In the Arena

More Brill, More Obamacare Incompetence

Obama barely scratches the surface of what needs to be done—there is no creative destruction in government, regulations pile up on top of each other like silt, generation after generation.

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Kevin Lamarque / Reuters

President Obama listens to former President Bill Clinton speak during a tour of an energy-efficient office building renovation near the White House in Washington, Dec. 2, 2011.

Steve Brill, who wrote TIME’s Bitter Pill cover story last month, has a follow-up in his Reuters column about Obamacare’s inability to implement the rules it has set in place against the depredation of so-called “non-profit” hospitals. 

I am really growing concerned about the sloppiness of this Administration. Bill Clinton, by contrast, was a governor. He cared about the “how” of government—how the Arkansas Department of Motor Vehicles dealt with its customers, for example. He brought that concern to Washington and made “reinventing government” a major initiative in his Administration. His reform efforts were hamstrung by the recalcitrance of the public employees unions, but he understood what was at stake: “Our biggest job is to move government from the Industrial Age to the Information Age,” he told me five years before he became President. If government didn’t work well, the public constituency for new and necessary programs like universal health care would evaporate.

Barack Obama is not a “how” President. Oh, he pays lip service to government reform. His people can tell you the number of unnecessary regulations they’ve eliminated. It barely scratches the surface of what needs to be done—there is no creative destruction in government, regulations pile up on top of each other like silt, generation after generation. And while the Democrats are feeling pretty smug these days, given the overwhelming silliness of the Republicans, the President may be paving the way for a conservative revival—if Obamacare turns out to be as nasty a mess as, say, the Veterans Administration.

The pattern is exactly the same: Obama does the right thing by allowing Vietnam veterans with Agent Orange claims or post-traumatic stress or Gulf War Syndrome to file for disability claims—but he makes no provision for how those claims will be process, leading to the current, outrageous backlog. He does the right thing by making health care available to the working poor, but he pays very little attention to how it will be implemented. (Knowing that his opponents are just salivating, waiting to turn the slightest screwup into Armageddon.)

The problem is not, as the Republicans claim, big government. It’s bad government. If the President doesn’t government reform and efficiency a major, high profile part of his second term—nothing less than a public crusade will do—he is in danger of tossing away his proudest achievements.

58 comments
freedomfighterX
freedomfighterX

Obamacare socialism leads to communism. Watch this documentary to find out what the POTUS and his communist party have planned for America. You'll be shocked and appalled! - Grinding Down America - http://vimeo.com/63749370

carolerae
carolerae

It's mainly staffing and lack of funding.  The Gop has not approved the extra funding needed to implement Obamacare and the Senate won't approve the nominees he's submitted......deliberately squeezing him.  You know who else was a Governor?? Kathleen Sebelius, HHS Secy. & she does a good job.  She just doesn't have the people or the funds  she needs.


Love how Klein gives a great BIG PASS to the Gop who is working overtime to defund every fund for Medicare & Obamacare.  When it hits your family, don't say you weren't warned.  The Feckless Press reports Nothing about Obstruction in the Senate or Refusal to Fund Projects by the Gop. That would be too hard though; easier to sit and whine about someone being incompetent b/c he personally is not running the Govt perfectly; while GOP refuses to Staff or Fund anything.  That's typical for what they call Press these days.  Truly Feckless!

LenSimpson
LenSimpson

ENRON, (in the news today) was no more corrupt than Foggy Bottom is now. Greed does not discriminate.. 

fb0252
fb0252

i am so excited the disability fraud system is exploding.  Obama/Reid/Peolosi = greatest usa leaders.

reallife
reallife

wait till they hear about the 20000 obamacare "navigators" - 2014 will be a shellacking of gigantic proportions - LOL

UnoWho
UnoWho

Mr. Kline big government is bad government.

shepherdwong
shepherdwong

Gosh, if only there were some sort of simple, efficient way of providing access and payment for health care services. And if only there were opinion leaders who knew enough of what they were talking about to advocate for such a system.

"Although only 8 percent of people with Medicare rated their insurance as fair or poor, 20 percent of adults covered by an employer-sponsored plan and 33 percent of those who purchase their own insurance reported dissatisfaction with their coverage."

http://www.pnhp.org/facts/single-payer-resources

Ivy_B
Ivy_B

How come Clinton couldn't get Hillary's health care reform passed?

grape_crush
grape_crush

As wrong as you were, Joe, on your first "Obamacare Incompetence" article, you at least - or Brill, actually - got part of this one right. There's no good reason why those rules aren't in place. And I said good. There's plenty of bad possible reasons - lobbyist pushback in an election season, not having the right people in place, or just a general inability of the administrative branch to get those rules written.

