Obama’s Anti-Politics and the Affordable Care Act
Attacks on Obama over the rough rollout of the ACA hit the president where it hurts: his attempt to replace politics with expert management.
The recent controversy over HealthCare.gov, the still-glitchy website through which the uninsured are supposed to apply for coverage under the Affordable Care Act, had seemed like a tempest in a teacup. It looked like just another iteration of partisan posturing over a law that is somehow both a fait accompli and an incomprehensible mess.
But a scathing editorial from Bob Kuttner, editor of the American Prospect, made me take notice. Attacking Obama for being “tragically and inexcusably hands-off,” Kuttner concluded that “the debacle reflects both flawed legislation and flawed leadership.”
This editorial is notable because, for one, Kuttner is a left-liberal, usually sympathetic critic of the administration, not a right-wing bandwagoner. Other liberals began to join in. William Galston, a political philosopher who worked in the Clinton administration and now at the Brookings Institute, recently wrote in the Wall Street Journal that “Every experienced manager knows that, left to its own devices, the system will not always behave this way. . . So the president must lean against these perverse tendencies. . . [but] it has become clear that President Obama failed to institute such arrangements.”
These criticisms of Obama are more than just indications of liberal discontent. The attack on Obama for being incompetent hits the president where it hurts: the latter’s attempt to replace politics with expert management.
The health care law was not just Obama’s signature initiative — it was also the single best representative of his general post-political approach to politics. Obama thought he could rise above partisanship by taking an essentially Republican plan and then leaving it up to Congress to manage the details of compromise. He thought he could avoid all semblance of ‘class warfare’ by taking single-payer off the table and by eliminating any talk of redistribution. He thought he could find a consensus plan by working with, rather than taking on, the insurance companies.
In other words, the belief was that he could get something done without taking any sides or even acknowledging that there were significant conflicts of interest and principle. The result was a public-private partnership that yielded a measure of agreement not so much because everyone could see their interests represented in the final result as because nobody could understand that result. It was legislation by stupefication.
Yet amid all of this, there was still one promise — that the Obama administration itself understood the moving parts. Once passed, the wonks and managers would deploy their technocratic savvy to guarantee the thing worked. ‘Fixing a broken system’ is the hopelessly apolitical metaphor endlessly deployed to describe this (and every other) piece of social policy the administration promoted. Somehow, though, the master technician rose so high above politics that he never made it back down to earth.
As Kuttner observes, “This law, after all, is Obama’s signature initiative. It has been on the books since March 2010, with a full implementation date of 2014. An engaged chief executive would have been demanding frequent and detailed progress reports from his team. He would have gotten early warnings about possible glitches. But this president is tragically and inexcusably hands-off.” Galston says much the same, noting that in late September and early October, checklists showed major and repeated failures during dry-runs of the website, concluding that there is good reason why “the president’s standing as a competent manager of his own government has eroded badly.”
There is very little to be said for Obama’s passionless program of ‘getting things done,’ but even by his own low standards, he has been caught out. In the Obama era, being a bad manager is close to the worst thing you can say about anyone.
Of course, now that a management consultant has been brought in to patch up the website, we are supposed to rest assured that all will be right in the world. Undoubtedly, the technical problems with the website will eventually be resolved. But this was never just a problem with administrative efficiency — it was with a model of politics that one might call neo-progressive.
Despite their many limitations, the original American progressives at least thought there were political tasks that could be best achieved through collective political agency. Neo-progressives like Obama, and Clinton before him, have raised what began as Reagan’s attack on Washington to the level of a concept. Not only have they tended to accept the view that public ownership and administration is, in itself, inefficient when compared to ‘market solutions,’ but they have turned this into a kind of principle. The operating assumption is that any government program would be better run as a public-private partnership operating in an artificially created market. The truth is much the opposite.
Here again, Kuttner’s recent editorial is on the mark. Noting the difference between Social Security and Medicare on the one hand, and the ACA on the other, he writes:
These great achievements [Social Security and Medicare] are public programs, efficient to administer and testament to the fact that government can serve social objectives far more effectively than the private sector. Obamacare, by contrast, is the inefficiency of “public-private partnerships” at its worst. It is a public subsidy for the private insurance industry. No fewer than 55 separate contractors were hired to design the software. Yet though it is not a true public program worthy of the name, Obamacare is being used to discredit government.
The argument generalizes to other boondoggles, like private prisons and highways. Not to mention that other signature public-private Obama initiative, the charter school. These ‘partnerships’ reveal a special viciousness — they are harderto manage. That is because, as Kuttner notes elsewhere, “a layer of complexity is added because of the need to supervise and monitor the private vendor. Corruption is invited, because it pays the vendor to offer disguised bribes to the public officials in charge of the contract.” The standard response, moreover, is to try to expertly manipulate the incentives of the market in which these entities operate, itself an impossible task that introduces only more complexity and confusion.
The deepest irony, then, of the neo-progressive vision is that its faith in expert management is belied by its lack of belief in the public. Indeed, the reliance on private contractors, management consultants, financial executives, isn’t just a sign of corporate influence, but also of a skin-deep confidence in their own powers. It is not so much the product of corporate corruption as it is a vision of politics that invites such corruption, beginning with a natural and spontaneous belief in the intellectual prowess of the managers, CEOs and Wall Street financiers upon whom they end up relying.
In this context, Obama’s oft-noted deference to major private sector consultants, in areas like finance, health and educational policy, are not so much a personality quirk as an ideological position. Rising above politics turns into an attempt to find a place beyond reproach — indeed, beyond the point at which one can be held accountable at all. No wonder, then, that the legislative products are not only incomprehensible and difficult to administer, not to mention designed to blur the boundaries between public responsibility and private interest, but that Obama then finds himself hoist by his own petard.
Of course, from the neo-progressive standpoint, it appears that everyone from Republicans on down to the “professional left” is unreasonable. But it turns out the truly unreasonable position is the one that hopes to avoid the messy world of taking sides, of competing interests and political fights. At the end of the day, democratically-determined objectives like universal health care or public education are best promoted democratically. That doesn’t just mean through socialized programs, but in a way that makes as transparent as possible the lines of authority and responsibility.