Columnist Dana Milbank is a liberal supporter of Obamacare. But he gives more details about the current roll-out debacle. He goes so far as to make comparisons between Obama’s handling of his health care program and his predecessor’s handling of the Iraq war.
In one account of what even administration officials acknowledge is a debacle, the Wall Street Journal reported that Obama’s policy advisers were aware long ago that the president’s promise that “if you like your insurance plan, you will keep it” wouldn’t hold up. “White House policy advisers objected to the breadth of Mr. Obama’s ‘keep your plan’ promise,” the Journal reported, citing a former senior administration official. “They were overruled by political aides, the former official said. The White House said it was unaware of the objections.”
Obama, to borrow Bush’s phrase [about his staff’s advice on the Iraq war], heard “nothing from anybody.”
No, the Obamacare pratfall is not Obama’s Iraq: The magnitude is entirely different, and the problems — Web site malfunctions and a wave of policy cancellations — are fixable. But the decision-making is disturbingly similar: In both cases, insular administrations, staffed by loyalists and obsessed with secrecy, participated in group-think and let the president hear only what they thought he wanted to hear.
In a damning account of the Obamacare implementation, my Post colleagues Amy Goldstein and Juliet Eilperin described how Obama rejected pleas from outside experts and even some of his own advisers to bring in people with the expertise to handle the mammoth task; he instead left the project in the care of in-house loyalists. “Three and a half years later, such insularity — in that decision and others that would follow — has emerged as a central factor in the disastrous rollout,” Goldstein and Eilperin reported.
Their report is based in part on a prescient memo sent to the White House in May 2010 by Harvard professor David Cutler, an outside adviser on health-care reform. “I am concerned that the personnel and processes you have in place are not up to the task, and that health reform will be unsuccessful as a result,” he wrote. “My general view is that the early implementation efforts are far short of what it will take to implement reform successfully. . . . I do not believe the relevant members of the administration understand the president’s vision or have the capability to carry it out.”
Cutler identified many of the problems that would later plague the Obamacare rollout: The perception of secrecy, the lack of qualified personnel and the likelihood that “if you cannot find a way to work with hesitant states and insurers, reform will blow up.”
Instead, Obama followed a different governing philosophy: Dance with the one that brung ya. He figured that those who helped him enact the health-care law should be the ones to implement it.
I’ve written frequently about Obama’s insularity. Like his predecessor, he has rewarded loyalty and surrounded himself with like-minded advisers disinclined to dissent. This, combined with a Bush-like fetish for secrecy, has left the president in a bubble, struggling to find support in Congress or among the public.
That’s what makes the Iraq comparison resonate, even without Obama’s call for a technology “surge” to HealthCare.gov inviting the comparison. Although the policies are entirely different, both were unforced errors aggravated by a president’s insularity. Both men failed to hear warnings (about the intelligence and the military plan, in Bush’s case; about problems with the exchanges and the Web site, in Obama’s), overstated their cases (Bush’s hysteria about Iraq’s nuclear program; Obama’s keep-your-plan promise) and used the other side’s partisanship as an excuse to withhold information.