Innovative State

by Aneesh Chopra

  For these reasons and others, Healthcare.gov disappointed many at the start, including those inside the administration. But, even then, it wasn’t quite as worthless and hopeless as the media hysteria suggested, especially in the context of providing what Tim O’Reilly coined “government as a platform.” New startups and commercial websites sprung up, accessing the APIs featured on the government’s companion to Healthcare.gov, Data.Healthcare.gov. Through the latter, any public or private sector organization could repurpose any data associated with the new marketplace to make it easier for consumers to browse for plans. Also, in May 2013, HHS provided guidance to online health insurance brokers on how they could plug in, and profit from, a direct connection to Healthcare.gov.14

  Healthcare.gov and its network of state-based exchanges sparked innovation in the insurance industry itself. Take what happened in Nevada through the launch of its new marketplace, Nevada Health Link. That platform offered a level playing field for a new insurance company, the Nevada Health Co-Op, to compete against long-standing incumbents by offering several unique features, including access to a new model for primary care—one focused on caring for the sickest patients. Iora Health (and its partner, Turntable Health)is focused on treating patients in a more coordinated manner. Prior to the state exchange, Iora’s services were only available by invitation through organizations that sponsored it. For those lucky few, they had achieved incredible results. For instance, over 85 percent of Iora’s patients with hypertension got the condition under control, as compared to the national average of around 50 percent. Even more significantly, this better care had contributed to up to 15 percent reductions in total health care costs. Certainly, this was something worth making more accessible to more people, and that’s what Nevada did.15

  Even as the initial repairs to Healthcare.gov reduced errors and improved responsiveness, there was still plenty of yelling, with backers pushing its benefits and detractors pulling the policy and the process apart. And that won’t wane all that much. It comes with the territory anytime government tries to make any sort of change to the status quo. There will be supporters and skeptics, hopes and doubts, starts and stops.

  That’s one of the reasons, however, why the open government movement is so unique and exciting. At least so far, it appears to be the rare policy agenda where leaders across the political spectrum, even those customarily at odds, are moving in a similar direction: forward. Simply, there doesn’t appear to be an “other side” to the argument, not when the benefits are so obvious. The only question is the degree to which those leaders are aware of its possibilities, and choose to emphasize it in their solutions. Even without much of the media’s attention, that awareness and that emphasis are increasing, here and abroad, across the aisle, and back again.

  Open government seeds may have originally been planted in America but, through the work of Secretary of State Hillary Clinton, among others, they have now started to spread and sprout across the world. On October 31, 2013, Great Britain’s conservative Prime Minister David Cameron hosted the second annual gathering of the international Open Government Partnership (OGP). That organization had been conceived during a meeting President Obama had convened on the sidelines of the 2011 United Nations General Assembly meeting in New York. In his speech, Cameron tried to make the case that open government was more than “an abstract topic” or “some sort of optional add on,” but rather, “absolutely fundamental to a nation’s potential success in the twenty-first century.”16

  That message also applies at the city level—again, encouragingly, across party lines. Prior to leaving office, New York Mayor Michael Bloomberg, a political independent, teamed up with San ­Francisco’s Democratic Mayor Ed Lee and London’s conservative Mayor Boris Johnson for a series of summits highlighting the importance of “building digital cities,” where technology becomes a vital element of economic growth.17 Bloomberg’s broad-reaching Open Data initiatives were among the beacons of his tenure, intended not just to increase transparency and solve problems, but to create jobs and economic growth.

  There is no questioning the impact of the latter. In October 2013, the McKinsey Global Institute released a seminal study of open data in the public and private sectors, estimating its annual economic value in seven sectors—health care, oil and gas, electricity, consumer finance, consumer products, transportation, and education—in the astounding range of $3.2 trillion to $5.4 trillion.18

  You could say that’s a figure worth shouting about. Or, better yet, maybe it’s something that can get us to stop shouting at each other.

