The key question about ObamaCare is: Who’s running this thing? And that explains why it’s such a disaster — just as confusion over that very question was the key to understanding why the Bush administration handled the war in Iraq so badly before the 2007 surge.
These were policies completely identified with the president who set them in motion. But that president chose to have very little to do with running them.
The “buck stops here,” Harry S Truman said of the president’s desk, but his famously pithy phrase was really just a simple acknowledgment that the president can’t avoid taking the blame if things go wrong. No complex endeavor can succeed without a clear line of authority.
Both Obama and George W. Bush were compelled to fight pitched political battles on behalf of those policies against partisan antagonists — and they may have mistaken those political battles for the managerial challenges involved in making the policies successful.
Indeed, both men seemed to assume all the while that they didn’t have to worry about the ultimate execution of their policies. They’d work because . . . well, they would, that’s all. Other nations had put national-health-care policies in place; we’d won wars before.
Both men were in the grips of a passionate idealism; both the Iraq War and ObamaCare were efforts to strengthen America and make it (and the world) a better place. Besides, they had very impressive people working for them, with all the resources of the executive branch at their command.
In Bush’s case, a plan was devised to stage three elections in Iraq to put the country on track to democracy by the beginning of 2006. The plan would take two years to complete.
On paper, it was a brilliant strategy — but, perhaps more important, a comforting one. It was rational and logical and thought through and would prevail through its own sweet reason. It set a time in the future by which Iraq would be fixed. The salvation of Iraq was (as James Russell Lowell said of the US Constitution) a machine that would go of itself.
But all that mattered was the war itself: It had to be won, and it hadn’t been, but the Bush policy basically assumed it had — because Bush basically assumed it had. He wanted to move on to other things, like reforming Social Security and welfare — and so he did.
And because he didn’t keep his focus on the only thing that mattered, his presidency was ruined.
In Obama’s case, he signed the health-care law in 2010 to great fanfare and his vice president telling him it was “a big f - -kin’ deal.” It was. It was also something entirely new.
It required the creation of an innovative infrastructure linking the Internal Revenue Service to the Department of Health and Human Services, all interacting with a consumer Web site that would market new health-care policies to tens of millions of Americans.
Obama focused on making sure the health-care plan would survive its political and legal challenges. He succeeded, just as the US military succeeded in toppling Saddam. What he failed to consider was the possibility that his new health-care system might be a piece of junk.
Just as Bush needed to win the war, Obama needed his system to function like a well-oiled machine. But he took no steps to ensure it would, and now he’s reaping the whirlwind.
Bush liked to say he didn’t play “smallball”; Obama pretty much agrees. And there’s much to this idea. Presidents learned to abhor micromanagement after the stories in the 1960s about Lyndon Johnson picking bombing sites in Vietnam and in the ’70s about Jimmy Carter overseeing the use of the White House tennis court.
Their job is simply too capacious, its responsibilities too vast. What a president must do now is make the difficult calls, set overall policy and work both with Congress and the public to maintain support for his national goals.
But if a president dedicates his presidency to wildly ambitious and world-changing efforts, wishing those efforts into being isn’t enough.
The entirely reasonable notion that the president can’t function as the line manager of the executive branch has, over the past two administrations, degenerated into a kind of contempt for management itself — the tiresome, boring and utterly necessary task of making things work.