My general view is that the early implementation efforts are far short of what it will take to implement reform successfully. For health reform to be successful, the relevant people need a vision about health system transformation and the managerial ability to carry out that vision. The President has sketched out such a vision. However, I do not believe the relevant members of the Administration understand the President’s vision or have the capability to carry it out. Let me illustrate the problem you face and offer some solutions.
–David Cutler, May 11, 2010 memo to Larry Summers
See also, this Washington Post story by Amy Goldstein and Juliet Eilperin. I agree with Tyler Cowen that both are essential reading.