Happy Birthday to Erick Threets, 32. Still trying, or at least he was in 2013...originally selected in the 2000 draft. It's a brutal game.
Good stuff, all about health care today:
1. Andrew Sprung on sabotage and the ACA rollout.
2. Kevin Drum's reaction: sabotage works. I may write more about this today. It's an important topic -- not to make excuses for the administration (neither Sprung nor Drum is doing that), but because it's important to know what happened, and what it means for the future. If anything.
3. And Garance Franke-Ruta on ACA and squeeky wheels.
Monday, November 4, 2013
Subscribe to:
Post Comments (Atom)
Posts
If there were a Smithsonian for Misperceptions of Management, I think columns like Sprung's and Drum's would be worthy candidates for such a forum. DeParle, we understand, was the best candidate for the rollout because she "knew a lot"; the rollout failed because resources were constrained and the situation was tricky.
ReplyDeleteFrom which we infer that the successful executive is one who "knows a lot", as opposed to say, someone who nevertheless delivers results where situations are constrained and tricky.
Here's DeParle's Wikipedia page. She certainly is knowledgeable! See any evidence of anything remotely looking like "getting it done in spite of challenges", what normal people associate with executive competence?
I didn't either.
Come to think of it, its staggering that the signature domestic legislation of Obama's presidency, the first sweeping reform to be passed in an entirely partisan manner - with the opposition hostility that inevitably suggests - would be implemented in some remote, underfunded back office of CMS (to hide from the braying dogs of the opposition)...and under those circumstances, the person responsible for "making that work" has barely run much more than a Tennessee public works project.
DeleteThere's a sense in which I think liberal wailing about Republican obstruction is understandable, but y'all might underestimate how quickly that sympathy turns to malice as a result of liberal errors.
I entirely agree, CSH. JB has an article up at The American Prospect defending kludgeocracy -- it's essentially the latest iteration in his ongoing defense of the Madisonian system. I don't want to get into the problems with the Madisonian system right now, let's just acknowledge that it leads to lots of kludges,that is to lots of patches and work arounds and inefficiencies.
DeleteNow, JB has a very good point in his article that ANY attempt to do public policy in a country like the USA (extremely large and diverse) is going to lead to kludges and inefficiencies and complexities and all sorts of other ugliness. Okay, once again granted, and once again I don't want to get into the problems with Madison here.
The issue is this: given a situation that pretty much guarantees kludges, it is incumbent on the people who construct those kludges to MAKE SURE THEY [EXPLETIVE] WORK! You have a situation where the potential for dissatisfaction is extremely high. Don't whine to me about the GOP, what the [EXPLETIVE] did you expect? As for liberals, most had little love for the ACA from the very beginning. Once again, don't whine to me, all I have to do is look to Ontario to see what you [EXPLETIVE] should have done, and I don't care what your problems with Joe Lieberman [EXPLETIVE] were. Put all that together and the ACA is in something of a Weimar situation, that is to quote Peter Gay "it wasn't so much that it's enemies were so virulent, but that its friends were so tepid." The only defense anyone has in a situation where they have virulent enemies and lukewarm friends is to succeed. And if the the Obama people want to complain that nobody loves them until it works and then they'll be popular, there are several hundred million Americans out there who will say, "Welcome to my [EXPLETIVE] life, buster!"
CSH, he said she knew a lot about the health bill (not just "a lot"), which is relevant. Presumably, someone who was better at the technical aspects could have done a better job on the technology, but it would still be necessary to understand the complexity of the bill and it would still be necessary to understand the politics and to fend off the sabotage, which was (and is) real.
DeleteI think it's interesting that people complain that the CMS didn't appoint an outside firm to coordinate the the various projects and piece them together, attempting to do the task itself. Interesting because through much of the Bush administration the Coast Guard had a huge high-tech ship- and aircraft-building project intended to replace their outdated stock, which was pretty much all of their stock. The project was generally denounced as a disaster, and one of the reasons cited was that the Coast Guard used an outside company to coordinate it and piece the bits together, and it turned out that the company didn't understand the Coast Guard's requirements. Well, I suppose the same thing can be a problem in one circumstance and a solution in another, but if so it may prove hard to know which it will be in advance. Perhaps we need a government office that knows how to put together large IT projects, or at least has the capacity to oversee outside firms that do the actual work, and is also adapted to tapping into the expertise of the client bureaucracy to make sure the requirements are being met. Perhaps it would be better for each bureaucracy to have its own such office, but that would probably depend on how many such large IT projects you expect to have.
@CSH
DeleteThe ACA was not "passed in an entirely partisan manner". Republicans like Chuck Grassley demanded all sorts of concessions before they pulled the football away, Lucy-style, and refused to vote for the thing.
but y'all might underestimate how quickly that sympathy turns to malice as a result of liberal errors.
Clearly that line has been crossed for many people, yourself included. Anastasios too judging by the expletives. Meanwhile, deadlines will be extended, kinks will be worked out, problems will be solved, and, eventually, the website will work as intended. Your malice notwithstanding.
Scott, that's a great point about the Coast Guard (I think), especially to the extent that the government as kludgeocracy is quite a bit more complex than corporate America. First, I'm not totally familiar with that story, but assume that the issue wasn't funding for the ships; the problems (such as they were) stopped at the Coast Guard dock.
DeleteBut problems there are still! This is still the government, which means the contract went out in an RFP, and a bunch of dossiers came back with successively low bids and glossy brochures advertising how expert the contractors were. In that case, the shipbuilding equivalent of Nancy-Ann deParle would have been most welcome; I assume part of the problem was the Coast Guard not using their version of her.