But of course we don't know that from your article, Joe. You're too busy pushing a narrative to do some basic research.

> Barack Obama is not a “how” President.

Yes, Obama's follow-up leaves something to be desired. But as Hollywooddeed says below, the President shouldn't be up in the guts of whatever is going on. He's just gotta make sure it happens...and that happening has admittedly been a mixed bag; some successes, some works in progress, some outright fails.

I am glad, however, that he put Biden in charge of the stimulus project, which was remarkably well run. And the effort to rein in government contractor abuses and control spending appears to be working. The auto bailout was handled well

There are other non-sexy initiatives underway. Jury is still out on Obamacare, although there are legitimate concerns. HAMP is considered to be a failure. You've made a point of justifiably calling out the VA. 

Like I said, mixed bag.

But use of the word incompetent is over the top, even if it's sure to draw attention from the likes of Limbaugh and Drudge.

> The problem is not, as the Republicans claim, big government. It’s bad government.

True. But government isn't just limited to the executive branch alone, is it? And Congress - specifically Congressional Republicans - haven't been very interested in good government, have they?

bobell
bobell

Jost one obvious point: If Congress is going to cut expenditures on everything across the board, the most efficient programs are going to suffer the most.  Featherbedded organizations can slim down and still get the job done.  Lean and mean orgainzatinos lose muscle, not fat. If you're a sensible manager and you see the sequester coming, your logical course is to fatten up the budget to the maximum before it's too late.

These sorts of cuts didn't begin with the sequester.  It's been going on for years -- nay, decades. And so has the fattening in good years -- like, say, the Bush Administration before the crash.  If the incentives are this perverse, what do you expect?  So yes, your average federal agency managers haven't lost sleep over how to reduce the cost of conducting their little corner of the nation's business.   Nor will they until someone figures out how to cut the fat and keep the muscle.

Don't hold your breath.

roknsteve
roknsteve

You would think by this article that Pres. Obama personally knows everyone who works for the govt.  Or you would think Joe Klein was writing for the WWF or the Ladies Home Journal. 

Paul,nnto
Paul,nnto

Following the link is helpful.---- "In theory, the IRS, which is a unit of the Obama Administration’s Treasury Department, could have promulgated those regulations at any time after March 23, 2010, the day Obamacare was signed into law. But the first draft of the rules was not issued until two and a half years later – last summer. And then the American Hospital Association’s lobbyists pushed back, calling the proposed rules “too prescriptive.”

A reporter might want to see what caused the delay, rather than have the vapors. Brill's phrasing "In theory" is curious. Also I doubt that was the first time the AHA has been gumming things up.

Of course with no reporting it's hard for a reader to reach a conclusion.

DonQuixotic
DonQuixotic

 I am really growing concerned about the sloppiness of this Administration.

Good one, Joe. We're all increasingly concerned about the sloppiness of your "reporting".

fitty_three
fitty_three

Joe's way of ignoring GOP obstructionism - blame it on Obama.

The nut in Joe's Nutsill.

Hollywooddeed
Hollywooddeed

Please.  Obama is President of the United States.  He doesn't have to be a "how" President any more than the CEO of any large company needs to be a "how" CEO.

S_Deemer
S_Deemer

"Barack Obama is not a “how” President." That's a fair criticism, especially in contrast with Clinton. Obama seems like a typical technocrat; the solution to a problem is "obvious," and having solved it, he moves on to something else. Except, that it's not obvious, and usually requires a lot of follow-up to make sure that the desired outcome actually transpires. More than most administrations, Obama's depends on good follow through by those under him; sometimes this happens, too frequently not.

georgiamd
georgiamd

The so-called “Affordable Care Act” is neither affordable, nor do Democrats care. Administration officials now admit President Obama “misspoke” when he claimed — repeatedly — that his law would reduce your insurance costs by $2,500 a year. The Internal Revenue Service estimates that the least expensive of the government-sanctioned health plans will cost the average family of four $20,000 a year, an increase of more than $4,000 from before Obamacare. Insurance companies are less optimistic and warn Americans to brace for “rate shock” where premiums could double.

Remember folks, there is more to come....higher taxes to pay for this monstrosity and an absolute guarantee of rationed care for ALL Americans. You will be paying substantially MORE for considerably LESS healthcare......some deal, huh?

aztecian
aztecian

@carolerae again more b.s.  go to the problem...it is the gee-O-pee that is creating the incompetence.  the oldman-wing is always trying to put the blame back on obama.

fb0252
fb0252

@EddieVonMises u pay $0.00 tax eddie vonmises.  wild guess. just today i receive BR claim from
SS Administration.  They want $26,000 for paying client SS disability while she was working for fire dept. for 26 yrs.  On it goes.

