It's a Tuesday morning in mid-February, and Topeka couldn't look much bleaker. A white winter sky weighs on the crumbly prairie town, with its sagging houses and faded fast-food restaurants.
At the Capitol Plaza Hotel, a tall gray bunker a few blocks south of the Statehouse, the Kansas Livestock Association is meeting in one of the banquet rooms. Leather-skinned men in cowboy hats and Wranglers wander the hallway, some of them gathering around a table stacked with "EAT BEEF" ball caps.
Farther down the corridor, in another large banquet room, is a meeting of the dozen or so board members leading the state agency that oversees health care in Kansas.
Once a month, these suckers take time off from real jobs — one is a vice president at a Fortune 500 company, one is a pediatrician, others are medical-center CEOs, two are high-level university administrators, and another is a professor of management at Harvard Business School — to spend butt-numbing hours listening to endless reports on things like what to do about prescription drugs for mentally ill people, how to spend the federal stimulus money that will be coming any day now, and whether Kansas should tax its nursing homes.
This is what Kathleen Sebelius' attempt at health-care reform looks like. The Kansas governor wanted to create a cabinet-level position and appoint someone to lead the way, but the state House of Representatives rejected that idea. Instead, the Legislature created a new state agency called the Kansas Health Policy Authority to "coordinate a statewide health policy agenda." It was, by most accounts, a compromise that thrilled neither side.
The board members meeting here today have been appointed by state House and Senate leaders. They run an agency that's also responsible for buying health insurance for publicly funded programs such as Medicaid and the coverage for state employees. It also tracks all sorts of health-care information, ostensibly so lawmakers can make better policies.
Last year, after months of research and meetings with people across the state, the KHPA presented the Legislature with 21 ideas for improving the state's health-care system.
The Legislature rejected almost all of them.
But the KHPA keeps working, its 266 employees managing Medicaid and researching policy. And the businessmen and businesswomen who sit on its board of directors keep coming to the Capitol Plaza Hotel once a month for these agonizing daylong meetings.
Today, however, they get a special reward. The meeting begins with an 8:30 a.m. visit from the governor.
Sebelius is having a rough couple of days. She's in a fight with Republicans about a spending bill, and threats not to pay state workers at the end of the week have kicked up a mini media tornado. But when she walks into the room, carrying a black, plastic travel mug and followed by an entourage of reporters and staffers, the governor looks at ease.
It has been a long time since these policy wonks have heard from the woman in charge.
"I want to start by telling you that I know you have to be pretty frustrated," she begins, now sitting at the head of the table. She tells the board members that she has been a close observer of their work.
"And, over and over again, people don't pay a lot of attention to what you've been saying, and that has to feel like you're out whistling in the wind sometimes. I do think that, at the end of the day, folks are paying attention. ... I just want you to hang in there because you're creating a template for exactly what we should be doing."