One of the most startling revelations in the continuing slow-motion carnage of the US federal health exchanges is that the government's Center for Medicare and Medicaid Services (CMS) decided to manage the whole affair themselves:
The people I spoke with did all confirm the importance of one other detail in the Times story: that CMS did not hire a general contractor to manage the exchange project but handled that overall technical management task itself. None of the people I spoke with wanted to get into how this decision was made or at what level, but all of them agreed that it was a very bad idea and was at the core of the disaster they have so far experienced.This is, I believe, the inevitable result of government agencies (UK and USA specifically, but I'm sure other countries are equally guilty) of hiring "generalists", who tend to have liberal arts degrees. Because the subject of these degrees (English, Geography, History, PPE etc.) is unlikely to be directly useful in their owner's regular government work, the story told is that the general communication, analysis and critical thinking skills absorbed are what makes that graduate more valuable in the workplace than (say) someone with pre-university qualifications.
This analysis more or less works for government work which involves reporting and planning, and even for some low-level management. Unfortunately, it fails comprehensively when hard technical issues come up. I still remember the expression on the face of a 25 year old Civil Service fast stream grad (Oxford, PPE) as my grizzled engineering boss tried to explain to her the main engineering issues of the project she was allegedly managing. Picture a dog being taught Greek and you won't be far off. She was so far out of her depth that James Cameron could have been exploring below her. To be fair, you'd get a similar effect by putting an engineering grad in charge of a biochemistry research project, or a chemistry grad in charge of a micro-lending organisation - but at least they'd both be numerate enough to spot errors in the finances.
I note that anyone who proposed that the UK Border Agency head honchos oversee and project-manage the construction of a major bridge or power system would rightly be excoriated in public. "How the hell could they even know where to start? What do they know about compressive strength / high voltage transmission?" Why, then, do we assume that IT projects are any easier for non-experts to manage? I suspect the answer lies in a combination of the infinite malleability of software, and the superficial familiarity that most people have with using web interfaces (and even tweaking HTML themselves). After all, it's just words and funny characters, how hard could it be?
Back to the exchanges: there's about as much reason to believe that the CMS has expertise in project management as there is to believe that I'm capable of designing a line of clothes to rival the products of Chanel and DvF. The fact that I can draw something that might be recognisable as a dress (if you squint a little) has absolutely no relevance to being able to design something that millions of people would want to wear - and that can be made for a reasonable sum of money while being resilient to the huge range of stresses and strains imposed on clothing by its wearers. What appalls me is that, given the quote above, no-one stopped the CMS from taking on the project management role despite the fact that everyone seemed to know that it was a terrible idea. Either this was a dastardly covert Tea Party guerilla plot to sabotage the exchanges, or there was a serious break-down in communication. Health and Human Services secretary Kathleen Sebelius is ultimately on the hook for the failure of the health exchanges; did she just not care that they were doomed to fail, or was there someone in the upper chain of reporting who knew what happens to the bearer of bad news and hence decided that discretion was preferable to being unceremoniously fired?
Sebelius, incidentally, is the first daughter of a governor to be elected governor in American history. She has a liberal arts BA and a master's in Public Administration. The CMS Chief Operating Officer is Michelle Snyder who holds advanced degrees in Clinical Psychology and Legal Studies and Administration. She has been a manager in the HHS budget office and had assignments with the Office of Management and Budget, Congress, the Social Security Administration, and as a management consultant in the private sector.
I'm sure liberal arts majors and management consultants have an important role to play in modern society. That role does not, apparently, include being in charge of a major IT project. Not only are they incompetent to run it, it seems that they are incompetent to appoint someone competent to run it. Personally, I'd have started with Richard Granger,, ex-head of the UK NHS Connecting for Health program that pissed £10-15 billion down the drain for no result. Yes, his track record is beyond absymal - on the other hand, a) he now knows first-hand all the mistakes you shouldn't make and b) when you announce his appointment the expectations on your project will plunge so low that even delivering a badly-working underperforming system will impress people.