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One interesting thing about the Patient Protection and Affordable Care Act (PPACA) exchange program is how it seems to monopolize a great deal of U.S. Department of Health and Human Services (HHS) attention, and certainly a great deal of the attention of the outsiders looking at HHS.

When President Obama announced the departure of outgoing HHS Secretary Kathleen Sebelius and his decision to nominate Sylvia Mathews Burwell to be her successor, he struggled to remind the press that HHS has to oversee tasks such as approving drugs and controlling flu outbreaks.

Sebelius’s first task as head of HHS turned out to be fighting a flu outbreak, Obama said.

Obama and Sebelius mentioned the fact that HHS serves the elderly and the disabled, but, in a transcript of the remarks sent out by the White House, they didn’t even use the word “dementia.”

Another interesting thing is that PPACA exchange sales of commercial “qualified health plans” account for just half of the exchanges’ business, and just a tiny percentage of the people enrolled in HHS-run plans.

It was a little sad to see House committees raking Sebelius over the coals for problems at the exchange QHP program at hearing after hearing — and, in many cases, ignoring whatever equally serious problems may exist at Medicare, Medicaid and many other HHS programs.

I think one moral is that, if the PPACA exchange system survives, it would be good to get it out of HHS as soon as politically and financially feasible.

I don’t want to come to conclusions whether the exchange program itself will work or not, or is good or bad, because it just seems people have to decide that sort of thing for themselves.

But I just think it’s clear that, whatever you think about the exchanges, the exchange program is an enormous drain on HHS officials. If, for example, the officials had not had to think so long about exchange enrollment systems, is it possible that they could have done a little more to promote long-term care (LTC) planning or to implement the PPACA programs aimed at people with serious disabilities?

People could have all sorts of views on whether and how HHS should regulate exchanges, but I don’t think it makes sense for HHS to have to obsess about the day-to-day operations of its own in-house

If the powers that be decide not to privatize the program, maybe they could at least spin it off into its own separate website-performance-obsessed government-sponsored enterprise.

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