The billionaire's presumption that a profit-seeking company — even one as forward-thinking as Google — might volunteer out of the goodness of its heart to build the government's insurance hub sounds far-fetched. But in fact, it wasn't so long ago that Google was actually building something similar.
The initiative was called Google Health, and its vision was to produce a centralized database for electronic medical records. Users could log on, add their information — or get their insurer to do it for them — and wind up with one set of documents they could give to doctors and other health professionals. The service was up and running by 2008. But by 2011, Google had decided to shutter the service. Its audience was too limited, the company said in a blog post. The only people who used it were fitness nuts and geeky early adopters.
Why did Google Health fail, and could it have been adapted to serve HealthCare.gov's purposes?
One big reason is that logistically, Google was hamstrung by some of the same forces that stymied CGI, the government's lead contractor on HealthCare.gov. According to Missy Krasner, interfacing with different systems across the medical industry proved to be an enormous challenge:
We had to create a ton of point-to-point integrations with large health insurance companies, academic medical centers, hospitals, medical practices and retail pharmacy chains. All of these providers and payors were covered entities in the world of HIPAA and were required to verify a patient’s identity before releasing any data to them electronically. It was a very bumpy user experience for even the most super-charged, IT savvy consumer.
That's a structural hurdle that isn't going to disappear overnight. And remember, all Google was trying to build was a health records database — not an insurance exchange.
Trump's suggestion isn't completely outlandish. But he's still wrong.