There’s a lot of good stuff in Colin Crouch’s new book, Making Capitalism Fit for Society (Powells, Amazon), but one point seems particularly relevant today. As umpteen people have pointed out, the rollout of the federal enrollment system for Obamacare has been a disaster. The polymathic David Auerbach has been particularly excellent on this.
The number of players is considerably larger than just front-end architects Development Seed and back-end developers CGI Federal, although the government is saying very little about who’s responsible. The Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS), which issued the contracts, is keeping mum, referring reporters to the labyrinthine USASpending.gov for information about contractors. … By digging through GAO reports, however, I’ve picked out a handful of key players. One is Booz Allen … Despite getting $6 million for “Exchange IT integration support,” they now claim that they “did no IT work themselves.” Then there’s CGI Federal, of course, who got the largest set of contracts, worth $88 million, for “FFE information technology and healthcare.gov,” as well as doing nine state exchanges. Their spokesperson’s statement is a model of buck-passing … Quality Software Solutions Inc …[have] been doing health care IT since 1997, and got $55 million for healthcare.gov’s data hub in contracts finalized in January 2012. But then UnitedHealth Group purchased QSSI in September 2012, raising eyebrows about conflicts of interest.
… Development Seed President Eric Gundersen oversaw the part of healthcare.gov that did survive last week: the static front-end Web pages that had nothing to do with the hub. Development Seed was only able to do the work after being hired by contractor Aquilent, who navigated the bureaucracy of government procurement. “If I were to bid on the whole project,” Gundersen told me, “I would need more lawyers and more proposal writers than actual engineers to build the project. Why would I make a company like that?” These convolutions are exactly what prevented the brilliant techies of Obama’s re-election campaign from being involved with the development of healthcare.gov. To get the opportunity to work on arguably the most pivotal website launch in American history, a smart young programmer would have to work for a company mired in bureaucracy and procurement regulations, with a website that looks like it’s from 10 years ago. So much for the efficiency of privatization.
Otherwise put, it’s a good example of Crouch’s critique of neo-liberal efforts to ‘shrink’ government – that in practice it is less about free markets than the handing over of government functions to well connected businesses.
Outsourcing is … justified on the grounds that private firms bring new expertise, but an examination of the expertise base of the main private contractors shows that the same firms keep appearing in different sectors … The expertise of these corporations, their core business, lies in knowing how to win government contracts, not in the substantive knowledge of the services they provide. … This explains how and why they extend across such a sprawl of activities, the only link among which is the goernment contract-winning process. Typically, these firms will have former politicians and senior civil servants on their boards of directors, and will often be generous funders of political parties. This, too is part of their core business. It is very difficult to see how ultimate service users gain anything from this kind of managed competition.
As Crouch suggests in an aside, we’ve been here before. The cosy relationship between corporations like CGI Federal and Booz Allen and the government bears a strong resemblance to feudalism (which, stripped of the pageantry, was a complex web of relations and privileges between a small and privileged elite of nobles and the state). It bears an even stronger resemblance to Old Corruption, the strangling web of sinecures and emoluments that radicals like William Cobbett inveighed against in the early nineteenth century. Government – even at the best of times – has many clunky and inefficient features (the American version particularly so – many of the worst inflexibilities of the US government have their origins in people’s distrust of it). Yet the replacement of large swathes of government with a plethora of impenetrable subcontracting relationships is arguably even worse – it has neither the efficiencies (sometimes) achieved by markets, nor the accountability (sometimes) achieved by democratic oversight.