Marilyn Tavenner Confirmation Watch June 19th Update: Who cares if anyone runs Medicare?

June 19, 2012 update on Marilyn Tavenner’s confirmation (don’t hold your breath) hearings:

“So what did Sen. Max Baucus (D-Mont.) say when HHS Secretary Kathleen Sebelius asked him to hold a confirmation hearing for Marilyn Tavenner, acting administrator of CMS?

“’It’s going to be difficult to proceed with the Republican opposition,’ said Baucus, chairman of the powerful Finance Committee, when I asked him about the conversation.'”

http://www.modernhealthcare.com/article/20120618/BLOGS04/306189981/max-baucus-fire-non-starter:

You call the enthusiastic endorsement of Tavenner by Rep.Eric Cantor, House Republican Majority Leader,  “Republican opposition.” Give me a break Senator Baucus.

Senator Max Baucus, Chairman of the Senate Finance Committee, who helped write the original Medicare legislation that President Johnson signed into law.

Here is what I told Katrina vanden Heuvel , the editor and publisher of the Nation Magazine [who appeared this Sunday as a refreshingly articulate advocate for abandoning the current foolish policy of austerity above all else on This Week with George Stephanopoulos ] when she asked me to give my younger daughter a gift subscription as a college graduation present:

Katrina:

“I am shocked by The Nation’s failure to report on the deterioration of the current Medicare system which as a recipient and a left-of-center Democrat, I can report on what is actually going on (despite the Nation’s unexamined rhetoric). Indeed, I have suggested that I write about it for you to no avail. Hence, no subscription for my daughter Amelia: https://joelsolkoff.com/blueroof-reality/countdown-to-amelias-graduation/

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In response to the report from the Wall Street Journal below:
11:52 pm May 21, 2012
Joel Solkoff wrote :

The failure of Max Baucus and the 12 Democratic members of the Senate Finance Committee, many of whom are liberals whose rhetoric on saving Medicare is voluminous, to hold hearings on Marilyn Tavenner to be head of Medicare and Medicaid is a disgrace. As a paraplegic who has experienced the deterioration of Medicare as it currently exists under President Obama, the fact that his Administration has not had a confirmed Administrator reveals the sharp disparity between a President who lauds Medicare while cutting its budget by half a trillion dollars as part of the cynical price paid to ensure passage of Obamacare. Eric Cantor’s support of Tavenner would have forced Senate Republicans to think twice about voting against her. As one who enthusiastically supported the President four years ago, my unenthusiastic vote for his re-election is indicative of the lukewarm support that could cost him the election. The Nation, The Progressive, and other presumed defenders of Medicare have failed to be critical of the President’s penny-wise, pound foolish administration of a program which he is currently destroying while speaking eloquently about preserving its future. A genuine confirmation hearing for an Administrator whose budget is larger than the Pentagon’s is long overdue. Failure to hold hearings undermines the Democratic pretense that Medicare is worth saving and makes me ashamed to admit that I am a Democrat. What happened to the party of Adlai Stevenson and Eleanor Roosevelt? The best way for Obama to prove his credibility is to push for the support of his nominee and to indicate his commitment to what used to be Democratic values.

http://blogs.wsj.com/washwire/2012/05/21/no-confirmation-hearing-planned-for-marilyn-tavenner/

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Every day I:

1. Log onto the Senate Finance Committee website. http://finance.senate.gov/

2. Click http://finance.senate.gov/nominations/

3. Then, scroll down to here:

12/01/11

Marilyn B. Tavenner, of Virginia, to be Administrator of the Centers for Medicare and Medicaid Services, vice Donald M. Berwick, resigned

4.   Click

  Check Status

5.  Watch paint dry as I go to this site http://www.thomas.gov/cgi-bin/thomas which reads:

Presidential Nominations
112th Congress (2011 – 2012)
PN1165-112

 

Nomination: PN1165-112
Date Received: December 01, 2011 (112th Congress)
Nominee: Marilyn B. Tavenner, of Virginia, to be Administrator of the Centers for Medicare and Medicaid Services, vice Donald M. Berwick, resigned.
Referred to: Senate Finance

Legislative Actions
Floor Action: December 01, 2011 – Received in the Senate and referred to the Committee on Finance.

