The faults of HealthCare.gov are still fresh in the memory. The rollout was a complete mess. And while the government is trying to claim fixes in the system, and an easier registration process, the damage cannot be truly undone. At least to this point, its greatest legacy has been a botched rollout.
Really though, HealthCare.gov isn’t even the worst product from the federal government, not by a long shot.
It is just one of a long string of information technology debacles by the federal government.
According to the research firm the Standish Group, 94 percent of large federal information technology projects over the past 10 years were unsuccessful.
That means that they were delayed, over budget, didn’t meet user expectations, or simply failed completely.
Let’s look at some examples:
Sam.gov, a system for government contractors developed by I.B.M. that started in 2012, has cost taxpayers $181 million and is just now beginning to work as expected.
Before that, a new version of USAJobs.gov landed with a thud, after years of development and millions of dollars down the drain.
In 2001, the F.B.I. started a virtual case file system. They dumped the project, renamed it, hired new vendors to build it, and after a mere 12 years, the “Sentinel” finally came to fruition.
For some reason though, Healthcare.gove seems more frustrating than others. Perhaps because we had higher expectations for this administration when it comes to technology, especially in light of a great campaign website. Perhaps our own technological advancements have improved markedly in the last 10 years.
This latest failure is frustrating for us to watch. Our careers have largely been about developing technology that allows more people to participate in the way we finance, support and elect candidates for public office. Together, we’ve done things that transformed elections, but we now need that work to carry into transforming government.
These frustrations shouldn’t be surprising though. It is the difference between private solutions and public solutions. When we think of private solutions, we have images of young, intelligent, entrepreneurs creating breakthrough IT applications on a bootstrap budget. As for public solutions, we think of bloated, entrenched vendors demanding huge paydays and delivering underperforming services.
Government contracting is a mess. full of large, entrenched vendors providing subpar services. Howard Dean changed that by reaching out to a new breed of Internet-savvy companies and staffers (including one of us). In 2012, Barack Obama beat Mitt Romney thanks in part to a mix of private-sector-trained technology workers and a well-developed ecosystem of technologies available from competitive consultants.
Much of the problem has to do with code called the Federal Acquisition Regulation. It is over 1,800 pages of legalese that all but ensure that the companies that win government contracts are those that can navigate the regulations best. Government vendor companies have become adroit at filling out convoluted paperwork, but not necessarily at building great products.
Silicon Valley company can produce a worldwide search engine with just two grad students in a garage. The government, however, produces something like HealthCare.gov, which leaves everyone frustrated and confused. Unsurprisingly, it was created by one the largest of the largest vendors, CGI Federal, which blamed everyone but itself when asked to explain the botched rollout of the Web site.
Prescription Drug Monitoring Programs
The same issue is happening with Prescription Drug Monitoring Programs, or PDMPs. These are the systems responsible for tracking the flow of prescription drugs from hospitals to pharmacies, in an effort to prevent prescription drug abuse.
However, like most government solutions, they are bloated systems, poorly built, ineffective, and out of the budget. Every single state is responsible for creating its own PDMP, so no single system is able to communicate with the other.
There is no mandate to actually use the systems, so physicians can simply ignore them if they choose to. In the state of California, the CURES system is only used by 5% of all physicians, and there is only one employee trying to manage the system.
Just like Heathcare.gov, the biggest losers are the American people. Prescription drugs continue to be abused, doctor shoppers abound, and we are none the wiser.
If we want real results, we need better systems. That means private systems. We need real results, not more excuses.