Secretary of Health and Human Services Kathleen Sebelius is not a tech founder. President Barack Obama does not have a GitHub account. The failed launch of the new health insurance e-commerce website, Healthcare.gov, came as a shock to political leaders that were too steeped in government shutdowns and the machinations of two-party infighting to understand how their hired geeks could flub a computer project.
Unfortunately, Silicon Valley’s powerful political lobbies were myopically focused on the stereotypical tech issues of immigration reform and broadband access to see that every single law affects the tech industry as much as the rest of the country. As a result, many Silicon Valley startups were legally shut out of a brand-new, multi-billion dollar market, while America’s new health-care system is in danger of missing crucial enrollment deadlines.
Here’s the lesson: there are no more “tech issues.” America and startups got hosed because Silicon Valley was politically absent. Since everything now has crucial technology components, the technology industry cannot sit out any issue.
The government, alone, is incapable of solving these problems. Upon entering office, President Obama thought he set a path to change by creating two new positions, the Chief Technology Officer and newly re-tooled Chief Information Officer, specifically designed to make government as innovative as his campaign.
New directors hired. Check! Problem solved? Of course! Unfortunately, it didn’t work out that way.
The first CIO, Vivek Kundra, practically stormed out of his office after two years, denouncing the entire system. “We almost have an IT cartel within federal IT,” he said to Google Chairman Eric Schmidt. The searing criticism fell on the deaf ears of a few wonky trade publications.
The next CIO, Steve VanRoekel, gave me his first interview and declared a bold solution to gut the system from the inside by hiring young folks from Silicon Valley. While we know his ambitious plans didn’t stop the Healthcare.gov failure, we don’t know why, because sometime last spring when Healthcare.gov began serious construction, he was
moved to a different role asked to take on additional duties in a new management role.
No one in the executive branch seemed to have the political power to change either the IT system or the Affordable Care Act’s regulations. In the end, the feds did what they normally do: hire a known contractor and keep the status quo.
“So what they did instead, and very rationally, is they opted to take a contract that they already had — one with CGI Federal — and amended that contract to add the Healthcare.gov stuff onto it,” wrote former Presidential Innovation Fellow Clay Johnson. Congress, likewise, had no incentive to anger a contractor that gives jobs to constituents. “No contracting officer wants a call from a member of Congress asking why their backyard IT integrator wasn’t selected.”
Worse yet, the Affordable Care Act put a new multi-billion-dollar commerce opportunity completely in the hands of the government. “Web-based entities,” or tech startup insurance brokers, who are designing an Orbitz-like experience for shoppers, were treated as second-class citizens. Startups like Fuse Insurance tell me they were given late access to the data and can’t test their product because of Healthcare.gov’s backend glitches. Worse yet, they’re completely overshadowed by a multi-million-dollar, celebrity-fueled ad campaign to drive consumers to the federal website.
The regulations, as written, give state exchanges the option to allow startups access to the new market. California and New York have delayed these partnerships for around two years. As a result of Silicon Valley’s inattentiveness, everyone got screwed.
Fortunately, there are models for Silicon Valley to broaden its reach.
Former Newark Mayor, now Senator Cory Booker, realized this fact on a problem that doesn’t seem to fit the typical “tech issue” mold: criminal justice. While civil libertarians were battling New York Mayor Michael Bloomberg over controversial stop-and-frisk policies, Booker won accolades from the local American Civil Liberties Union for finding a unique tech solution: open up all the data on police officer street stops. Watchdogs can now work cooperatively with law enforcement to find out exactly which stops are happening.
After the Sandy Hook Elementary massacre, noted Facebook investor Ron Conway spearheaded investment for startups that could equip police with gun-fire detection technologies; it’s also exploring ways to empower community volunteers with social media sentiment analysis that can find public gang feuds and defuse them with preemptive diplomacy.
In foreign policy, Benetech helped develop a James Bond-like eraser tool for spying dissidents, they used statistics to indict war criminals, and helping crisis workers more efficiently find victims of national disasters.
All of these areas are not only ripe for business but can save lives. Education, health care, immigration, tax reform, infrastructure (self-driving cars), energy, foreign policy, gay rights, voting rights, disaster relief — they’re all tech issues now.
Silicon Valley’s citizens and its well-heeled lobbyists better expand their interests. Where I can, I will also try to be better at identifying technology-relevant aspects of all major legislation. Health care was a rational oversight. But we shouldn’t get fooled again.