[tjr225]

Lol this is kind of funny given my other post but in addition to having worked in government I’ve also worked in healthcare.

I made about 50% of what I do now at that vendor and was glad to leave. I truly think if people had an incentive to make things better in government and healthcare then things would get better. It was a terrible job but a good starting point. I wonder if health care vendors paid as much as google or Facebook how good things could be.

In fact there are a few people that do try to make things better, but they value their progress over money. Same with teachers. We know they make a fraction of what a tech worker does but the value they provide is immense.

I don’t know if you’ve lived on the west coast and worked in tech but if you have surely you know someone who makes an absurd amount of money at Facebook, or google or whatever and also hates what they do. Imagine if you could pay people faybu bux but to make government work. They would do it. There would be an impassioned soul who is want to make government better and would do so. Instead the government pays half rate and gets half rate old dudes who want to retire in place.

[shadowgovt]

A former Googler got called in by the Obama administration to try and put healthcare.gov back on its rails after the disastrous launch, and the things he learned about it were fascinating. He talks about some of them here

https://youtu.be/0albm_hhQzM

It's not only the pay rate attracting employees who prefer stability to income... It's an entire decisionmaking ecosystem centered around minimizing blame coupled badly with compartmentalization. The end result is employees are heavily incentivized to do things that minimize risk not for the entire project but for their individual department. couple that to the percentage of the work that is done by third-party vendors under strict contracts written before the full scope of the project is understood, and it's a bad recipe.

One of the first problems the embedded team identified with the whole design of healthcare.gov was that every team had responsibility for its individual component, but nobody was empowered to have responsibility for integration. It was possible for every subcontractor to satisfy every bullet point of their contract and the result to not actually be a functioning healthcare exchange website.

[tjr225]

I’ve experienced this first hand. I really think more money would solve this problem.

If the departments weren’t structuring themselves to survive indefinitely out of fear, then we could engineer in government.

[lostlogin]

> I don’t know if you’ve lived on the west coast and worked in tech

No. I don’t live in the US and don’t work in tech. I work in healthcare and have done so in the private sector and public sector. I don’t think you have pay a an amazing amount to get good people. Decent conditions go a very long way. My public sector pay isn’t worse than my private pay, and depending on how you measure it, the public pay may be better.

Would I be right in thinking that your healthcare experience was all private sector?

[tjr225]

Definitely all private sector in the US. That’s almost exactly what I’m getting at.