NPR had a pretty good comment on why many of the Governments tech contractors are terrible. It was summed up in that any tech company with muscle and expertise don't even bid for Government contracts. The way contracts have to be written require a full time division just to bid for the job, never mind produce it.

Having had to mine government Request For Proposals for jobs, I know even something as small as landscaping is a task in tedium. Bids build in inordinate amount of profit and overhead for simple things, because companies create many proposals, but win few. The time dedicated to constructing the proposal blows any profit away. So prices are inflated. While competition should yield a better product, in government contracting instances it results in massively inflated prices.

In this healthcare case, it's probably a result of poor reporting, poor subcontractors, poor project management, overrun budgeting and timeline. If an existing powerhouse in the tech world was presented with this task, they could probably produce something streamlined and under budget. I can only wonder what a Google or Apple Healthcare site would look like. It would probably be easy to use and would actually work.