Today, according to the Associated Press and Washington Post, President
Obama will announce
Kathleen Sebelius as his nominee for Secretary of
Health and Human Services. She has a once in a lifetime opportunity to
execute healthcare reform – a popular President, a sense of urgency,
and enough resources to get the job done. What are these resources?
You'll find the Office of Management and Budget FY2010 Budget Overview Document online The full FY2010 Budget is expected to be released this Spring.
Highlights from the Healthcare portion of the overview document include:
A reserve fund of more than $630 billion over 10 years to finance
fundamental reform of our health care system, funded half by new
revenue and half by savings proposals that promote efficiency and
accountability, align incentives for quality, and encourage shared
responsibility. Examples of new revenue include a proposal that
individuals earning more than $85,000 pay higher premiums for their
Medicare drug coverage starting in 2011. Examples of savings include a
revision of payments to insurers that provide Medicare Advantage plans.
Those payments have been on average 14% higher than what the government
typically spends per beneficiary. Under the budget proposal, insurers
would be required to competitively bid to offer plans beginning in
2012, which the administration believes would lower per-patient outlays.
The Budget expands research comparing the effectiveness of medical
treatments. Building on the unprecedented $1.1 billion included in the
Recovery Act for comparative effectiveness research, the Administration
will continue efforts to produce state-of-the-science information on
what medical treatments work best for a given condition.
Budget includes language to "Strengthen Program Integrity," noting that
reducing fraud, waste, and abuse is an important part of restraining
spending growth and providing health care quality service delivery to
beneficiaries. The Budget proposes to dedicate additional resources
that will initially be targeted to improving oversight and program
integrity activities for the Medicare Prescription Drug Program (Part
D), Medicare Advantage, and the Medicaid Program.
* The Budget
includes over $6 billion within the National Institutes of Health (NIH)
to support cancer research. This funding is central to the President's
sustained, multi-year plan to double cancer research. These resources
will be committed strategically to have the greatest impact on
developing innovative diagnostics, treatments and cures for cancer.
This initiative will build upon the unprecedented $10 billion provided
in the Recovery Act, which will support new NIH research in 2009 and
* The Budget includes $330 million to address the shortage
of health care providers in certain areas. The Budget's new resources
will sustain the expansion of the health care workforce funded in the
*The Budget includes continued efforts to
accelerate the adoption of Health Information Technology, building on
funding provided in the Recovery Act.
The combination of a
reserve fund to accelerate transformation/additional coverage,
comparative effectiveness data, enhanced operations, a strong NIH, and
appropriate numbers of primary care physicians is a powerful array of
As with any change process, she'll encounter
resistance from some stakeholders and will be distracted by the tyranny
of the urgent (naming a new head of the FDA to help address the recent
peanut butter salmonella contamination problem, a perceived failure of
our food safety systems). However, I am confident that government,
payers, providers, and patients all recognize that our current
healthcare system provides low quality/high cost (poor value) care
which reduces our ability to compete in world markets. The FY2010
budget summary reflects a serious amount of resources and a commitment
to change that is likely to move us forward.
Best of luck Kathleen and welcome to Washington!