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Commentary
from Dave Durenberger
2009
June 17
OBAMA MOVES TO D-DAY ON HEALTH POLICY REFORM
Having spent time in Normandy commemorating the 65th anniversary of D-Day, President Obama returned to launch what appears to be a White House offensive to bring health policy reform legislation out of two committees in the Senate and three in the House.
June 4
DAVID BROOKS ON INSTITUTIONAL CULTURE
Like many of you, I like the way David Brooks (NYT-Lehrer News Hour Friday) thinks about the politics of social change. We read his June 2nd column in the
New York Times
on why we, as the new owners of General Motors, shouldn't expect too much. It's the problem of institutional culture and its resistance to change.
May 21
NOTRE DAME AND THE POLITICS OF
ABORTION
I was raised in and educated by a Catholic university and teach
in a Catholic university's graduate school. I served in the U. S.
Senate in the 1970s, 1980s and 1990s and witnessed the growing
influence of the U.S. Supreme Court decision in Roe v. Wade on the
politics of my church and my party.
April 30
SPECTER SURPRISES
Five-term Pennsylvania Senator Arlen Specter announced this week he intends to enter the Pennsylvania Democratic primary in 2010, thus making him the 59th Democrat in the U.S. Senate. He cited John F. Kennedy to the effect that "sometimes Party asks too much" and that his independence as a Pennsylvania Senator was more important than the demands being made of him by Republicans and the Republican base in this country.
April 7
THE LIGHT AT THE END OF THE TUNNEL
We are seven months into the worst recession since 1932. We are 10 weeks into Barack Obama's presidency. And already some pundits are using an up-turn in a down market and a 60% approval rating as the end is in sight. Others believe unemployment that matches a point 24 months into Ronald Reagan's
presidency, record budget deficits and the firing of a GM
president as signs of another train bigger than the one we're
on.
March
26
MARCH MADNESS
Usually means the start of the NCAA Basketball Tournament and two weeks of more interesting sports TV than the World Series or the Super Bowl. This year March Madness began in Washington D.C. Finally the public had a chance to blow off steam at bonus bankers and caught a $1 a year executive in the cross-hairs.
March 13
OBAMA AND EDUCATION
When the president said the $410 billion congressional spending
bill this week was “last year’s business,” he was right. He could
say the same about his decisions to fight the economic “cliff” we
dropped off in September 2008 with bailouts and stimuli.
February 26
ASH WEDNESDAY 2009
In the tradition of many religions there can be found a time for
self-reflection, of prayer, a search for meaning and of
spiritual and relational growth. Usually followed by a
celebration of new life. In the Christian tradition there are 40
days of Lent, launched on Ash Wednesday and concluding on Easter
Sunday. Ashes on my forehead signify a commitment to changing my
heart. Psalm 51: “A clean heart create for me O Lord.” Letting
go of some old life and adapting a new and better one. To pray,
to do alms giving, and to fast by limiting my food consumption.
To learn what it means to be a son of God and a brother to
others.
February 5
NEW ERA OF
RESPONSIBILITY
It hasn't taken long for President Obama to discover just
how difficult it will be to change the way Washington does
business. Republicans in the House of Representatives chose not
to support the majority's economic stimulus legislation for
quick passage. Several of the President's choices for key
Cabinet posts ran into trouble of their own making, and the
president appeared ambivalent about sticking to his new ethical
standards or his Cabinet choices. So far he seems to be losing
on both counts.
January 23
A
NEW ERA OF RESPONSIBILITY
The emotions of the inaugural of President Obama and
Vice President Biden are perhaps so obvious as to need no
elaboration from one who was honored to have been invited to
participate. The fact, however, that the 44th President of the
United States has pledged to change the role of government and
thus our own responsibilities is enormous. The responsibility of
the president to keep his word while asking those who say "yes
we can" to do the same is what we all count on.
January 8
CHANGE WE CAN BELIEVE IN
Since that's the promise of 2009, it seems appropriate to wish
you all a "Happy" New Year. The 10 weeks since the American
people spoke and the Chicago Grant Park acceptance by
President-elect Obama have tried the patience of some who are
eager to experience the promised change. The national and world
news headlines are no more hopeful than they were the previous
10 months. The land of Lincoln and Obama is producing a most
bizarre set of "nothing really changes" headline.
