Viral Implosion – chapter eight

chap 8ripples in the pond


Rika threw down the paper. Another morning ruined as she read:

Former Medicare Chief to Lead Lobbying Arm of Health Insurance Companies

WASHINGTON — Marilyn B. Tavenner, the former Obama administration official in charge of the rollout of, was chosen on Wednesday to be the top lobbyist for the nation’s health insurance industry.

Ms. Tavenner, who stepped down from her federal job in February, will become president and chief executive of America’s Health Insurance Plans, the trade group whose members include Aetna, Anthem, Humana, Kaiser Permanente and many Blue Cross and Blue Shield companies.

As the new voice for insurers, Ms. Tavenner will lead the industry in a time of tumultuous changes and challenges, including delicate negotiations with Congress over the future of the Affordable Care Act.

On Aug. 24, she will succeed Karen M. Ignagni, a former health policy specialist at the A.F.L.-C.I.O., who has led the industry’s lobbying arm for 22 years.

The board of America’s Health Insurance Plans unanimously elected Ms. Tavenner at a meeting here on Wednesday, according to Mark B. Ganz, the board chairman, who is also the chief executive of Cambia Health Solutions, based in Portland, Ore.

“This is a great opportunity,” Ms. Tavenner, 64, said in an interview. “AHIP has a longstanding reputation as focused on consumers and consumer advocacy, and being a leader in the transformation of health care.”

Most recently, Ms. Tavenner was the administrator of the Centers for Medicare and Medicaid Services, the federal agency that insures one in three Americans and has an annual budget of more than $800 billion. As administrator, she was in charge of

She said that, because of federal conflict-of-interest rules, she would not lobby the agency or other parts of the Department of Health and Human Services in the remaining months of the Obama administration. But she said she was free to lobby Congress.

Mr. Ganz said that Ms. Tavenner had “the trust and respect of members of Congress from both sides of the aisle.”

Senator John Barrasso, Republican of Wyoming, described the selection in more negative terms. “While millions of Americans are still being hurt by Obamacare’s soaring costs and fewer choices,” he said, “Ms. Tavenner’s appointment shows how the law has created a cozy and profitable relationship for some.”

Another Republican senator, Bill Cassidy of Louisiana, said he admired Ms. Tavenner’s past work to help low-income older people eligible for Medicare and Medicaid.

Ms. Tavenner led federal efforts to carry out the Affordable Care Act. She was stunned in October 2013 when crashed, creating a political crisis for President Obama and frustrating millions of consumers who tried to buy insurance online.

In the ensuing months, she helped fix the website, after the White House deployed a management expert to supervise the operation, with the assistance of technology experts from Silicon Valley.

“The rollout was far from ideal,” Ms. Tavenner said on Wednesday. “But I spent a month pulling a team together and creating a turnaround. The management challenges seemed insurmountable, but I am proud of what we accomplished.” Millions of people eventually gained insurance, she said.

Her selection as chief lobbyist for the industry highlights how federal health programs have become a priority for insurers, which increasingly depend on revenues from Medicare and Medicaid and the new public insurance marketplaces.

Ms. Tavenner, a nurse, worked for more than two decades at the Hospital Corporation of America, a commercial hospital chain. From 2006 to 2010, she was the secretary of health and human resources in Virginia, managing Medicaid and other programs.

Asked about her priorities, Mr. Tavenner said she wanted to protect Medicare Advantage, the program under which private insurers manage care for more than 30 percent of the 55 million beneficiaries of Medicare.

She also said she wanted to keep down the rising cost of prescription drugs. Some drugs for cancer, cystic fibrosis and other conditions cost more than $100,000 a year.

Ms. Tavenner’s move comes as some of the nation’s largest insurance companies pursue mergers sure to be scrutinized by the Justice Department. Aetna said this month that it would acquire Humana, and Anthem has made offers to acquire Cigna.

In September, Ms. Ignagni will become president of EmblemHealth, the parent of Group Health Incorporated and the HIP Health Plan of New York, which provide coverage and administrative services for more than three million people.[1]

Even without this centralization of power Rika’s patients have stopped taking prescriptions that weren’t covered by Medicare, since Medicaid became virtually impossible to attain. The fact that ‘Obamacare’ was supposed to encourage (extort?) all citizens to get medical insurance should have made the insurance companies happy for the increased income. Instead, they took this opportunity to raise prices to everyone, since there was no alternative. Co-pays had become huge, and she was getting more and more hassles trying to process insurance claims for her services. To avoid the three-page justification of why she was an independent physician, Rika created the Clinical Lab LLC, of which she just so happens to be the only member. This also allowed her access to pharmaceutical supplies, so she could manufacture and dispense medications herself.

Fortunately her musing was interrupted by the phone. She could tell by the ring that it was one of her friends, so she went in to answer Beth’s call. She immediately started spewing out her most recent outrage. Beth punctuated it by news of her own.

“The GAO just got shut down too.”

“I should know what GAO means, but I seem to be having a senior moment here.”

“The Government Accountability Office. They oversee waste and abuse in government contracts.”

“Ah, yes. Well, they haven’t been doing their job anyway, from the looks of things. So … why did you call?”

“Oh. Well, actually I called for a little optimism. Esther just called. She’s suffering from terminal boredom, unlike the rest of the world. And as usual she got me feeling down along with her. I invited her to come visit. Her husband could give her a modest travel budget so we could at least play tourists around central Pennsylvania. I’ve travelled so much I never got a chance to see the local sights. She sounded desperate enough to possibly accept. I picked a bad day to have you cheer me up, huh?”

“Hey, things may be getting tough for the world outside, but we’ve managed to adapt, haven’t we? A lot of our squirrely habits are paying off. Say, do you have any plans for the get-together next week? I found an interesting recipe for, of all things, cucumber sandwiches.”

Beth chuckled. “How quaint. They’ll fit right in. I decided to make a sinful chocolate cake, and Willie’s creating a drunken fruit bowl.”



[1] This article was actually published in the New York Times on July 15, 2015; it was written by Robert Pear.


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