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We’ve known for at least nine months that Obamacare’s website could turn out to be a “third-world experience.” In recent weeks, we’ve learned that there hadn’t been an end-to-end test of whether Americans could enroll as late as September 26, five days before the October 1 launch. So the obvious question has been: if the administration knew the website wasn’t ready, why did they roll it out anyway? An explosive new report confirms that the decision was political. Some staffers were so desperate to persuade the President to change course that, during a September 5 demonstration of the healthcare.gov website, they “secretly rooted for it to fail so that perhaps the White House would wait to open the exchange until it was ready.”The report comes from Amy Goldstein and Juliet Eilperin of the Washington Post. Goldstein and Eilperin interviewed “more than two dozen current and former administration officials and outsiders who worked alongside them” to get to the bottom of why the rollout of Obamacare’s insurance exchanges has been so problematic.One of the individuals they interviewed was Harvard’s David Cutler, who served as a senior health policy advisor to the 2008 Obama Presidential campaign. On May 11, 2010, Cutler sent a searing memo to former Harvard President Larry Summers, now serving as director of Obama’s National Economic Council, relaying his concern “that the personnel and processes you have in place are not up to the task, and that health reform will be unsuccessful as a result.”“While this memo is my own,” wrote Cutler, “the views are widely shared, including by many members of your administration (whose names I will omit but who are sufficiently nervous to urge me to write), as well as by knowledgeable outsiders such as Mark McClellan (former CMS administrator) and Henry Aaron (Brookings). Indeed, I have been at a conference on health reform the past two days, and have found not a single person who disagrees with the urgent need for action.”“They were running the biggest start-up in the world,” Cutler told Goldstein and Eilperin. “And they didn’t have anyone who had run a start-up, or even run a business. It’s very had to think of a situation where the people best at getting legislation passed are best at implementing it. They are a different set of skills.”In the 2010 memo, Cutler complained that the Department of Health and Human Services was “far behind the curve on the key long-term reform efforts.” Don Berwick, Obama’s choice to head the Centers for Medicare and Medicaid Services, “has never run a provider organization or insurance company, or dealt with Medicare or Medicaid reimbursement. On basic issues…Don knows relatively little.” Senior staff at CMS has “no experience running a health care organization,” Cutler said.Cutler also criticized the person tasked with setting up the insurance exchanges, because that person was ideologically hostile to the industry. “If you cannot find a way to work with hesitant states and insurers, reform will blow up. I have seen no indication that HHS even realizes this, let alone is acting on it.”Jeanne Lambrew, “the overall head of implementation inside HHS…is known for her knowledge of Congress, her commitment to the poor, and her mistrust of insurance companies. She is not known for operational ability, knowledge of delivery systems, or facilitating widespread change. Thus, it is not surprising that…exchange administration [is] receiving little attention. Further, the fact that Jeanne and people like her cannot get along with other people in the Administration means that…valuable problem solving time is wasted on internal fights…no one I interact with has confidence that your current personnel and configuration is up to the task.”