI, …and as a result, “CGI has not met its commitments.”
This is bad. This is not a technology issue in a super-complicated new system, as the Administration has insisted; it’s a failure of management on the part of Administration officials who should have been riding herd on CGI. Instead, the Vermont Press Bureau’s Neal Goswami says,
Optum found that accountability for program management is unclear. “Neither (the state) nor CGI believe they are accountable for project outcomes,” the report says.
Am I the only one who’s appalled by that? CGI was fired for poor performance; but state officials failed to make CGI “accountable for project outcomes.” As any business-school professor could tell you, that’s fucked up. And if CGI deserved to be fired, so do the government officials who played a big part in its failure.
And none of those officials are named “Doug Racine.”
Optum recommended that the state hire a project manager with experience in handling large-scale IT projects. State health care reform chief Lawrence Miller says the state is about to hire such a person.
Well, huzzah. That’s a little bit late, isn’t it?
In March, TIME Magazine published a cover story about how the federal health care exchange was on the brink of complete failure last fall. The Obama Administration realized, belatedly, that while they had a lot of policy expertise, they were woefully short in IT. So they basically called the Geek Squad: a team of IT experts from Silicon Valley “dropped what they were doing… and came together in mid-October to save the website. … Washington contractors had spent over $300 million building a site that didn’t work, this ad hoc team rescued it and, arguably, Obama’s chance at a health-reform legacy.”
You’d think, after all of that, the Shumlin Administration would have known it had a huge challenge on its hands, and that it required both IT expertise and intensive management oversight to fix the health care exchange.
Instead, only now are we hiring an IT expert.
On Friday, in the Governor’s absence, Lawrence Miller and Health Access Commissioner Mark Larson released the Optum report. And their statements were not at all encouraging; they downplayed the significance of the report and the need for further action. Miller called the report “something of a snapshot,” although as Goswami says, “the findings… are similar to previous assessments by independent parties.” In other words, this report may have been a snapshot, but the picture has stayed pretty much the same over time.
Miller also said the Administration would use the report “to make decisions about the best way forward with the project.” Well, that’s half right. But you should also use the report to assess the failings of the past — so that you stop repeating them.
For his part, Larson was even more determinedly lipsticking the Optum pig:
“On a broad level what we have taken, generally, from this report is that we have worked hard with our vendor partners to create a foundation for Vermont Health Connect.”
I’m sure they’ve all worked hard. But I’m not convinced that they have worked well or effectively. In fact, if the Optun report is accurate, a lot of the hard work has been wasted or misdirected thanks to a lack of accountability and oversight. Working hard is not an excuse for failing to deliver the goods.
Oh, and the other news from the ultimate Friday afternoon newsdump: on Optum’s advice, Vermont Health Connect has stopped working on fixing the system. Instead, it will try to make the incomplete system more customer-friendly in advance of the November-February open enrollment period. Further work on fixing the system won’t resume until after open enrollment.
Great. Even as Governor Shumlin is unveiling his single-payer health care system and asking the Legislature to approve it, Vermont Health Connect will still be an unproven work in progress.
You know, if I were a lawmaker, I’d refuse to take any action on single-payer until Vermont Health Connect is fully functional. The Governor can’t, in fairness, ask lawmakers to vote for a huge new system as long as the health care exchange isn’t working.
I’m fully aware that single-payer will actually be simpler than Vermont Health Connect. On a policy level it makes perfect sense. But on a political level, you can’t take the next step in the process until you’ve successfully finished the previous one.
Beyond the immediate situation, bad as it is, I have a more existential concern. Governor Shumlin earned a reputation as a capable manager in his first term, thanks largely to his response to Tropical Storm Irene. The endlessly-troubled health care rollout threatens his reputation for good management. And that’s why I’d advise him to step up strongly and take his medicine. And, yes, fire the people who failed to hold CGI accountable.
If he doesn’t, I fear the best days of the Shumlin Administration may be over. When you’ve been in office for a while, and the opposing party is in disarray, there’s a natural tendency to relax a bit, start seeing yourself as invulnerable, and pay more attention to your image than to the quality of your work. That is the beginning of the end for great leaders everywhere throughout history. Is it the beginning of the end for Peter Shumlin?
And for single-payer health care?
“You know, if I were a lawmaker, I’d refuse to take any action on single-payer until Vermont Health Connect is fully functional. The Governor can’t, in fairness, ask lawmakers to vote for a huge new system as long as the health care exchange isn’t working.”
What d’ya know John, we completely agree on something! 🙂