Analyzing the Obamacare Rollout Failure

Monday, February 24, 2014

The online clearing house for the Obamacare exchanges went live on Tuesday, October 1st, 2013 (

Jonathan Alter, MSNBC analyst and author of The Promise: President Obama, Year One (Simon & Schuster, 2010), talks DC politics and his Foreign Affairs analysis of the how the president's management style led to a failed launch of the ACA.


Jonathan Alter

Comments [15]

Christopher from New York from New York

@RUCB Alum

That there was a working version is probably true. But there are pieces of the puzzle that never get mentioned because this has been a "functional" discussion. Albeit, the backend functionality needed to be tested and validated and even that was screwed up, but the more important piece is usability - the user experience (UX) and the user interface (UI). Without understanding what people need to see or how the system needs to communicate with them, the changes (change management) to the requirements will be endless and useless. Proper design and research at the front end of this would have obviated any change management.

Example: When PG invented the Swiffer, they observed that 80% of mopping required cleaning the mop. They removed cleaning the mop. Simple. The users provided the key to innovation.

Feb. 25 2014 12:47 PM

@Christopher from New York

" he listened to misinformed "experts" who don't understand people."

I heard it reported that there was an end-to-end working version of the ACA website in June 2013 but too much was based on open source software (and therefore) too easily hacked. The late surfacing changes to requirements are ALWAYS hazardous to successful roll-outs.

The "Wha happened...?" of the ACA roll-out will likely by studied in B school and CS classes for the next decade.

Feb. 25 2014 11:57 AM

@Mr. Bad

Well...This is where my self-interest takes over. The general meme building toward November is about "Obama's competency". He is head and shoulders above the person who held the office before him and if we don't do some sort of balancing of his ability to lead versus the GOP's ability to obstruct we are going to find the President even more hand-cuffed by the *ssholes who haven't the slightest understanding of what it means to put the nation before party.

Neither you nor I want that do we?

Feb. 25 2014 11:52 AM
Christopher from New York

Someone earlier mentioned that this rollout partially failed because it envisioned a future state and that's true, but only partially. It failed because there was no understanding of the "current-state". Ethnographic research - watching people - allows you to understand behaviors, language, culture, communication and how dots and arrows and boxes on a screen are interpreted by the masses. Once you understand the current-state and it's problems FROM THE USER PERSPECTIVE, you can then solve for the future.

Peer into your laptop and think about how many times you've had to ask a friend or called a help desk because something wasn't working or the process you had to go through was too complicated. Did you make your own workaround? Another way of looking at it - how many of you use 100% of Microsoft Word or even know what it's capable of? Why can you goto Amazon and use the interface without any training, but when you use a system at work, it requires a three day meeting and a 100 page instruction manual??

Technology is rarely the solution - it's part of the answer - but innovation comes from the people that need to use these things and technology is rarely made off of the insight of users. Simply asking people what they need fails 100% of the time because they really have no idea. Answers come from watching.

If Henry Ford asked people what they needed, they'd have said faster horses.

The rollout fiasco is a common everyday occurrence in every large company across the planet regardless of their IT bench strength. The problem isn't functionality. All of these systems are remarkably functional. The problem is understanding what the user needs and creating a system that allows for them to simply do what they need to do.

Hiring all of these IT specialists will not solve the problem because they're asking the wrong questions (or guessing) and therefore; running after the wrong solutions. It's a short sighted fix.

Put it in perspective, SAP states at their national meetings that the cost of implementing some of their systems will cost 8 times as much as the system itself. That might be a $5-8Million dollar investment in an ERP system followed by years of training at a cost of another $40M for a 50,000 employee firm. How many times larger is the Obamacare rollout? How many people must use this that don't have to follow directives from their bosses to use something they hate?!

The rollout can be a smashing success if they first understand people and what they need. The system would be simple and surprisingly, the way it looks and functions would not be interpreted by anyone from IT at all. IT COULD HAVE WORKED perfectly ON DAY ONE.

Engineers don't design homes for a reason. They'd be functional, but not usable or desirable. Engineers designed Obamacare and it's not Obama's fault. He did what every company in the world does - he listened to misinformed "experts" who don't understand people.

Feb. 25 2014 09:20 AM
Mr. Bad from NYC

@ RUCB_Alum from Central New Jersey

"Dude, what...?"

It is about competency. Everybody picks up the phone when the POTUS calls. I would, you would, the calls weren't made. His piece is about hubris and it hit home, hard. The "facts" haven't been released yet for some reason and his piece makes that crystal clear. Wonder why?

No need to beat a dead horse but it's obvious that this POTUS was more hype than substance and we're paying for the smug satisfaction that comes with electing America's 1st African American president, whatever his credentials...I like his foreign policy and I applaud him for keeping us out of Syria but he'll go down in history as a Wilson not a Roosevelt, he doesn't have the guts.

