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I agree. I worked in the Medicaid program in Arizona for over 30 years. The last 4 years I worked very closely with the Center for Medicaid and Medicare Services, under HHS, to implement the ACA IT provisions in Arizona. I love President Obama, but so few of his appointees in this area had practical experience with implementation of a major IT development and implementation. The very best I can say about that experience was 1. Extremely Painful. 2. It encouraged me to retire before it killed me. Having people who can get things done, know how things work, can make decisions, understand timelines, those kind of people are invaluable.

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