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Dear America,
Maximum Out-of-Pocket Premium Payments Under PPACA

Maximum Out-of-Pocket Premium Payments Under PPACA (Photo credit: Wikipedia)


Healthcare.gov has been the story at the top of the news since October 1.  The Republican party apparatus has cranked out blow after blow against the Obama administration using essentially a single gambit: government is incompetent, and the Obama administration is particularly so.  Daryl Issa, the Republican congressman who chairs the House Oversight Committee, has taken his inquisition on the road and is taking testimony from properly politically aligned witnesses all over the country.  In Georgia last week, he and his panel of three other Republicans--no Democrats would participate in the Tea Party pandering road show contrived by Mr. Issa--took testimony from a few disgruntled business owners while refusing to even acknowledge the offers to testify of a very satisfied, newly insured, never-before-insured citizen, and probably others who would have liked to tell congress what the Affordable Care Act has given them.  And Issa is taking his road show to other states as well despite the chants outside his Georgia performance of "go back to Washington and get back to work."  But the story doesn't seem to be as simple as an effort by conservative Republicans and the Tea Party to capitalize on something that happens to most big internet projects as they start out.  It is not just the notion that government is incompetent that is being promoted; it is also the notion that business and free enterprise do things better that is now in question.  It isn't the government that made this mess.

There is a single civilian corporation--a Canadian corporation at that--that is at the heart of the problems that have plagued the web site, and by extension, the millions of people whom it was supposed to serve...to help.  CGI, Inc. specializes in government projects, and with regard to the Affordable Care Act, it has been involved centrally not just in the development of the federal website, but in that of some states, Massachusetts in particular, that have decided to develop their own sites under the law.  And according to reports last week, they didn't do any better in Massachusetts than they did in Washington, D.C.  Of course, they are pointing to the governments' oversight of the project and failure to formulate specifications for the websites in a timely manner, but it has to be acknowledged that CGI put in a bid on the federal project for a certain amount of money, and it won the project based on that bid at the expense of two competitors that also bid.  So, while the proposal that they bid on may have had some ellipses in it, CGI knew what it was getting into, especially in light of the fact that this wasn't their first federal contract.  And if you add the failures they seem to be at the heart of in Massachusetts, and perhaps even other states, it gets harder for CGI to escape responsibility, which begs another question.  Is the growing emphasis on contracting out the work of government really a good idea?  Do big corporations really do any better than big government when it comes to complex projects?  The answer appears to be, no.

In this instance, CGI was a corporation that had been pre-vetted, and thus had the right to bid on contracts generally under a procedure created by congress as part of the law governing the bidding process overall.  That procedure, as it turns out, creates a de facto prejudice against small contractors that may not want to make such government work their m├ętier, but may want to bid on a particular project.  So huge CGI's only competition was only other pre-qualified corporation in reality, and they got the contract over two other bidders.  But there might have been many more except for the statutory scheme for selecting contractors promulgated by congress to bind the executive branch to do business a certain way...one that favors big business over small business, which the Republicans always claim to be the heart of the American economy.  And if the critiques of the process by which the federal healthcare site was created and is being revised to make it effective are correct, small business competitors of CGI might well have done a much better job, simply by virtue of their tendency toward simplicity rather than complexity that justifies big fees.  Of course, the issue is complicated, and even after piercing that obstacle to resolving it, what remains will be essentially opinion, and we all know that in politics, everyone involved will say only what serves him best.  Still, there is a lesson to be learned here, though it certainly will not be.

It may be true that for many tasks, government is not the best option given its size and lack of nimbleness and adaptability.  But the problem is not that it is government.  The problem is that it is big...like big business.  So, the people who are dogmatic about keeping government out of our lives should be rethinking their choice of big business as out salvation.  It is becoming ever more obvious that size does matter.  However when it comes to the operation of government it is sometimes an advantage, as in the case of old-age retirement.  No large corporation could run a system like Social Security efficiently and do as much good as the federal Social Security Administration does.  But in cases in which private enterprise is a better choice, maybe bigger isn't better then either.

Your friend,

Mike

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This page contains a single entry by Michael Wolf published on November 29, 2013 1:24 PM.

Letter 2 America for November 26, 2013 was the previous entry in this blog.

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About this Entry

This page contains a single entry by Michael Wolf published on November 29, 2013 1:24 PM.

Letter 2 America for November 26, 2013 was the previous entry in this blog.

Letter 2 America for December 3, 2013 is the next entry in this blog.

Find recent content on the main index or look in the archives to find all content.

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