Current leaders.

Found these old pictures from 2007 lurking on th blog, so I'm publishing them. 10 years ago.  Wasn't that a time.



Picture 7: Like father, like son. (3 votes)

Picture 14: josh in tux (3 votes)

Picture 16: Ben at Mudd (2 votes)

Picture 4: Julie and Josh at graduation (2 vote)

Picture 9: On the train to the German border. (2 vote)

Picture 22: Julie and Diane in the kitchen (2 vote)

Picture 13: Frisches sturm (1 vote)

Picture 18: At the Phipps Conservatory (1 vote)

Pictre 23: Screwdriver Past and Present (1 vote)

Picture 6: The 35th reunion of the Jackson Laboratory Class of 1977 (1 vote)

Welcome to Rome!

The flight to Munich seemed quick.  I reviewed abstracts (for the Alpert Award) and watch two action-adventure films that Julie would never want to see in theatre.  Slept a little, coughed less.  My flu, which had me bedridden on Thursday, seems to have passed.  A quick word on the food on Lufthansa:  edible, but just barely.  Unlimited wine made it palatable.

The wait in the Munich terminal was only 3 hours- not much to say about Munich's airport.  We boarded and flew off in the the clouds, which cleared only briefly to afford a glimpse of a passing alp.
 We landed after a quick 1 hour flight, quickly based through customs and we were in Rome! Well, at least, at the airport.  Walking through the airport, many tried to get us into a cab, but resolutely persisted until we found the Leonardo Express, a very nice light rail train that brought us through the suburbs into the center of the city, the Termini train station in the heart of Rome.

First impressions:  Busy modern city- New York, London, Paris, Vienna- like those, Rome is an important place and it knows that it is an important place.  What's different?  Well, we crossed under a 2000 yr old aqueduct on the way in- Paris is old, but not THAT old.  The streets and sidewalks were cobblestoned, but we decided to wheel our suitcases to our flat through the Via Venuto and the Piazza de Spagna- people watching, trying to make out the signs and to keep from getting lost.  We did OK, finding our place and climbing the 5 flights of stairs to our 4th floor flat.

Peter and Grayson did well by us- beautiful place, three bedrooms, big living room and plenty of wi-fi.  Julie and I took to the small room with the loft- I am still trying to keep Julie from catching my illness.  A cup of tea, a shower and we decided to take a quick walk around the neighborhood to see what we could see.

Oh, my.  The Spanish Steps are two blocks away.  The Caffe Grecco offered pastries and caffeine along the way.  Fashion and high end clothing was everywhere.  Signage suggested that Keats and Shelley, Goethe and Byron, all had stayed in the neighborhood during their time in Rome.  We walked to the top of the steps, and debated whether or not we could see the Vatican.  Pretty nice digs.

I'll stop here.  May try to upload some pictures later, and tell you of our drink at the Caffe.  But we are heading off Gran Sasso now.
-----
Resting after our drive to the mountains.  So much to talk about...but let's begin with the rest of yesterday.  We combed the Spanish Steps, and admired the view from the front of the Church.
Grayson and Peter headed back to the flat, and Julie and I continued to wander down some steps, looking for a place to have a first drink.  The rooftop bar at the top of the Steps was clinical sing at 6, so that wouldn't do.  Walking down the north ramp got us,back to the Piazza, which was bustling with activity.  A bubble blower, some mendicants, sales folk with selfie sticks, police and an endless wave of tourists strolling at sunset.  We found our way back to the Caffe, took our seats and ordered wine- red for me, Prosecco for the lovely Julie.  Imagine our surprise when the waiter brought us a two tiered tray of food - bite sized sandwiches of salmon, cream cheese and crackers, quiche, pistachios, olives.  It was a lovely accompaniament to the wine, in an atmosphere full of old prints of the Collesium and the Pantheon.  We finished at 6:30, and went back to the apartment, where Peter and Grayson had been working on a simple repast: pasta, bread, brocholini.  Oh, and we had picked up some pastries from Greco for dessert.  Tasted great, and, by the end of the day, we were,ready to go to sleep.  Hildy and Bev arrived in the midst of it all, but I closed my eyes at 8 and woke at 6 the next morning, ready to face a new day in a great city.

Leaving on a Jet Plane

Well, it has been a while.  I blogged about our trip to Prague and Vienna, back in 2008.  And our choir trip to Budapest and Hungary.  I turned this blog private when I "went to Washington" in 2009- worried that it might get tangled up in the politics of the time.   Nepal and India somehow defied blogging- I recall journalling some about those trips in 2012 and 2014.  Facebook seems to have taken over as the preferred means constant contact by that time.  This time, however, I think I'll try blogging again.  I could use the time to reflect on what we are seeing in Rome and Gran Sasso and the Amalfi Coast.  That is where we are heading, Julie and I, along with her sibs and their spouses.  Two weeks, minimal obligations, should be a great time.

Wheels up in 6 hours.  Can't wait.

An Offer from the Office of the ASPE

Just got off the phone with Don Moulds, who says that they would love to have me join their team at the Office of the ASPE, which I mentioned earlier. I am really jazzed: these are the folks who make policy recommendations to the Secretary, which she either accepts or discusses more. They have a lot on their plate right now, and will have a lot more. They think that my breadth of experience is just what they need.

Wow.

