Hot, Hot, Hot

Eighteen days over 90 degrees in June, another eighteen already in July. Today its over 100. Very tough. Sitting by the air conditioner watching movies on Netflix.

Friday I went to a public meeting held by the National Association of Insuramce Commissioners on implementation of health care reform. Good, but a bit strange, to see old friends now that I'm on the other, other side--not the industry, but the Feds.

There is a lot of uncertainty and a fair amount od suspicion about how this law will be interpreted and how it will work in practice. Some of this is understandable, there are lots of provisions that are unclear and the regulations that will provide some clarity (and undoubtedly raise more questions) haven't all been issued. And of course there will be problems, both with the law and because the law doesn't address much of what is wrong with the health care system.

But there also seems to be a underlying lack of trust, or confidence, or maybe it's just fear of change. Even when the way things are going is bad, the devil you know seems better than the unknown one you can't see up ahead.

For those of us at the Office of Consumer Information and Insurance Oversight the feeling is quite different. We are creating something new, we have very little that "has always been done that way" or "isn't the way we do things here." We have an enormous amount to do, and very little time to do it, and much of it has never been done before. But we believe in what we're doing and in our ability to get it done.

Random Thoughts

Went to see my Giants beat the Nationals 6-2 last Sunday. The stadium a disappointment when compared to the standard set by Camden Yards, PacBell park--no architectural elements to reflect the location in Our Nation's Capital, apart from the relentless red, white and blue. They do have mascots with huge George Washington, Abe Lincoln, Teddy Roosevelt heads who do race from center field to a finish line along the first base line. Live version of the animated cable car race. Seat almost too hot to sit on at 1:00 in 95 degree heat, lucky for me I got tickets on the third base side, in the shade by the third inning. Strong performance by the Giants, good pitching, good clutch hitting.

It's been the best of times and the worst of times (well, not really) at HHS. I've decided that if I do end up in Purgatory I'll just say, "Naah, this isn't anything, I've been through the process of getting a security badge at HHS." After numerous visits to the Security Office, filling out lengthy, repetitious forms for a background check which I'm sure no one actually did, the day finally came when I was supposed to get my badge--when I was told that they had run out of badges. "Badges? We don't have no stinkin' badges."

For the best of times, I attended a meeting of the leadership group at HHS that is coordinating implementation of health care reform. Deputy Secretary Corr presides, Secretary Sebelius attended as well. Very impressive group, very impressive process. You're in good hands.

Week deux

When I was practicing law, I used to imagine that my client could be in my office watching me work, and I'd want them to be satisfied that they were getting good value for their money. Ok, ok, there were some clients whom I was happy to bill for every second I spent, say, in the shower, thinking about their case. Anyway, with the enduring debate over whether the amount of government we have is too little, too much, or just right, and all the hostility expressed toward civil servants (for example, in the budget debate and the campaign for governor in California), I wonder sometimes what the public would think if they could watch their tax dollars at work in the agencies and departments that do the people's work.

Of course at times they would see inefficiency and incompetence at times. More than in your average corporation? I don't know. But they would also see people working long hours to get a web portal running to provide information to people about their options for health care coverage. www.healthcare.gov. Check it out. They would be impressed, as I was, by a meeting of brilliant, dedicated people working together to figure out what things that insurance companies spend their money on should count as "improving health care quality." I know we may disagree over whether the government should be influencing how insurance companies spend your money, or whether we should leave that up to them and to "the market." But I think most people would agree that if we are going to have a law that gives the government that job, this was an impressive group of people and an impressive process to be involved in the decision.

So many decisions, so little time. I feel as though I'm drinking from the proverbial fire hose while running after the proverbial train that is leaving the proverbial station.