Feb. 24 2014 06:52 PM

I blame George W. Bush.

" . . . ObamaCare isn't working? Go Single Payer? There are no more doctors? Outlaw illness. People are still getting sick? Fine them for sabotaging progressive medicine. Like the island whose colonial overlords tried to solve their rat problem by dropping snakes only to discover that it now had a snake problem, progressives always have solutions. The trouble is that they never understand the problem. . . "

Feb. 24 2014 12:44 PM
RUCB_Alum from Central New Jersey

Mr. Alter's opinion is not about competency. Landing a tech project successfully is not easy. Windows Vista, Apple Newton, MediCare Part D...Roll-Outs are tough because your organization is predicting a future state. A nearly impossible task. How quickly your initial vision is trued up to reality is what matters in the end.

Be serious...A fumbled roll-out should not be balanced against:

-The nation's lowered credit rating
-A government shutdown
-Cuts to LT unemployment bennies
-No significant action of any kind on employment issues
-Blocked or filibustered judgships and Presidential appointments
-and over *40* ineffectual votes to repeal ObamaCare! As Alter pointed out, even a passed vote would not survive the veto pen.

The only reason the GOP has a shot is because the media hub-bub around the 'expected results' BS generates more eyeballs than a straight reporting of the facts.

Feb. 24 2014 11:16 AM
RJ from prospect hts

It seems as though it would be difficult for anyone to walk into a management situation when the opposition was so hostile that McConnell could get away with saying the Senate would block Obama's management attempts (appointments, negotiating bills, etc.) in order to make him a one-term president. The mess up with the Web site has been excruciatingly lame--no question--but I can't help but wonder how much was due to the complications forced by the fightback from the Republican states forcing the feds to take over more than expected and industry-forced compromises that had to be factored in technologically. I think it's distinctly possible that any company would have had difficult dealing with all of these issues on top of the intricacies of implementing the bill itself. Of course, the substantially easier management approach to the health care needs of the country would have been to simply add everyone to Medicare--an infrastructure in place that's greatest difficulty would have been integration rather than creating from scratch--but Obama's greater problem than management deficits is a courage deficit:: He didn't both even trying to start negotiating from there--management arguments included--and see what compromises would have been needed from there.

Feb. 24 2014 11:12 AM
GK from Manhattan

So we are saying that the ACA, which is a law that was put into place by the legislative branch and is part of the President's daily task list? In an administration which has and continues to be obstructed at every turn in a multimillion dollar campaign to undermine his presidency every way it can, government is sabotaged.
I think we are assigning the President duties that are not necessarily his sole responsibility. No matter his advocacy for restructuring health care.

Feb. 24 2014 11:09 AM
Ann from Westchester

Thank you, Jonathan Alter. I too was a supporter of Obama's... and while I recognize the roadblocks that have been placed in Obama's way and limited his effectiveness, I have been so disappointed with his performance. But what I particularly like about your approach is that you do not engage in Obama-bashing, like O'Reilly and his lackeys do. Instead,you offer an analysis.

I have not been able to fathom how this Obamacare fiasco could have occurred. I have been offended by the lame apologies that do not fix, but instead gloss over the issues. (Oh yeah, we can hold onto our insurance for another year.)

Thanks for trying to pick this apart. And for being balanced.

Feb. 24 2014 11:09 AM

The reason the Obama election-tech was so much better than the Obamacare tech, is that the only thing Obama has shown to actually care about is his own personal advancement.

Feb. 24 2014 11:08 AM
Prowilliams from Montclair, NJ

Did Alter just now look at Obama's resume?

I voted for Obama twice, but his inability to see the economy as more important than healthcare, then to alienate his opponents in passing healthcare in a way that any good manager would NEVER DO, showed me he was no manager.

But really, isn't this just politics?

Bill Clinton and even GWB had friendly relations with opponents because they knew how important it was-- That's politics. Or POLITICAL MANAGEMENT

And as been said and shown, Obama doesn't do politics (on the retail) level.

[Alter: Obama loves business- some of his best friends are businesspeople. C'mon.]

Feb. 24 2014 11:06 AM
fuva from harlemworld

But what about the fact that the rollout mess-up was not unprecedented; that many such previous initiatives, under other presidents, had similar problems?

Feb. 24 2014 11:04 AM

By now we've heard the apologists for Obamacare's troubled website rollout rationalize that, well, the Medicare rollout was a failure too.

I have met Medicare. I've known it. Obamacare, you are no Medicare.

Garnishes -- abandon your platter. A half-cooked chicken just needs to go back in the oven.

Feb. 24 2014 11:03 AM
Ed from Larchmont

Followed by the general failure of O-care, perhaps. On another note, the movie 'Son of God' is coming out this week, highly recommended. A movie can't handle all the details and has to adjust to the screen, but a must see for Christians, and for non-Christians an informative movie about what Christians believe, done by Catholics.

Feb. 24 2014 09:08 AM

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