Does Obamacare Need a CEO?
Sure. Let's add another layer of bureaucracy to an already fantastically complicated program.
A group of healthcare experts close to the White House is urging the Obama administration to appoint a new chief executive officer to oversee Obamacare's online health insurance exchanges and safeguard the next open enrollment period that begins in six months.
The recommendation, in a report due to be released by the Washington-based Center for American Progress think tank, calls for a major shakeup within the U.S. Department of Health and Human Services, which presided over last year's disastrous rollout of the federal market portal, HealthCare.gov.
The idea would be to take the exchanges out of the current bureaucracy and put them in the hands of a CEO with private-sector experience who could run them as true e-commerce sites. The CEO would answer only to President Barack Obama and his intended new health secretary, Sylvia Mathews Burwell.
CAP's plan would have the CEO assume full oversight of both federal and state exchanges, as well as insurers and market regulations, but not Medicare or Medicaid.
The White House said in a statement it had not reviewed the CAP recommendation, but was open to considering "all ideas" that might improve the law's implementation after the botched October rollout and subsequent recovery.
The report's co-authors, including former White House healthcare adviser Dr. Ezekiel Emanuel, say the change should be made soon to address challenges that include the completion of automated "back end" systems needed to carry out vital functions with insurers, state Medicaid agencies and other entities.
"An absolutely essential element of achieving these goals is having the exchange run by a CEO who is both given the resources and made accountable for the exchange's performance," Emanuel, who teaches at the University of Pennsylvania, told Reuters in an email from Switzerland.
The idea is not new. Reform advocates, including CAP pressed the same idea on the White House after HealthCare.gov's October crash, the first in a series of setbacks that posed a political challenge for Obama and his Democratic allies. The administration opted instead for a more narrowly defined health technology czar to rescue the site.
I hate to break the news to the wonks at CAP, but what the hell do we employ a cabinet-level Secretary at Health and Human Services for except to be accountable and run programs like Obamacare? If they're saying that Obamacare is too complex for one agency to run, then it's too complex to be run by government at all.
Why is the standard liberal answer to every problem in government to add on more layers of bureaucracy? Why not cut some bureaucracy, simplify things? The levers of power to run Obamacare won't change. CMS will still be heavily involved. What will change is that CMS will answer to the Obamacare CEO, who will have his own staff, his own departments. One need only look at the Department of Homeland Security to get an idea of what ever expanding bureaucracy can do.
Making someone responsible for a disaster doesn't mitigate the effects of the disaster. It's bound to make things worse.