Are any of the managers in the White House, HHS and CMMS in that category? Certainly not loud (nobody is speaking on the record: https://news.ycombinator.com/item?id=6586119), but perhaps anti-Obamacare moles?
Because the people running this show every sign of being true believers, and I seriously doubt they're playing much attention to the "waco birds" who are totally against it.
Certainly the U.K. NHS experience shows the running of such a system is political. I don't watch it closely, but as I understand it Tony Blair/New Labour doubled spending, but somehow functionaries and bureaucrats got the new money, not the front line people and institutions.
You think we can have anything less than a totally political discussion about euthanasia, most recently known as the Liverpool Care Pathway in the NHS?
I find some of it amusing - I've worked on some enterprise-level projects with business systems talking to other business systems, and I can only imagine how much eye-rolling is going on among the programmers that are actually trying to do the work. This is a project where some very visible, loud people have a vested interest in it looking bad even if it were flawless.
I actually think it would be kind of fun to be close enough to the technology to really identify the core constraints and be in a position to help alleviate them.