“You’re the one who tried to hurt me with goodbye…Think I’d crumble? You think I’d lay down and die? No, not I, I will survive.” If you are tapping your foot already, then you know these are the lyrics from Gloria Gaynor’s 1978 song that makes for a classic scene in the movie The Replacements. It’s a silly but inspirational movie about a Washington D.C. football team made up of random players replacing the regular players that went on strike. When I heard that Gene Hackman (and his wife and dog) suddenly died, I immediately thought of his role as a coach in this film about underdogs just trying to do their best under difficult circumstances. This theme resonates with me right now as many people try to do their best for the healthcare system despite exceptional challenges. In the One Thoughtful Paragraph below, I explain the latest series of challenges.
Other news about policy and political challenges:
- Reports that the Trump Administration plans to lay off up to 500 staffers at the National Institute of Standards and Technology (NIST) are creating tough questions for the new Commerce Secretary (who oversees NIST) and the nominee about to lead the White House Office of Science and Technology Policy. Many experts see this move as something that could disrupt our work on cutting-edge technology and much-needed cybersecurity defenses, as well as undermine our ability to compete with China.
- With little progress on Congressional budget negotiations and a government shutdown looming, telehealth advocates are realizing that making video medical visits easy for seniors for the long-term is just too much to ask for. Instead, telehealth advocates (more than 350 organizations) are asking Congress to extend the flexibilities only for a little while (see their letter that acknowledges Congress is too dysfunctional to pass even the most obvious policies — I may be paraphrasing).
- In case you have nothing better to do on April Fool’s Day, you can draft a response to the House Energy & Commerce Committee’s request for information (RFI) on a national data privacy framework. Interestingly, healthcare is not specifically mentioned in the RFI, but it seems like health data privacy may be important enough to mention.
Gene Hackman, a master of the spoken word, narrates the ending of The Replacements movie: “When the Washington Sentinels left the stadium that day, there was no tickertape parade, no endorsement deals for sneakers … Just a locker to be cleaned out, and a ride home to catch. But what they didn’t know, was that their lives had been changed forever because they had been part of something great.” Thousands of dedicated public servants are not only being denied a tickertape parade, they are being treated with disrespect. Just this past Saturday, federal employees received an email asking them to name five productive tasks they accomplished in the week prior. After some Trump-appointed HHS leaders told their workforce not to respond to the email, Elon Musk sent another email confirming that the task was mandatory, saying that the workers needed to respond to justify their jobs or risk termination. Then on February 26, 2025, the DOGE Cost Efficiency Initiative ordered the freezing of federal workers’ credit cards, required higher-level approval for staff travel, and instructed each agency to create a centralized system that records every payment. It is difficult to understand where the “efficiency” part is coming from when you’re stopping work to answer random emails and you’ve got a shellshocked, hostile workforce. Overseeing all of this unusual efficiency is Susie Wiles, White House Chief of Staff, who happens to be the daughter of Pat Summerall, the late NFL sportscaster. Pat had a cameo with John Madden in The Replacements, and they had an apropos dialogue about unusual activity in a traditional situation:
Pat Summerall: [Watching a football team line dance from one side of the field to the other] Hey John, how long have we been calling football games?
John Madden: I dunno 19 years?
Pat Summerall: Have you ever seen anything like that?
[Watching the dance]
John Madden: Not on a football field.
