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.

First week at HHS

I was walking to meet a friend for a drink and it ocurree to me that the Founding Fathers weren't as smart as they are made out to be. I understand that it was important to put the Capitol somewhere in between the North and the South and they found this swamp on which cto build a new city. But as I was trudging through the 95 degree 90% humidity, reaching my destination with my shirt soaked through, I thought, "Why didn't they put the Capitol in Washington in the Spring and Fall, Florida in the winter, and New Hampshire in the Summer?". It would have been even better from the point of view of regionalism, and sure would be a lot more pleasant. Of course as the country grew westward, we could have had capitals in Chicago, St Louis, Denver and SF as well. Perhaps there'd be some benefit in not having the federal government so far away from most of the people . . . .

I just finished my first week at my new job. For those of you who missed it, here's the full job title, for the last time. Take a deep breath: Director, Division of Enforcement, Office of Oversight, Office of Consumer Informarion and Insurance Oversight (OCIIO) Office of the Secretary (OS), Department of Health and Human Services (HHS). Whew!

I spent a good part of the week interviewing candidates for the fourteen (plus or minus) attorney positions that I'll have reporting up to me. And I'm pleased to say that I've made some excellent progress--including some candidates who were already in progress, I've got one hire and offers out to five others. Not bad for one week! I've got some more interviews scheduled, but if you know any lawyers who want to be a part of history, tell 'em to send me their resumes.

I learned that the Office is moving in July to a commercial office building in Bethesda. At first I was a bit bummed that we will be away from headquarters and Capitol Hill, but that feeling only lasted until I saw where they have me sitting now, about which the less said the better. I've posted photos of the Humphrey Building and of the new digs, across the street from the Bethesda Metro Station. I'm told I'll have a window, and everything.

I'm now immersed in a process that's been going on here for several months now, of figuring out how we're going to interpret and enforce this law. There are countless decisions to be made, scores of people, within our office, elsewhere in the government, in state government, and among "stakeholders" (industry, consumer groups, etc) who are involved in one way or another in making them, and very little time. The law goes into effect September 23, and we've got to be ready to enforce it from Day 1. Much of the enforcement will ultimately be done by the state insurance departments, but we will have some direct enforcement and will also have to be making determinations as to whether the states are "substantially enforcing" the law. It is daunting, exciting. I feel trust I'm in the right place at the right time and that everything I've done until now has prepared me for this moment. I guess we'll see whether I'm right about that, won't we?

The next phase of the journey . . . .

It is with a mix of excitement, pride, anxiety, hope and fear that I report that as of June 21 I will be taking the position as the (first) Director of Enforcement in the Office of Consumer Information and Insurance Oversight in the Department of Health and Human Services. Quite a mouthful, I know. I will be responsible for enforcing the provisions of the health care reform law that impact the insurance companies. I'm expecting a ride every bit as wild as when I went to the CPUC during the energy crisis.

Probably needless to say, but I am extremely pleased and stunned that my move to DC has worked out as well and as quickly as it has. Come visit!

They give you hope for the future

WASHINGTON, DC–The DC office of Congressman John Garamendi (D-Walnut Creek, CA), a member of the House Science and Technology Committee, welcomed and congratulated the President’s Environmental Youth Award (PEYA) winners for the southwest region. Since 1971, PEYA is award annually to young Americans for demonstrating excellence in protecting our country’s air, water, land, and ecology. Adarsha Shivakumar, Apoorva Rangan, and Callie Roberts, high school students from Pleasant Hill and Martinez, earned the PEYA by founding Project Jatropha, a biofuel venture that seeks to lessen our dependence on fossil fuels and mitigate global climate change.
As described by the students, “Project Jatropha Team promotes the cultivation of Jatropha curcas, a perennial shrub with oil-rich seeds, as an ecologically friendly and economically sustainable source of alternative fuel production. To date, the work of Project Jatropha has supported the planting of 13,000 seedlings by more than 50 farm families in Southern India.”
On Wednesday May 19th, Adarsha, Apoorva, Callie, their family members, and their EPA liaison were given a tour of the Capitol complex and Congressman John Garamendi’s office. Chief-of-Staff Gary Cohen spoke with the students about their project, the COMPETES bill to fund scientific research, and the Joint BioEnergy Institute. The Joint BioEnergy Institute is a partnership project that includes Lawrence-Livermore and Sandia National Labs and aims to develop the next generation of biofuels.
“I want to commend Adarsha, Apoorva, and Callie for their ongoing work on Project Jatropha. Unhindered by their young age and the scale of the problem, these students are courageously working to combat global warming. They approach this serious challenge with humility and youthful excitement,” Gary Cohen said.
“This generation’s students enter a globally competitive labor market. Their success depends on the ability to work hard, think creatively, and adapt to quickly evolving market conditions,” Mr. Cohen added “These three Bay Area students display these qualities in spades and serve as an inspiration to the many talented young students of the 10th District.”
On Friday May 21st, the students joined other PEYA winners in meeting President Barack Obama.


More information about Project Jatropha is available at http://projectjatropha.com/
Contact: Adarsha Shivakumar at adarsha@projectjatropha.com
More information about the President’s Environmental Youth Award and the 2009 winners is available at http://www.epa.gov/peya/winners.html.

Look Who Stopped By (3)

No, I'm not in the picture, and this doesn't truly qualify as a "Look who stopped by" because Don Cheadle and Jame Goodall didn't come to our office, but they did speak at a briefing on the Global Conservation Act of 2010. It was fun to see Don Cheadle and to hear him apeak on the need for the US to have a global conservation strategy with meaningful benchmarks to measure its success. But to hear and then meet Jane Goodall was inspirational. When she was introduced we were told that it was 50 years ago that she first went to the Gombi in Tansania to study chimpanzees, so young that the British Government wouldn't permit her to travel there alone, insisting that her mother go with her. I remember vividly those National Geographic stories with the pictures of that slight young woman living with those apes, our closest relatives. (I confess that I didn't learn as much as I might have, because unlike Playboy, which I read only for the articles, I looked at National Geographic for the pictures).
Dr Goodall has gone on to do amazing things, not only for conservation of animal habitat, but much more which you can read about at www.janegoodall.org.
After she spoke, we talked about one of her programs and what could be done to expand its presence in Israel and Palestine. More on that if and as it develops. Amazing woman, such a privilege to have heard her and met her.