2008
December 19
The
snow fell in St. Paul so lightly that I could see the design of
the flakes. It was December 4 and we were departing for Phoenix.
I was also departing the instant feedback from my last
Commentary. “Are you off your anti-depressants this week” from
my brother. Dee Christiansen wrote that my poor grammar
endangered my credibility. The Hill editor emeritus, Al
Eisele, who played baseball for my dad: “I didn’t know your
father was a bootlegger. “Susan, my wife: “I haven’t seen
it- must have been trapped by the junk mail screen at the UMN.”
December 4
ST. NICHOLAS DAY
On December 6 a lot of us have long celebrated the feast of a
third century bishop/saint to whom all kinds of cures and
"mighty deeds" have been attributed. Nicholas was born in what
is now Demre, Turkey the only child of wealthy eastern orthodox
parents who died early in his life. His life as monk and bishop
was of such legend that, after his death around Dec.6, 345, many
came to his tomb and were healed by liquid secreted from his
bones. Emperor Justinian built a church in his honor in
Constantinople.
November 20
FORMER SENATE MAJORITY/MINORITY LEADER TOM
DASCHLE
It comes as no surprise that South Dakotan Tom Daschle
will be in the Obama Cabinet as Secretary of HHS. Tom’s
former staffers have been all over the Obama campaign, the Obama
transition team, and the new administration. Many of us who
served with Tom respect his judgment and his keen political
sense – both of which are needed to run HHS. Especially if the
new President elects to lead major health policy reform. Past
efforts at policy change have been run from the White House.
Even before Hillary. Because they are so politically charged.
Tom can handle that as well as select those who will administer
programs under his jurisdiction.
November 6
ALL THINGS ARE POSSIBLE
There is little to add to what each Presidential candidate said
late last evening about the campaign, the future, and the people
who make up the United States of America. There is something to
be said for the positive, uplifting, and inspiring tone of a
positive message. Despite the billions collected and spent on
negative media messages and the thousands of "pundits" who
infested this election, we won. All of us.
October 23
ST.
PAUL
Is a pretty small town, even by Minnesota standards. But it has
been a sign of the times in national politics this year. I
couldn't believe it when my hometown newspaper, the Pioneer
Press, chose not to endorse a candidate for President.
Saying that it didn't have the insight to choose between two very
good candidates and would leave the choice to its voter/readers.
October 7, 2008
WHOM DO WE TRUST ?
Watching the rather bizarre Monday night football game
between the Minnesota Vikings and the New Orleans Saints, made
me long for the good old days of Coach Bud Grant and Quarterback
Fran Tarkenton. They didn't always win, and they were
occasionally unpredictable, but you always knew whom you could trust
to be in charge.
September 17, 2008
TOO BIG - (bound) TO FAIL
It began with Sunday's meetings of the best paid corporate
executives in the world in the financial capital of the country.
Paparazzi captured "shirts - no ties" guys exiting limos into a
world they created, but none seem to understand. On Monday the stock
market traded a record 8 billion shares down 504.8%.
August 28, 2008
THE PRESIDENTIAL CAMPAIGN BEGINS
The 2008 campaign is about as good as it
gets in America. Nothing is predictable, but pundits and bloggers
galore insist on magnifying minutiae. The party conventions are not
about selecting the party's candidate, but defining him. Similar
themes ring out in Denver and St. Paul. Change is on the way or
there is a better way.
August 22, 2008
MCCAIN AND PAWLENTY
Most Minnesotans expect John McCain
will announce Tim Pawlenty,
their Governor, as his choice for vice president on Friday, August
29. Media outlets are searching for comment as though it's a
reality, so it must be.
August 19, 2008
READY TO RETIRE?
Today I begin the 75th year of my life. Also the second month of
working part-time as Senior Health Policy Fellow at the University
of St. Thomas. I am fortunate to be where I am in life. Family,
friends, and faith are growing better each day...
August 12, 2008
CAN YOU TOP THIS?
After beating Norm Coleman
and Skip Humphrey to win
the MN governorship in 1998, Jesse
Ventura decided we didn't deserve four more of his years.