Which - from here in the cheap seats - sort of supports Jeff and Anastasios' suspicion of the American kludgeocracy. Compare it to the corporate version. Think about a company like Ford; when the family with their controlling interest gives up the ghost of putting their own family incompetents in charge, in favor of Boeing senior manager Allan Mullaly.
The point in the Ford case is not that Mullaly's expertise in planes is going to translate to (trains or) automobiles, but rather that he has the management cred in a similar industry to get everyone rowing together in the right direction. That worked for Ford, which has beaten the market the past decade, including the Detroit aspect of the financial meltdown.
But it wouldn't work as cleanly in the government case. Or it might sort of work in the Obamacare case, but probably not in the Coast Guard case. This stuff is hard in a government context, to the extent the Obama Administration isn't great at knowing the difference is not the worst thing of which to be accused.
This article is proof that we interpret facts to fit our mindset. I'm really struck by Brendan's recent comment that liberals will always make excuses for Obama, and conservatives will seize on any minor scandal to prove he's worse than Nixon.
ReplyDeleteAndrew Sprung is a liberal excusing Obama.
The White House makes multiple politically motivated decisions to delay regulations, and the author blames this on the Republicans? What's next? Blaming Watergate on that wily McGovern guy who dared oppose Nixon?
He claims "Goldstein and Eilperin do a good job documenting the effects of sabotage". Yet he cites not a single example of "sabotage". I briefly glanced through that article, and nothing rises even remotely to that level. Many states didn't sign up for ACA, and funding was tight. So what. That is not "sabotage". You more progressive types - what did I miss there? Did some republicans downgrade the servers to Windows XP, or stage a DDoS attack?
And let's stop throwing way over the top "terrorist" and "sabotage" charges at political opposition, on both sides. Then complain about "hate speech: and "civility".
I don't recall anyone mentioning terrorism, and highlighting factors that led to decisions, even unfortunate decisions, isn't the same as making excuses.
DeleteAnd I'm not sure what word is better than sabotage.
DeleteSome of the stuff that Republicans have done since ACA passed is normal. But some of it -- such as refusing to give HHS normal funding for implementing the law -- really isn't. Nor is killing by filibuster executive branch appointments, especially the "nullification" ones (it took three years to confirm someone at CMS).
@Scott the "terrorism"" charges were made during the CR/debt limit debacle.
Delete@Jonathan I had to lookup definitions for "sabotage", since I think of it as violent, usually wartime acts bordering on treason.
To my surprise, yes, it does fit these actions, but in like the 3rd or 4th option for the definition. For example, Merriam Webster 3a says "an act or process tending to hamper or hurt". By which *any* political action, such as adding an obnxious rider on a bill, or calling for a point of order, could be claimed to be "sabotage". Or, wikipedia says that "political sabotage" is "sometimes used" for things like Watergate, which involved illegal actions against US citizens. Like the NSA. :-)
Maybe I'm overreacting, but I think "sabotage" is an emotionally charged word. Since the article uses it 10 times in a few pages, the author, IMO, was over-zealous.
I consider myself a very rational, practical person. I do not subscribe to conspiracy theories, as a rule. And yet I can't help but feel (despite the lack of evidence) that there was some nefarious intent behind the healthcare website clusterf*ck.
ReplyDeleteThe GOP and its benefactors have made it very clear that they will do anything - up to and including shutting down the government for a month and threatening national default - to stop this law from taking effect. What better way to do that than to intentionally foul up the website from the inside? Most of the work was done by private entities anyway; it wouldn't be difficult for a few people with malicious intent to infiltrate those entities and take the thing down from the inside.
This is a conspiracy theory, but it's a rational one. And it should be a warning to conservatives not to gloat over this too much. People who aren't plugged in to the daily political back-and-forth might just conclude - despite what the evidence says - that the failures in implementing the law were caused by the people who relentlessly want it to fail.
Anon 1:38,
ReplyDeleteI'm not sure we are to malice just yet -- that is to say, I don't know that anyone who approached the ACA with any kind of good will has yet gone that far down the road. However, I think lots of people are to the point of exasperation and intense disgust. People to the right of the administration were always wary of the scale and complexity of the program, and of its potential unintended affects. They were constantly reassured at best and stiff-armed at worst, and now many of their worries seem to, at the very least, have the potential of coming true. Meanwhile people on the left never liked the administration's approach to this issue, both for reasons of basic ideology and because they honestly felt that the policy was deeply flawed and had all sorts of deficiencies compared to a single-payer style system. They were persuaded that this was the best that could be done politically, but felt disrespected, if not treated with contempt, by the administration, and harbored deep resentment toward the fact that Obama and his advisors did not prioritize getting them at least some clear victory. Now they feel like the administration, with its fat in the fire, expects them to come to the defense of a policy they did not ever like, and that they feel is clearly inferior to a dozen health care systems they could name off the top of their heads. (And I'll add that if the filibuster ends up going down over the latest problem with confirming judges, that will pour gas on the fire, as many will say "You should have done THAT in 2009 and told Lieberman and the other conservative Dems where they could go and how they could spend their time once they got there!").
If the ACA ends up working, and I agree by the way that the odds are that it probably will work eventually after a lot of turmoil and pain, then all of this will quiet down. If it doesn't, then we have a mess, since the status quo has been irrevocably changed and there is no going back. Something will have to be kludged together to replace the ACA, but the knives will come out from all sides first, and whoever builds whatever comes next will be slipping and sliding in the gore.