The Obama White House's Original Sin: A Failure of Effective Management

The Obamacare debacle is the latest error from an administration that doesn't know how to run the executive branch and has shown little interest in learning.
Kevin Lamarque/Reuters

The Healthcare.gov debacle has been thoroughly dissected so far by America's best health journalists and policy analysts. To be sure, every major rollout of a new or changed social policy, including Medicare itself, is rough and takes weeks or months to resolve. But this rollout is clearly worse, and, as we learn more about its history over the past six months and more, the failures in vision and execution, in the face of clear and blunt warnings of problems ahead, are striking and troubling.

Go back, first, to Max Baucus's famous and widely distorted and misused "train wreck" comment in a hearing to Health and Human Services Secretary Kathleen Sebelius in April 2013. Contrary to Ted Cruz and countless other Republicans, Baucus did not call Obamacare a train wreck—he was referring directly to its implementation through the website. He said, "I understand you've hired a contractor. I'm just worried that that's going to be money down the drain because contractors like to make money more than they like to do anything else. That's their job. They've got to worry about their shareholders and whatnot.

"And also, all the other agencies are all involved. People are going to be really confused. And maybe give some thought to one-stop shopping somehow, so you go to one location—a businessperson—one location, get the answers.

"I just tell you, I just see a huge train wreck coming down. You and I have discussed this many times, and I don't see any results yet."

"What can you do to help all these people around the country going, 'What in the world do I do and what—how do I know what to do?' "

If Sebelius, the president, the leaders at the Centers for Medicare and Medicaid Services, and other White House officials were unaware before that hearing about the implementation problems, they could not be unaware afterward. And, as we are now hearing, the stark internal warnings from tech experts of deep-seated problems in the programs came months ago and went unheeded.

Michael Gerson, the Washington Post columnist channeling his inner Friedrich Hayek, says this is the inherent flaw in a huge system run by government—an obviously false conclusion given that the health care systems in France, Canada, the Netherlands, and, yes, Great Britain work smoothly and are immensely popular, and that in several states running their own exchanges, the implementation has been quite smooth.

Putting aside the fact that the federal exchange is much larger to start than anyone anticipated, because so many Republican governors opted out of creating their own exchanges, and that the demand has been strikingly high, I view the problem in a broader way. It is the larger failure of public administration that has been endemic in the Obama White House, and is probably the president's most significant weakness.

The first clues to this problem came during the transition in 2008. George W. Bush and his chief of staff, Josh Bolten, offered exemplary assistance to the incoming Obama team—but many of the ideas on the table to streamline the nomination process for executive posts, including the cumbersome vetting element, were ignored. From the get-go, the Obama Administration was behind the curve on nominating people to fill key posts; many remained unfilled for the first term. Combine that with the shocking failure to quickly nominate judges to fill vacancies—for a constitutional-law professor who had served in the Senate. Both meant that the early tendency in the Senate to confirm presidential nominations was lost, and subsequent nominees got caught repeatedly in obstructionist tactics by Republican senators.

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Norm Ornstein is a contributing writer for The Atlantic, a contributing editor and columnist for National Journal, and a resident scholar at the American Enterprise Institute for Public Policy Research. More

Ornstein served as codirector of the AEI-Brookings Election Reform Project and participates in AEI's Election Watch series. He also serves as a senior counselor to the Continuity of Government Commission. Ornstein led a working group of scholars and practitioners that helped shape the law, known as McCain-Feingold, that reformed the campaign financing system. He was elected as a fellow of the American Academy of Arts and Sciences in 2004. His many books include The Permanent Campaign and Its Future; The Broken Branch: How Congress Is Failing America and How to Get It Back on Track, with Thomas E. Mann; and, most recently the New York Times bestseller, It's Even Worse Than It Looks: How the American Constitutional System Collided With the New Politics of Extremism, also with Tom Mann.

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