ANALYIS: Private contractors cost taxpayers millions while demonstrating few clear results

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Sun, 2021-08-22 22:13 — mike kraft

How the U.S. vaccination drive came to rely on an army of consultants Private contractors cost taxpayers millions while demonstrating few clear results and papering over weaknesses in the country’s public health system. Isaac Stanley-Becker Washington Post

When Gavin Newsom outsourced key components of California’s vaccine rollout to 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.

McKinsey’s role extended beyond California to other states, including Ohio and New Jersey. Deloitte worked in 10 states. BCG received millions of dollars from the federal government to coordinate vaccine planning, while at least 11 states also worked with the company, in some cases paying it to address gaps in federal planning.

Consultants say they helped save lives by supporting overextended public servants with specialized expertise. “Our work helped state decision-makers quickly size up key factors impacting the effective distribution of vaccines,” said McKinsey spokesman Neil Grace. “All our work was based on state-defined priorities, and the data we analyzed was provided by state and local public health authorities.”

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 because the internal documents of private consultancies are 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. ...

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