This could be an amazing experience. I would get to know all of HHS, from the CDC in Atlanta to CMS in Baltimore. I would help to shape the way in which health reform is operationalized, in ways that I could not do on the legislative side. I would get to be involved in cross-departmental initiatives (like a mental health-education thing that they have just started). I would be tested in ways that I can't possibly imagine.

I asked to be able to think on it over Christmas, and to get back to him next week. I'll probably take it, but I want to think a little bit about the Senate, and to talk with Marie, if I can.

It is nice to be wanted.

Executive Branch is Looking Up: The Office of the ASPE

On Wednesday and this morning, I had good meetings with some of the people who are workig really hard to restore the Office of the Assistant Secretary for Planning and Evaluation to it's former glory. APSE is a funny thing- it is supposed to be the Secretary's "Think Tank", the folks who generate ideas and help the Secretary "pull it together". One can tell a lot about an Administration's approach to the Health and Human Services issues by looking at how they staff the ASPE. I've met with 4 of the senior leadership, and it was great. I've got that "I would take a bullet for these people" look in my eye, coming out out of those meetings. I'll try to summarize:

1) Pat Conway: "Medical Director" with a loose portfolio to work on a variety of areas of interest. 3 years out of a RWJ Clinical Scholars program, got a Presidential Fellowship under Mike Leavitt in the Bush Administration, and has been retained in office since the change last year. He is a go getter, interested in CER and EMR and other things, and is involved in lots of discussions. And he was my entre to the rest of these folks.

2) Don Moulds: "Deputy ASPE": Former California Medicaid Policy guy, brought in a year ago to be the Civil Servant paired with the new ASPE to make the system work. Neat guy, curious about lots of things, clicked when we met.

3) Dara Corrigan: Lawyer, former Inspector General for CMS, Directors the Health Policy shop within the ASPE, and someone with whom I would be working. Neat lady, heavily involved in Children's Issues, including cross Department initiatives. Seemed interested in my work with Medical-Legal Partnerships.

4) Richard Franks, Director of Long-Term Services: Genius from Harvard, with a long history in the mental health world. He's spoke with me of working on a newly stood up project involving collaboration with the Department of Education.

Responses from these folks are positive so far.

From Don:

From: "Moulds, Donald (HHS/ASPE)"
Date: Thu, 17 Dec 2009 11:07:02 -0500
Subject: RE: Yesterday's meeting

Dear David,
It was a pleasure meeting you as well. Margaret is (and may have already succeeded in) working to schedule you with Richard, who I think you will enjoy. I look forward to talking again in the next few days.
Best,
Don

From Dara:

From: "Corrigan, Dara (HHS/ASPE)"
Date: Thu, 17 Dec 2009 15:42:36 -0500
Subject: RE: Thanks for meeting yesterday
David:
It was lovely to meet with you. It is inspiring to meet physicians like you who personally take the time to care for kids and fight on the policy side as well. I would welcome the opportunity to talk about medical-legal partnerships.
I look forward to speaking with you soon.
Dara

Very hopeful. I'll see how the next phase goes. Also got a "ping" from the Rockefeller people, which is also hopeful. We will see.

When I was in college, I auditioned for all 4 a cappella groups that were available to Princeton undergraduates whenever there were open auditions during my Freshman and Sophomore years. I had sung with the "Guys and Dolls" at Roger Ludlowe, hadn't I? I could do the same in college. Besides, in college, these groups went on trips and made recordings- all very cool things. The auditions had two parts: first, was a vocal audition. I passed that, and made it to the finals for several of the groups. Then the second audition- you went to the "practice room", usually in the basement of one of the dormitories, spent a few hours with the group, learned a piece and performed it. After each one of those experiences, I felt good about the singing, and felt like I had gotten along with the others reasonably well. But I never got to experience the joy of being awoken at midnight and being "sung" into the group.

That's a lot like what the current process feels like.

Just had breakfast with Diane Meier, a Health and Aging Fellow who just accepted a placement on the HELP committee. A few salient details:

1) She got her interview when a friend, Dan Smith of the American Cancer Society, was named Chief of Staff for the committee. He got her the interview with Jenelle Krishnamoorthy, who apparently is staying on as staff. Might be worth a following up.

2) She had an offer from Rockefeller that she turned down yesterday. Perhaps that will open something for the rest of us.

The CMS Office of Policy

So, I now found another place within CMS that is interested in having me on board: the Office of Policy. This is essentially the Administrator's think tank, and suffers a bit from the current lack of an Administrator. Karen Milgate, with whom we met a long tome ago in a faraway galaxy, is optimistic that there will be an administrator soon, and that, once that happens, they will be moving ahead.

Working here would be much more akin to working as a graduate student; I would be given several projects, on one of which I would be the lead, and I would go forth. Most of what they are working on right now is Medicare related, looking at geographic variations and the relationship between cost variation and service delivery, some work on the issue of dual eligibles, some things related to CER, EHR and other hot topics. They are really interested in the idea of having a clinical person work with them on these projects, and offer insights into that process. They freely admit that they don't have a lot to do with CMSO at present, but the the new director of that Center does have an agenda that she is trying to push actively. And they want me to come to visit.

I asked a bit about how Health Reform was going to work its way through CMS. They said that the Office of Legislation would have little to do with it; that we would more likely see activity in Baltimore, with some input from the Office of Policy providing background research to inform the decisions. All of this, of course, would depend on the Administrator.

Tomorrow, I will be meeting the acting ASPE. And I continue to wait on the Hill. We will see.