After reading Malcolm Gladwell’s stream of consciousness review of Steven Brill’s book on the making of the PPACA, I was left with three thoughts:
- Monoculture as they were, the people in the Obama Administration couldn’t agree among themselves on what “healthcare reform” should consist in and the finished law reflects that. I think that casts at least a little doubt on the view that the PPACA was the best bill that could actually be enacted into law. Rather, it may have been a compromise among a number of arrogant, opinionated personalities with conflicting views.
- Nobody could figure out how to pay for it.
- The Administration wasn’t interested in the details.
You’re welcome to read the whole thing but I’m not sure you’ll learn much more by doing so. There’s a lengthy digression on the nature of non-fiction accounts, contrasting the highly-successful modern point-of-view approach mastered by the author of Moneyball, Michael Lewis, with the “encyclopedia” approach epitomized by Bob Woodward.
An enormous amount of column space is devoted to the credentials of the various participants which I gather repeats what’s in the book being reviewed. My reaction to that is two-fold. First, I read them as I do all resumes: don’t just tell me where you went to school, tell me what you’ve done. Apparently, the answer is not much. And then there’s the old wisecrack: you can always tell a Harvard man but you can’t tell him much. It sounds to me as though the Obama Administration needs about a tenth as many Harvard grads in its policy team and a heckuva lot more from Purdue.