With more than three years to prepare for the launch of the federal exchange, Health and Human Services’ Kathleen Sebelius has failed (after spending more than half a billion dollars in funding) to create a functional exchange.

The first excuse we heard is that eight million people tried to get on and the server couldn’t handle the capacity.  Let’s contrast that with the private sector and Amazon.com which handles seventy million people a week on their website.

In a country that is the home to Oracle, Microsoft, Apple, Twitter, Facebook and a myriad of technology firms in the Silicon Valley, Ms. Sebelius and Health and Human Services chose the Canadian company, CGI Federal, along with fifty-five other contractors to coordinate and put the health insurance exchange in place.

The Wall Street Journal reports Health and Human Services concedes that there were built-in information, technology and structural defects that had nothing to do with the amount of traffic on the website.  The system was never stress-tested with the carriers to make sure that documents and information flowed smoothly.  And out of the fifty-four thousand currently enrolled nationally (nineteen days after the launch), almost eighty percent of those have been submitted incorrectly to the carriers and actual health insurance policies have not been issued.

While Health and Human Services continues to talk about competition and calls the exchange a marketplace, consumers have learned that prices on the exchange are significantly higher than what can be purchased in the private market.  Now that the budget and debt limit crisis are over, expect the media spotlight to shine on the failure of the Obama exchange rollout.

The Sunday, October 13th, New York Times, had a two page article outlining the failures of the exchange and pointing out that one of their staffers had tried for eleven days making forty attempts to get on the exchange, none of which were successful.  Couple that with Jon Stewart’s searing interview on The Daily Show with Ms. Sebelius, where he bet her he could download every movie ever made before she could access the exchange and followed up by asking her how many people had enrolled (a question she was unable to answer).

If the problems with the exchange can’t be fixed quickly, expect to see Ms. Sebelius click her heels and arrive back in Kansas looking for Toto.  In addition, the President may have to take executive action to roll back the individual mandate or extend the open enrollment period  (either of which will be a definitive blow to his signature legislative program The Patient Protection and Affordable Care Act.

Cary Hall

America’s Healthcare Advocate