A lot of the most effective pushback we end up never seeing at all -- it happens in decisions and conversations we aren't party to. We do think in the long run delivering a radically better product will win out... But the presence of pushback does really demonstrate the need for tech-savvy partners inside the government, like those we have been lucky to work with at the Center for Medicare and Medicaid Services, and a reformed contracting process. The only way there will be better technology in government long term is if the people signing the checks are able to discern between the modern way and the old way, and insist on a better way of doing things. (Apologies for brief responses - on mobile)