EddieVonMises
EddieVonMises

@fb0252  

I am so excited for those WMD to show up any day now! And all the jobs from the Bush tax cuts!

 

reallife
reallife

yes sir - truer words have never been spoken - that is a winning slogan for 2014!


DanLittlehouse
DanLittlehouse

@shepherdwong Wait till all the cuts to Medicare really kick in. That dissatisfied figure will get really big, really fast as doctors are increasingly not taking Medicare patients due to lowered reimbursemenrts, while the Baby Boomers swarm in.

This admin wants seniors to just go away and die. They have little respect for old 'economic units,' as they are Marxists and perfectionists.

LindaKoss
LindaKoss

@Ivy_B Thanks for pointing out the Essence of Wrong with Klein's posting.  He is praising Clinton to the skies for his "competence," completely forgetting that Clinton couldn't even get a health insurance bill passed, forgetting DOMA, forgetting Dont' Ask, Don't Tell, forgetting that Clinton gutted the Glass-Steagall Act and moving us into the Too Big to Fail/Prosecute era.  When Clinton was in office, the conventional wisdom clucked about what he did with his penis, as if it mattered.  Now they are clucking about Obama's struggles with an intractible Republican enemy that wants to see Obama fail, even (especially) if he takes the whole country with him.  Taking on the Repubs would require more courage than Klein has.

collioure
collioure

@Ivy_B 

If I remember correctly, no bill was even submitted to a vote.

tommyudo
tommyudo

@Ivy_B 


Because Billy boy has always been an Eisenhower Republican (and the son that George Bush Sr. always wanted) and had no interest in getting any piece of progressive legislation passed.

jmac
jmac

@grape_crushConsidering that Obama was originally not for universal health care (all you had to do was watch the primary debates and his Republican Harry/Louise attack ads on Hillary) he's come a long way in a short time.   

Incompetence in journalism (Joe's use of the word incompetence) is, however, alive and well.   

bobell
bobell

@roknsteve The last time sacred and I had lunch with Obama (Dutch treat, of course), he asked us how to save money in the federal budget. We told him to fire Congress.  He just shook his head sadly.

grape_crush
grape_crush

@Paul,nnto > A reporter might want to see what caused the delay, rather than have the vapors.

Brill isn't a reporter, but he's doing a service in pointing this out.

Klein, OTOH...

Ivy_B
Ivy_B

@Paul,nnto I'm sure the AHA has been gumming things up. The woman who is the executive director was NPR's go to person on health care reform and I heard her comment almost weekly until people finally got through to them that they needed to at least explain her affiliation instead of presenting her as a non-biased source. Haven't heard her since long before the ACA passed. Guess it was time to move behind the scenes.

BTW, it's safe to return to MMR - particularly in the mornings. We finally got everyone to agree to ignore the troll and even if there are posts, there are few, never responded to, and easy to scroll by. Fewer & fewer every day.

fitty_three
fitty_three

Stop whining about your taxes.  You'll live.

I'm glad Obama's president, aren't you?  :)

fitty_three
fitty_three

@georgiamd  

You're a racist slot, earljr1.

May you be buried under your filth when you go.  

This is MLK day, btw.

Hollywooddeed
Hollywooddeed

@georgiamd Your health plan premiums have been going up for decades.  Please don't think for a minute that Obamacare is to blame for the current rate hikes.  Making money off you is how they pay their CEOs $20 million a year.

shepherdwong
shepherdwong

@DanLittlehouse Actually, if you were paying attention (instead of lip-service to "conservative" dogma), you'd realize that the problem is greed in the form of the owners of insurance companies and hospitals, and the duplicity and denseness of their apologists in the market-worshiping, centrist media (so-called) intelligentsia, insisting on tweaking the for-profit capitalist status quo, rather than following the proven, government single-payer option model used by the rest of the civilized world. Cutting our own closest cousin, Medicare (or voucherizing it) to force seniors into the for-profit insurance market only further proves that rapacious market greed, the exact opposite of socialism. Moron.

Ivy_B
Ivy_B

@LindaKoss Thanks for expanding so well on my brief comment! 

TyPollard
TyPollard

@jmac @grape_crush 

Joe is just hoping for another sh!t storm in the comments section like he got before. Inflaming passions is the only responsible thing to do.

retiredvet
retiredvet

@bobell I suppose I shouldn't wonder but... Why does anyone keep blaming Obama for all the f-ups? Our government is supposed to have three equal branches. Congress asks the President to lead and, when he does, they give him the finger.

DanLittlehouse
DanLittlehouse

@Hollywooddeed @georgiamd It's fascism, Dude. Obama is happy with it. He'll get to cut out the competition so that there are only a few companies left, who will then make big bucks as contractors for your beloved single-payer. The big companies like it for the money, Obama likes it for the total control over the citizens' healthcare.