The Republican mayor of St. Paul, Norm Coleman went right back into
the Governor's race and the Republican leader of the Minnesota House
Tim Pawlenty decided to
run for the Senate against Paul
Wellstone...
July 29, 2008
WHAT A CAMPAIGN
Summer in a presidential election year usually does not bring out
the public or the best in the candidates. This summer is a huge
exception. It's about change regardless...
J uly
7, 2008
AN EXCEPTIONAL
ELECTION CAMPAIGN
I recall that the 1968 presidential campaign lasted a couple of
exciting (to a 33-year old Governor's executive secretary) years. A
Democratic war (Viet Nam) was tearing the Democrats and the country
apart...
June 18, 2008
IT DOESN'T GET ANY BETTER THAN THIS
Tim Russert's professional colleagues tell us how
contagious Tim's journalistic enthusiasm and professionalism has
been and how much it will be missed. The suddenness of his departure
- in the middle of what he considered a "once-in-a-lifetime"
election campaign - makes it more difficult to bear...
June 3, 2008
IT ALL BEGINS IN ST. PAUL - TONIGHT
I love living in St. Paul just a ten minute walk from the Excel
Energy Center "downtown."...We'll find out tonight when the
Democratic candidate, Senator Barack Obama of Illinois, comes to St.
Paul's Excel ostensibly to launch his general election campaign
against his Senate colleague from Arizona. All kinds of political
campaign history is being made this year and you get the feeling we
haven't seen the half of it. Tonight is another of those likely
events we won't forget...
May 22, 2008
TED KENNEDY
When I saw the first e-mail news of Ted's diagnosis, I thought of
the irony of the diagnosis and the man who spent his professional
lifetime making medical miracles possible for everyone. There is no
health policy that he hasn't shaped...
May 9, 2008
"LET'S KEEP MAKING HISTORY TOGETHER" is how
Hillary Clinton closed her
Wednesday morning thank-yous to her supporters. Indeed she is. An
important part of the history of the American presidency and
politics...
April 23, 2008
IT'S JOHN MCCAIN'S ELECTION TO LOSE
It seems quite clear to Washington DC types that
Hillary and
Bill Clinton are in this
race until the Democratic Convention in Denver in August. They have
nothing to lose - or so they think - in all out war...
April 3, 2008
WE ARE N0. 50
Usually Minnesotans don't brag about being 50th among the states.
But when it's the number of us without health insurance we're
pleased to be there...
March 14, 2008
THIS IS NOT A BILL
Breathes there an American who knows what price is paid for her
medical experience and by whom? For how many years have insured
Americans lived with "This is Not a Bill" health insurance payment
system...
February 28, 2008
HHS SECRETARY MIKE LEAVITT,
in presenting the President's Medicare "trigger" recommendations to
Congress, talked of "two competing visions of what America's healthcare
system should look like." This will be the theme for the presidential
campaign as well...
February 14, 2008
OBAMA AND MCCAIN
In Madison, WI Tuesday night, Barack Obama
spoke as though he will be the Democratic candidate and McCain the
Republican. Despite all the pundit talk about Clinton super-delegates,
he will be. Momentum is real...
January 31, 2008
STATE OF THE UNION
Attending the traditional assessment of the nation by its head of state
and government is always more fun than watching it on television. As you
could probably tell from the behavior of the many members of Congress
who lined the aisle of the House chamber to schmooze with the President
and the presidential wannabes...
January 17, 2008
HEALTH POLICY PROGRESS - 2007
Not a lot of legislation passed Congress last year that didn't get
vetoed. But lots of change is occurring in the system. We all know of
the efforts by state and local governments to expand access and coverage
and to work hard at cost containment through greater access to provider
performance information...
January 7, 2008
HAPPY NEW YEAR
Looking over the news from Lake Wobegone in 2007 was not a pleasant
task. Our economy is looking worse than our neighbors or the rest of
the country. Our professional and Gopher sports teams are a real
optimism stretch for fans. Like "Timberwolves close in on
Philadelphia 76ers 9-73 worst NBA record." Our Republican Governor
is in far-off New Hampshire campaigning for John McCain and our
Republican Senator is taking another optimistic trip to Iraq. And
all the real political news is in that backwater neighbor - Iowa....