  There are those actually interested in achieving more consensus, and open to any new ideas that might enable it. Some belong to the newly formed bipartisan Congressional Future Caucus, a group of forty members under the age of forty, aspiring to develop long-term solutions to the issues facing America’s next generation.19 Long after I had left the administration, on September 18, 2013, I joined its co-chairs Rep. Aaron Schock (R-IL) and Rep. Tulsi Gabbard (D-HI) at the inaugural event.20

  I tried to leave the audience with a message, that open innovation can help solve many of our long-term problems by tapping into widespread talent and the latest technology, while always putting a premium on pragmatism and collaboration.

  When I was finished, both members of Congress asked for more.

  That was all I needed to hear.

  Acknowledgments

  Innovative State, like so many of the achievements it spotlights, was a collaborative effort. It required the assistance of friends and associates from way back, and of countless others I’ve met along the way.

  My journey began with a generous gift from an old college roommate, Ethan J. Skolnick. A popular sports journalist, Ethan offered his time and talents to both immerse himself in the growing open government innovation movement and to share its most inspiring stories in a more accessible way. I am so grateful for his friendship and would suggest that if you found Innovative State a useful read, it is largely on account of Ethan’s writing. That, and the enriching work of our publisher, Morgan Entrekin, and his brilliant colleague at Grove Atlantic, Jamison Stoltz.

  For much of the historical context, I turned to two distinguished thinkers and authors. One, Ken Baer, had shined light on a great deal of this work from his perch at the Office of Management and Budget, and had previously covered the growing reinventing government movement, including Elaine Kamarck and James Pinkerton, in his thoughtful book, Reinventing Democrats. The other, Dr. Michael Lind, had forgotten more in a few minutes than I had ever known in terms of the history of America’s growth and prosperity. I am deeply grateful for his generous contributions related to America’s impressive track record in public sector innovation, and enthusiastically recommend a reading of his Land of Promise: An Economic History of the United States.

  While Ethan, Ken, and Michael were instrumental in shaping the material herein, the heartbeat of Innovative State was provided by those who are engaged in the day-to-day work of making our country more innovative and collaborative. We were blessed that so many eagerly cooperated with us. I consider many of these passionate public servants to be part of my extended family. I’m especially thankful for my successor, Todd Park, and for my dearest friend, Vivek Kundra, who has been alongside from the start of Governor Tim Kaine’s administration. Both represent the best of the best, when it comes to open government innovators.

  They are among those who have had an immeasurable influence on me. That list is quite long.

  For inspiration, no one trumps President Obama, whose riveting speech at the 2004 Democratic Convention stirred my already active passion for public service, and whose vision for harnessing the full power and potential of technology, data, and innovation to both grow the economy and solve problems gave life to this fledgling movement. Thank you for entrusting me with the opportunity to put that vision into action. And I know I wouldn’t have had the opportunity to s
erve you if it hadn’t been for the support of my two mentors—former Virginia Governors Mark Warner and Tim Kaine. They embody all that is good in public service and for the great people of the Commonwealth, and we are blessed that both currently serve us in the U.S. Senate.

  There are so many others, some of whom we introduce in Innovative State. Start inside the White House: former Chief of Staff Rahm Emanuel and his highly effective deputy, Mona Sutphen; Our sponsor in the West Wing, Valerie Jarrett; Peter Orszag and his fellow OMBers—my former boss at the Advisory Board Company, Jeff Zients, and our intellectual godfather, Cass Sunstein; our open government global ambassador, Samantha Power; the original policy entrepreneur, Tom Kalil; the smartest man I’ve ever known, John Holdren; my partners on all matters innovation, Phil Weiser (with support from his bosses, Larry Summers, Gene Sperling, and Jason Furman), Sonal Shah, Terrell McSweeney, and Austan Goolsbee; and the man who made WAVES, Norm Eisen. Our small but scrappy CTO team deserves the lion’s share of credit in translating ideas to action. That roll call includes Beth Noveck (the reigning queen of open government–land!), Andrew McLaughlin, Scott Deutchman, Danny Weitzner, Chris Vein, Tom Power, Eugene Huang, Nick Sinai, Steve Ondra, Brian Forde, and Tristen Pegram.

