Sunday, February 27, 2011


clearance, n

1. The action or process of removing or getting rid of something
2. Official authorization for something to proceed or take place.
3. Clear space allowed for a thing to move past or under another.

You probably think of clearance the way i used to, when I was told to turn off my personal device, or when I was installing some bookshelves. Or when a bookstore files for Capter 11.

Clearance has taken on much more importance for me since I joined the executive branch. It's the process for getting approval to release something in writing to the public: it could be a regulation, to be published in the Federal Register, explaining what we think Congress meant and how we're going to implement it, some sub-regulatory guidance explaining what we meant by the regulation, or it could be just a letter.

Clearance involves some list of people being given some amount of time to make comments on whatever I and my team have written. Some of the people on the list are up the chain of command, so that makes perfect sense. And the lawyers in the General Counsel's Office. And if it's a regulation, the Office of Management and Budget, part of the White House, that must approve all regulations.

Some of these reviewers are other people in the agency, some may be in other agencies. Many of them I've never heard of, and they've never heard of me; some likely know little to anything about the subject the're reviewing.

It's easy to chalk this up just to bureaucracy, and it's also easy to chafe at the delay it causes. But I have come to appreciate the fact that something I do might have an unexpected impact on something that others in the Federal government are doing, and that of course I know nothing about. So we understand why the process is needed. And when we can, we plan our work with a timeline that takes account of the additional time that will be needed. And the system works pretty well. Which doesn't mean we can't grumble a bit now and then.

Tuesday, February 22, 2011

Traveling south

With apologies to Tony Hurwitz and Sarah Vowell . . .

We went down to Fredericksburg on Saturday. There's some colonial history, George Washington's mother was born there, and his boyhood home, Ferry Farm, is nearby. And beautiful homes, some ante, most postbellum. Apart from some cute shops, for tourists its' mostly The War Between the States.

We had Zorro with us, and folks down there sure love dogs, so we got lots of smiles and he was much admired and petted. One gentleman came over and ended up with Zorro licking his whole face (as he will do, if you let him), after he left Liz said that at first she thought he was speaking another language, but no, it was just the combination of a drawl and maybe a few less than a full complement of teeth. Nice fella.

So we walked around the town, did some window shopping and spent just enough time retracing the battles of Fredericksburg (December 1862, Confederate victory, due mainly to bureaucratic hangups that delayed the arrival of pontoon bridges needed to cross the Rappahannock--I guess the federal government hasn't changed all that much) and Chancellorsville (May 1863, Confederate victory, due mainly to "Fighting Joe" Hooker's failure to live up to his nickname; known best as the battle in which Stonewall Jackson fell to friendly fire). We left the battles of the Wilderness and Spotsylvania Courthouse (Grant v. Lee in 1864, bloody but inconclusive) for another day. The National Park Service does a good job of helping you to imagine what it must have been like to fight over that ground, where so many gave their last true measure of devotion or were maimed for live. There's a genuine Confederate uniform with the leg cut off due to the amputation the man who wore it endured.

All very interesting and noble, but I can't help but wonder why one of the main roads is called the Jefferson Davis Highway, and why the Park Service memorializes Lee and Jackson, both of whom went to West Point, wore the uniform of the United States and fought for their country before raising arms against it. The guy who leaked information to Wikileaks is called a traitor, some are calling for him to be executed, and he will undoubtedly spend some years in prison. Somehow I don't think they'll be naming state highways after him. So why do we have statues honoring Confederate generals? Why wasn't Lee taken out and shot as a traitor?

Liz says that this reconciliation is part of what preserved the Union and is a testament to America's strength. But didn't it also help preserve a Jim Crow way of life that persisted into the 1960s? Maybe a little more shock and awe after the Civil War was over would have been a good thing. Of course I know my history, Lincoln was assassinated, Andrew Johnson became President and radical reconstruction came to an end. But that still doesn't explain why we continue to glorify a society that was built on the idea that one person can own another. I'm not sure why my tax dollars are going to honor those who fought to continue that barbarism and cruelty.

Saturday, February 19, 2011

My wife Liz has the most wonderful laugh. When something strikes her as really funny -- and you never can be quite sure why or when that will be -- she loses control completely. Her eyes close, she whoops, she screams, she roars. One of my favorite things is to render her helpless in that way.

She has recently taken laughter to another level, as a certified laughter yoga leader. Check out, it's good for you.

Saturday, February 12, 2011

New Title, New Duties, redux

I posted here a week ago about my new position as Acting Director, Oversight, in the Center for Consumer Information and Insurance Oversight (CCIIO) within the Center for Medicare and Medicaid Servics (CMS). I took the post down because I heard some mindless chatter that some folks out there--you know who you are, I don't--thought I'd jumped the gun because they hadnt seen a press release from CMS announcing my appointment. As if. For the record, there has been and there will be no press release about this--I am not all that (yet, anyway). And of course I had approval from the right people to share the news, as it was official and all the people who needed to know had been informed. 'Nuff said.

I've been in the job just short of two weeks and things are going just great. There's a lt going on and quite a few plates to keep spinning on those long sticks, but I wouldn't have it any other way. This is what I came to Washington to do; I'm happy and grateful that I'm having the chance to do it.

If you go to our new website,, you can see lots of info about what we do. One day we may have an organization chart on there, but for now I can tell you that there are four Offices below the level of Center Director. The website describes our duties this way:

The Office of Oversight
This office will implement, monitor compliance with, and enforce the new rules governing the insurance market and the new rules regarding medical loss ratios. It will also be responsible for rate review at the federal level, and for providing rate review grants to states.

So that's what we're going to do.