2007
December 5, 2007
INTELLIGENCE ESTIMATE
No national security secret has been as well kept as the discovery
that the Iranians ended their military-run nuclear weapons program
after the U.S. invasion of Iraq in 2003. Members of Congressional
intelligence oversight committees will be the first to learn how we
learned it and when our confidence in its accuracy was high enough
to go public...
November 20, 2007
HAPPY THANKSGIVING
Thank you for taking time to read this commentary. I love working in
public policy. I believe that only in the USA could anyone who's
been there continue to find excitement in the way in which we
Americans judge and encourage our policy makers...
October 31, 2007
HAPPY HALLOWEEN
In Minnesota we started
tricks and treating early in the week. Governor Tim Pawlenty
returned from a week's trade mission in India to announce that
Indian corporate giant Essar Global is going to acquire and invest
in a $1.6 billion makeover of the Minnesota Steel Industries plant
in Nashwauk on our declining iron range in northeast MN. Until he
received a call from his Republican friends in Washington informing
him that Essar Global of Mumbai may be doing energy business with
Iran...
October 3, 2007
CHILDREN'S HEALTH
The national debate over the SCHIP
program demonstrates how difficult will be the quest for Universal
Coverage. There is the concern about excessive spending. Republicans
thought nothing of spending $700 plus billion on a new prescription
drug program for elderly and disabled, but can't stomach $35 billion
for children's health insurance coverage...
September 11, 2007
SEPTEMBER 11, 2001
There are more "frequent flyer elites" riding in Northwest Airlines'
coach section between MSP and Washington, D.C. than any other
destination. So I felt lucky that at 7:15 am on a beautiful
September morning I was riding "up in first" while the Mayor of St.
Paul rode coach. We ended that day riding with two Twin Cities'
businessmen in a brand new van from Detroit to our homes...
August 16, 2007
THE GREAT LAKES
Africa's Great Lakes - Tanganyika (my favorite), Victoria, Albert,
and Edward - are big, deep and beautiful just like our Great Lakes
starting at Lake Superior. The countries of Tanzania, Uganda,
Rwanda, Burundi and the Democratic Republic of the Congo surround
the Great Lakes...
July 24, 2007
JACK AND THE BEANSTALK
People of California "have seen me on the screen to be the big
action hero, so they know I can be the big action hero in
Sacramento". This statement is from Governor Arnold Schwarzenegger
regarding his ability to persuade the California Legislature to
raise enough taxes to finance universal health insurance coverage ...
June 29, 2007
REWARDED FOR GOOD HEALTH
Back in the winter of 2003-04, the Minnesota Citizens Forum on
Healthcare Costs reported Minnesotans believe the best way to reduce
health care costs is to stay healthy. They suggested that small
incentives or rewards for healthy behavior could make a big
difference...
June 14, 2007
ALL HEALTH CARE IS LOCAL
Three national analyses of
health care quality and performance this week reminded us of what we
all know. That for all the money we spend on health and medical care
services, we can’t seem to get it right in this country. Anywhere.
The good news is some Americans...
M ay
31, 2007
SHE’S B-A-A-A-A-CK Hillary Clinton has re-entered the
national debate over health care reform in a big way. As one who
admired her ability, if not her plan, in 1993-94, I say WELCOME,
HILLARY. The Senator identified the challenge of lowering healthcare
costs as the first goal of health policy and health system reform...
May 16, 2007
PAUL ELLWOOD
He's a bright-as-ever, happy, policy
guru at 83. He took his first airline flight in nearly two years to come
to Minnesota for a few days, and a group of us enjoyed a couple hours
talking past, present and future. The “road to value” as healthcare cost containment, which Paul and
colleagues at Interstudy designed 3-4 decades ago, still runs...
May 2, 2007
MORE CARE DOES NOT EQUAL BETTER CARE
Having had a hand in Maggie Mahar’s recent story, I hope you will take time to read “The State of the Nation’s Health” in the spring issue of
Dartmouth Medicine. It is a well-written tale of Jack Wennberg’s
unending quest for aligning the doctor-patient relationship through
informed...
