Today the president discussed the problems with Obamacare’s exchanges:
I have to say I found his remarks far less contrite than they should have been. Where is the unqualified apology? Where is the commitment to basic accountability for this clusterfuck? Instead, we have all these positive rationalizations and excuses in a confusing technical lecture. Ezra reports that the White House was blindsided by the Healthcare.gov problems:
The problem here isn’t just technological. It’s managerial. The White House’s senior staff — up to and including the president — was blindsided. Staffers deep in the process knew that HealthCare.gov wasn’t ready for primetime. But those frustrations were hidden from top-level managers. Somewhere along the chain the information was spun, softened, or just plain buried.
The result was that the White House didn’t know the truth about its own top initiative — and so they were unprepared for the disastrous launch. They didn’t even know they needed to be lowering expectations. In any normal corporation, heads would roll over a managerial failure of such magnitude and consequence.
And perhaps heads will roll. But for now, the White House is focused on trying to make HealthCare.gov work.
Not. Good. Enough.
Obama needs to get ahead of this, and stop being as defensive as he was this morning. He does not have the credibility to sell us on the ACA when he does not cop more aggressively to his own failure to stay on top of this most important domestic initiative. Sebelius is the person most obviously responsible for the managerial – not technical – problems that have plagued this new program’s rollout.
The reasons liberals should want to prevent their long-awaited victory on health care reform from being turned into defeat by the haphazard implementation of a poorly constructed law are obvious. But what’s in it for conservatives? Nothing would better vindicate their case against Obamacare than the “death spiral” that would follow young people fleeing exchanges that are being flooded with the old and sick.
Yet if Obamacare undermines the entire individual health insurance market, it will make it even more difficult—and perhaps impossible—to ever implement any free-market health care reforms. In fact, single payer may loom ever larger as the only viable remaining option to an employer-based system that both conservatives and liberals would like to substantially remodel.
But for Republicans, Obamacare is not and perhaps never has been a program to favor or oppose, to reform or to abandon. It has become a doctrinal issue of paramount importance. They have not acted rationally in shaping it, as they could easily have, or in reforming it, as they could now do. They will continue a policy of sabotage – and the possibility that we could all end up in single-payer as a result is not the kind of empirical thing they can compute. It requires an analysis of costs and benefits, which they are unable to do. All they do is proclaim eternal, political truths and purge any dissenters. That’s all they know. Because actually governing – rather than controlling – the country is of no interest to them.
In a later post, Ezra assesses the efforts to fix the ACA website:
HealthCare.gov is monstrously complex. The Times reports that there’s more than 500 million lines of code — of which more than 5 million lines may need to be rewritten. And that code is interfacing with computer systems (and computer code) at the Internal Revenue Service, the Social Security Administration, state Medicaid systems, insurers like Aetna, and more. Even the best programmers would have trouble figuring out what’s going on — much less what’s going wrong — quickly.
The truth is that the Obama administration is, to a much greater extent than it would like, dependent on the very people who built HealthCare.gov to fix it. They’re the only people who know what’s going on inside the system.