Where’s czar? Ebola raises management questions
WASHINGTON — President Barack Obama’s commander in the fight against Ebola was expected to operate below the public radar. But did that mean invisible?
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Ron Klain has barely been seen, and a week before midterm elections, Obama is pressing to dispel criticism that the government can’t manage the Ebola crisis.
The White House’s behind-the-scenes coordination of the Ebola response is being severely tested, while the Pentagon and states like New York and New Jersey take public steps that are far firmer than federal guidelines. That’s creating the appearance of a crazy quilt of Ebola measures.
“The CDC is behind on this,” New Jersey Gov. Chris Christie said Tuesday. “Governors ultimately have responsibility to protect the public health of people within their borders.”
Some public health law experts say the government could have anticipated differences in approaches and acted sooner to establish federal guidelines for states to follow.
“What happened is the case showed up in New York and New Jersey, those two governors respond, knee jerk reaction, … then you see the federal government catch up to that a little bit,” said James G. Hodge Jr., a professor of public health law at the Sandra Day O’Connor College of Law at Arizona State University. “It would have been more beneficial if CDC’s guidance had come out, gosh, maybe a week or so ago.”
White House officials say Klain was brought in for his management skills and ability to coordinate the work of agencies that range from the Pentagon to the Department of Health and Human Services, leaving most of the talking to the public health doctors at the Centers for Disease Control and Prevention and National Institutes of Health.
White House spokesman Josh Earnest said Klain, who has been in the job since last Wednesday, has been dealing with the various agencies of the government to streamline the federal response. He has met virtually daily with Obama including a lengthy Sunday meeting with the administration’s Ebola team.
“The impact of his work is already being felt both here at the White House but across the government,” Earnest said Tuesday.
Obama has tried to place his own imprint on the government’s response, making sure photographers captured images of him meeting with the Ebola team and embracing Nina Pham, one of the Dallas nurses who recovered after contracting the disease. On Tuesday he called U.S. workers in West Africa and delivered a statement from the South Lawn before leaving on a campaign trip to Wisconsin.
“It’s also important for the American people to remind themselves that only two people so far have contracted Ebola on American soil: the two Dallas nurses who treated a patient who contracted it in West Africa,” Obama said.
White House officials bristle at the suggestion that the administration has mismanaged the response. They have cited their reliance on science and best health practices for every decision they have made, and health professionals have said the CDC has so far acted prudently.
Administration officials have raised concerns about the steps taken by New York and New Jersey while also arguing that those actions have received outsized attention. As for measures taken by the Army to quarantine some troops returning from West Africa, the White House argues that is a special circumstance that shouldn’t apply to civilians.
“We’re starting to see an emerging consensus from other states about the policies that can be best implemented to protect their civilians,” spokesman Earnest said.
Without mentioning the New Jersey and New York policies, Obama himself said that restrictions that are too confining could dissuade health care workers from volunteering to help fight Ebola in West Africa where an outbreak of the disease has killed thousands.
“We’ve got to make sure that those workers who are willing and able and dedicated to go over there in a really tough job, that they’re applauded, thanked and supported,” Obama said.
The White House defense of its management comes just a week before midterm elections. And while new polls show that seven out of 10 of those surveyed are confident that the federal government can prevent a national epidemic of Ebola, more than half believe the government’s ability to deal with the country’s problems in general has gotten worse.
The virus has made its way into the final weeks of the campaign, with Republicans portraying the federal response as inadequate. “You have two governors of two very populous states saying, ‘No, I’m going to protect my citizens in a way that we think is appropriate with a quarantine,’” Republican Sen. Pat Roberts, who is struggling in his re-election bid in Kansas, said on Fox News. “Then you have the federal government coming in and changing their entire policy about every few days, there’s no trust there.”
James Pfiffner, a professor of government at George Mason University, said presidential decisions are inevitable targets during an election season. “The media and the public always want immediate decisions, when it may be wise to wait until the president knows more before making an important decision,” he said.
Others say Obama’s deliberative style leaves him open to criticism.
“He is a person who likes scientific evidence or other evidence when he makes a decision and goes forward with it,” said James Thurber, political scientists at American University who has written about Obama’s decision making. “It’s not inspirational. Sometimes you have MEGO — My Eyes Glaze Over.”
Yet others blame an insular White House that is too centralized to distribute decision making to Cabinet officials. Shirley Anne Warshaw, a presidential expert at Gettysburg College, said Obama’s decision to select Klain was a capitulation to Republican criticism that should have been avoided.
“Ron Klain is a great guy, smart, couldn’t be a better guy,” she said. “But to have any Ebola czar is huge mistake. This says we lack confidence in our own HHS, in our public health system.”