Monday, June 27, 2011

Reflection - Admay style!

Hey guys, it's been a while since I've posted how I've been doing. It's been a little less than a month that I've been working in the Family and Social Services Admin. and I realized I should probably evaluate my experience, and see how I'm enjoying it and see what I've made of the experience so far. For those of you who don't know what (nope, it's who, haha) an Admay is, Catherine Admay is a professor of International Law and Global Health at Duke. She has been an awesome prof., probably my favorite so far. She cares about teaching us so much, it's awesome. She's really cool too. For the last like 10 years, she taught classes blind and just regained her vision this past year. Talk about an amazing feat. She's really strong and awesome and I can't think of enough amazing things to say about her!

So, all the posts I've made have probably made my experience sound really awesome and it is. But I also realized that I usually post something when I have something really big or cool to say. A lot of the other days, I attend meetings, learn cool information, and do some busy work. I assume there's some busy work in all jobs, so it's not too big of a deal. And usually when I'm doing busy work, I end up meeting new people who have different and interesting stories to tell, so I don't usually mind it too much. Also, especially on one week when Shawna was out, I spent a lot of time just reading a book (Freakonomics, which is btw an awesome book!) because there wasn't much for me to do.

Today, though, was a really intense day. It felt more and more like what you would see on TV or how you might imagine President Obama and his team passed the health care law last year. There was boisterous and harsh diatribe going back and forth between different parties. We (the Policy Team) feel like the Business meetings are moving too fast and we're not sure that we're getting as much out of our Business team (who's on contract) as we could or should be. They're doing a good job, but we're just not ready for them to be moving that fast. I can't wait till we start having meetings with the stakeholders, like the insurance companies (carriers), and businesses, and providers... because all of them are bound to be upset about something in our version of the Exchange or another. It should be quite interesting.

So today was a great day. But overall, I have gotten what I wanted to out of this internship. The internship was supposed to clarify and narrow down what I want do with my next three years at Duke and my life beyond that. I came in believing I'd love what I was going to do, but it wasn't all I expected it to be, which is fine. It has been a great learning experience so far because it crossed something (being a policy expert?) off my list. Why don't I like it? First of all, I HATE working in a cubicle. I feel SO constrained... and there's no one to talk to. I always feel like I'm intruding when I talk to people. Problem number one. Second problem is that nothing gets done in the short term. I like to see results and right now, there are no day-to-day results, only long-term results, which are hard to visualize. It's not that it's a bad job or would be a bad career; it's just not the right choice for me.

So, I need constant personal contact, can't work in a cubicle for sure, and I like to see results right away. I learned something and I'm really happy about it. Also, knowing that I can't do what I'm doing right now for the rest of my life is going to make my next month even more exciting. Wait a minute. Is that right? Yup. Because I'm thinking that I'm not going to be doing this sort of thing again, I want to enjoy my last month as much as can. Obviously, I'm going to keep an open mind about it, as I'm still less than half way through my summer, but that's what I've learned so far.

What's on my plate for the rest of the summer? A lot of meetings about how the Exchange will be set up. Today, I sat through a financial meeting about how and where certain costs will be allocated and I was totally lost. It was a really boring meeting for me just cause I didn't have any idea what was going on. So tonight I read a little bit about premium aggregation and cost-sharing subsidies and other interesting health care info. Hopefully, it'll help me understand things a bit better.

Also, Shawna set up a few meetings with other people in Government offices. I'm going to be meeting with an Actuary in a week or so. Actuaries do all the math and calculate how much everything will cost all parties involved. It sounds really interesting, but also sounds like WAY too much math. Another person I know I'm going to be talking to is a guy who went to med school, dropped out, became the State Director Of Medicaid in Indiana and just recently started his own business in the State. I'm not sure, but I think somewhere in there, he went back and finished med school. He seems like he's had an awesome experience and I'm really looking forward to talking with him.

Also, have you noticed how mean people seem to be getting? I've noticed a large number of people that seem to flick me off on my drive from Chicago to Indy and back. It's quite surprising since I'm actually a good driver I think. Between Friday's drive back to Chicago and Sunday's drive back to Indy, I was flicked off four times. I try to think of it as people are just really mean. Idk if I should start checking my driving or what. Also, the first time I saw it on Friday, I originally thought the guy was waving and waved back excitedly, which was just a little bit awkward.

See ya guys!

Tuesday, June 14, 2011

Want to Exchange?

