Sunday, February 26, 2006

Mr. Broder's Column, Revisited

Having done my mea culpa, let me take another crack at the plans of Secretary Leavitt for four "breakthrough projects" in health care and the column written by David Broder here.
  1. Either Leavitt or Broder gets the genesis of the projects wrong--they aren't HHS initiatives; they're done under direction from President Bush with HHS as the "managing partner" with OMB's Tim Young as "portfolio manager".
  2. The column reveals what may be a problem--according to Broder: "worthy as these big projects may be, it is clearly the New Orleans challenge that stirs Leavitt's juices." Why is this a problem? Leavitt may be doing NIH (not National Institutes of Health but "not invented here"). The four projects evolved over years and HHS got the job of managing them back when Tommy Thompson was the Secretary. (See the April 2004 Executive Order.) Assuming that Leavitt has the healthy ego of most successful politicians, Satan will tempt him with the idea that he will do more for the world by his work in the Big Easy, rather than supervising the four project effort. If Bush is a lame duck, so is Leavitt, so he may be tempted to push hard to get the Big Easy project done. Pushing hard is incompatible with maintaining good relations with DOD and VA. It's also likely to take people and money away from the four projects.
  3. Another problem may be Broder's. In the piece he says Leavitt is "modest," "creative," "attacking the problem," "experienced", and interested in "empowering" people. Quite the description of the modern Presidential candidate.
  4. It certainly made a better story for both Leavitt and Broder to slight the involvement of White House, DOD, VA, state and local government, and private "stakeholders" in the four project effort. I'm sure as good bureaucrats the members of the various workgroups will soldier on regardless of how much credit they get in the Post. But an effort as complex as this has low odds of success in any case and doesn't need any more straws added to its back.

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