For the sake of argument, let’s leave aside for the moment the many, serious problems with the actual implementation and execution of Obamacare and focus on the widely storied problems with the web site. Could it have worked out flawlessly – or at least with only modest roll-out problems common to any large launch – if it had been designed by someone competent? Clearly there’s only one person to ask, and as per Brian Fung at the wapo, that’s The Donald.
In an interview with the Washington Examiner, Donald Trump lashes out at HealthCare.gov and argues, somewhat trollishly, that a U.S. company such as Google would never have dropped the ball on such a project:
“I would have advised them to go to Google or one of our other great technological companies and get their act straightened out,” Trump told the Washington Examiner. “They should have done that before they did the roll out with a Canadian company with a bad track record.”
Since this is the Washington Post, they have to scoff at the idea immediately, but it’s an interesting question. I’m not saying they’d have done it for free as Trump suggests they might, but given a few years and a reasonable budget, could they have filled the bill? Fung brings up one of Google’s many, many tech initiatives over the years which I’d forgotten about. Back in 2007 they actually launched a product which aimed to do something very similar.
The initiative was called Google Health, and its vision was to produce a centralized database for electronic medical records. Users could log on, add their information — or get their insurer to do it for them — and wind up with one set of documents they could give to doctors and other health professionals. The service was up and running by 2008. But by 2011, Google had decided to shutter the service. Its audience was too limited, the company said in a blog post. The only people who used it were fitness nuts and geeky early adopters.
Why did Google Health fail, and could it have been adapted to serve HealthCare.gov’s purposes?
One big reason is that logistically, Google was hamstrung by some of the same forces that stymied CGI, the government’s lead contractor on HealthCare.gov.
The thing that killed Google Health, at least according to this analysis, was the myriad different interfaces used by individuals, government offices and health care providers of all stripes in fifty different states. Getting a single tool able to securely talk to all of them, collect data through those various tools and deliver it in a way that they could all usefully digest was a monumental task. Of course, they didn’t have a government mandate to do it or to gain cooperation from all the various parties involved, either. I suppose it’s possible that a giant like Google might have mastered the task if enough weight was thrown behind the effort, but we’ll probably never know.
This does, however, highlight one of the overarching problems with a government overhaul of and meddling in something as mind bogglingly huge and complex as the American health care system. The government has not historically been all that efficient at doing “big things.” And the bigger they are, the harder they are to get under control. This is true for experts in any field, to say nothing of the collection of boobs and bozos you find inhabiting DC. When their reach exceeds their grasp, bad things tend to follow. That’s why I’m immediately suspicious when I hear somebody on the Hill talking about a gigantic proposal for “comprehensive” anything.
Perhaps Congress should focus on passing specific, limited laws which focus on one individual situation at a time. That seems to be more in their skill range.