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Kathleen Sebelius on Boosting U.S. Competitiveness Through Health Care Reform


Health care reform is a vital step toward making U.S. businesses more competitive in a global economy, declared Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, in her keynote address during the University of Miami Global Business Forum, held Jan. 12–14, 2011.

“Healthy adults are better workers and healthy children are better students,” she said. Yet Americans eat too much, don’t exercise enough, continue to smoke and don’t always receive quality medical care. That translates to about 45 million avoidable sick days a year — the equivalent of 180,000 workers calling in sick for an entire year.

“That alone puts the U.S. at a severe disadvantage in global markets,” said Sebelius, who called for a new direction in health care focusing on prevention and wellness. “Employers have spent billions trying to deal with health care,” she said. “Now, we have a historic opportunity to join together and build a healthier nation.”


  Kathleen Sebelius, Secretary, U.S. Department of
  Health and Human Services

“In the past two years, Congress has passed more important health care legislation than at any time since Medicare,” she continued. “The future looks brighter now than it has in decades.” She cited a long list of recent government accomplishments, including expanding health insurance for children, increasing regulation of tobacco and advancing the use of electronic medical records.

Sebelius strongly defended the Patient Protection and Affordable Care Act of 2010, which the House of Representatives in January voted to repeal. “People across the country are starting to connect directly with the benefits of health care reform,” she said. “The members of Congress need to have a conversation with their constituents and ask themselves, ‘What is the alternative?’”

She said the legislation incorporates fresh ideas and best practices from around the country in order to improve the quality of care and lower costs. “We know a better health care system is possible because it already exists, although it is scattered in pockets across the country,” she said, listing as an example a hospital system in Michigan that is saving lives using a patient safety checklist developed by Johns Hopkins University. “We are seeing school districts serve healthier lunches, employers establishing on-site clinics and hospitals trying new ways to improve patient outcomes,” she added.

For too long the federal government has lagged the private sector in promoting wellness and quality health care, Sebelius continued. But when government puts its support into improvements, the pace can speed up dramatically. “Whether it’s bringing farmers markets to urban areas, providing more access to walking and biking trails or monitoring local projects that produce great outcomes, we will be able to shine a light on effective strategies,” she said.

Sebelius noted the Affordable Care Act increases worker rewards for participating in wellness programs and meeting health benchmarks. It also gives employers an extra incentive to invest in a healthy workforce. “We also want to take down financial barriers to diagnostic procedures like mammograms,” she said.

While the law will make it easier to keep workers and their families healthy, people still get sick or injured — and that brings other challenges that the act aims to address. “Far too many Americans go to the emergency room rather than to a primary care doctor,” she said. “All too often they get care that actually makes their conditions worse.”

One in five Medicare patients, for example, goes back to the hospital after discharge without having seen a provider. “Some readmissions are unavoidable,” she continued, “but many could be prevented if someone checked to see if the patient was taking his medications or continuing the right wound care.”

The federal government is also examining changes in financial incentives to encourage health care providers to keep patients out of the hospital. “Right now, hospitals benefit from readmissions,” she said. “So we are looking at strategies like bundled care payments to reward hospitals. In Denver, that approach reduced readmissions by 30 percent.”

Another strategy is greater use of the medical home model, where patients receive care from a team of doctors, nurses and community health workers. “This is particularly effective for managing chronic conditions,” Sebelius said. “It can result in fewer and lower-cost hospital stays, and dramatically improved patient satisfaction.” However, the current reimbursement system pays per procedure and appointment — not necessarily for keeping people healthy. “We want to allow more medical practices to adopt this model,” she said.

Electronic medical records — an imperative in the health care reform legislation — will help. “Going to an EMR doesn’t just shift those records from paper onto a computer — it also helps coordinate best practices and improve the delivery of patient care,” she said. For example, a Cincinnati hospital used EMRs to reduce medical errors and improve clinical efficiency, and as a result went more than 1,000 days without a serious safety incident in its neonatal ward.

Returning to the idea of global competitiveness, Sebelius emphasized the importance of scientific research in helping the U.S. remain a worldwide leader in health care. “Even in difficult economic times, we need to continue to invest,” she said. “We also want to move ideas from the microscope to the marketplace in a timely, seamless fashion.”

Sebelius underscored the need for public-private partnerships as well. “Employers have spent billions trying to deal with health costs and strategies,” she said. “Our willingness to join with them and invest in strategies that work can help make America competitive in the global economy.”

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