[stocksinsmocks]

There are a few answers to that but the most obvious reason is quality of work. You can expect a lot more out of a contractor whose billed rate is $250 an hour versus a grad student. The second point is that least in the United States, all government jobs are purely clerical and administrative. The government, as you know it does nothing for itself, except may be law-enforcement. Contractors do everything. Space flight, building the roads, managing construction programs, hauling trash, everything. In this particular case there are “national security“ interests that have inserted themselves into the healthcare domain who want the data and to control treatment. You don’t get to say no to people who with unlimited resources and a “by any means necessary” MO.

[DontchaKnowit]

The "government does nothing for itseld" thing..... I am not sure thats true. Pretty sure the government is the single biggest employer in the country a d I dont think that even counts contractors

[stocksinsmocks]

Employee headcount is not a good proxy for actually accomplishing the tasks government is expected to do. Your DOT has a huge number of employees, but I can say from first hand knowledge that none of the staff engineers actually design anything. They manage and administer projects, and they attend a lot of meetings and spend a lot of hours in the office, but they probably don’t actually do the things you care about as a taxpayer: deliver infrastructure improvements. Contractors manage the programs, plan the jobs, design the jobs, build the job, and inspect the job. State employees might do maintenance, and they will do it with 3-5X the headcount of the contractors.

[bitsage]

This comment isn’t as much of an exaggeration as it seems, at least regarding engineering. At a previous job, I was tasked with helping a product line achieve certification to a government standard. The public facing government contact I interacted with was just a middle man with the consultancy, ICF, who actually developed and maintained the standards, to government specifications. Also, those government specifications had significant input from industry.