The President’s Prediction of the Explosion of the ACA
Mar28

The President’s Prediction of the Explosion of the ACA

The announcement of the death of the AHAC and the president’s prediction of the “explosion” of the ACA broke in an unusual way. Robert Costa of the Washington Post got the word directly from the president and then tweeted that the AHAC was being withdrawn before Paul Ryan had a chance to meet with Republican House members to tell them of the big decision. Costa published an article about the surprising call he...

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A Time to Renew and Expand Our Sense of Professionalism
Mar21

A Time to Renew and Expand Our Sense of Professionalism

Retirement is a time of reflection. Most of one’s agency lies in the past. I must organize opportunities to transfer bits of experience, insight and wisdom to those who still do the work if I am to have the joy of continuing to contribute to the dream of a future where we enjoy   …Care better than we’ve seen, health better than we’ve ever known, cost we can afford,…for every person, every time…in settings that support...

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Understanding “Ryancare”, the AHCA
Mar14

Understanding “Ryancare”, the AHCA

With Paul Ryan’s  launch of his “repeal and replace” bill , which he calls the American Health Care Act (AHCA) and I prefer to call “Ryancare,” he initiated a new phase of the healthcare debate. Finally, we are seeing the focused discussion of the complex issues of care, coverage, and cost that should have been a central part of the debate before the election. Talk show hosts and comedians are demonstrating a grasp for the complexity...

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Looking Underneath the President’s Comments About “Repeal and Replace”
Mar07

Looking Underneath the President’s Comments About “Repeal and Replace”

As the “talking heads” who analyzed the President’s speech and Governor Beshear’s Democratic party response were fading into the 11 o’clock news, Verizon offered an advertisement that contained as much or more wisdom than anything that I had heard over the previous two hours.       Why promise something that you can not deliver? (Verizon Ad)   The President seems intent on the delivery of everything that he promised...

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“Repeal and Replace”: Finally, Something From the Republican Leadership
Feb28

“Repeal and Replace”: Finally, Something From the Republican Leadership

This last week Congress has been recessed for the Presidents’ Day holiday week. Paul Ryan accurately anticipated that many of Republican members of Congress would be having town meetings with their constituents and would face angry voters who wanted to talk down the plans to “repeal and replace” the ACA. Ryan met with his troops on the Thursday before they left Washington for their week of hometown meetings. Like a good general,...

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Applying Lean Thinking to the Future of the ACA
Feb21

Applying Lean Thinking to the Future of the ACA

Tom Price is now in place at his new office at HHS. One of Dr. Price’s first actions was to release a YouTube video that promises us a lot but does not say anything specific about what he plans to do. Seema Verma has been working her way toward Senate confirmation as the Administrator of CMS. Paul Ryan is throwing himself into the work of getting all his ducks in line for the repeal of the ACA. Across the country real people are...

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It’s Still The Truth, Ten Years Later
Feb14

It’s Still The Truth, Ten Years Later

In the January 29th New England Journal of Medicine Foller, et. al. published an interesting article, “Population Health–A Bipartisan Agenda for the Incoming Administration from State Leaders.” The first paragraph said a lot.   The common goal of health policy leaders at the level of state government in the United States is promoting the health and well-being of all populations to the greatest extent possible within fixed...

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Good Strategy in a Fog of Uncertainty
Feb07

Good Strategy in a Fog of Uncertainty

There is no challenge like the challenge of creating a strategic plan in uncertain times. What do you do when you do not know what to do? That is a question that frequently challenges leaders. Over eight years ago, after Lehman Brothers had failed and the value of the stock market had fallen by almost fifty percent and we did not know if we were facing a deep recession or the second coming of the Great Depression, I was asking myself...

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