[Mb-civic] WORTH READING: Bush the Incompetent - Harold Meyerson

[William Swiggard]

Bush the Incompetent

By Harold Meyerson
Wednesday, January 25, 2006; A19

Incompetence is not one of the seven deadly sins, and it's hardly the 
worst attribute that can be ascribed to George W. Bush. But it is this 
president's defining attribute. Historians, looking back at the hash 
that his administration has made of his war in Iraq, his response to 
Hurricane Katrina and his Medicare drug plan, will have to grapple with 
how one president could so cosmically botch so many big things -- 
particularly when most of them were the president's own initiatives.

In numbing profusion, the newspapers are filled with litanies of 
screw-ups. Yesterday's New York Times brought news of the first official 
assessment of our reconstruction efforts in Iraq, in which the 
government's special inspector general depicted a policy beset, as Times 
reporter James Glanz put it, "by gross understaffing, a lack of 
technical expertise, bureaucratic infighting [and] secrecy." At one 
point, rebuilding efforts were divided, bewilderingly and 
counterproductively, between the Army Corps of Engineers and, for 
projects involving water, the Navy. That's when you'd think a president 
would make clear in no uncertain terms that bureaucratic turf battles 
would not be allowed to impede Iraq's reconstruction. But then, the 
president had no guiding vision for how to rebuild Iraq -- indeed, he 
went to war believing that such an undertaking really wouldn't require 
much in the way of American treasure and American lives.

It's the president's prescription drug plan (Medicare Part D), though, 
that is his most mind-boggling failure. As was not the case in Iraq or 
with Katrina, it hasn't had to overcome the opposition of man or nature. 
Pharmacists are not resisting the program; seniors are not planting car 
bombs to impede it (not yet, anyway). But in what must be an unforeseen 
development, people are trying to get their medications covered under 
the program. Apparently, this is a contingency for which the 
administration was not prepared, as it has been singularly unable to get 
its own program up and running.

Initially, Part D's biggest glitch seemed to be the difficulty that 
seniors encountered in selecting a plan. But since Part D took effect on 
Jan. 1, the most acute problem has been the plan's failure to cover the 
6.2 million low-income seniors whose medications had been covered by 
Medicaid. On New Year's Day, the new law shifted these people's coverage 
to private insurers. And all hell broke loose.

Pharmacists found that the insurers didn't have the seniors' names in 
their systems, or charged them far in excess of what the new law 
stipulated -- and what the seniors could afford. In California fully 20 
percent of the state's 1.1 million elderly Medicaid recipients had their 
coverage denied. The state had to step in to pick up the tab for their 
medications. California has appropriated $150 million for the 
medications, and estimates that it will be out of pocket more than $900 
million by 2008-09. Before Jan. 1 the Bush administration had told 
California that it would save roughly $120 million a year once Part D 
was in effect.

California's experience is hardly unique. To date at least 25 states and 
the District have had to defray the costs to seniors that Part D was 
supposed to cover. What's truly stunning about this tale is that, while 
officials may not have known how many non-indigent seniors would sign up 
of their own accord, they always knew that these 6.2 million seniors 
would be shifted into the plan on the first day of the year. There were 
absolutely no surprises, and yet administration officials weren't even 
remotely prepared.

No such problems attended the creation of Medicare itself in the 
mid-1960s. Then, a governmental agency simply assumed responsibility for 
seniors' doctor and hospital visits. But, financially beholden to both 
the drug and insurance industries, the Bush administration and the 
Repsublican Congress mandated that millions of Americans have their 
coverage shifted to these most byzantine of bureaucracies.

This is, remember, the president's signature domestic initiative, just 
as the Iraq war is his signature foreign initiative.

How could a president get these things so wrong? Incompetence may 
describe this presidency, but it doesn't explain it. For that, 
historians may need to turn to the seven deadly sins: to greed, in 
understanding why Bush entrusted his new drug entitlement to a financial 
mainstay of modern Republicanism. To sloth, in understanding why 
Incurious George has repeatedly ignored the work of experts whose advice 
runs counter to his desires.

More and more, the key question for this administration is that of the 
great American sage, Casey Stengel: Can't anybody here play this game?

http://www.washingtonpost.com/wp-dyn/content/article/2006/01/24/AR2006012401163.html
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