Changing the scenery

John O'Connor
John O'Connor

The middle of July gave us quite a dose of ironic juxtaposition.

On Monday, the White House rolled out what it called the most comprehensive nursing home regulations revision in a quarter century. All in the name of ensuring greater accountability, you understand.

Two days later, the former head of the Centers for Medicare & Medicaid Services (the agency that created and will enforce these pending rules), announced she will soon be the insurance industry's top lobbyist. 

Such a sudden about-face might raise eyebrows in most places. Then again, most places aren't Washington.

I'm not here to slam Marilyn B. Tavenner. Running CMS was and is no cakewalk. Among other things, the agency insures nearly a third of the nation's population and grinds through roughly $800 billion a year. It also decides which Medicare and Medicaid rules skilled operators must abide by. By all accounts, Tavenner was well-liked and did a pretty good job. 

But what I do find a bit troubling here is the big picture. Tavenner joins a long and growing list of people who have earned their bona fides as public servants, only to seek a K Street cashout afterwards. 

The public-official-to-lobbyist-two-step is a legal and usually lucrative maneuver. But it's also rife with potential conflicts of interest.  

As president and chief executive of America's Health Insurance Plans, Tavenner will be lobbying on behalf of many of the companies that will determine your managed care payments. Firms like Aetna, Anthem, Humana and Kaiser Permanente, just to name a few. She'll also be urging lawmakers to make the new rules for her clients as minimally invasive as possible. 

Not that she's the first to give the old revolving door a spin. Earlier this year, five former House members and a U.S. senator were on the payroll at lobbying firms less than one month after leaving office. 

So there's plenty of precedent for the crossover. Still, it's unlikely that few of this year's newly minted lobbyists have had to swing so far, so fast. In fact, she might want to make sure her new employer's health plan covers whiplash.