Healthcare.gov is not the same as health reform aka Obamacare aka PPACA

It’s time to begin to focus on how to improve Healthcare.gov.

It seems like the government made all the classic rookie mistakes around implementation. They went for the Big Bang. They worked on it for years only to release it at the last second. They brought in tons of vendors and no one really coordinated them. They over paid for the project and didn’t tie anything to performance. They minimized the testing and complexity.

I think they’re going to make the same mistake again unfortunately. Fixing it may be harder then starting some of it over. Not the integration but the workflow. Bringing in the A-team and not delaying the penalties won’t be quick. And the new people should be smarter and slow things down so they don’t get thrown under the second bus.

But, this failure shouldn’t doom health reform. They are two different things. Sometimes I think the politicians living in their Disneyland of Washington forget more than they know.

The reality is that we have a huge, unsustainable healthcare issue in the US. We should be ashamed to have all the people without coverage that we do. While health reform won’t fix everything, it’s a stepping stone and a lot of the CMS work around innovation, ACOs, and Medicare STARS is critically to payment reform and the shift from FFS to value-based healthcare. There is still a ton of work to be done. We haven’t addressed health literacy. We haven’t addressed quality. The overall experience is still disconnected and generally poor.

The politicians need to focus on making our country better not playing games (on both sides).

And, while I disagree with the tactic, the Republican play to focus on the budget was important. We can’t bankrupt this country for our kids. While the government villianizes the Private Equity industry that leverages up companies and takes on debt risks that’s exactly what the government is doing now.

BTW – one of the interesting benefits of the healthcare.gov debacle is that it’s a ton of free advertising for the site. Everyone is talking about it for free and pulling consumer awareness up. (I doubt that was a strategy.)