Why Government-provided services are always more expensive
The Gormogons provide what may be the Grand Unified Theory of Safer Browsers and Government Healthcare service. Essentially, it boils down to the Fed.Gov procurement system being completely, utterly, irredeemably broken:Follow me here: pressure mounts from savvy end users for an alternative web browser (since Microsoft STILL can't get a web browser right even after trying to claim that it was integral to the Windows operating system and couldn't be separated). In response to the pressure, some government program manager gets up the guts to propose adding Firefox to the baseline applications on the network. The contractor running the IT support desk waves their hands claiming that this is a change in scope to the contract and demands an ECP (Engineering Change Proposal). After the government spends thousands of dollars authoring a terrible RFP (Request For Proposal) for this change, the contractor spends thousands of dollars authoring a response to the RFP. The government contracting office then spends some more money evaluating the technical and cost aspects of the response. The proposal contains management reserve, engineering SWAGs (Seriously Wild Ass Guesses) as to the extent of the effort required, etc. And let's be honest, there are security issues identified periodically with Firefox and upgrades to apply, so some amount of work needs to be accounted for somewhere. So the evaluators (who mostly didn't know about Firefox or think about putting it on the network in the first place) think, "hey, this proposal is pretty good." Bam. Firefox 5.3 shows up on the State Department's network in 2012.That's really how it works. No joke.
After I left Three Letter Intelligence Agency (since all the cool work was done by contractors, why not become a contractor?), I worked on a big DoD project that was run precisely this way. No work could be done without a Charge Number to account for what type of work you were doing. No work could be done that was not in the Statement Of Work. Half of my time was spent evaluating Engineering Change Proposals.
The project ended up $200 Million over budget and in Congressional hearings. Not my fault, of course, but why I've stayed away from any sort of work like that since.
Now I'm sure that there are all sorts of Really Smart Ivy League types out there who can explain - mathematically, no doubt - that with Government healthcare it'll be different. Really. The plan seems to revolve around having the Right Sort of People in charge this time, which - strangely - nobody has ever thought of doing before.
The Gormogons' posts are worth your time: both part 1 and part 2.
So Healthcare will be run by beancounters who are all about making it easy for the beancounters, instead of delivering service, and irrespective of the cost. However, it will be a great success, because it will be defined to be so. That project I worked on? It was delivered "in a shopping cart" - all the code, whether working or not. Someone scavenged the bits that worked, delivered it to the DoD Agency users, and everyone celebrated the "great new system".
Everyone celebrated except the users.
6 comments:
Great article and your statements are absolutely correct. We did a 7 page RFP for something. When the powers that be got through with it, it was 139 pages of BS, teaming requirements, etc. We never even bothered to put it out... sigh
"Now I'm sure that there are all sorts of Really Smart Ivy League types out there who can explain - mathematically, no doubt - that with Government healthcare it'll be different. Really. The plan seems to revolve around having the Right Sort of People in charge this time, which - strangely - nobody has ever thought of doing before."
Why does this sound familiar to me?? Oh, yeah, the same is said about socialism/communism.
Well stated, Borepatch!
I worked for DoD for a bit. I was the admin for the analytics tool. When I first started I was waiting for work to start coming down the pipe so I was getting familiar with the the data, the objects etc. I noticed that the data objects alternately used all caps or mixed case. I started to make them uniform (i.e. changing ADDRESS to Address etc.) and was told, in no uncertain terms that any such change in metadata had to be approved by the CTO.
On the other hand, "not enough Process" is also a thing. (Cough, cough, 737 MAX, cough.)
... Or was that a case of plenty of Process, but altogether the wrong process?
If this is true, then Aesop is right, it would not be possible for the government to give away heroin cheaper than the free market.
Yeah, government customer service sucks. Increasingly, however, so does customer service in the private sector. This is especially true in the health care field. Some of this is directly or indirectly caused by government involvement (CMS is a major suckage center). But other parts of it are entirely internal to the the parts of it that are private. Like keeping banker hours except even bankers work on Wednesdays. Or giving answers to questions where they don't really know the answer and are just making stuff up. Like forcing all incoming calls into voice mail and then not returning calls. Like sitting on test results that indicate a problem. Like losing documents. I could go on but I am limiting myself to just the things that have happened to me in the last week.
I think the root cause is that no one goes to medical school so they can run a business but then they won't hire competent people to do it for them. And they outsource stuff to contractors who are not competent, don't communicate with the core business and are located in another state.
If I knew what to do about this, I would tell you but the whole system is broken, not just the government part.
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