Today was an awesome day. I left to work a little late today and got to work at like 8. That's still earlier than a lotta people but I normally get there at about 7:45. One day I want to arrive at like 7, just to see where I would park in the parking garage then. I always get the 3rd or 4th level and I'm usually the first person to arrive in my department, which is one of the biggest one. Idk, I was thinking about it earlier today and while I was talking about how early I got in, I figured I'd mention it.

Shawna, who if you remember is the main person in charge of health care in Indiana, is on vacation in Greece, so without her here, the job is very slow-paced compared to normal. She's very good at keeping everyone on their toes... something about her persona. Even though I've been relatively busy most days either reading, summarizing articles that usually either need to go to the feds or the Governor, or writing or making presentations based on articles already written (papers or presentations which will look entirely different from my draft by the time they're ready to turn in).

So today I decided to bring in a book I've been reading. It's really academic and way above any of your reading levels, so I'm not sure if I want to go into it. Have you ever seen The Blind Side about the football player? Yup, and the book's even better (if you like some football history thrown in on the side). Really advanced stuff, like Masters level. Wasn't sure if I should even bring it up.

What did I do today that was so interesting? Well, for today, after lunch, at 12:30 is when the fun starts. I had been organizing all these meetings that started today until July 15th or so, and today was the first one. I didn't really know exactly what they were about, but they were called Business Process Meetings... very descriptive.

Basically what business process meetings mean is that we're actually going to be designing Indiana's Exchange, grudgingly abiding by the least number of Obamacare rules we can! Not that I don't like it or do like it for that matter, but Gov. Daniels is not a huge fan - he's written a few articles in the WSJ, so I'm not spilling any secrets. A great analogy that appealed particularly well to me that began the meeting was building a house. You have sub-contractors for all sorts of things - plumbing, walls, electricity, etc. But separately they can't do anything, so we need em all to meet in one place to get a functioning product. So these meetings have people from various departments across the state to ensure every one is at the table.

Today, we discussed who's eligible to enroll in the Exchange and we actually designed something something similar to a program called eHealth, which from what I've heard (I'm going to actually use it tmrw!) and how it was described is pretty much a drop-down menu based on your preferences and data that you provide about yourself and family. It actually is a marketplace as President Obama had meant it to be, tho it is hard to picture it as the Marketplace that I had pictured in my head (which is the one from the 9 min video that Kaiser has about the entire ACA bill).

So to give you a bigger picture, there are three parts to getting the Exchange off the ground - the business part (today's part), the policy part (always a work in progress), and IT (actually allowing users to see it online). We were informed today that our current IT system called ICES is like 25 years old and written in Cobalt, which I guess is a really primitive language. The lady told me that with a can-you-believe-it voice so that why I assume something must be really bad about it. I do know, though, that it can't keep up with what we need it to do for the Exchange. This is a big problem for Indiana. Updates to come hopefully.

The meeting went until 3, when a few of us stayed back to tell the people hosting the meeting (they are hired consultants, I think, and I know they've assisted Wisconsin with their plan as well as headed the Massachusetts Connector [Obamney Care, as Pawlenty described it  - btw, it would have been nice to see him stand up to Romney about it last night and not be such a little wimp about it] in 2006) how we thought it could be better. Our group of 5 people is in charge of the final result, so I think the consultants report to us, which is why we were there at the end.

Funny (by funny, I mean kind of embarrassing) story sidetrack. So, I went to the meeting 20 minutes early to set up because I knew the room was going to be too small, but one lady apparently needed to get there like 25 minutes early... as if she has nothing better to do... your tax dollars at their best. Anyways, I couldn't set up because of that, so I ended up sitting next to one of the consultants, Eric, who I'd met once before (I was sitting in the very back of the conference room). We'd briefly talked the first time. So this time we start talking again, and I realized he has a deep Boston accent. When I say deep, think Matt Damon in The Departed times ten. I'm taking deep Boston. The first time I hear it, I brush it off as nothing but a blip in my hearing. The second time when he says he loved "college" and how big of a Boston Bruins "hockey" fan he is, I start laughing at his accent. Not in a mean way, because it was an awesome accent, but I just broke down laughing. He asked why and I told him I'd never heard an accent that deep Boston. And we kept talking from there. Now that I'm not sure how to end this story, I'm wondering if it was actually funny, or if it was a you-had-to-be-there sorta story. If so, oops :)

Well, now it's night time and I'm have a food baby in my stomach. I ate Chipotle, which tasted amazing like it always does. The after-effect is terrible though. Oh, also I'm running out of some of my supplies now and I'm not sure what to do about it. I need milk for cheerios tmrw morning. Got milk? Want to Exchange what's left of my Chipotle for some milk? Gahh, no idea what I'm going to do about it. Eh, it's tmrw's problem. Goodnight!

