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More Obamacare and Government Incompetence

Steve Brill, who wrote TIME’s Bitter Pill cover story last month, has a follow-up in his Reuters column about Obamacare’s inability to implement the rules it has set in place against the depredation of so-called “non-profit” hospitals. 

I am really growing concerned about the sloppiness of this Administration. Bill Clinton, by contrast, was a governor. He cared about the “how” of government—how the Arkansas Department of Motor Vehicles dealt with its customers, for example. He brought that concern to Washington and made “reinventing government” a major initiative in his Administration. His reform efforts were hamstrung by the recalcitrance of the public employees unions, but he understood what was at stake: “Our biggest job is to move government from the Industrial Age to the Information Age,” he told me five years before he became President. If government didn’t work well, the public constituency for new and necessary programs like universal health care would evaporate.

Barack Obama is not a “how” President. Oh, he pays lip service to government reform. His people can tell you the number of unnecessary regulations they’ve eliminated. It barely scratches the surface of what needs to be done—there is no creative destruction in government, regulations pile up on top of each other like silt, generation after generation. And while the Democrats are feeling pretty smug these days, given the overwhelming silliness of the Republicans, the President may be paving the way for a conservative revival—if Obamacare turns out to be as nasty a mess as, say, the Veterans Administration.

The pattern is exactly the same: Obama does the right thing by allowing Vietnam veterans with Agent Orange claims or post-traumatic stress or Gulf War Syndrome to file for disability claims—but he makes no provision for how those claims will be process, leading to the current, outrageous backlog. He does the right thing by making health care available to the working poor, but he pays very little attention to how it will be implemented. (Knowing that his opponents are just salivating, waiting to turn the slightest screwup into Armageddon.)

The problem is not, as the Republicans claim, big government. It’s bad government. If the President doesn’t government reform and efficiency a major, high profile part of his second term—nothing less than a public crusade will do—he is in danger of tossing away his proudest achievements.