Will the Botched Healthcare.gov Rollout be Obama’s Vasa Moment?
On a pleasant August day in 1628, the Swedish ship Vasa, the most heavily armed warship built to that time, sank in Stockholm harbor after sailing less than a mile on its maiden voyage. The sinking came at a bad moment for Sweden’s King Gustavus Adophus, who was in the middle of a deadly naval conflict with the Poles. The mighty Vasa was supposed to have turned the whole war around. Its loss was a huge blow both militarily and financially.
Since that time, the Vasa disaster has become a classic case study in how not to manage the rollout of a technologically advanced new product. Will the launch problems of healthcare.gov be President Obama’s Vasa moment? If we read what modern business consultants and management professors have written about the Vasa debacle, we find some disturbing parallels.
The Vasa was lost neither in battle nor in a storm. It sank in on a clear day within sight of downtown Stockholm. It was, quite simply, a casualty of faulty design. Its narrow hull, inadequate ballast, and unprecedentedly heavy armament put its center of gravity too high. It rolled over and sank in a moderate breeze that was far below the maximum to which any sailing ship would be exposed as a matter of course.
Many observers see have pointed out analogous design flaws in the healthcare.gov website. It, too, is large and complex, yet the number of users required to put it out of action was no greater than what its designers could reasonably have expected. However, in at least one respect, the healthcare.gov designers have less of an excuse than did the builders of the Vasa. Whereas no one had ever built a ship equal in firepower to the Vasa, private firms from Amazon to Zazzle have successfully built and operated websites even more complex than healthcare.gov. As the Financial Times reported, “If a website as vast and technologically complex as healthcare.gov had been launched in Silicon Valley, it would have been ramped up slowly, fine-tuned for months and taken offline at the first sign of trouble.” The Obama administration did none of these things as it launched the centerpiece of its flagship Affordable Care Act.
Tight deadlines were another factor that sank the Vasa. In the previous year, while the Vasa was already under construction, the Poles had captured the Swedish flagship Tigren in battle. At the pain of “incurring His Majesty’s displeasure,” work on the Vasa was rushed to make it ready for sea by July 25. Its fatal maiden voyage on August 10 was already two weeks behind schedule. There was no time for prototypes, sea trials, or modifications.
Time pressure has also been a factor in the healthcare.gov fiasco. Getting the ACA up and running o time was no less important for President Obama than beating the Poles was for Gustavus Adolphus. Some ACA deadlines had already slipped, for example, the launch of its small-business exchanges. To delay the rollout of its most visible component, the consumer exchanges, would have been an intolerable embarrassment.
Communication failures were a third parallel between the two disasters. Although there was no time for thorough sea trials of the Vasa, there had been one critical test in harbor. While the ship was afloat at the dock, but before outfitting was complete, the builders, in the presence of the ship’s captain and the admiral of the fleet, conducted a simple “lurch test.” It consisted of having 30 sailors run back and forth from one rail to the other. The vessel rocked so violently that the builder stopped the test after the sailors had made only three passes. It was clear to all present that continuing the test would capsize the ship. Yet they told no one, and most certainly, not the king.
Similary, Health and Human Services Secretary Kathleen Sebelius now says that President Obama was not told of known problems with the site before it went live. In particular, the failure of a simple test run in late September, involving only a few hundred users—the equivalent of the Vasa’s lurch test—was one item of information that no one passed along.
Gustavus Adolphus overcame the Vasa setback. He managed to lead the Swedish forces to further victories, on land, if not at sea, before he himself was killed while leading a cavalry charge in 1632. Historians remember him as one of Sweden’s greatest military commanders.
Will President Obama similarly be able to put the botched healthcare.gov rollout behind him? I certainly hope so. Despite the many design flaws of the ACA, the country needs to move forward in the field of healthcare policy. Letting the ACA sink and lie on the bottom is not what we need, although many in the GOP appear eager to see just that happen, having now dropped the “replace” part of their earlier “repeal and replace” mantra. Supposedly some of the private sector’s best brainpower has joined the struggle to make healthcare.gov work as it is supposed to. I wish them fair winds and a safe voyage.
One Response to “Will the Botched Healthcare.gov Rollout be Obama’s Vasa Moment?”
As a fairly vocal supporter of ACA I must say that the program is, so far at least, far from living up to its promises. The incompetent rollout of the website is apparent to all. Moreover, in my own state of Washington, none of the three (why only three) insurers plans cover either my physician (a board certified internist) or my preferred hospital – a major regional medical center that is part of the Legacy group. And to rub salt in the wound my premium for a policy similar to my current coverage would have cost about 25% more than I currently pay. So much for "affordable" care.
Health care in America is in desperate need of reform. We spend nearly double what other industrialized nations spend as a percentage of GDP and have good but not first-in-class outcomes to show for it. The financial burden reduces our competitiveness internationally without delivering any incremental benefit.
It is not too late for Mr. Obama to save his Vasa from capsizing. But that won't be accomplished by tweaking the software. Ms. Sebelius and Ms. Tavenner should resign. Mr. Obama should convene a panel to evaluate the strengths and weaknesses of ACA, then propose regulations and, where necessary, legislation to fix it.
Pretending that all is well except for a computer glitch that the techies are working to fix will assure that ACA ends up as a metaphor for a presidency that was long on promise and short on deliverables.