  We amassed an exciting band of brothers and sisters across the government, from federal to state to local, and we have shared many of their exploits throughout this book. Thank you, first and foremost, to Julius Genachowski who generously extended his hand to welcome me in the Obama community. Thank you, George Arnold, Doug Fridsma, Pat Gallagher, Pat Hoffman, Peter Levin, Farzad Mostashari, Jen Pahlka, Jim Shelton, and Tom Baden. I wish to especially thank the gurus who generously offered both personal guidance and global leadership on this approach to problem solving. From my childhood, I’d heard of the legendary Sam Pitroda and would later pinch myself when given the chance to partner with him on the U.S.-India Open Government Dialogue. During my graduate school years, I was fortunate to befriend Dr. John Halamka, who has mentored me on every step toward IT-enabled reform. And, over my decade plus association with the Advisory Board Company, I was equally blessed with the opportunity to learn corporate values under David Bradley’s leadership, an entrepreneur with a rich soul and caring heart.

  Though Innovative State is written on my experiences in the public sector, it is shaped by the leading voices in the private sector advocating and implementing open innovation to bring new ideas to life. The movement owes a great deal of gratitude for the time and energy invested by our hero, Tim O’Reilly, whose phrase “government as a platform” embodies the essence of our approach. Additionally, thought leaders Henry Chesbrough, Eric Ries, Mitch Kapor, Brad Feld, Peter Diamandis, and Bruce Brown contributed greatly to our policy work, and all are quoted in this text.

  Further, on this front, I would be remiss if I didn’t close with my deepest thanks to the thousands of entrepreneurs and innovators who deployed a bit of their cognitive surplus (hat tip, Clay Shirky) to demonstrate our capacity to solve big problems. Thank you to leaders from a variety of backgrounds, like Jon Bon Jovi and Karen Austin, who used their platforms to foster improvement in areas as diverse as access to homeless services and energy savings for families. Thank you to David Kenny, Dwayne Spradlin, Jay Rogers, Mark Emblidge, and so many others for building platforms that connect them to opportunities. Thank you to all of those moving this movement forward: Dave Augustine (and his Federal Register partners, Bob Burbach and Andrew Carpenter), Fabien Beckers, Brian Chiglinsky, Chuck Drake, Gail Embt, Victor Garcia, Aamer Ghaffar, David Hart, Michael Jackson, Waldo Jaquith, Clay Johnson, Mike Krieger, Oliver Kuttner, Arien Malec, Amir Reavis-Bey (and his Blight teammates Alex Pandel and Eddie Tejeda), Karen Rheuban, Nancy Schwartzman, David Van Sickle, and Tony Webster.

  I save my favorite thank you for last.

  Thank you to my family—to my parents for instilling in me a sense of what’s possible in this great country, and to my beautiful and incredibly supportive wife, Rohini, and our two daughters for, well, everything. I love you with all of my heart. I am thankful that the intensity of the past several years has eased a bit so we can spend more time together. As my oldest childhood friend reminds me, it’s time to feed the ducks.

  Notes

  Prologue

  1.Face the Nation, transcript, CBSNew.com, October 13, 2013, cbsnews.com/8301-3460_162-57607292/face-the-nation-transcripts-october-13-2013-schumer-mccain-ayotte-huelskamp/?pageNum=2.

  2.Abraham Lincoln, “Second Inaugural Address,” Bartleby.com, bartleby.com/124/pres32.html.

  3.“VA History in Brief,” United States Department of Veterans Affairs, va.gov/opa/publications/archives/docs/history_in_brief.pdf.

  4.James Dao, “Veterans Report G.I. Bill Fund Delays,” New York Times, September 24, 2009, nytimes.com/2009/09/25/education/25vets.html?_r=0.

  5.Ed O’Keefe, “Federal Diary: Post-9/11 GI Bill Problems Dog VA,” Washington Post, October 7, 2009, washingtonpost.com/wp-dyn/­content/article/2009/10/06/AR2009100603681.html.

  6.Peter Nicholas, “Rahm Emanuel’s Old-school Style Was Key to New Presidency,” Los Angeles Times, October 1, 2010, articles.latimes.com/2010/oct/01/nation/la-na-rahm-assess-20101001/2.

  7.“New Technology Used For Streamlining Data” Washington Post, September 23, 2009, washingtonpost.com/wp-dyn/content/­article/ 2009/09/22/AR2009092202424.html.