Organization: Department of Health and Human Services

Control Number: 112PN0116500

__________________________________________________________

Now for some background information. In December, I published the following article in HME News, the publication for the home medical equipment industry which may help you understand the circumstances behind the nomination of Marilyn Tavenner to head the half trillion-dollar agency which significantly affects the life and health of all Medicare and Medicaid recipients.

Who is in charge of Medicare?

The wide-ranging debate over Medicare, a major factor in the presidential election next year, primarily focuses on whether future generations will benefit in the same way that the current 46 million recipients like me benefit. Politicians, critics and would-be-recipients express the illusion that the health care I receive from Medicare represents the ideal. I believe that the only way to save Medicare is to dramatically improve the way it is run today so that it remains a program worth saving.
The primary audience for this commentary is the men and women who provide DME other equipment necessary to sustain and maintain the quality of life. Recently, 87-year-old Lilian Hutchinson, who gets around on an unstable walker, fell and broke her elbow in an independent living facility for 90 elderly and disabled residents where I live in State College, Pa. I believe that if Lillian had access to a scooter or a power chair in her apartment, she would not have fallen. The tales of needless suffering you could tell resulting from a Medicare bureaucracy that increasingly limits access to mobility equipment and medical oxygen seem beside the point.
Durable medical equipment represents only a small fraction of the Medicare budget. The whole system for providing medical care for the elderly, disabled and poor is not working efficiently in large part because of the absence of leadership at CMS, an agency of the U.S. Department of Health and Human Services. My intention here is to answer the question: Who runs Medicare? In theory, Dr. Donald Berwick, a distinguished Harvard physician with an outstanding reputation as an advocate for efficient health care, runs CMS.
Last year, President Obama named Dr. Berwick to be administrator of CMS, a position one senator described as the nation’s health czar since the job also includes putting in place much of the legislation passed last year, which, by one estimate, will extend health care to 32 million Americans who do not have coverage.
Sadly, the president had failed to appoint an administrator early on in his administration, when Senate confirmation would not have been a problem and when an adviser with the expertise and gravitas Dr. Berwick has in the medical community would have proven useful. The major flaw in the president’s landmark legislation was how he intended to pay for it. He decided against raising taxes, which might have doomed passage.
Instead, half the estimated trillion dollars required to extend healthcare coverage was targeted to come from savings to the Medicare budget as a result of achieving cost savings, reducing fraud and abuse, and increasing efficiency. Anyone who has ever made a New Year’s resolution to save money can tell you it is imprudent to spend it before the money is actually saved.
By the time Dr. Berwick arrived at Medicare, he was in the impossible situation of being required to save $500 billion, a requirement for which he had not been consulted and in a situation where the president had given him neither the time nor the authority to implement.
The political comedian Mark Russell observed, in a similar context, that exercising leadership without the necessary authority is equivalent to sending a eunuch to an orgy. Fearful of Republican reaction to Dr. Berwick’s appointment and unsure of the allegiance of Democrats on the Senate Finance Committee, the president refused to fight for Berwick’s confirmation or to find a replacement who would achieve bipartisan support.
Using the recess appointment mechanism, which allows a president to appoint an official on a temporary basis while Congress is not in session, Berwick currently serves as acting administrator and will be replaced next year by his deputy Marilyn Tavenner. Tavenner, while respected for her organizational skill, her background as a nurse and a hospital and state health care administer, does not have the stature required to lead what is in effect a cabinet level position.
Although CMS has a larger annual budget than the Pentagon, as I write this, there has not been a confirmed head of Medicare since 2006. For the purposes of comparison, if the Defense Department did not have a confirmed secretary for five years, there would be a national outcry.
–Joel Solkoff was a political appointee in the Carter Administration, serving as special assistant to the Under Secretary of Labor. He believes a bipartisan solution to the problems of Medicare is achievable.

On February 3, I sent the following letter to Senator Max Baucus (D Montana), chairman of the Senate Finance Committee which has oversight over Medicare and has the power to conduct confirmation hearings on President Obama’s nominee to run Meadicare:

The Honorable Max Baucus

Chairman

Committee on Finance

United States Senate

219 Dirksen Senate Office Building

Washington, D.C. 20510

Dear Senator Baucus

I am writing to request an invitation to testify at the confirmation hearing of Marilyn Tavenner to be Administrator of the Centers for Medicare and Medicaid Services.

