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To: Rep. Perry, L.,
Subject: Better, Faster, Cheaper: Lessons from the HealthCare.gov Fiasco
Date: 2013-12-18T19:08:02Z

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Governing Better, Faster, Cheaper

Better, Faster, Cheaper Ideas

Government IT and the Promise
of Agile Development

Most public-sector IT projects use cumbersome, outdated methods. Some could benefit from a faster moving approach that prizes speed and flexibility. Plus: How to keep a big government project from exploding on the launchpad.

2013 Public Officials of the Year

These nine officials have demonstrated the true power of public service.

Beyond the Suggestion Box: Government's Crowdsourcing Revolution

This social media tool is being embraced by governments far and wide. A new report offers guidance on what it can do and how to make it work.

Boston Mayor Blogs His
Way Out of Office

Outgoing Mayor Tom Menino, who was in office for 20 years, has launched what may be the first-ever transition blog to help his successor succeed. Plus: What did Cory Booker actually accomplish in Newark?

How to Kill Competition for the Delivery of Government Services

Rather than trying to regulate what private-sector contractors pay their executives, governments should be looking for the best deal for the taxpayers.

Tax Amnesty: A Short-Term Solution with Long-Term Problems

Nearly every state has at some point offered forgiveness to tax evaders. While it raises revenue quickly, it sends the wrong message to taxpayers. Plus: A new report ranks states with the best and worst tax administration.

Milwaukee Sets the Stage
to Grow Businesses

Instead of focusing on start-ups, a new pilot program helps cities identify and support companies that have the potential to grow rapidly.

Arkansas Provides Path for Making Medicaid Expansion Attractive for All

Only 25 states have expanded Medicaid so far, but some see ways to make expansion attractive for both parties in every state.

Houston's 'One Bin' Recycling Idea

The cost of picking up people's recycling is high, but the portion of people who actually recycle is low. That's why Houston wants to get rid of recycling bins.


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Lessons from a Fiasco

BY Stephen Goldsmith

The tumultuous launch of HealthCare.gov presents issues of complexity, failure and consequence unlike anything likely to be faced by state or local government officials. Yet just about every government has experienced some major information technology project that went awry.

I remember when I was deputy mayor of New York City and Mayor Michael Bloomberg had had enough of the delays and expenses associated with a payroll modernization implementation known as CityTime. Bloomberg asked me to remediate the project. The project's costs had ballooned from $63 million to nearly $700 million. In the end, the prime contractor had to reimburse $500 million to the city and the effort was brought to a successful close by moving the project management to a city agency.

Implementation snags almost inevitably come up on projects of such a large scale. Those of us who follow statewide benefit system modernization efforts have seen major issues from Florida to Texas to Indiana, where the state and IBM ended in court in a very messy and expensive exercise in finger-pointing over a $1 billion welfare IT system.

So what can we learn from these large, complicated and flawed implementations? I would suggest the following:

-- Nothing will work in the absence of high-level executive leadership and a skilled government project manager. The more agencies a project touches, the stronger that leadership needs to be. Of course, a good leader manages collaboratively -- until a decision needs to be made. Negotiating and listening have their place, but decision-making delays not only slow a project down but also magnify problems. Keep reading >>

Health and Human Services Special Report: Health Care Policies and Practices that Work

Read this special report to learn about the best practices and most noteworthy solutions currently on the ground in the HHS sphere. Click here to learn more.

Cities and the Fiscal Challenge of Retiree Health Care

BY Charles Chieppo

As state and local governments focus on how to fix their pension problems, a recent report demonstrates the dramatic measures large American cities will have to take to address another issue: huge retiree health-care liabilities. The overarching lesson of the study from ElderBranch, an online information portal that helps people find and evaluate long-term-care providers, is to address the retiree health-care issue before it gets out of hand.

For many cities, it's already too late. In fiscal 2012, only five of the nation's 25 largest cities had set aside 95 percent of their annual required contribution (ARC) -- the amount that would put them on track to pay for the health-care costs of all current and future retirees over 30 years. More than half the cities contributed less than half of ARC.

That leaves most large cities with three distasteful options: raise taxes, cut spending and/or reduce health benefits. Keep reading >>


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