Sunday, April 5, 2009

Governor's Sebelius' Nomination, Delay and the Art of War

Not too long ago, the Disease Management Care Blog read Sun Tzu’s classic, The Art of War. Given the news of the delay in Ms. Sebelius’ nomination as Secretary of HHS, believes the Congressional Republicans have also.

While the DMCB read it years ago, it recalls Sun Tzu had a dim view of obvious frontal attacks. Rather, his was a game of strategy, flexibility, deception, deflection, feinting, leverage and delaying until the time was right. General Tzu’s opponents knew an apparent lack of activity by his army did not mean all was well. Quite the opposite: more likely, disaster was on the way.

Ms. Sebelius’ Congressional confirmation as the Secretary of Health and Human Services (HHS) has been delayed. Republicans have asked that further action be put off until answers to ‘additional written questions’ can be reviewed. That will push the nomination back two weeks. While two weeks may not seem like a long time, the DMCB is vaguely aware that Congress has a very proscribed legislative calendar and that getting a major health bill to the President by September involves a lot of moving pieces – including a number of deadlines and a visible and supportive HHS Secretary. Quietly depriving HHS of a leader of Ms. Sebelius’ caliber for even a short time would be approved of by General Tzu.

As those days pass and other delays add up, the minority opposition’s disadvantage may lessen even further, thanks to the 1) eventual evaporation of the ‘Blame Bush’ marketing strategy, 2) the likely intrusion of other newsworthy distractions, 3) inevitable decline in the President’s approval ratings, 4) more bad economic news (unemployment is bound to rise further, tax receipts are likely to be lower than anticipated and other shoes are getting ready to fall) and 5) the natural second thoughts that arise once the details of Any Big Plan become apparent.

This isn’t enough to derail the ObamaExpress entirely, but the momentum has been slightly slowed. The DMCB suspects that Dr. Tzu would calculate the likelihood of large scale reform this fall decreased by one notch. Disease management organizations may want to plan accordingly.

While the Federales continue to tie themselves up in knots, check out this report from Hewitt. Employer-sponsored population care programs are continuing their torrid growth. The challenge, as always, is to engage more enrollees, even if it means developing performance guarantees, value-based benefit designs, financial incentives and sophisticated and industrial strength employee communication, outreach and marketing strategies. Growth opportunities in the non-government commercial health insurance sector continue to increase by additional notches.

General Tzu knows the DMOs are already planning accordingly.

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