Paul Waldman

The Biggest Design Flaw in Healthcare.gov

The pathway to disaster.
In my column today , I argue that the Healthcare.gov disaster has its roots in the government-contracting system, where big projects that go past deadline and over budget is standard operating procedure. There is one particular design flaw, however, that I didn't get a chance to discuss there but is worth noting. My guess is that it wasn't given all that much thought, or at the very least, somebody had what sounded like a good reason at the time to do it the way they did. But the result was that the administration needlessly multiplied the headaches it would have with the rollout and made everyone's experience significantly worse, and it didn't have to be that way. Before I tell you what it is (the suspense is killing you, I know), let's stipulate that Healthcare.gov did indeed present an extremely complex challenge, much more so than just creating an ordinary website. That's because it isn't a closed loop, but rather needs to communicate in real time with a bunch of outside systems,...

Healthcare.gov 2: The Contractors' Search for More Money

AP Photo/John Amis, File
AP Photo/HHS E veryone agrees that the rollout of Healthcare.gov has been something between a fiasco and a disaster. One of the mysteries is how a famously tech-savvy administration, headed by a president whose campaigns broke new ground in using digital technology to accomplish their goals, could have presided over this kind of screw-up. The answer is nearly as complicated as the website itself, but as the administration has said, the problems are not insurmountable and the site will be fixed (hopefully sooner rather than later). The next important question is what we can learn from this episode. There are vital lessons to be absorbed about how our government functions—not the Obama administration in particular per se. Instead, we got a good peek at what happens when private companies adept at squeezing billions from the taxpayers are hired to build something big. There's plenty of blame to spread around, from the White House to the Department of Health and Human Services to the...

Politician Tries to Be Cool Dad, Destroys Career

Party politicians in the house tonight/Everybody just have a good time...
If you don't live in the D.C. area, you probably haven't heard about the increasingly amusing travails of Doug Gansler, Maryland attorney general and candidate for governor. But his latest problem raises a question we as a nation must confront: Under what circumstances should a politician make the heavily freighted moral decision to be a total buzzkill? To back up a bit, Gansler is a common type: the firm-jawed, ideologically unremarkable yet intensely ambitious politician who'll rise pretty high but may or may not reach the upper echelons of elected office. Chances were that he'd eventually lose the primary (and thus the governorship in this most Democratic of states) to Lieutenant Governor Anthony Brown, who has the support of the current governor and future presidential candidate Martin O'Malley, among many others. Brown has a glittering resume (Army veteran, Harvard Law School, etc.), hails from vote-rich Prince George's County, and would be the state's first African-American...

Terrible Republican Idea Exposed as Even More Terrible

Flickr/adwriter
Yesterday, the Congressional Budget Office came out with a report assessing the budgetary impact of something many conservatives have supported, raising the Medicare eligibility age from 65 to 67. What they found was that the change would save far less money than had previously been assumed: only $19 billion over the next decade. The main reason is that many of the people no longer eligible for Medicare would be eligible for either Medicaid or insurance subsidies through the health exchanges, so the net effect on the federal budget would be small. But more important than that, this is an opportunity to remind ourselves that when government is doing something worthwhile, doing less of it isn't a good idea even if it saved a lot of money. And if cutting back only saves a modest amount of money, it's a really bad idea. You know what else would save a lot of money? Eliminating the United States Navy. But I'm guessing that most conservatives think having a navy is a good thing. Medicare is...

The False Glow of Remembered Childhood

Wait a minute - are you saying that my perspective on this might be colored by the fact that I'm ten years old? No way!
Three years ago, John Boehner was doing an interview when he lamented, perhaps with a tear peeking its way through the corner of his eye, that Democrats "are snuffing out the America that I grew up in." As Michael Tomasky noted at the time, the America Boehner grew up in (the 1950s) featured things like strong private-sector unions, a 90 percent top income-tax rate, enormous public-works projects, and a moderate Republican party, presumably all things Boehner wouldn't like, not to mention Jim Crow, terrible discrimination against women and gay people ... you get the point. But of course, "the America that I grew up in" is a place that exists only in the imagination— everyone's imagination. This is from an interview in Salon the other day with Adam Goldberg, creator of The Goldbergs , an ABC sitcom set in the 1980s: Why do you think audiences will be interested in a family show specifically set in the 1980s? I think the '80s works for a TV show because it's the last time the world was...