Once the govt is the only payer, who are you going to sue when you get denied care? There is no recourse after that. No more accountability. You can't tell them you are going to switch to another insurer if they don't give you good service. You can't go complain to the government because they are the ones cheating you! Wake up!  The government is little different from one single enormous, all-powerful, unaccountable corporation.

We need to get back to a free market in healthcare, which we have not had in a long time. And common-sense laws to prevent price-gouging.

curt3rd
curt3rd

But didnt obama say this would lower premiums?  Didnt he say it would only cost 90 billion and now that has more then doubled?

georgiamd
georgiamd

@Hollywooddeed @georgiamd  Then why, Hollywooddeed. did Obamacare give MORE power to the Insurance companies?

Health insurers are privately warning brokers that premiums for many individuals and small businesses could increase sharply next year because of the health-care overhaul law, with the nation's biggest firm projecting that rates could more than double for some consumers buying their own plans," The Wall Street Journal reported March 22.

Insurers made those projections in sessions with agents and brokers; they provide some of the most damning evidence so far of just how much Obamacare will force companies to raise rates when major provisions of the law kick in next year - just as scores of industry experts and economists warned would happen.


jmac
jmac

Steven Brill's Time article on health care:    " There is no such thing as a free market in healthcare, if one defines a free market as a place where there is some balance of power between the buyer and the seller. Instead, health care is - except when Medicare is the buyer - a lopsided seller's market. That became clear at both ends of the money trails I followed - from the patients' lack of any knowledge of what they were buying or its prices, much less any leverage to bargain over it, to the sellers' ability and willingness to charge absurdly high prices on everything from gauze pads to ambulance services to cancer wonder drugs. "


tommyudo
tommyudo

@DanLittlehouse @Hollywooddeed @georgiamd 


Spoken like a bought and paid for insurance lobbyist hack. It makes me chuckle when you little brown shirts throw out words like "fascism" when you have s concept of history that dwells in some sort of parallel reality that is part of your paranoid makeup.

DanLittlehouse
DanLittlehouse

@Irony @georgiamd @Hollywooddeed The profit motive is the only reason to try to accomodate your claims. Good service increases profits, as well as employees' paychecks. The govt has no incentive to give you good service.

georgiamd
georgiamd

@tommyudo @jmac @georgiamd @HollywooddeedThe President and congressional leaders have argued that a primary benefit from the health law will be reduced long-term budget pressure and thus a brighter future for coming generations of taxpayers. But when the cost estimate is adjusted for omissions, gimmicks, double-counting, and unrealistic assumptions, it is clear that the new health law will increase the burden, not lessen it.

One recent estimate projects the bill will add more than $1 trillion to the deficit over the next 10 years and $2.5 trillion in the decade following. And any cost-cutting that does occur under the new law will come in the form of arbitrary governmental controls that will put up barriers to care in future years

Obamacare will die at least one of three deaths: judicial, political or economic. I would place my money on the latter.

tommyudo
tommyudo

@jmac @georgiamd @Hollywooddeed 

To get a viable single payer system in place we will have to wait at least until the mid point of Hillary's second term, when the overwhelming greed of the heathcare industry has reached a tipping point in affordable care and equal access for all citizens. If we are lucky some of us may still be around to see it.

georgiamd
georgiamd

@Hollywooddeed @georgiamd  Guess what, Hollywooddeed? I have...all 2.471 pages of it...have you?

1,147,271 Words of Obamacare Regulations Published So Far—270% as Long as the Text of the Statute.

Yet there is nothing in there protecting the American public from precipitous price increases...what you DO get is LESS healthcare and this is before IPAB starts denying treatment. Stay tuned....it's coming!

curt3rd
curt3rd

The 1600 pages of legistration that had to be passed so we could find out what was in it?

jmac
jmac

@georgiamd @Hollywooddeed Then why did Obama give power to the insurance companies?    Because he had to get a bill through Congress.    He got through a REPUBLICAN health care plan (being the Blue Dog that he is).      It is in no way a Democratic health care plan.   If you want to join hands, georgiamd,  and get a Democratic health care plan eventually, you know who to vote for.  

Hollywooddeed
Hollywooddeed

@georgiamd  Blame the insurance companies.  They are not forced to do anything they don't want to do.  Read the bill.

Irony
Irony

@georgiamd @Hollywooddeed Well, Obama wanted to go with a single payer program which would have taken the Insurance companies out of the game and took the profit motive out of denying your claims. What he got instead was a program that secured the Insurance companies' power and kept much of the profiteering intact. Now the question is, who was it who pushed for those changes?