We already know that the government is one of the largest IT buyers, but in many ways it is also an IT builder. Especially for areas where the government is doing something that no one else is doing, like running Medicare and Social Security -- i.e., unique services no other company out there is building software for. That's where the USDS comes in. Now almost two years old, the United States Digital Services is "a startup at the White House" responsible for mission-critical, citizen-facing services like improving Veterans' Affairs healthcare applications and benefit claims appeals, or student loan repayments.

But can one really operate as a startup while embedded in an entity as complex and huge -- remember, each agency would be like a Fortune 500 company -- as government? It may not be move fast and break things, observes Mikey Dickerson, Google engineer-turned-administrator of the USDS (and one of the fixers of the original healthcare.gov), but "There's a world of difference between moving a little slower than you're used to and not moving at all." And it's not like large companies don't have huge, bureaucratic structures either. In fact, argues USDS co-founder and deputy administrator Haley Van Dyck, both government and big companies are going through the same shift right now, one where technology is moving "from what used to be the periphery into the core mission of business".