Alan Greenspan Tries Unsuccessfully to Have It Both Ways: Whiskey-Tango-Foxtrot Weblogging
Rise of the Machines?: From the Inaugural "Uncharted"

Assigning the Blame for HealthCare.gov...

Amy Goldstein and Juliet Eilperin: HealthCare.gov: How political fear was pitted against technical needs:

In May 2010... Larry Summers... and Peter Orzag... had just received a pointed four-page memo from a trusted outside health adviser. It warned that no one in the administration was “up to the task” of overseeing the construction of an insurance exchange and other intricacies of translating the 2,000-page statute into reality. Summers, Orzag and their staffs agreed....

For weeks that spring, a tug of war played out inside the White House, according to five people familiar with the episode. On one side, members of the economic team and Obama health-care adviser Zeke Emanuel lobbied for the president to appoint an outside health reform “czar” with expertise in business, insurance and technology. On the other, the president’s top health aides--who had shepherded the legislation through its tortuous path on Capitol Hill and knew its every detail--argued that they could handle the job.

In the end, the economic team never had a chance: The president had already made up his mind, according to a White House official.... Obama wanted his health policy team... to be in charge of the law’s arduous implementation. Since the day the bill became law, the official said, the president believed that “if you were to design a person in the lab to implement health care, it would be Nancy-Ann.” Three and a half years later, such insularity... emerged as a central factor in the disastrous rollout of the new federal health insurance marketplace....

“They were running the biggest start-up in the world, and they didn’t have anyone who had run a start-up, or even run a business,” said David Cutler, a Harvard professor and health adviser to Obama’s 2008 campaign, who was not the individual who provided the memo to The Washington Post but confirmed he was the author. “It’s very hard to think of a situation where the people best at getting legislation passed are best at implementing it. They are a different set of skills.”...

The project was hampered by the White House’s political sensitivity to Republican hatred of the law--sensitivity so intense that the president’s aides ordered that some work be slowed down or remain secret for fear of feeding the opposition. Inside the Department of Health and Human Services’ Centers for Medicare and Medicaid, the main agency responsible for the exchanges, there was no single administrator whose full-time job was to manage the project. Republicans also made clear they would block funding, while some outside IT companies that were hired to build the Web site, HealthCare.gov, performed poorly. These interwoven strands ultimately caused the exchange not to be ready by its Oct. 1 start date. It was not ready even though, on the balmy Sunday evening of March 21, 2010, hours after the bill had been enacted, the president had stood on the Truman Balcony for a champagne toast with his weary staff and put them on notice: They needed to get started on carrying out the law the very next morning. It was not ready even though, for months beginning last spring, the president emphasized the exchange’s central importance during regular staff meetings to monitor progress. No matter which aspects of the sprawling law had been that day’s focus, the official said, Obama invariably ended the meeting the same way: “All of that is well and good, but if the Web site doesn’t work, nothing else matters.”

Comments