Neil

Wednesday, June 8, 2011

Friends and a Boring day

Hey guys,

So yesterday was a grrreeeaaat day, cause I made friends! Ya, I know I kind of sound like a loner, but it was awesome! It was the first time I met the other interns. Most of them are either going to be seniors in college or just finished college, but one girl was only going to be a junior. We all went out to this place called Bourbon Street Distillery. I felt pretty awkward at the beginning because they all knew each other already (b/c they all worked in the same office), but it became chill pretty quickly. It was also kind of awkward cause they all ordered a beer and i just sat there with water in a kiddy cup... i felt really immature (apparently they ran out of water cups and didn't wanna waste a beer glass on me? ya, really cool, haha).

Today was a very boring day for me, but very exciting and active for everyone else in the office. We were preparing for our meeting with the Governor tomorrow, but all the stuff we had to prepare was so far over my head that they couldn't really give me anything useful to do other than stapling papers in preparation for tomorrow. Oh wait, nope, had to re-do all the papers because "the Governor prefers paper clips." Awesome. haha, but overall, today was really the only boring day I've had yet and Mickey told me that tomorrow, after the meeting, I'm gonna be given a big project that will take me a good amount of time, effort, and a lot of learning, so i'm really excited about that!

There's probably more to report, but Weinergate's on CNN for like the millionth time. Gotta see what other stupid things he's doing. Catch ya later!

Thursday, June 2, 2011

Wow - I've learned a lot!

Hey guys,

So, it's been a few days since my last post. Nothing too interesting happened yesterday, though I did find out that people work from home, which was interesting. Shawna works from home two days a week, and both Cady and Doggy (if you haven't been able to tell by now, all four of the people I work with have made up names on this blog, you know, just to make it more interesting :) ),  who you haven't met yet, but are both pretty awesome, work from home one day a week.

Today, though, I was constantly on the move. I usually (by usually, I mean a grand total of three days so far) get to work earlier than everyone, just cause I got into a good rhythm. I started catching up on some reading. Remember those 500+ pages. Yup, just finished those and another 40 pager got dumped on tonight's plate! But the reading is interesting and I've learned more in these three days about national health care policy as well as Indiana state health care policy than I ever could've imagined and I'm loving it!

In fact, today, while looking up one of the countless words I'm always researching (b/c I've never seen half of the words and acronyms that are used), I decided I might try to write a book, which would just be a glossary of all health care words I learn this summer. The problem, though, is that all my definitions would be plagiarized off the Internet, but at least anyone in the health care business who doesn't know something could look it all up in one place. The plagiarism tidbit is the only problem. Any ideas!?!

Another thing I realized today is how many hats (cue to Admay!) you really need in a business place. I am working with the policy team to form what will become Indiana's Exchange, but there is also a business aspect and IT aspect. Sounds easy, right? Ummm, nope. Under each department, there are legal aspects, computer aspects (mostly IT), and actuarial aspects (money!). There are so many aspects of the bill to keep track of that just learning the ACA (Obama's bill) back and front wouldn't be enough. You need to know the ins and outs of the IRS (yup, taxes), everything about health care premiums, copayments, coinsurance, deductibles, and many other words (glossary anyone!?!), and how to calculate mathematically if all these words added together ends up with a positive bottom line. Pretty crazy how much there is to keep track of. But there's always someone who specializes in every little aspect. It's kind of amazing how many different tasks there are and how people specialize in the littlest things!

One thing that I love is how many question marks I have in my notebook. It might be more than I had in APUSH class with Coach Lopez (cue Munster High School!?!). Eh, prolly not, seeing as he just put question marks after everything on the board. haha, but tomorrow, I'm gonna have like a million different things to ask Mickey, who along with me, is going to be the only person at work tomorrow.

Another aspect of policy work I have found very interesting is the lack of males! And I thought we dominated everything! no, no, just kidding, but males really are sparse! The four main people I work with are all females and when we have large meetings, the only males I've seen are the math actuarial guys who sit in their office and do a bunch of calculations and a few lawyers who told us how many legal problems our bill would face. Interesting, just pointing it out.