April 19,
2007
AARP’S
HEALTH MARKET EXPANSION
… AARP,
United Health Group, and Aetna will soon launch a bold experiment to
improve healthcare quality and outcomes by changing the healthcare
marketplace. Those of us who have long hoped Medicare payment policy
would change the U.S. health care system...
April 5, 2007
SO
WHAT’S WRONG WITH A MASSIVE MERGER?... Like
you, I read a headline this week about the merger of Independence
Blue Cross of Philadelphia and Highmark, Inc. of Pittsburgh. The AP
story claimed this “massive merger” would result in the nation’s
third largest health insurance plan after UnitedHealth Group and...
March 22, 2007
MEDICARE “UNFAIR” ADVANTAGE…House Ways and Means Health Committee
Chair, Pete Stark, accused AHIP of “lying, using false information”
last week when the organization stated the impact that reductions in
Medicare Advantage (MA) reimbursements would have on minorities. ..
March 6, 2007
AMERICANS SUPPORT HEALTH INSURANCE FOR ALL…New York Times/CBS News
Poll taken Feb. 23-27 says the biggest domestic policy issue is
health care costs and 64% of us want the federal government to
guarantee health insurance for every American...
February 14, 2007
“I’d
like to die broke.”
With that, South Dakota multi-billionaire T. Denny Sanford announced by
far the largest financial gift ever made to a U.S. medical institution
and recipient Sioux Valley Hospitals changed its name to honor the gift
and the giver. Sanford’s $400 million...
February 1, 2007
So many of the reports about
our health care system tell us the number of uninsured and underinsured
Americans continues to grow, and at a steady pace. At the same
time, the cost of extending life and improving functionality by the
application of medical technology innovation has been growing faster
than any other costs...
In case you haven’t noticed, health
policy change is front and center on the national political agenda.
That’s good news. The better news is that it is likely here to
stay. The best news is that we are seeing a surprisingly large
number of new players picking up leadership roles.
2006
December 28, 2006
It was a very good year for most of us.
For those of us who thrive on being in the public arena the highlights
were the mid-term elections. The resounding message sent to the two
political parties and their message-bearers was easy to interpret. So
was the meteoric rise of the junior Senator from Illinois who is riding
that message for all it’s worth...
December 6, 2006
Who
can argue with the need to assure everyone of access to high quality
health and medical care? Especially in a nation as rich as ours which
is already willing to spend twice as much per citizen as any other
country in the world...
November 2, 2006
By November 8th
it will be clear that American voters had much more in mind than a
failed Iraq War policy when they went to vote in 2006. Popular
frustration with the failure of Congress to deal with any of the serious
problems which Americans face - and the time consumed dealing with the
much less relevant - is reaching 1977 “madder than hell” proportions...
October 19, 2006
This week starts with the news that Dr. William McGuire has been asked
to leave the $79 billion company he “owned” by the board of
directors he also owned until last March. It was then that the Wall
Street Journal uncovered how they have all been licking the frosting
off the financial giant United Health Group of Minnetonka...
October
3, 2006
We know that a
one-size-fits-all payment policy is not the most effective way to
drive behavior change. It makes no difference whether the payer is
CMS or a national health insurance plan...
September 21, 2006
The best
front page news recently is the September 18th New
York Times story on “Democrat, Republican and a Bond of
Addiction” featuring two addicts: Representatives Jim Ramstad
from Minnesota’s third congressional district, and Patrick
Kennedy of Rhode Island and son of Senator Ted Kennedy...
September 6, 2006
On the way to work yesterday morning I
stopped for our neighborhood school bus, and 8 parents, 3 siblings,
2 dogs, 4 cups of coffee, and 2 caffeine-free cokes – all on one
corner...
August 14, 2006
HHS Secretary
Michael Leavitt was in the Twin Cities last week learning from the
Minnesota Community Measurement Project and health care quality leaders
about our vision of the future and how to get there. Earlier he visited
in Wisconsin with the physician leaders of the
Wisconsin Collaborative for Healthcare Quality (WCHQ) and their
partners...
July 27, 2006
The Hospital
Quality Alliance (HQA) and the AQA Alliance, originally known as the
Ambulatory Care Quality Alliance, have joined efforts through the
creation of a new steering committee to better coordinate and
expedite a national quality strategy...
