Peggy Noonan‘s latest Wall Street Journal column explores the notion of President Obama’s apparent disinterest in the functional operation of his signature health care legislation.

It’s a shock for most people that it’s a shambles. A fellow very friendly to the administration, a longtime supporter, cornered me at a holiday party recently to ask, with true perplexity: “How could any president put his entire reputation on the line with a program and not be on the phone every day pushing people and making sure it will work? Do you know of any president who wouldn’t do that?” I couldn’t think of one, and it’s the same question I’d been asking myself. The questioner had been the manager of a great institution, a high stakes 24/7 operation with a lot of moving parts. He knew Murphy’s law—if it can go wrong, it will. Managers—presidents—have to obsess, have to put the fear of God, as Mr. Obama says, into those below them in the line of authority. They don’t have to get down in the weeds every day but they have to know there are weeds, and that things get caught in them.

It’s a leader’s job to be skeptical of grand schemes. Sorry, that’s a conservative leader’s job. It is a liberal leader’s job to be skeptical that grand schemes will work as intended. You have to guide and goad and be careful.

And this president wasn’t. I think part of the reason he wasn’t careful is because he sort of lives in words. That’s been his whole professional life—books, speeches. Say something and it magically exists as something said, and if it’s been said and publicized it must be real. He never had to push a lever, see the machine not respond, puzzle it out and fix it. It’s all been pretty abstract for him, not concrete. He never had to stock a store, run a sale and see lots of people come but the expenses turn out to be larger than you’d expected and the profits smaller, and you have to figure out what went wrong and do better next time.

People say Mr. Obama never had to run anything, but it may be more important that he never worked for the guy who had to run something, and things got fouled up along the way and he had to turn it around. He never had to meet a payroll, never knew that stress. He probably never had to buy insurance! And you know, his policies were probably gold-plated—at the law firm, through his wife’s considerable hospital job, in the Illinois Legislature, in the U.S. Senate. Those guys know how to take care of themselves! Maybe he felt guilty. Maybe that’s to his credit, knowing he was lucky. Too bad he didn’t know what he didn’t know, like how every part has to work for a complicated machine to work.