Agency in Charge of Medicare Has Had 29 Leaders in 35 Years

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Monday, March 12, 2012

Agency in Charge of Medicare Has Had 29 Leaders in 35 Years

Marilyn Tavenner

The agency in charge of Medicare—and also of implementing the Affordable Care Act—has suffered from a revolving door at the top, leading to bipartisan criticism. Since its birth in 1977, the Centers for Medicare and Medicaid Services (CMS) has had 29 administrators who served an average of just 14½ months, including several who lasted a few weeks. Acting administrators, who typically have less commitment to an agency’s mission and less clout to carry it out, have run the agency for more than 7 of its 35 years. The most recent acting CMS administrator, Dr. Donald Berwick, resigned in December after 16 months when all 42 Republican Senators signed a pledge that they would vote against his nomination even getting a hearing.

The situation has earned criticism from both parties. Calling it “almost paradoxical,” Bruce Vladeck, who ran CMS under President Bill Clinton, noted that despite the importance of Medicare to so many Americans, “the overwhelming communication the people running the program get is hostility.” Gail Wilensky, CMS administrator for George H.W. Bush, said the turnover at the top sends a negative message to employees, who respond by being “more inward and protective.” Criticizing the Senate for not confirming a permanent administrator since 2006, Thomas A. Scully, CMS administrator under George W. Bush, said it was like going two years without a secretary of defense.

Now, health care reform brings CMS major new responsibilities, including supervising insurance exchanges in 50 states, improving health care efficiency, and implementing changes to Medicare and Medicaid. Nevertheless, the current administrator, Marilyn Tavenner, who was nominated in November 2011, is still waiting for the Senate to schedule her confirmation hearing.

-Matt Bewig

To Learn More:

At Health-Care Reform’s Key Agency, No One Stays in Charge for Long (by Gilbert M. Gaul, Washington Post)

Director of the Centers for Medicare and Medicaid Services: Who Is Marilyn Tavenner? (by Matt Bewig, AllGov)

Comments

Karen Smith 9 years ago

No matter when I call Medicare and/or Social Security and no matter how many times I call, the people I speak with are always without fail patient, understanding, helpful, considerate, kind, professional, pleasant - more than pleasant, actually....I have to wonder what kind of training they have or where they come from as I'm always practically stunned. I almost wish I were one of them.

Brenda Carol Bear 9 years ago

I have been waiting for 6 months to receive my medicare card with my correct legal birth name on it. Why?????????? I have 4 pages of info with the date,time and person I spoke with. I should not be waiting for 6 months. What are you people doing, does anyone in this office know what they are doing???????????????

Diane 10 years ago

I am still dumb founded that our government couldn't initiate a better plan for medicare identification. Social Security Numbers. Really? How stupid and why. Why would our own government take such action to implement such a ridiculous plan for identity. Social Security Number = Identity Theft. And our government does not protect us if and when our identity is stolen. Not only is the Social Security Number on the Medicare card, so is your birthdate. Really? Why? Is our government exempt from Social Security? Is theor Medicare card exempt from having their social security number on it? Why can't it just show the last 4 digits?

kathy rohall 10 years ago

my suggestion is that every dec. you send out a bill to all participating medicare people with the due date jan `1 for $147.00 that way every one has made their deductable. as of now i go to the heart dr. in jan my visit is $65.00 i don't go make to him again until the following jan. my deductable will never be met as it is the first dr. you see that year that gets the deductable so none of my other bills will be paid because i did not meet the $147 yet and won't because i won't see him again til next year. i don't understand this can you explain it to me.

Joel Solkoff 13 years ago

as a 64 year-old low-income paraplegic who is dependent on medicare for, among other things, mobility equipment to lead an independent life, the senate finance committee’s failure to hold confirmation hearings on a medicare administrator belies the rhetoric of a democratic president and the 13 democratic members of the senate finance committee on the esteem with which they regard medicare. http://www.joelsolkoff.com/disabilities/marilyn-tavenner-confirmation-watch-who-cares-if-anyone-runs-medicare/ indeed, there has not been a confirmed administrator of the centers for medicare and medicaid services (cms) since the bush administration. on november 11th of last year, i wrote for hme news, the publication of the home medical equipment industry, “although cms has a larger annual budget than the pentagon, as i write this, there has not been a confirmed head of medicare since 2006. for the purposes of comparison, if the defense department did not have a confirmed secretary for five years, there would be a national outcry.” in february, i posted a blog on my website, “marilyn tavenner confirmation watch: who cares if anyone runs medicare?” i congratulate you for raising the issue: if medicare is so important to the democratic party, why do its leaders fail to provide medicare with the leadership it needs? thanks to house majority leader eric cantor’s enthusiastic endorsement, the republicans on the finance committee are likely to vote for the president’s nominee if only the senate finance committee decides to hold hearings. waiting for finance committee chairman max baucus' decision to hold hearings is like waiting for paint to dry. --joel solkoff, http://www.joelsolkoff.com

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Agency in Charge of Medicare Has Had 29 Leaders in 35 Years

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