So, today... we had two meetings today. One was a phone interview with "the people from Utah." Yup, that's all I knew going into the meeting. But that was the first meeting that I understood maybe 75% of what was going on! Utah has a new health care system of defined contributions (glossary w/o Wiki? here goes... defined contributions would be if, instead of an employer giving an employee one health plan which many experts/employees don't like cause it's a "one size fits all" plan that often doesn't cover each employee's specific needs, a defined contributions plan gives an employee a certain amount of money and there would be an Exchange offering various health plans, which an employee could choose from and acquire the plan that best fits their needs, whew) and I had looked it up and understood it and it was awesome! Oh ya, while I remember, I've pretty much been sworn to secrecy about Indiana's plan, so all you friends (yes, currently, all one of you) working for CNN, it's not gonna happen!!

The second meeting focused all its attention on SPAs or various state planned amendments (?? - I think?, see, a glossary would be useful!). Didn't understand almost 95% of the meeting, so I was pretty much a blob :(

By the end of the day, everyone was getting tired and talking about the weekend already. Though I'm technically not assigned homework, I ask for projects as much as I can, both because I enjoy the work and to keep me busy at night. Tonight, I have to look through that long 40 pager and then maybe start a defined contributions update paper. Oh ya, I really have to get all that done tonight just because I already know of a CHIP paper (you know, like chips ahoy, just in all CAPS... no, CHIP is the children health insurance plan that all states have, i think, and that is partially subsidized by the federal government, i think, and that is only for people below a certain FPL, oh my bad, that's federal poverty level, for you!) that I have to read tmrw.

Oh ya, almost forgot! I met some of the other interns the other day and they all seem really nice... again almost all girls, but hey, who's complaining!? We're supposed to go on some trip this upcoming Tuesday and hopefully we start hanging out as the summer goes on. Most of them go to Indy schools or Purdue. Surprisingly, no IU kids?

Overall another great day, though. I'm at Barnes and Noble right now and I still have to read that 40 pager. Hopefully, I can at least start it before the game tonight, cause after it starts tonight, nothing's gonna get done! Let's go Mavs... or any team not the Heat!


Neil

Tuesday, May 31, 2011

First Day = Incredible!

For those of you that don't know, I got an Internship this summer working in Indiana Governor Mitch Daniels office! Too bad he didn't run for President... that would've made my experience so different and interesting in a completely different way. Specifically, though, I'm working in the Family and Social Services Administration. I probably won't be seeing too much of my man Mitch - maybe once a week or once every week and a half.

First day at work today... and only one word can describe it - amazing! So what am I doing? I'm asking that rhetorically as much as I'm seriously asking myself. It's difficult to describe, but it comes in the aftermath of the Affordable Care Act (the new health care bill) of March 2010. In my first day there, I've learned so much, chiefly that Indiana is on the edge of some groundbreaking stuff!

So when I got to work (almost 45 minutes early... just to make sure :) ), I met Shawna, who engineered Indiana's Medicaid plan, called the Healthy Indiana Plan (HIP). To my knowledge so far, it's been very successful. It's a high deductible health plan (meaning high deductibles, low premiums) with a Health Savings Account (HSA). Shawna probably handed me about 1000 pages to read, so much so, that I noticeably and awkwardly stumbled out of her office.

When I got to the cubicle the office set up for me, I got started reading. It was extremely disorganized and I instantly felt like I was in way over my head. I mean all I did was take one class on the health care bill. Who was I to think I was some sort of expert!?! Then, Mickey, who seems to be the one I will be reporting to all summer showed up and gave me an organized stack of only about 500 pages to read. Yes! Mickey's been really nice all day and I can tell she'll be an awesome boss.

Next, the entire office went to the first meeting of the day, which was a policy meeting about Indiana's plan for implementing the Exchange. The plan might as well have been in another language for all that I understood of it. Next, I read up for another 45 minutes before a second meeting with some litigators who were to inform our policy group if there was anything unlawful about our plan. Mostly, it seemed like a preliminary meeting, where we just gave them some basic information. Afterwards, I was assigned to read the plan that we were planning on submitting to Congress for approval.

Then, the coolest part of the day! I was assigned to, similar to Prof Ubel's class, make a Presentation that will be given by Shawna to the Governor in a week. The Presentation in my mind was like writing a policy briefing in class. Obviously, it'll be reviewed by at least three or four people before the final powerpoint is seen by Governor Daniels. Overall a great first day, though! I'm excited about tomorrow!