The Health-Exchange Failure Isn't Just An IT Problem

Two years ago, at a conference about open-source technology in the government, run by the U.S. State Department, I talked to two people who worked in IT at the state level. My notes from the conference are buried in a box somewhere, but the two agreed, essentially, with the argument Paul Ford made last week in Bloomberg Businessweek: government should adopt open-source programming. But they added a caveat: To use open source software effectively, the people who work in IT need to stop being government purchasers and start being government developers.

This is a culture problem, the hardest kind to fix for any organization. Which means that whatever happens with Healthcare.gov, the root cause—a culture problem—will definitely not be fixed by Nov. 15.

Yesterday, Barack Obama instructed Jeff Zients to trot over to the Department of Health and Human Services to fix healthcare.gov. Zients is Obama’s Mr. Wolf. He fixed problems with the GI Bill and the Cash for Clunkers program. He ran Obama’s attempt to reorganize the government, served as chief performance officer for the Office of Budget and Management, then ran the agency when the seat was empty. The president’s decision last month to have Zients run the National Economic Council now seems like a move to keep him around in something else blew up. Something else did.