Posted November 5, 2013on:
A very widderful Tuesday to all the Widdershin friends out there in the intertubz land.
This is a follow-up on my post last week, Your Wait Will Be. Its subject was the rollout debacle of the Obamacare Marketplace website.
As more information becomes available, it seems apparent the telltale signs of a “major go-to-pieces” was in the offing for the rollout. We can learn from this. Anyone who has ever been in charge of something new can learn from this.
A leaked memo details most of the larger problems facing the rollout of the law. The memo was authored by David Cutler, a Harvard health economist and a former advisor to the Obama campaign. You can see the memo here as an embed to a larger article.
The memo was dated May 11, 2010. You read that right — 2010 — forty months before the October 31, 2013, “go live” date. It was written to Larry Summers, he of the “women can’t do no figurin,” fame. Unfortunately, none of Cutler’s recommendations were taken up by the White House.
You need only read to the third paragraph to uncover the major landmine where Cutler said:
You should also note that while this memo is my own, the views are widely shared, including by many members of your administration (whose names I will omit but who are sufficiently nervous to urge me to write) as well as knowledgeable outsiders. Indeed, I have been at a conference on health reform the past two days, and have found not a single person who disagrees with the urgent need for action.
As many of you know, I have put food on my table and Glenfiddich in my glass by being a management and leadership consultant. Cutler’s two sentences are what I call, “listen fors.” You listen for words like that to signify a much larger problem. The larger problems signified here — ineffective management, non-existent communication, and fear of failure.
In essence, “many members of the Administration,” didn’t want to talk about the problems and were afraid to speak up. I don’t know about your mammas, but if I ever said to Mother Prolix, “I don’t want to talk about it,” it guaranteed one thing — Mother Prolix didn’t want to talk about anything else. With the insistence of a Gitmo interrogator, talk about it we did until Mother Prolix uncovered the real problem. Our home was littered with dead horses unmercifully beaten in such attempts.
This is not the only example of ignoring “listen fors.“ Another part of the memo talks about assigning major parts of the ACA’s implementation to chronically weakened and demoralized agencies like the federal Center for Medicare and Medicaid Services (CMS).
Despite an exponentially greater workload, the CMS had fewer employees than it had in 1981. The IT services section was antiquated, but was charged with overseeing the IT contractors. Simply put, the politicians were hiding the ACA implementation in CMS knowing congressional Republicans wouldn’t cut appropriations to CMS. This hide and seek game has come back to haunt the implementation.
Again, if your mammas were anything like Mother Prolix she would have ended the hide and seek game pretty quickly. Mother Prolix knew, “Putting off a problem today just guarantees you will face the problem tomorrow.”
If the White House had faced the Republican opposition in 2010, the continual drip, drip, drip would have ended and the most vehement Tea Party opposition would have waned. By tiptoeing around congressional Republicans, it did nothing but empower them. So much so, Republicans refused to confirm a CMS director until 2012.
I know all this sounds like the ramblings of Captain Hindsight, but when you put this in perspective, it is instructive. It is during this 2010 period where the President was still trying to appease the congressional scorpion riding across the river on his back. Just like in the parable, it has stung him three years later because that is the nature of scorpions — it’s what they do.
With that said, you can’t blame the scorpion for being what it is without blaming Obama for the misplaced belief his magical appeal would somehow hypnotize the scorpion. You can’t blame a faulty website, ineffective beta testing, and poorly managed IT contractors on John Boehner and Mitch McConnell. Most importantly, the White House can‘t blame anyone else for underlings purposefully withholding information. Magical thinking can’t cure such things.
Everyone is hopeful these problems will be fixed by November 30th — which happens to be the third night of Hanukkah. Perhaps this year there will be an extra Hanukkah miracle to celebrate.
This is an open thread.
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