While the young Disease Management Care Blog was first introduced to the concept of the "credibility gap" by Lyndon Johnson's Vietnam war, it wasn't until it started paying attention to blogs that it ran across the term "credibility trap." The former describes a disbelieving citizenry, while the latter describes a disbelieving government.
Enter this telling PolitcoMagazine article on the travails of being a Washington DC Cabinet Secretary.
In the modern course of our Republic, there are 23 talented overachievers who nominally preside over a huge federal bureaucracy. The DMCB thinks of that as the core machinery that lies at the heart of the liberal promise that Big 21st Century Government Can Accomplish Great Things.
If the Politico article is correct, successive White House Administrations have marginalized the Secretaries, letting the majority of Washington DC run like some side-show perpetual motion machine. As the DMCB understands it, that leaves the White House to insource the management of the really important stuff, like getting reelected or reversing rising ocean levels.
And so it was when it came to the implementation of the Affordable Care Act. Looking past the partisan cacophony, it appears the White House genuinely counted on HHS to smoothly implement the health care marketplace and its various mandates. What happened was a fumble of historic proportions that will continue in the weeks and months to come.
While conservative pundits are using the Obamacare imbroglio as another tiresome I-told-you-so lesson in government overreach, the DMCB is worried that the bright men and women who are responsible for implementing health reform are getting a crash course in the cynicism of the credibility trap.
Statutory deadlines are now meaningless. Regulations can be ignored. Being "on message" trumps the truth. Czars go into private equity so that lobbyists can become insiders. Political expediency is allowed to batter markets. Blowback begets stopgap crisis management by an insular political elite.
And as 2014 is threatened by death spirals, corrupted commercial enrollment data, unpleasant out-of-pocket surprises for consumers, small as well as large business market rate shocks, unpredictable legal challenges and further mischief by an emboldened Republican opposition, it becomes less a function of whose "fault" it is and more of a dreary exercise in keeping the Amtrak of health care from running off the rails.
The folks running the government bureaucracy are stuck with this lemon. Many are probably thinking that they deserve better.
Is the DMCB reading too much into the symptoms of C.T?
You be the judge.
Home »
Affordable Care Act »
Big Government »
Credibility Trap »
cronyism »
Health and Human Services »
Health Care Reform »
Obamacare »
The Looming Credibility Trap of Obamacare?
The Looming Credibility Trap of Obamacare?
Artikel Terkait The Looming Credibility Trap of Obamacare? :
The "Coporatization" of U.S. Health Care: Why the Good Prognosis for Health Insurers & ACOs May Be GuaranteedCorporatizationThe Disease Management Care Blog is ashamed to admit it, but it's reading Edward Klein's The Amateur. While much o ...
The Sunshine Act Will Cost Pharma and Medical Device Manufacturers Hundreds of Millions of DollarsThe regulators go to work....Fed up by pharmceutical, biotech and medical device manufacturers' vulgar use of "honoraria," "consu ...
Health Care Cost Insights and Capitation for the Patient Centered Medical Home (PCMH)The Population Health Blog finally caught up with the Oct 22/29 "Price, Cost and Competition" issue of JAMA. One of the mor ...
What Is the Plan B for Healthcare.gov's IT ProblemsWhile Obamacare skeptics have glommed onto this government document for all the usual reasons of partisan advantage, the Dis ...
The State of the Union is Over. Advice on What's Next for ObamacareWhen it comes to assessing or "monetizing" the possibility of a bad future event, the insurance-minded Disease Manageme ...