If you've been watching C-SPAN—and who hasn't?—you'll know the House Energy and Commerce Committee started hearings yesterday with the government contractors for HealthCare.gov, the maybe-not-quite-ready-for-prime-time website for the Affordable Care Act.
Ostensibly, these hearings are a way for opponents to poke more holes in Obamacare, but it's also a bleak reminder of the true role of technology in our federal government. Yes, we know that the Obama administration is tech-savvy. But what it really needs is to be tech-centric.
Whenever the country wants to mount a IT huge project (like, say, a website that will serve most of the country's citizens), it has to hire outside contractors. For HealthCare.gov there's a bunch of them, getting paid a lot of money. In yesterday's testimony, those outside contractors like CGI Federal and Optum/QSSI were the ones on the hot seat, testifying against (and blaming) the government agencies that hired them (one of which is confusingly abbreviated CMS) for HealthCare.gov's failings. That's a problem, on multiple levels.
It wouldn't be, though, if instead of outsourcing all of our governmental tech projects we had an in-house team of experts working in full-time collaboration with the policymakers legislating them. Not only could we fix mistakes more efficiently, we'd be able to head them off at the pass.
The British government faced a similar problem a few years ago, and have provided a great example of centralized in-house tech being effective, according to an interview on NPR yesterday with Mike Bracken, executive director of digital for the U.K.:
Instead of writing behemoth, long-term contracts with a long list of specifications for outside contractors, Parliament greenlighted the creation of the Government Digital Service, a "go-team" of 300 technologists who began streamlining 90 percent of the most common transactions the British people have with government. It appointed Bracken, a tech industry veteran, as the first ever executive director of digital — a Cabinet-level position.
This gave the British government a "digital core," as Bracken calls it, and one of its major accomplishments was gov.uk, the no-frills government website we heaped praise upon earlier this month, and that won the Design Museum's Best Design of the Year award in April. Just creating this one site to consolidate so many government functions is estimated to save British taxpayers $20 million each year. The problems that plague HealthCare.gov are of an entirely different nature, and go far deeper than a simple redesign. But in a general sense, a centralized approach would have benefited both it and any future government tech endeavors.
We could even take it a step further. What gov.uk did that was so brilliant is that the team focused on 25 of the top 50 transactions that citizens make with their government and decided to make those transactions painless. So instead of having hundreds of different sites to visit whenever you have to pay money or register something with the government, you can do it all at once, with one account. Imagine that. Instead of a labyrinthine mess of federal sites for every different purpose—or more frustratingly, the absence of online infrastructure at all in some cases—the U.S. builds one website that serves as a one-stop shop to pay your taxes, get a passport, register your business, and, yes, buy health care.
Not that this kind of tech-centric culture can't still be a reality. We have an Office of E-Government & Information Technology. We have a Digital Government Strategy. We even have a Chief Technology Officer for the U.S. His name is Todd Park and he was appointed in 2012. Before that he served as one of the “entrepreneurs-in-residence,” in the Health and Human Services department, and before that he was the co-founder of two massive healthcare startups: Athenahealth and Castlight. He's done a lot of pretty sweet things, like hold an annual "health datapalooza" where entrepreneurs presented projects using open data from the government with the goal of improving care in the U.S.
But! Park's role is kind of irrelevant if he doesn't have the right team and structure to back him up.
Bracken points to some potential bright spots in the US: the Presidential Innovation Fellows, a group of private, nonprofit and academic leaders who advise government officials, and the appointment of Jen Pahkla, founder of Code for America, who is serving a year in the new role of Deputy U.S. Chief Technology Officer for Government Innovation. According to a blog post by Pahlka, the 10 fellows for 2013 are working on some pretty big and important projects, including MyUSA, which seems to be an effort similar to gov.uk. But these need to be addressed by a full-service, full-time, in-house team... not just fellows who come and go every year.
Most of the conversation about HealthCare.gov is highly politicized rhetoric at the moment, but it can also be an opportunity to voice some real change. Hopefully, eventually, the outrage about this one site can be translated into an effort that acknowledges how important simple and functional websites are to our government's efficiency—to our daily lives! We can and should start demanding more from all our government tech, starting with establishing a true, dedicated tech team.