The Obamacare syndrome, in Expansión
My weekly column in Spain’s leading financial daily Expansión this Friday (pdf) takes as its inspiration, if that’s the word, President Obama’s healthcare program, known popularly as Obamacare, which has proved to be one of the worst technological scandals in recent US history: healthcare.gov is unable to deliver; when it isn’t crashing there are myriad other problems, and when there aren’t it is still exasperatingly slow.
One of the pillars of Obama’s election campaign, and whose passage through Congress and the Senate once again nearly brought the country to a standstill, healthcare.gov is a nightmare for its users due to the wrong choice of technology supplier—largely as a result of the US system of tendering, which instead of giving the job to the company best equipped to deliver, does so to the company that best understands the Byzantine procedures of said system.
Such systems are common to many countries, including Spain: government technology projects that end up costing a fortune and are notably inferior to what is out there. The reason being that the system tends to favor bids from the same companies: those best able to meet the needs of the government, not the people. These are companies that put enormous resources into winning government contracts, which, once they have done so, then present a mediocre project, badly put together, and in many cases subcontracted out to other companies (which then often subcontract them out to others, and so on). And by the time they get to the public, they tend to make users see that there are good websites and there are bad websites, and that ones created with public money usually fall into the latter category.
Here’s the column in full.
The Obamacare syndrome
The rocky road toward President Obama’s healthcare reform through Congress and Senate has ended in disaster: the website used by millions of Americans without health insurance to ascertain their options when seeking medical treatment doesn’t work.
Weaknesses in the registration system, crashes, exasperating slowness, and problems with the database that force men to apply for cover that includes maternity care have prompted Katherine Sebelius, the Secretary of State for Health and Human Services, to admit that she was wrong when she gave the website the green light. During its first three weeks in operation, of the 20 million people who tried to access the page, only half a million were able to complete their application form, while a significantly lower number were actually able to obtain cover.
The reasons for this resounding failure are to be found in the way that the state puts tenders related to technology out for bidding. In short, it is an unwarrantedly complex procedure that systematically results in the same companies being awarded government contracts, regardless of whether they are the best-suited applicant, and instead on the basis that they are the only ones able to navigate the complexities of said procedures.
We need look no further than the websites of many of Spain’s public services to find other, similar examples of why they don’t work: contracts awarded to the same few companies; those who understand the complexities of public tendering… and that in many cases then simply subcontract the work out to a cheaper — if not the cheapest — supplier.
We are talking about a President’s most ambitious project being stymied because public bodies seemingly do not know how to pick the best supplier. This is an issue that needs to be addressed.
