Last March, Rocky King, executive director of Oregon’s health insurance exchange, predicted that Cover Oregon was about to become the pride of the state. “This is an incredible project,” he told the Lund Report, a local health-care news site. “When people see what we’re doing in Oregon compared to Idaho, Maine, or Florida, they’ll be proud of what we’ve been able to accomplish.”
He wasn’t the only one brimming with optimism. “The state of Oregon is leading the nation,” Carolyn Lawson, chief information officer for the Oregon Health Authority, told legislators in 2012. “According to the feds, we’re easily nine months ahead of any other state. We have multiple states that are asking if they can participate with us.”
Cover Oregon has certainly attracted national attention since the exchange went live. The wrong kind. Its online enrollment system still isn’t working, though the exchange did try a partial relaunch on Feb. 18. The state has resorted to paper applications and so far has signed up roughly 35,000 individuals to private plans. Officials originally projected 217,000. In Washington there’s talk of investigations into whether Cover Oregon misled federal officials about the project’s progress with a nonworking mock-up of their nonfunctional system.
The most amazing part of this whole story is that King and Lawson were told this would happen. Reporting by the Oregonian newspaper shows that Maximus, the consulting firm hired to provide oversight, warned as early as November 2011 that the project was already running late and had insufficient management controls. Bob Cummings, a technology-oversight analyst working for the state legislature, informed lawmakers in the spring of 2012 that the odds of the project being ready in time were “not good.” …
… Why did they try to shoot the messenger instead of listening to the message? One answer is that’s what organizations do—especially dysfunctional organizations. As a young IT consultant, I sat through more than one meeting where we, or someone, tried to stop a client from doing something obviously crazy. Usually, the result was that the client did something crazy, and that someone went looking for another job.
Doctor No, that grating in-house critic, can be your most valuable employee—if you can make yourself listen. That’s surprisingly hard to do. Organizations exist for the purpose of doing stuff. That’s what their staff is hired to do. The guy who says maybe we shouldn’t do that stuff—or the stuff we’re doing isn’t working—is not very popular. There’s a large body of literature on dissenters, and it mostly tells you what you already know if you’ve ever been to a project meeting: Nobody likes a Negative Nancy.