  8.Obama Inaugural Address, January 20, 2009, nytimes.com/2009/01/20/us/politics/20text-obama.html.

  9.Steve Hamm, “Obama’s Big Gov SWAT Team,” Bloomberg Businessweek, November 25, 2009, businessweek.com/magazine/­content/09_49/b4158044764871.htm.

  10.“New Automation Process Cuts Post-9/11 GI Bill Claims Processing Times by More Than Half,” United States Department of Veterans Affairs, last modified March 13, 2013, va.gov/opa/pressrel/pressrelease.cfm?id=2432.

  11.Peter Orszag, “Modernizing Government,” WhiteHouse.gov, last modified January 14, 2010, whitehouse.gov/omb/blog/10/01/14/Modernizing-Government.

  12.“Remarks by the President at Opening Session of the Forum on Modernizing Government,” WhiteHouse.gov, last modified January 14, 2010,whitehouse.gov/the-press-office/remarks-president-opening-session-forum-modernizing-government.

  13.“Keynoting at the OGD Camp 2011 . . . Andrew Rasiej!” Open Knowledge Foundation Blog, last modified October 12, 2011, blog.okfn.org/2011/10/12/keynoting-at-the-ogd-camp-2011-andrew-rasiej.

  Chapter 1

  1.“Publication 100—The United States Postal Service—An American History 1775–2006: The Pony Express,” USPS.com, last modified November 2012, about.usps.com/publications/pub100/pub100_013.htm.

  2.Leroy R. Hafen, The Overland Mail, 1849–1869: Promoter of Settlement Precursor of Railroads, p. 166.

  3.Michael Lind, Land of Promise: An Economic History of the United States, Harper Reprint edition (April 9, 2013) amazon.com/Land-Promise-Economic-History-United/dp/0061834815/ref=cm_cr_pr_product_top.

  4.Michael Lind, Land of Promise: An Economic History of the United States (New York: Harper, 2013).

  5.Cynthia Monaco, “The Difficult Birth of the Typewriter,” American Heritage’s Invention & Technology 4, no. 1 (Spring/Summer 1988), 50.57.231.74/IT/content/difficult-birth-typewriter-1?page=6.

  6.“The Federal Civil Service and the Death of President James A. Garfield,” The Garfield Observer, last modified September 21, 2012, garfieldnps.wordpress.com/2012/09/21/the-federal-civil-service-and-the-death-of-president-james-a-garfield.

  7.Abbrevations for Securities and Exchange Commission, Federal Communications Commission, Civil Aeronautics Board, National Labor Relations Board, National Recovery Administration, Works Progress Administration, Civilian Conservation Corps.

  8.“Distrust, Discontent, Anger and Partisan Rancor: The People and Their Government,” Pew Research Center for the People & the Press, last modified April 18, 2010,
people-press.org/2010/04/18/section-1-trust-in-government-1958-2010.

  9.Seymour Martin Lipset and William Schneider, “The Decline of Confidence in American Institutions,” Political Science Quarterly 98, no. 3 (Autumn 1983): 379–402, http://www.planethan.com/drupal/sites/default/files/The-Decline-of-Confidence-in-American-Institutions-By-Lipset-Seymour-Martin-and-Schneider-William-Political-Science-Quarterly-Fall83-Vol-98-Issue3p379.p

  10.The National Commission on Excellence in Education, “A Nation at Risk: The Imperative for Educational Reform, A Report to the Nation and the Secretary of Education,” United States Department of Education, April 1983, scribd.com/doc/49151492/A-Nation-at-Risk.

  11.Ben J. Wattenberg, Values Matter Most (New York: Free Press, 2007) 22.

  12. Sally R. Sherman, “Public Attitudes Toward Social Security,” Social Security Bulletin 52, no.12 (December 1989), ssa.gov/policy/docs/ssb/v52n12/v52n12p2.pdf.

  13.D. Andrew Austin and Mindy R. Levit, “Mandatory Spending Since 1962,” Congressional Research Service, March 23, 2012, fas.org/sgp/crs/misc/RL33074.pdf.