July 7, 2006
My first exposure to
public report cards on doctor performance came in 1990 at a Capitol Hill press
conference where I introduced Sheila Leatherman, who explained United Health
Group’s plan to issue the country’s first ever “report cards” on doctors...
June 6, 2006
The second week in May was “Health Week” –
caps on medical malpractice and association health plans were debated, and
nothing happened...
May 24,
2006
There never was a better
man than Lloyd Bentsen. The announcement of the end of the former Texas Senator's life on Tuesday reminded me of what there is to miss about being in
the Senate. My first “welcome to the committee” letter from a Democrat was from
Finance Committee chair Russell Long of Louisiana who traced the rich history of
the Minnesota-Louisiana relationship...
May 5, 2006
A cousin of mine in
Southern California by the name of Carl Durenberger discovered the fact that
Raytheon CEO Bill Swanson had adapted as his “unwritten rules of management” the
published rules of engineering whiz W. J. King (1944), national defense
re-engineering whiz Don Rumsfeld (2001) and humorist Dave Barry...
April 19, 2006
Faced with losing $385 million in Medicaid funding because of the
state’s number of uninsured residents, the House and Senate, both
controlled by the Democrats, passed, for the first time in a state in
several decades, the first major universal healthcare legislation. ..
March 30, 2006
The biggest health issue today is not Medicare
prescription drugs but the potential of a 12-18 month pandemic in the
United States...
February 9, 2006
Bono, Bush's Budget, Congressional
Earmarks, Deficits, Rumor Mill, Lobbying Reform, Redefining Health Care
January 25, 2006
Secretary Leavitt and Medicare Part D,
21st Century Mission-Driven Healthcare, Health Insurance Leadership,
MedPAC, Delay-Abramoff
January 9, 2006
2006 New Year
2005
December 8, 2005
Decoding Part D: Medicare’s Drug Benefit,
TPT Television
August 4, 2005
President Bush and Congress,
Congress' Healthcare Agenda,
Healthcare Monitoring and Oversight,
Medical Markets
September 16, 2005
Supreme Court Nominations,
Brent Asplin, HealthPartners
September 9, 2005
Alive Again in Washington, D.C.,
Hurricane Katrina
July 26, 2005
Roy Ramthun at NIHP,
MedPAC Retreat,
New York's Medicaid Fraud,
Health Tech Alley
July 7, 2005
Medicaid,
Battleground State and Cities,
For-profit Medicare,
Health Insurance Regulation,
Health Information Technology
June 28, 2005
Consumer-Focused Healthcare Summit
June 10, 2005
Non-profit Hospitals, Healthcare Information Technology
May 27, 2005
Health Policy Seminar, Quality Improvement Efforts in MN, For-profit Healthcare
May 13, 2005
In Search of Quality, Consumer-driven Healthcare
April 28, 2005
MedPAC,
Ann Coulter's Visit to UST, Edutainment, Health Policy Instincts
April 7, 2005
Medicaid, Medicare Premiums, Physician Leadership, Consumer-driven Healthcare
March 24, 2005
Red vs. Blue States, GOP-Style Reform, Tom Delay
March 10, 2005
Pay-for-performance, Medicare regionalization, Drug prices and importation, Healthcare costs
February 27, 2005
Health
spending projections, Budget approval process, Medical Technology
Leadership Forum, Long-term care and
Medicaid, Senator Arlen Spector
February 10, 2005
Senator
Mark Dayton, Medicare, President Bush's budget
January 27, 2005
21st
Century Health System, Governor Pawlenty's budget, Medicare, Quality,
Safety and Efficiency
January 13, 2005
Health
policy predictions for 2005, Medical
liability reform
2004
December 21, 2004
MedPAC, NCQA,
Medicaid
December 9, 2004
Health
insurance, Medicare
November 11, 2004
The
2004 election , Healthcare
policy in the second term
November 4, 2004
2004 Presidential
election, Medicare Modernization
Implementation
October 8, 2004
David
Brailer, Medical
Technology Leadership Forum
September 24, 2004
NCQA
report on quality
September 21, 2004
Presidential
politics, MedPAC, National
Quality Forum, Specialty
Hospital Study
September 9, 2004
Medicare Part B, MedPAC, Specialty
Hospital
Study
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