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I think exclusive contracts should be abandoned anywhere they can be. Why should there only be one monolithic Healthcare.gov? Every single company that wants

I think exclusive contracts should be abandoned anywhere they can be. Why should there only be one monolithic Healthcare.gov? Every single company that wants to should be able to build their own solution to this. They can be rewarded based on how many users they get, or the best one can win a bounty.

DanBC 12y ago
I really really wish that governments would define some specs for what a patient record MUST and MUST NOT do; and what the software must and must not do, and so on, and then just let software providers sell software to medical providers.
privong 12y ago
I do not think what you are suggesting is a bad idea. But a counterargument would be that having many organizations doing the same thing might make it more expensive overall, by increasing the cost of overheads (e.g., every company needs to have its own HR department). Those costs may not manifest themselves outright, but they will go into the cost equation.
incision 12y ago
>'I think exclusive contracts should be abandoned anywhere they can be. Why should there only be one monolithic Healthcare.gov?' I completely agree with the first sentence conceptually, but think the second is a terrible fit for that concept. A monolithic healthcare.gov actually makes a lot of sense as every implementation will necessarily have loads of shared functionality. There's a reason state exchanges have spent multiples of what healthcare.gov has per sign-up. [1] >'Every single company that wants to should be able to build their own solution to this. They can be rewarded based on how many users they get, or the best one can win a bounty.' This isn't a throwaway chat app. The tacit Government approval of free-for-all collection of the SSNs, income and health coverage information that go into a marketplace application would not be wise. 1: http://www.npr.org/blogs/health/2014/05/08/310721495/healthcare-gov-looks-like-a-bargain-compared-with-state-exchanges http://www.npr.org/blogs/health/2014/05/08/310721495/healthc...
deleted 12y ago
[deleted]
Iftheshoefits 12y ago
I agree that exclusive contracts should be abandoned where they can be, but for a much different reason: I have little or no confidence at all in the private sector to meet the requirements properly. A lot of the work done by private contractors ought to be done and maintained directly the government. The current system is not one of efficiency; it's one of corporate welfare.
andrewliebchen 12y ago
There were suppose to be 50 healthcare.govs. Unfortunately, the intransigence of some Republican governors have left us with more states than intended falling back on a Federal solution. One of the governing principles of the ACA was that the states would be afforded the ability to experiment with their own approaches to meet the law's guidelines, the other states could replicate what worked. Would have been a wonderful opportunity to try 50 differnent ways to bid, design and build the same system...
andrewliebchen 12y ago
There we're suppose to be 50 healthcare.govs. Unfortunately, the intransigence of some Republican governors have left us with more states than intended falling back on a Federal solution. One of the governing principles of the ACA was that the states would be afforded the ability to experiment with their own approaches to meet the law's guidelines, the other states could replicate what worked. Would have been a wonderful opportunity to try 50 differnent ways to bid, design and build the same system...

DanBC 12y ago

I really really wish that governments would define some specs for what a patient record MUST and MUST NOT do; and what the software must and must not do, and so on, and then just let software providers sell software to medical providers.

privong 12y ago

I do not think what you are suggesting is a bad idea. But a counterargument would be that having many organizations doing the same thing might make it more expensive overall, by increasing the cost of overheads (e.g., every company needs to have its own HR department). Those costs may not manifest themselves outright, but they will go into the cost equation.

incision 12y ago

>'I think exclusive contracts should be abandoned anywhere they can be. Why should there only be one monolithic Healthcare.gov?' I completely agree with the first sentence conceptually, but think the second is a terrible fit for that concept. A monolithic healthcare.gov actually makes a lot of sense as every implementation will necessarily have loads of shared functionality. There's a reason state exchanges have spent multiples of what healthcare.gov has per sign-up. [1] >'Every single company that wants to should be able to build their own solution to this. They can be rewarded based on how many users they get, or the best one can win a bounty.' This isn't a throwaway chat app. The tacit Government approval of free-for-all collection of the SSNs, income and health coverage information that go into a marketplace application would not be wise. 1: http://www.npr.org/blogs/health/2014/05/08/310721495/healthcare-gov-looks-like-a-bargain-compared-with-state-exchanges http://www.npr.org/blogs/health/2014/05/08/310721495/healthc...

deleted 12y ago

[deleted]

Iftheshoefits 12y ago

I agree that exclusive contracts should be abandoned where they can be, but for a much different reason: I have little or no confidence at all in the private sector to meet the requirements properly. A lot of the work done by private contractors ought to be done and maintained directly the government. The current system is not one of efficiency; it's one of corporate welfare.

andrewliebchen 12y ago

There were suppose to be 50 healthcare.govs. Unfortunately, the intransigence of some Republican governors have left us with more states than intended falling back on a Federal solution. One of the governing principles of the ACA was that the states would be afforded the ability to experiment with their own approaches to meet the law's guidelines, the other states could replicate what worked. Would have been a wonderful opportunity to try 50 differnent ways to bid, design and build the same system...

andrewliebchen 12y ago

There we're suppose to be 50 healthcare.govs. Unfortunately, the intransigence of some Republican governors have left us with more states than intended falling back on a Federal solution. One of the governing principles of the ACA was that the states would be afforded the ability to experiment with their own approaches to meet the law's guidelines, the other states could replicate what worked. Would have been a wonderful opportunity to try 50 differnent ways to bid, design and build the same system...