10 Questions with Kathleen Sebelius
Service as a state legislator, insurance commissioner and Kansas governor has given Kathleen Sebelius a better understanding of how the U.S. Department of Health and Human Services impacts the states. That understanding has helped her in her role as the department’s director.
1 How has being a former governor, state legislator and insurance commissioner shaped your understanding of the need for health care reform with regard to state concerns?
“Governors and state legislatures are struggling under the weight of escalating health care costs and I know how high health care costs and the growing number of uninsured Americans make their already challenging jobs even harder. … It isn’t easy and I know that it will only get tougher if we do not enact health insurance reform. I also know how difficult it is to achieve real systems changes and cost containment within the borders of just one state.”
2 Why is now the time for health care reform?
“We know that states and the American people cannot afford to wait for health insurance reform. We know that if we keep the course we’re on, by 2019, the number of uninsured Americans will rise at least 10 percent in every state in the country. In over half our states, it will go up more than 30 percent. We also know from a study done by the Business Roundtable that employer-based health costs will nearly triple from around $10,000 a year to almost $30,000.”
3 How can health information technology—which was included in the 2009 economic stimulus package—help to improve care and lower costs in the health care system?
“Today, too many hospitals and doctors offices are relying on paper records—the same system used by Hippocrates. It’s time to bring medicine into the digital age. By providing incentives to doctors and hospitals that meaningfully use health information technology, the Recovery Act will help ensure this critical technology is put to good use.”
4 Why is it important for states to be involved in developing health IT?
“States will be administering the federal health IT payments to Medicaid providers and are eligible now to receive new federal funds—at a 90/10 federal matching rate—to help them develop their health IT plans. In addition, the Recovery Act included grants worth $564 million to help states create statewide health information exchanges. … State planning and programs to promote health information exchange will help to realize the full potential of health IT to improve the coordination, efficiency and quality of care.”
5 A new report from your department addresses prevention and treatment for diabetes, a major cost driver in our health care system. What role can states play in addressing diabetes control?
“States can establish quality priorities and incentivize providers to practice high quality care through mechanisms such as grant programs and educational outreach. Emphasizing that all people with diabetes should receive regular recommended preventive exams … could help keep diabetes under better control and prevent complications down the road.”
6 What is the federal government doing to enroll the 5 million children eligible for Medicaid or the state children’s health insurance programs but are not enrolled?
“Helping states reach and enroll these children and assure that all children keep their coverage for as long as they are eligible is one of our highest priorities. The Children’s Health Insurance Program Reauthorization Act fully funds CHIP over the next four years and offers states a new (performance bonus) when they boost enrollment of Medicaid-eligible children. It also devotes an unprecedented amount of federal funding to support outreach and enrollment efforts for both CHIP and Medicaid.”
7 How have states been successful in enrolling these children?
“The strategies that have proven effective vary from neighborhood-based application assistance, such as the efforts underway in rural communities in Arizona and in the twin cities in Minnesota, to developing online application and renewal capacities, such as the initiative under development in Maryland. States like New Jersey have used the new ‘express lane’ eligibility option to make it easier to identify and enroll eligible children by relying on existing data sources, and Louisiana has been successful in virtually eliminating coverage losses due to red tape and unnecessary paperwork. These types of initiatives not only help cover children, but they also streamline the process for states and localities—a double benefit for states making do with fewer staff.”
8 The Recovery Act included funding to train health professionals. Why is this important in addressing health care challenges for the country?
“We know we have a shortage of primary care providers and that those providers are not distributed to areas that need them most. The shortage makes it difficult for some Americans to get timely, quality care, especially during an economic downturn. This Recovery Act funding makes important investments in ensuring that America’s health care work force is well-distributed, diverse and has the skills to provide high quality primary health care.”
9 Funding was also made available in the Recovery Act for health centers in underserved areas. Is this segment of the health care delivery system becoming more important?
“Absolutely. Community health centers’ work has never been more important. As Americans lost their jobs and coverage and their medical bills piled up, community health centers stretched resources to plug the holes in the system. We are committed to supporting community health centers and we’ve made a historic investment of over $1.3 billion in community health centers under the American Recovery and Reinvestment Act. That funding will support the construction of new health center sites, expansion of services, and the treatment of 2 million additional patients over the next two years.”
10 What have you learned about how the federal government handles public health issues from the H1N1 flu situation this year?
“The response to the H1N1 flu has been an unprecedented vaccination campaign with federal, state and local governments, the private sector and the American people working together to protect the public health. State and local governments have been incredible partners in the preparedness and response effort. … While we have had challenges along the way, the investments we made in pandemic preparedness allowed us to develop a vaccine in record time, administer vigorous testing and clinical trials to ensure its safety and effectiveness, and get it to the American people as quickly as possible.”