Health for life

Its the eve of Mr. Obamas State of the Union address (or, as the beltway cognoscenti apparently er to it, "SOTU").

What better way for the Disease Management Care Blog readers to mark this momentous occasion than by pretending that were in the Oval Office advising the President on the best way forward?

Here are some your options in helping our Chief Executive dispatch the problematic sequester, sustainable growth rate, Medicare and health orm.  Who knows, maybe someone from the White House is paying attention.....

Realizing that the sequester is both a bad deal for Medicare and a trap for the Democratic party, you recommend:

1. compromising,
2. changing the subject back to "evil insurers,"
3. a series of heartland speeches with nodding fawning accountants sharing the stage that explains to the American people the federal budget sequester and why you signed the enabling legislation in the first place,
4. hiring a Kardashian lawyer because hell know how to arrange a quickie divorce from the sequester deal.

To fix the SGR and prevent a physician flight from Medicare participation, you recommend:

1. compromising,
2. changing the subject to "oil companies,"
3. applying the vast anticipated 2016 savings from the "Medical Home" and ACOs to this years budget shortfall; if necessary add another zero or two,
4. re-tasking the controversial military drone program to drop freshly minted $100 bills on doctors offices.

You want mention Marilyn Tavenner, Acting Director for CMS, and ask that she confirmed by the Senate.  To make this happen, you advise the President to:

1. nominate her in the regular course of business and trust the Senate will do the right thing,
2. ask her to change the subject to the White House meme of "corporate jets,"
3. announce she will expand the care management program for FFS Medicare beneficiaries, ignoring, for the moment, that that is the largest insured population in the U.S. without that benefit,
4. fix the Chuck Hagel debacle by changing Ms. Taveneers nomination to Secretary of Defense

 Knowing that the President risks having his second-term being stymied by a defiant opposition party, you suggest Mr. Obama neutralize them by:

1. reaching out with Lincoln-esque "malice toward none and charity for all."
2. characterizing Republicans as "hateful munchkins"
3. recycling the "previous administration" blame strategy by reminding listeners it was Mr. Bush who kicked off the electronic health record mess in a previous State of the Union address and that its yet-unfulfilled promise is not your fault either.
4. suggesting everyone get out of their closed partisan information loops by regularly reading the Disease Management Care Blog.

Since 2014 promises to be the watershed year for Obamacare, you remind the President to:

1. avoid the subject because everyones projections are turning out to be wrong
2. decide now between the red pill and the blue pill
3.  announce that his White House advisors know more than any commercial health insurance executive about the underlying actuarial equivalence of an essential health benefit
4. in contrast to the 2010 SOTU, be respectful to the Supreme Court because they saved your Obamacare as*.

If no poster, a statue maybe?

The Disease Management Care Blog is always on the lookout for wall decor for its fashionable world headquarters and all but decided on this framed poster picture. The alarmed DMCB spouse inappropriately intervened, citing a host of silly concerns*.

The politically shrewd DMCB countered the spouses raw power play by appealing for the input from a stacked deck of friends and family. They appreciatiate the similarities between the bon vivant DMCB and The King, and they also have a sense of humor.  Thusly armed with the support of its handpicked cadre, the DMCB thought the day was won.

Why not?  The DMCB is only copying from the White Houses playbook.  Check out this HHS press release.

Dare: June 20, 2012 11:30 AM PDT

Subject: External Affairs Welcomes Dr. Mandy Cohen

Dear Stakeholders,

I am pleased to announce that Dr. Mandy Cohen has joined our team in the HHS Office of Intergovernmental and External Affairs (IEA) as Senior Policy Advisor and Director of Provider Engagement. In her new role, she will focus on the Department’s work to transform the delivery system and oversee the Department’s outreach and engagement with clinicians, health professionals and other providers.

For the past two years, Dr. Cohen has been the Director of Stakeholder Engagement at the CMS Innovation Center, working with the Center’s many constituencies to develop and test new payment and delivery models. Prior to joining CMS she was the Executive Director of Doctors for America. Dr. Cohen received her medical degree from the Yale University School of Medicine and trained in internal medicine at Massachusetts General Hospital. (bolding DMCB)

Dr. Cohen and I both look forward to working with you as we improve the health care system together. 

The DMCB was first introduced to "Doctors for America" thanks to this HuffPo posting describing a mutual-admiration health orm meeting at the White House. Having never heard of Doctors for America, the DMCB naturally turned to Wikipedia, where it all became clear. 

The DFA used to be known as DFO, i.e., Doctors for Obama during the 2008 elections. While the White House also gets to conflate the "A" and the "O," its real purpose is the portrayal of getting seemingly neutral input from an impressively named physician organization that is not the AMA.

Unfortunately, it doesnt look like the DMCB will get its way on the hanging the picture.  Unsurprisingly, the White Houses stacking the deck with political backers doesnt mean theyre necessary going to get their way on health care either. 

(In all fairness, however, it should be pointed out that CMS is working with former AMA President Nielson).

Statue image from Wikipedia. 

*The controversial poster shot  was taken during rehearsals for the filming of Captain EO in 1986.