More reorganization

My boss Steve Larsen, head of the Office of Oversight in OCIIO, announced this week that we are combining two divisions to create a Division of Compliance and Enforcement. You may already be wondering why in the world you should care about this piece of Tricia, and there is no particular reason other than the fact that I am the head of the Division, and now have about half of the staff in the Office of Oversight reporting up to me. So to the extent one measures success in a bureaucratic organization by an increase in span of control, this would be an indication of success.

There will be lots of changes in the days to come, which I will try to keep my faithful readers up to date on, to the extent I can speak publicly.

Beginning of a New Year of Change

I can make no comment on the accuracy of the story I have provided a link to on the right, although I will say that it is odd to assert that Secretary of Health and Human Services Kathleen Sebelius has relinquished control over the office responsible for implementing health care reform by moving it into the Center for Medicare and Medicaid Services (CMS), since CMS is part of the Department of Health and Human Services.

I will also say that I can now state without any fear of contradiction that I am a federal bureaucrat.

End of a year of change

This has been a year of change, in many unexpected ways. For me, it meant a move to DC, first to work for Congressman Garamendi as his Chief of Staff, and then in the Office of Oversight in OCIIO at HHS. By now you know that Dave has decided to keep Adam on as GC. I hadn't wanted to say anything until he made the announcement.  I'm disappointed, but I've also got plenty more to do at my job in DC.  

All the best for a happy and healthy New Year.  That job has brought some unexpected changes as well; I never imagined that I would be managing the teams responsible for drafting two sets of regulations implementing major parts of health care reform; one on how the requirement that health plans spend 80 or 85% of premium dollars on clinical care or activities that improve health care quality, the other establishing a process for review of "unreasonable" increases in health care premiums.

The process was long and exhausting, including working late into the night. I think that any reasonably objective view would be that we did an excellent job of staying true to the language of the statute (sometimes rather opaque), giving deference to the States as much as possible, while providing a federal "floor" that will protect consumers.

Next year will bring it's challenges, as the political environmental will be, shall we say, less friendly to our efforts. We will persevere.

Happy New Year to you all, I hope that 2011 brings you all the happiness that life can offer.

At Last

I was filled with so many emotions last night My Dad grew up in NY a Giants fan.  By the time I was old enough for him to take me to games, the Yankees were the only team in town. My Dad took me to see Mantle,  Maris, Tresh, Richardson, Howard, Ford.  When he moved to LA, he became an SF Giants fan, which caused some good-natured conflict with my Stepmom, who rooted for the hated Dodgers.  Who were much more successful, of course.  

We went to some great games together, we saw Barry hit his 71st homer, we were at the tragic Game 6 in Anaheim, when we were six outs away.  But no championship.

After we moved to SF in '85, i took up the team.   That meant freezing at Candlestick with crowds around 5,000, that first year they lost 100 games.  I was in the stands when they beat St Louis in '87 to go up 3-2, only to lose the last two.  I was in the stands when the Thrill beat the Cubs in '89, only to be beaten by the A's and Loma Prieta.  Then there was '93, Dusty's first year, when they won 103 games and didn't make the playlets.

David and Kate were raised Giants fans and I loved the fact they they enjoyed going to the ballpark with me.  By 2000  they won the division, only to lose to the Meta.  Kate and I were there for one of the most exciting moments in sports I've ever seen, JT's 3 run shot in the bottom of the 9th to tie game 3, which they lost in the 10th.

Finally in 2002, we were there to see Kenny Lofton put us in the Series, the year we should have won it all.

And now, at last, we have.  Here I am, 3,000 miles and three time zones away.  How can it be that this team was able to do what all those other teams with all those stars couldn't do?   Better pitching, I guess.   It's a funny game.


Gary

Long time, no post

I see that it's been just over month since I last posted here, the reason being the same--there is really very little I can say about the work I'm doing, most of which involves drafting regulations and recommendations to policymakers, none of which is public. I did meet Secretary Sebelius last week, she was very gracious in her appreciation of the work we've been doing and remembered that John Garamendi had spoken to her about me.

The other big thing that has been going on for the past few weeks has been the GIANTS !!!! I've been glued to the TV throughout the playoffs, and have been thrilled by their wins, especially in the first Series game last night. It's hard being so far away while all this is going on . . . .

Here in DC, we've been enjoying a lovely fall, the city looks beautiful, the weather has been great, we've done a lot of walking, sitting on the roof of our building at dusk, etc. I know that winter is coming, but for now it feels like an ideal climate.

We're looking forward to being home for Thanksgivivg, seeing David and Kate, being back in California. We miss them, and it, a lot.

September 23, 2010--The beginning of a new day in health care in America

As I'm sure you know, yesterday was the first day that a number of the new health care insurance market provisions of the Affordable Care Act went into effect. I'm sure you've heard the drill: no more excluding children under 19 with pre-existing conditions, no more deductibles or co-pays for preventive care, no more cancelling your policy when you get sick unless the insurance company can prove that you intentionally withheld important information when you applied, no more lifetime limits on how much your insurance company has to pay for your medical care, and a minimum of $750,000 in annual limits, phasing out to no annual limits in 2014.

On a personal note, these are some of the provisions that it is my job to enforce, along with the Departments of Insurance in the states.

The post to the right, by John Garamendi on Huffington Post, tells some stories about real people who have already been helped by this law. If you make it through almost to the bottom, you'll see some extraordinarily gracious remarks John made about me. It's possible that someone outside my immediate family has said such nice things about me before, but I can't remember when.

Is this law perfect, or is it the end of the need for reform to our health care system? Unquestionably not. Is it a enormous step forward, and will it help millions of Americans get affordable, quality health care? Unquestionably yes.

It's been a while

It's been quite a while since I posted here last. The main reason is that there's very little that I can say about what I'm doing at work--we are busy drafting regulations, developing options for how we are going to enforce the Affordable Care Act, and none of it is public just yet. And I don't want to become one of those people you read about in the paper who had to resign because of impolitic comments in a blog.

I can say that the work environment is wonderful--everyone is smart, dedicated, motivated, excited to be doing this work, pleasant to work with, a team player, etc. etc. There is something about our mission and the fact that we are creating something new that so far has enabled us to keep our spirits high despite impossible deadlines, not enough people, many and conflicting demands on our time. The staff that I've put together for the Division of Enforcement has already been recognized for its superb work and work ethic. I am proud to be doing this job with them.

Meanwhile, Liz came out at the end of August, just in time for the weather to turn from the miserable heat and humidity we had for three months. We love the neighborhood and all the places we can walk to easily from our apartment. Liz has started blogging as well, you can follow her at liznichdc.blogspot.com