No, Healthcare.gov's Problems Will Not Offer the GOP Political Deliverance

Some of the healthcare.gov contractors testifying today.
Today marks the beginning of what will surely be a series of hearings in Congress at which members will fulminate and shake their fists at various people who had responsibility for creating Healthcare.gov. It's quite something to see some congressman who's still struggling to figure out how to work the Blackberry his staff gave him asking questions about beta testing and error logs and a bunch of other stuff he doesn't begin to understand. But maybe the weirdest thing is the feeling one gets from the GOP over the last few days, which can be summarized as, "We got 'em now!" They seem to believe that the website problems are going to provide the deliverance they've been waiting for after the political disaster of the government shutdown. Here's a little prediction: Feigned Republican outrage over the ACA web site is going to be just as effective in reversing the GOP's current fortunes as feigned Republican outrage over Benghazi was in undoing Barack Obama's re-election bid. Nevertheless...

The Key to the Broffordable Care Act's Success

Flickr/CNDOZ
W hen Barack Obama made the decision to design a universal health care program based on the private insurance market, he faced one key problem. If you require insurance companies to accept anyone regardless of pre-existing conditions—as everyone wanted—you face the threat of "adverse selection," in which only those who are sick (and therefore expensive) get insurance. Just as the system of car insurance needs those who go long periods without having an accident to pay premiums so there's enough money to fix the cars of those who do have accidents, the health-insurance system needs the currently healthy to keep paying to support the currently sick. The answer was the individual mandate, which pulls people into the system and expands the risk pool. And especially critical to expanding that risk pool is getting as many young, healthy people as possible to get insured. So it may have been inevitable that young people would become targets for both the law's advocates and its opponents. A...

Instead of a Grand Bargain, Let's Have a Little Bargain

Flickr/Julia Taylor
As part of the agreement to reopen the government, a House/Senate conference committee was formed to negotiate a new budget. The last time we tried this, with the "Supercommittee," the two sides couldn't agree, and that failure triggered sequestration, which was supposed to be so terrible for both sides (defense cuts that Republicans don't like, domestic spending cuts Democrats don't like) that it would force them to do anything to avoid it. But it now seems that Republicans don't have too much of a problem with sequestration. They're moving toward the position that undoing sequestration isn't something everyone agrees should happen, but instead is a concession Republicans would be making to Democrats, for which they'd have to be repaid with something they want, like cuts to Social Security and Medicare.* Sound familiar? It's not that different from when they said they didn't want the government to shut down, but not shutting the government down was a concession for which they'd need...

Before Long, We'll Forget about the Problems with Healthcare.gov

I'll confess that I was pretty surprised about the difficulties Healthcare.gov has been having. After all, despite all the complexities of creating this system, it wasn't exactly hard to foresee that the workability of the exchange website would be a very big deal. So you'd think that once a day or so for the last six months, the President would be calling the Secretary of Health and Human Services and saying, "This is going to go smooth as silk, right? Don't let me down, Kathleen." And she'd light a fire under everybody reporting to her to make damn well sure it did, so they wouldn't have to scramble like mad to fix a hundred problems once it had already launched. While the different things the site has to do certainly present technical challenges, they're hardly insurmountable. Now, you might just put it down to the fact that the whole thing was outsourced to private corporations, and we all know you can't trust the private sector to do anything without screwing it up (ha!). But...

Continuing the Republican Civil War with Immigration Reform

Flickr/Elvert Barnes
Even before the shutdown crisis was over, President Obama was already making it clear that his next priority was going to be immigration reform. So can it actually happen? Right after the 2012 election, one Republican after another was saying that if reform didn't pass, their party was all but doomed, since they'd be blamed for stopping it. The country's largest minority group would be driven even further away from them as a result. You might think that after the political disaster of the shutdown, Republicans would be even more eager to find something, anything that would improve their party's image. But maybe not. Over the weekend, Marco Rubio said that Republicans wouldn't allow immigration reform to pass because Obama was super-mean during the shutdown. "The president has undermined this effort, absolutely, because of the way he has behaved over the last three weeks." Rubio's not the only one with hurt feelings. "It's not going to happen this year," said Representative Raul...

