Quackery On “Fixing the Glitches”

Ezekiel Emanuel is back, offering quack advice:

Now what should be done? On Monday, President Obama both criticized and defended the Web site. While he conveyed an all-hands-on-deck attitude and his commitment to solving the problems, he did not give sufficient specifics.

He proposes creating a new level of bureaucracy.

Definition: quack, n. an untrained person who pretends to be a professional

What qualifies doctor of medicine Ezekiel Emanuel to dispense advice in this area? Has he ever headed a large department? Been elected to high office? Managed a major computer project? He is, essentially, a medical consultant. He has no more authority in this area than any other amateur.

I agree with Dr. Emanuel that somebody needs to take responsibility for the project. Who could that possibly be?

However, I would remind him that no project has ever been sped up by creating a new department. And that “independent” is a term very loosely applied in the Obama Administration.

17 comments… add one
  • jan Link

    What qualifies doctor of medicine Ezekiel Emanuel to dispense advice in this area? Has he ever headed a large department? Been elected to high office? Managed a major computer project? He is, essentially, a medical consultant. He has no more authority in this area than any other amateur.

    Such decision-making follows Obama’s administrative pattern — to choose consultants and department heads compatible to his ideology, not for having any extraordinary expertise or capacity for the job they were chosen to develop, run, or, in the case above, problem-solve.. For instance, I remember the person in charge of the ‘cash for clunkers’ program had no prior experience in the automobile industry, and was juggling it’s planning and implementation on the fly. A congressman interviewed, who in his private life had owned/operated a car business, expressed dismay that a novice would be selected to oversee such a high profile project.

    However, when comparing and contrasting the mix of people dominating previous administrations to Obama’s, there is a vacuum of business minds inhabiting his inner circles — the overwhelming majority processing domestic/foreign policy from an intellectual POV, rather than hands-on private sector experience. Obama, himself, came to be POTUS with a thin, unimpressive resume. In fact, the most striking part of his work history was being a community agitator, where he developed skill sets following the tactical model designed by his mentor Saul Alinsky — the father of community organizing. Even though Obama has elevated himself to a much higher position, he continues to use the strident community organizer format in his negotiations with detractors, a tactic not only validated but also augmented by the like-minded crew he keeps close to him.

    No matter how complicated or morally gray an issue, polarize it as Us vs. Them: “All issues must be polarized if action is to follow.” Added Alinsky: “One acts decisively only in the conviction that all of the angels are on one side and the devils are on the other.” This is why Obama has spent the last few months saying the Republicans in so many words are devils. “Our enemies (are) always immoral,” Alinsky advised.

    • Clearly identify the enemy by putting a bull’s-eye on his back: “Pick the target, freeze it, personalized it, and polarize it.” The president has targeted “Tea Party Republicans” — namely GOP Sen. Ted Cruz — for rebuke, taking every opportunity to demonize them as “crazy extremists” and “radicals,” while knowing the media would never call him out on his own radicalism.

    Hence you can see that rather than dissipating political polarization, muting the racial divide, Obama’s prior training and cultivated philosophies have always been focused on just the opposite — ratcheting them up, in order to gain the political advantage. So far he has been quite successful in doing just that.

  • steve Link

    Not to be pedantic, but Emanuel was an assistant to Orszag at OMB and is provost at Penn, which has a $6 billion budget. That is larger than any charity and puts it well within the Forbes 500 list. It is possible that he has not headed a large computer project**, but very unlikely given his time at Harvard and Penn. Still, he is just writing an op-ed piece AFAICT. Has he been named to some office now recently by Obama and I missed?

    (** I hired the largest, top rated scheduling company in the world for our specialty. They write scheduling programs for hundreds of groups across the country of all sizes. It has taken over a year to work out the kinks. I have very low expectations when it comes to implementing computer based anything. )

    Steve

  • ... Link

    Looks like glitches with the fixes.

    HealthCare.gov pricing feature can be off the mark

    I guess they’re going to need more hands on deck. And a bigger boat.

  • ... Link

    From the aforementioned article:

    Industry executives CBS News spoke with could not believe the government is providing these estimates, which they said were useless and could easily mislead consumers. They also said that the website repeatedly states the actual prices could be lower, but it makes no mention that they could be higher.

    Age of Competence? Sure!

  • Not to be pedantic, but Emanuel was an assistant to Orszag at OMB and is provost at Penn

    Don’t tell me his job titles; tell me what he did. I see no evidence that he’s ever been anything but a medical consultant. He certainly has no actual credentials (as in formal training) and there should at least be some signs of OJT. Why are you defending quackery?

  • Ellipsis:

    I read that article early this morning, was outraged, and was going to post on it. However, when I looked at it more closely I recognized that it wasn’t quite as awful as it seemed.

    The estimates are, apparently, derived from simplistic assumptions. The estimates aren’t actually wrong. They’re just not necessarily right. It’s a fine distinction but I don’t think it’s completely nuts, either.

    The article does illustrate something significant, however. Unless the Obama Administration gets out in front of this story, they’re going to die the death of a thousand nitpicks. I’m not sure they can get out in front of this story. They goofed. It’s as simple as that.

  • ... Link

    The estimates aren’t actually wrong. They’re just not necessarily right. It’s a fine distinction but I don’t think it’s completely nuts, either.

    I disagree. This is basic information that should be provided ahead of decision time, and should you be provided fairly accurately. Also, the fact that they expressly do NOT mention that prices could be higher is a mark against them.

