Editor's Note: Unsolicited Advice

Some dos and don’ts for Sebelius, or whoever finally takes the helm of HHS.

“Advice is seldom welcome; and those who want it the most, always like it the least.” That’s one of many truisms from British politician Lord Chesterfield Stanhope. He should have known; he doled out volumes of advice in his life, including the counsel that England should neither pass nor implement the Stamp Act, which helped spark the American Revolution. I guess Parliament didn’t like his advice...

I was reminded of Stanhope’s axiom about advice while following the saga that has been the Obama Administration’s continuing efforts to put a Secretary of Health and Human Service in place and ensure that person stays put. Let me explain:

As we all know, President Obama originally nominated Former Senate Majority Leader Tom Daschle to be Secretary of HHS to lead a massive reform of our national healthcare system. And, as well all know, Daschle withdrew his nomination after it came to light that he had owed more than $128,000 in back taxes. Daschle had paid them back with interest, but he fell on his sword in order to help restore public faith in government. (And then Timothy Geithner got a pass for his non-payment of back taxes and ironically is now Secretary of the Treasury, so I guess image control only goes so far.)

To replace Daschle, Obama has nominated Governor of Kansas Kathleen Sebelius to the office (see News, Trends & Analysis, page 8). While Sebelius is a former Kansas state insurance commissioner who gained a reputation as a healthcare policy wonk, she is a relative unknown to the HME industry, and there are some worries that she might have CMS revisit competitive bidding.

This leads me back to Stanhope’s quote about advice. I, a lowly editor, am going to have the audacity to offer the HHS Secretary-nominee some advice concerning healthcare reform and HME:

HME and homecare are two of your greatest assets. Treating patients in the home rings in at a significantly cheaper price tag than prolonged hospital stays, and improves outcomes. That’s a win for the taxpayer and for healthcare reform.

Competitive bidding doesn’t work. Trust us, we know. In a foolish bid to try and whittle away a fraction of what amounts to less than 2 percent of its budget, CMS jeopardized patient access to needed healthcare products and services, as well as an industry that could save taxpayers money. Moreover, competitive bidding would shutter many small and regional businesses, contributing to the nation’s growing unemployment figures.

Don’t talk healthcare reform to death. Broad reform requires fast action not lengthy discussion. We saw what happened when the Clinton administration allowed its healthcare proposals to be debated by congress and cable news talking heads for approximately 18 months — nothing.

Ensure all reform players move in lock-step. Once you tell us the plan, start moving on it. Better yet, make sure the White House Office of Health Reform and HHS work in concert to implement it. Not ensuring that uniformity of agenda is another Clinton mistake we don’t need to repeat.

Pay your taxes like the rest of us. Is this really that much to ask?

Let’s hope that Sebelius realizes that HME represents a hidden gold mine when it comes to healthcare reform. In the meantime, providers are looking for their own gold mines. Two opportunities for new cost savings and new revenues might be through optimizing their inventory control, and pursuing cash sales, respectively. However, implementing inventory control can be complex, and the value proposition for some cash sales categories might be changing due to the economy. Turn to this month’s two features, “A Well Oiled Machine” (page 22) and  “Cash Sales Checkup” (page 15), to learn more.

For now, Sebelius is an unknown, and that’s frustrating. Hopefully, she will get a good dose of sound advice when it comes to HME — and follow it.






This article originally appeared in the April 2009 issue of HME Business.

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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