I am a paraplegic who is a Medicare recipient. While I am generally supportive of Acting Administrator Tavenner’s appointment, especially since it has been so long that CMS has had a confirmed Administrator; I have considerable concerns about durable medical equipment. As a user of mobility devices and as one who has researched other equipment in the durable category, especially medical oxygen, I think it important that my concerns be discussed.

Specifically, I am concerned about the cumbersome procedures involved in obtaining medical equipment. The current competitive bidding program, the absence of assurances that award winners will provide batteries, other necessary equipment, and maintenance are among the issues on which I would like assurance—both from Acting Administrator Tavenner and from the Senate Finance Committee with its oversight responsibilities.

I realize that no hearings have been scheduled as of this writing. However, given the importance of Medicare and Medicaid I would appreciate my voice being heard, especially on the subject of indigent disabled individuals who have suffered most from current and proposed CMS practices.

I write frequently on disability issues for Voices of Central Pennsylvania, HME News, the monthly publication of the home medical care industry, and for a variety of other publications. I am the author of three books including Learning to Live Again My Triumph over Cancer. My disability writing can be accessed easily by keyboarding my name into Google.

Thank you.

Sincerely,

Joel Solkoff

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Of course I cannot testify unless there are hearings.

For a number of reasons, it seems likely that Marilyn Tavenner is not a controversial nominee and the committee and the Senate would vote to confirm her.

It is hard to run something when you do not have the necessary authority.

Politicians are using this election season to talk about the important of Medicare and Medicaid. If they really believe what they say they would hold confirmation hearings.

There has not been a confirmed had of Medicare since the Bush Administration. 

 

 

Suggested stories:

 

Lady Gaga: When you became disabled in “Paparazzi,” you needed cooler equipment

Living in Central Pennsylvania has isolated me from the world’s realities. Until last month, I was unaware of Lady Gaga. [This posting originally appeared on October 10, 2010 at the web site of Voices of Central Pennsylvania, my home away from home.  http://voicesweb.org/invitation-lady-gaga-perform-bingo-parlor-addison-court-plus-disability-suggestions-paparazzi .]

This Lady shattered my consciousness. Not paying much attention to the fact that Lady Gaga was on the cover of September’s Vanity Fair, I bought the issue anyway. I buy Vanity Fair for the political reporting and because it is one of the best paying magazines for writers. I figure buying and reading a copy is like buying a lottery ticket. You can’t win if you don’t play.

The cover story on Lady Gaga says, “She is, without question, the world’s biggest pop star—with 12 million sales worldwide of her 2008 debut album (The Fame and bonus disc The Fame Monster). She had six No.1 hits on the Billboard charts: Just DancePoker FaceLove GamePaparazziBad Romance, andTelephone. She has had close to 800 million viewers of her videos on YouTube. She recently broke the record on Facebook with more than 12 million fans—surpassing those of President Obama.”

Then, Lady Gaga became a political activist.Lady  Gaga has close ties to the gay community. Indeed, there have been rumors that Lady Gaga is a man in women’s clothing—a rumor effectively quashed in a startlingly revealing scene in the brilliantly made video Telephone in which two prison guards strip her to determine that she is a woman. “Pity,” one guard says to the other guard.

Telephone is about a telephone call that takes place in a woman’s prison in which the astoundingly beautiful Beyoncé plays a featured role. I do not know whether Lady Gaga is beautiful or whether her songs are great music because she is basically a magician and I love her with a love that is more than a love.

At the end of September Lady Gaga engaged in one of the most bizarre forms of lobbying I have ever experienced. Groups such as the Service Members Legal Defence Network asked Lady Gaga to ask senators primarily REPUBLICANS to repeal the “Don’t ask; don’t tell policy” established during the Clinton Administration in which gays can serve in the military as long as they do not reveal their homosexual proclivities.

News 24 Entertainment Celebrity News reported: “In a black-and-white video posted on her website, the singer is dressed in a modest suit and tie, with a US flag as a backdrop, and looks somberly into the camera as she describes how ‘gay soldiers have become targets’ under the 1993 rule that has seen 14.000 Americans discharged from military service, ‘regardless of how honorable or how valuable they may have been to their units.’”

