At a Washington Ideas Forum panel on Wednesday, Washington Post columnist Gene Robinson asked the question on everyone's mind after the release of the first Obamacare enrollment numbers: "What the hell happened?"
The man to whom he addressed his question was health-care management expert Ezekiel J. Emanuel, a Wharton professor who served from 2009 to 2011 as a special advisor for health policy in the White House Office of Management and Budget.
"I'll give you a technical answer: I don't know," said Emanuel.
"The one thing that didn't happen is—and I've said this before," Emanuel continued, "is we needed a CEO who understood, who's a really great manager understood the health side—especially health insurance, because after all, what's the website, what's the exchanges if not health insurance—and understood how to make sure that... the e-commerce aspects were going to run well."
"No one ever got appointed to really do that of sufficient stature," said Emanuel. "You don't hand this to [the Center for Medicare and Medicaid Services]. This isn't in their wheelhouse. This isn't something they can do.
"And I think if you had to pinpoint one thing that was that should have been done differently in hindsight, that's the thing," Emanuel added, "though I don't know it was hindsight, since I think a lot of people concurrently thought that is what ought to happen."