    And forget what some commenter on the internet thinks, one of the people behind the California website thinks this is bad, as well. Also from the article:

    Chini Krishnan is the chief executive officer of GetInsured.com. His company helped design California’s new health-care-exchange website. It requires people to enter their birthdays to get a real price quote. Krishnan said, “It’s important that the users have a proper, trustworthy, honest brand experience when they interact with HealthCare.gov, and I think providing accurate prices is an integral component of that.”

  • steve Link

    @Dave- You asked “Has he ever headed a large department? Been elected to high office? Managed a major computer project? ”

    Working with OMB, you think he was giving advice on chemo doses? A medical consultant? It is a budget office. Beats me what he did there. You called him a quack so I assume you know. Was he treating OMB staff or something? Big, modern universities are very dependent upon their computer systems. I think it would be hard to not be involved with managing some IT projects, but maybe he has avoided that. I dont know.

    Mostly I am just puzzled about why his opinions would be that much worse than anyone else’s. Let’s face it, IT causes problems for most of us who are not digital natives. People with mediocre computing skills and little knowledge of programming have to hire people to do the work. It can be very frustrating. If Emanuel has had to deal with this kind of problem in one of his leadership roles, he is probably about as qualified to make comments on this as anyone. Maybe even better if he has gone through multiple rounds of failed EHRs, billing programs and scheduling problems like many hospitals have gone through.

    Steve

  • TastyBits Link

    There is an enormous difference between an IT Project and the Healthcare.gov website. A destroyer and an aircraft carrier both float, both are run by the navy, and both have a chow hall, but design knowledge of a destroyer is vastly different than an aircraft carrier.

    The website is like a destroyer with an aircraft carrier flight deck on top. It cannot support the flight deck, and it is listing badly.

  • Red Barchetta Link

    “What qualifies doctor of medicine Ezekiel Emanuel to dispense advice in this area?”

    Apparently the same logic that resides inside certain commenters here to opine on finance, economics, business practices and regulation, credit or executive capability……..

  • Steve:

    Physicians have been going hammer and tongs against unlicensed and untrained practitioners for more than a century now, both in the courts and in the legislation. They have benefited mightily from the restrictions that have resulted.

    I think that imposes certain obligations on physicians that I wouldn’t expect from ordinary laymen. IMO his opinions are no worse than anyone else I might pass on the street. Most of them don’t get column space in the NYT and, absent his medical degree, I think he’d have been given a lot less credibility in his pronouncements on matters that are only peripherally related to what he actually has training in.

    Basically, I think he’s bootstrapping. What do I think he did at OMB? I think he’s a Democratic fund-raiser who got a sinecure with a title. I think he was a consultant. Maybe a “consultant”.

  • I’ve been pretty coy about what I actually do for a living but I’ll disclose this much. I’ve never managed a half billion dollar software development project. I have managed multiple multi-million dollar software development projects and one $100 million software development project (in today’s dollars). And I have a relevant post-graduate degree.

    I also have put in substantial time working with various different organizations in the healthcare sector as clients and lots of sad experience with physicians who thought they knew better about everything than anybody. When they’re only losing their own money by butting in, I have no problem with it.

  • sam Link

    @Red

    “Apparently the same logic that resides inside certain commenters here to opine on finance, economics, business practices and regulation, credit or executive capability……..”

    Two words for you, dude, Sun Capital.

  • steve Link

    Why would his medical degree matter at all? I dont believe I ever said that. The guy has experience in administration in the health care field and in education. He has written extensively on health care ethics, policy and finance. He worked with OMB, but you seem to know that he did nothing there that was actually involved with the budget process. Ok, I will take your word for that since I have not investigated. However, I find it nearly inconceivable that he has not participated in multiple rounds of software implementation.

    Granted, he would not have been the one writing the code. If we want highly technical articles, he is the wrong guy. If we are looking for someone who has had to work as an administrator and software problems, i doubt he is anymore or less of a quack than most other managers who could write such a piece. His gets published because he is famous. The odd thing is that you seem to agree with his recommendation (s).

    Query- You favor untrained practitioners providing care?

    Steve

  • jan Link

    I’ve found the daily news on Obamacare, especially all the repercussions emanating from it, to be highly troubling. While I’ve been opposed to government-implemented HC, I frankly never thought it would be this much of a mess, having such a negative impact on people’s lives, in so short of a time. Furthermore, techs are saying that the initial so-called ‘glitches’ are actually masking deeper programing flaws. So, who knows how extensive the damage really is!

    In the meantime, people having individual health care plans, that don’t meet government HC criteria, are having their insurance canceled, right and left. Some estimates say that as many as 16 million previously insured people may end up having no health insurance at all! This is something I hadn’t realized — that those already happily signed on to a policy would still be susceptible to losing their insurance if their coverage didn’t conform to the newly minted government prerequisites. IOW, I naively thought Obamacare would have nothing to do with rocking the boat of those already insured — that it’s primary aim was to insure the uninsured.

    Wrong!

    In my own family, my son’s policy is subject to cancellation. My husband and I enrolled in a new plan over a year ago, and luckily it appears to have all the bells and whistles passing the Obama HC test. Nevertheless, our premiums still rose, after only being on it for a short time. From what I’ve read and personally experienced, this HC bill seems to be doing nothing more than creating maximum chaos, anger, confusion, selectively increasing rates or structural policy changes for some, as it attempts to pull others, having no prior coverage, into the system at bargain basement priemiums.

    Fair? I don’t think so.

  • Red Barchetta Link

    sam

    Do you know who Sun Capital is and what they do?

  • sam Link

    Yes I do. And I’ve read the opinion. And a host of articles on the opinion. Have you?

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