Healthcare.gov: Why the Washington state site eclipsed D.C.'s

Like the Mariners’ string of depressing seasons and lost opportunities, this month’s botched rollout of the federal Department of Health and Human Services (DHHS) healthcare.gov website represents a huge lost opportunity for the federal government. And some of the root causes of these two fiascos are amazingly similar.

Washington state’s own, separate, health benefit exchange registered phenomenal success, enrolling over 35,000 people in three weeks.

How can one state succeed where the federal government, with all its resources, cannot?

In many ways, software development is like running a baseball club. The club will have an owner, or, if multiple owners, a board. The board hires the general manager (GM) who, in turn, hires the players, negotiates their contracts and hires the coach. The coach makes sure the players work together, trains the team and practices practices practices in preparation for game day.

The state of Washington succeeded by starting off with a solid infrastructure for the project, and by creating a separate Health Benefit Exchange – a public-private partnership – with its own board. Although the board is appointed by the governor and the Legislature, it is otherwise independent. And it hired its own CEO – veteran health executive Richard Onizuka. For their part, Onizuka and his staff made smart choices, contracting with a single vendor – Deloitte – to build its exchange.

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http://crosscut.com/2013/10/24/health-medicine/117084/affordable-care-act-website-obamacare-what-wrong/?page=1