This story of a lobbying effort that began as a Twitter tweet was covered extensively. For another version as well as the tie in to the meat dress (at the Google prompt type in “Lady Gaga’s meat dress”); first, though, key in, “Lady Gaga lobbies Republican senators.”

The reason REPUBLICANS were targeted primarily has to do with the way the U.S. Senate conducts its business, a discussion that is too long for now. There were not enough Democrats willing to vote for gay rights and there were enough moderate Republicans who could have made the difference. Lady Gaga personally lobbied Senator Sue Collins of Maine, who said on the floor that she was in favor of abolishing Don’t ask; don’t tell. If she had voted then and there to follow her own convictions, then her vote would have made the difference. Instead, she chose not to vote for “procedural reasons” which the panel of Washington Week in Review said meant that in this election year, Senator Collins did not want to give the Democrats a win.

The following is Lady Gaga’s lobbying YouTube video. When she’s old enough (minimum age is 30), can you picture Lady Gaga in the U.S. senate? I can.

Lady Gaga says in the video that she is against all kinds of discrimination. I would like to enlist Lady Gaga’s help in helping solve ongoing problems here in State College regarding our disabled and elderly residents.

Lady Gaga is especially equipped to be helpful in this regard given her sensational video Paparazzi. Her lover throws her off a balcony and she emerges in a wheel chair, holding on to forearmed crutches (such as the ones I have in my closet): While she uses the crutches to get up, she is wearing a silver bodice, tight and revealing, singing:

“I’m your biggest fan/ I’ll follow you until you love me/ Papa-Paparazzi/ Baby there’s no other superstar/ You know that I’ll be/ Your Papa-Paparazzi./”

As she sings she wears a neck brace studded with jewels.

[Fashion note: Suggestion to Lady Gaga. You might want to consider wearing a better class of brace when doing future versions. The forearm crutch comes in a number of variations. The top of the line is the Lofstrand forearm crutch (also known as the Canadian crutch) in wood. I saw a Mexican soap opera star who wore forearm crutches in oak which was polished to gleam and made him look very sexy. I have spent more time than I care to admit looking for a Lofstrand crutch in wood. Wooden versions of the crutch were commonly available 10 years ago, but comfort (aluminum and other materials are lighter) has given way to beauty. If, oh Lady, you decided to go with gleaming oak, I will find you a sexy crutch. As for a wheelchair, what you need is a scooter. Suggested manufacturers include Amigo, made in the USA. and Pride, designed in Scranton, PA. The movement where your sycophants carry you effortlessly up a stair, she be redone to make it clear that you and the chair are heavy.]

What I want you, oh dear Lady Gaga, as a disability and elderly rights advocate here in State College, Centre County, Pennsylvania to do is:

  1. Sing for us at noon at the bingo parlor at Addison Court, 120 East Beaver Avenue, State College. Addison Court is an independent residence for the elderly and disabled. There are 90 of us. Several of us could use cheering up. We do not get to hear a lot of live music. Dazzle us.
  2. Advocate for us. After Florida, Pennsylvania has more elderly residents than any other state in the union. Centre County is attracting large numbers of elderly residents who retire here. Yet the music venues in Downtown State College are closed to us because Downtown businessmen do not think it is worth their while to provide access so people using canes, wheelchairs, walkers, scooters, and power chairs can listen to live music.
  3. Meanwhile, you could do a lot to increase opportunities for elderly and disabled residents of my town.
  4. Come on by. Use your wealth to buy a front-wheel drive
  • or an Amigo real wheel drive
  • or a Pride Power Chair

See Amigo and Pride webpages for more details:

http://www.myamigo.com/

http://www.pridemobility.com/

Here in State College you can purchase these and similar products at T and B Medical

http://www.tandbmedical.com/

  • or Dick’s Homecare

http://www.dickshomecare.com/content/state-college-pa

Then drive around town and tell Marilyn Tavenner, (as of December 2011, not yet confirmed), Acting Administrator of the Center for Medicare and Medicaid Services what it feels like to use mobility equipment to get around and then to get stuck.

“I’m your biggest fan/ I’ll follow you until you love me/”

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Note: Here at Addison Court, we still have a candle lit to guide Lady Gaga to our bingo parlor.