Dick Cheney Still Thinks He Was a Character on "24"

One of these two is not a real person.
Dick Cheney felt moved to write an entire book about the heart troubles he's had over the years, which I can understand. After all, we all find our particular maladies fascinating. What I don't get is why anybody else would care, since we don't tend to find other people's maladies interesting in the least. If you'd let me, I'd love nothing more than to blather on about my various knee injuries, but since I'm not RGIII, I have the sense to know that you really don't give a crap. Nevertheless, there's apparently an interesting tidbit or two in Cheney's book, including this reported by CBS News, which may validate what you already thought about him: Cheney had [his defibrillator] replaced in 2007 and his doctor, cardiologist Jonathan Reiner, with whom he wrote the book, had the device's wireless function disabled so a terrorist couldn't send his heart a fatal shock. Some years later, Cheney was watching an episode of the SHOWTIME hit "Homeland," in which that terrorist scenario was woven...

Don't Kill Your Darlings!

Flickr/Sharon Drummond
There's a new movie about the Beats, called Kill Your Darlings , and as you might know, the title refers to a piece of literary advice which says that as a writer you should let go of the sentences or passages you love most dearly, presumably because they're self-indulgent and reduce the quality of the work as a whole. Today, Forest Wickman of Slate investigates the provenance of this saying, which apparently is often attributed to Faulkner, though it has been repeated by many a great writer. Turns out it goes back to one Arthur Quiller Couch, who wrote in 1914, "If you here require a practical rule of me, I will present you with this: Whenever you feel an impulse to perpetrate a piece of exceptionally fine writing, obey it—whole-heartedly—and delete it before sending your manuscript to press. Murder your darlings ." Now maybe I'm just a narcissistic hack who'll never get anywhere, but I've always found this oft-repeated maxim to be infuriating. In short, I think it's crap. One of the...

The Tea Party, Now and Forever

Flickr/Rob Chandanais
P eople (including me , I'll admit) have been predicting the demise of the Tea Party for a long time, yet it has managed to stick around, the tail wagging the Republican dog even unto the point of shutting down the government and bringing the country within hours of default. Yet at the same time, if you paid attention to this crisis, you would have seen the words "Tea Party" escaping only the lips of Democrats (and a few reporters). None of the Republicans holding out to destroy the Affordable Care Act started their sentences with "We in the Tea Party…" It has become a name—or an epithet—more than a movement, even as its perspective and its style have woven themselves deeply within the GOP. Not that there aren't still Tea Party organizations in existence, but how many Republican politicians in the coming months are going to be eager to show up at a rally where everyone's wearing tricorner hats? What this moment may mark is the not so much the death of the Tea Party as the final stages...

Conservative Does Journalism, Gets Hailed as Demi-God

The National Review's Robert Costa. (Flickr/Gage Skidmore)
Back in 2009, Tucker Carlson gave a speech to the Conservative Political Action Conference, in which he told the crowd that what the right needed was more real journalism. He even pointed out that, as much as they hate The New York Times , that paper has people who do actual reporting and care about accurately relaying facts, and conservatives ought to try the same thing. He was booed resoundingly. Then Carlson founded the Daily Caller , which is kind of like giving a speech to a group of overweight people about the importance of cooking moderately sized meals filled with vegetables at home, then saying, "Let's go to McDonald's—Big Macs are on me!" Conservatives aren't wrong when they say most journalists are liberals. That isn't because of a conspiracy to keep out conservatives, any more than the fact that most stock brokers are conservatives is a result of a Wall Street conspiracy to keep out liberals. It's primarily because of the kind of people who are attracted to that kind of...

How Conservatives Reacted to the Shutdown/Default Deal

The despair that comes from knowing poor people are going to get health insurance. (Flickr/Jerry Furguson Photography)
Yesterday, John Boehner told a Cincinnati radio station, "We fought the good fight. We just didn't win." That's one way to look at what happened; another is that frightened Republicans allowed their most unhinged members to pull them into a political disaster that any rational person could have foreseen (and many certainly did). That Republicans would never get what they wanted—the destruction of the Affordable Care Act—was obvious. That they'd come out of it with almost nothing at all was nearly as predictable. So now that the battle is over, how are conservatives reacting? Let's take a look around. First, we've got some people who are seething with rage at their party for not hanging tough until they destroyed Obamacare: "I was trying to think earlier today if ever in my life I could remember any major political party being so irrelevant … I've never seen a major political party simply occupy placeholders, as the Republican party is doing." — Rush Limbaugh "Republican leadership has...

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