One on One with Secretary of Health and Human Services Kathleen Sebelius
Thursday, July 09, 2009
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SUSIE GHARIB: Secretary of Health and Human Services Secretary, Kathleen Sebelius and the Obama administration are also pressuring Congress to come up with health care reform bills before the August recess. Earlier today I talked with Sebelius about that. My first question: despite all the cost cutting concessions from hospitals, insurance companies and drug firms, is that real reform?
KATHLEEN SEBELIUS, SECRETARY, HEALTH AND HUMAN SERVICES: Well, I would say that cost reductions are a piece of it. But what we're tying to cost reductions is a higher quality system. What we know, whether it's in hospitals or too often in doctors' offices or in health clinics around the country, that some Americans get very high quality health care and some do not. We have a very erratic distribution system in terms of quality. We know that there are systems in various parts of this country that are much higher quality day in and day out at a much lower cost, so we're trying to not only reduce costs, but tie reduced costs to higher quality.
GHARIB: Secretary Sebelius, most Americans are in favor of health care coverage for everyone. But they're not happy when they find out how much it's going to cost and how it's going to impact their own care. So how are you going to sell the Obama plan to the American public?
SEBELIUS: Well, I think Americans who have coverage right now know that they're a day, a month, a year away from losing that coverage because it's unaffordable or they can lose their job or their family can have an existing held condition and they're going to be locked out of the market. So no one is safe and secure. Those who are uninsured need direct access to the system. Those who are insured are within precarious steps of losing that health coverage. The comprehensive reform is really about everybody. It's also about changing from the sickness care that we have to wellness care and a truly healthier America.
GHARIB: Can you really pay for national health care without some kind of tax increase?
SEBELIUS: I think right now Congress is coming to the table with payment plans. The president put on the table for Congress to consider about $660 billion worth of savings, money that we're spending right now in the current system that can be redirected and then about $330 million in revenue raisers. And his preferred approach is to look at the itemized deductions, take that back, cap the top itemized deductions to 28 percent, back to the days that we were when Ronald Reagan was president. It will affect the top 1 or 2 percent of Americans. It would raise the additional money and that combination would pay for the health plan. But the president has made it clear, we're not going to add to the deficit. This is going to be paid for.
GHARIB: That's exactly the point. The one thing that worried the economists that I talked to is that the budgeting for this health care plan is over a 10-year horizon. But what about the next 10 years? They're nervous about the long-term fiscal problems, especially since we've already wracked up some huge deficits to solve this current financial crisis that we're in.
SEBELIUS: Well, again, I think when you hear people use the term a trillion dollars, first of all, that's pending over a 10-year period of time, so the spending for a health plan is likely to be in the category of a $100 million a year. That's step one. Secondly, over two thirds of that money is in the current system. We're not talking about new money. And we also think that a lot of the implementation of health technology to lower medical errors and make people healthier and the implementation of wellness and prevention strategies will save billions of dollars as we go forward and they are not scored by Congress. So we've got some additional savings on the horizon if we can truly achieve comprehensive reform.
GHARIB: What do you see as the biggest obstacle to getting a health care bill through Congress?
SEBELIUS: Well, I think it's getting a bill through the House and the Senate. They're approaching it in slightly different fashion. I'm encouraged by the number of common ground issues that are emerging, how to address the uninsured population with the new health exchange marketplace, the fact that small business owners need to be protected and actually encouraged to get into the marketplace, building on the building blocks of the current employer-based plan and strengthening that, how we move forward with prevention and wellness care. So there are a lot of common themes around insuring all Americans and lowering costs for everyone.
GHARIB: What if health care reform is done wrong? What are the risks of that?
SEBELIUS: Well, I don't know what kind of done wrong means. I think that the biggest risk right now is doing nothing because the current economic situation is such that we can't fix the economy without fixing health care. We can't fix the economy without lowering costs and having a higher quality care at a lower cost for all Americans. So doing nothing, I think, is the biggest looming obstacle on the horizon that people just back away from the table and say we're not going to do anything at all. And what we need is this momentum to continue. We need a bill on the president's desk in the fall and that's what he's asked for and I think that's what we're going to have.
GHARIB: Hopefully we can get back to you and talk to you when that happens. Secretary Sebelius, thank you so much for your time.
SEBELIUS: Thank you Susie.
