This is, after all, America:
When Gavin Newsom outsourced key components of California’s vaccine rolloutto the private sector during the pandemic’s darkest days last winter,the Democratic governor promised the changes would benefit the most vulnerable.
His “number one”reason for handing the reins to Blue Shield of California, an Oakland-based health insurance company, was “equity” —delivering vaccine doses to those at greatest risk, many in communities of color, he said in February.
But the $15 million contract with Blue Shield, plus another $13 million for McKinsey, did not deliver on that promise, according to state and county officials, as well as public health experts.
“Equity is a useful catchphrase, but the work was either nonexistent or completely nontransparent,” said Kim Rhoads, a health advocate and physician researcher at the University of California San Francisco. About 45 percent of eligible Black residents and Latino residents are fully vaccinated in California, according to state data, compared to nearly 60 percent of the eligible White population. “The numbers speak for themselves,” Rhoads said.
California wasn’t alone in using private contractors to manage the vaccination campaign. At least 25 states, along with federal agencies and many cities and counties, hired consulting firms, according to a Washington Post tally. The American vaccination drive came to rely on global behemoths such as McKinsey and Boston Consulting Group (BCG), with downsized state and local health departments and even federal health agencies relying on the private sector to make vaccines available to their citizens,according to hundreds of pages of contract documents, emails and text messages obtained through public records requests.
But critics question whether such contracts improve government performance, arguing the arrangements are costly and difficult to oversee. Taxpayers have no way to know what precisely they are getting under no-bid contracts worth millions of dollars becausethe internal documents of private consultanciesare not subject to public records laws.
“California has chosen to pay Blue Shield and other consultants millions of dollars to do the job that their public health workforce was already doing, while on reduced salaries due to pandemic-related budget cuts,” said a state health official, who spoke on the condition of anonymity to avoid professional reprisal.
It’s an excellent story, well worth reading, but the bottom line is that consultants have made a ton of money to provide work of highly dubious value, while eroding the capacity of government to respond to crises. And in the great circle jerk of life, politicians who hire consultants often get their reward when they leave office. As a member of academia, it’s a very familiar story.