HealthCare.Gov? It’s The Contracting, Stupid!
Here’s a little something that slipped past my radar (hat tip to my friend TW for emailing it to me) . It adds several facts that back my view that the media has completely dropped the ball on the real reason healthCare.gov got off to such a rocky start.
A couple of days ago, Heather “Digby” Parton posted this nugget to her blog (I’ve preserved a few key links for the benefit of readers): for the benefit of readers):
Henry Farrell had an interesting post last month over at Crooked Timber about the new book by Colin Crouch called “Making Capitalism Fit For Society“ that’s well worth reading. He starts by highlighting these comments by David Auerbach on the health care reform outsourcing:
The number of players is considerably larger than just front-end architects Development Seed and back-end developers CGI Federal, although the government is saying very little about who’s responsible. The Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS), which issued the contracts, is keeping mum, referring reporters to the labyrinthine USASpending.gov for information about contractors. … By digging through GAO reports, however, I’ve picked out a handful of key players. One is Booz Allen … Despite getting $6 million for “Exchange IT integration support,” they now claim that they “did no IT work themselves.” Then there’s CGI Federal, of course, who got the largest set of contracts, worth $88 million, for “FFE information technology and healthcare.gov,” as well as doing nine state exchanges. Their spokesperson’s statement is a model of buck-passing … Quality Software Solutions Inc …[have] been doing health care IT since 1997, and got $55 million for healthcare.gov’s data hub in contracts finalized in January 2012. But then UnitedHealth Group purchased QSSI in September 2012, raising eyebrows about conflicts of interest.
… Development Seed President Eric Gundersen oversaw the part of healthcare.gov that did survive last week: the static front-end Web pages that had nothing to do with the hub. Development Seed was only able to do the work after being hired by contractor Aquilent, who navigated the bureaucracy of government procurement. “If I were to bid on the whole project,” Gundersen told me, “I would need more lawyers and more proposal writers than actual engineers to build the project. Why would I make a company like that?” These convolutions are exactly what prevented the brilliant techies of Obama’s re-election campaign from being involved with the development of healthcare.gov. To get the opportunity to work on arguably the most pivotal website launch in American history, a smart young programmer would have to work for a company mired in bureaucracy and procurement regulations, with a website that looks like it’s from 10 years ago. So much for the efficiency of privatization.
I had no idea. If you want complexity, that’s one good way to get it.
Digby also highlights this quote from Crouch’s book:
Outsourcing is … justified on the grounds that private firms bring new expertise, but an examination of the expertise base of the main private contractors shows that the same firms keep appearing in different sectors … The expertise of these corporations, their core business, lies in knowing how to win government contracts, not in the substantive knowledge of the services they provide.
Digby’s full blog post is well worth your time.
It reinforces a point that I have been making ever since my days as a lobbyist: the system by which government contracts work out to the private sector is an incubator for an unregulated culture of corruption. When something goes wrong, contractors – no matter the sector, be it health care, defense, or security – are rewarded with more money to fix the problem.
I would wager that if the executive branch had a dedicated IT wing handling everything from server farms and data centers to standards-compliant coding and security vigilance, not only would the bill to taxpayers be reduced by more than half, but the nation would have more robust cybersecurity in both the public and private sectors.
But no. We keep getting told over and over and over and over by conservative think tanks, corporate media talking heads, and government efficiency “experts” that the unfettered free market has the best solutions for everything! Praise the Lord and pass the anniversary edition of “Atlas Shrugged.”