"The torch has been passed to a new generation of Americans," Jack Kennedy famously said in his 1961 inaugural address, a phrase once swollen with optimism and American pride.
It may be tempting for President Obama to use this same expression now to describe Health and Human Services Secretary (Baby Boomer) Sebelius handing off the HHS secretarial torch to her apparent (Generation X) replacement, Sylvia Burwell, but such a sentiment would be false optimism.
It is time for a physician or an expert in health care to administer Health and Human Services, not another numbers-massaging manager, no matter how able.
It is easy to forget that Secretary Sebelius was once Kansas Insurance Commissioner. This qualified her to administer health insurance, not health care.
Though she certainly helped to fumble the ObamaCare website rollout, an even greater misdeed was her inability to anticipate how the arrival of ObamaCare could translate into less care and less access and higher premiums for those who already have insurance.
HHS stands for "Health and Human Services," not Health and Insurance Services. Only a doctor who deals with ObamaCare every day can attest to the problems the growing insurance bureaucracy pose to actual patient care.
Here are some actual questions that come up in my office:
1. Is that patient eligible to see Dr. Siegel or is his insurance expired?
2. How come Dr. Siegel is listed as a Blue Cross provider but is not part of the Blue Cross network for policies offered on the state exchange?
3. Can Dr. Siegel's patient Victoria Scott afford the care she needs for her thyroid condition when she has a whooping deductible (almost $6000) on her Bronze plan?
It hardly matters to doctors and their patients what the cumulative numbers are for new enrollees on the state exchanges, and how many of these folks were actually uninsured beforehand (the latest RAND data suggests less than half). What matters most is what kind of care these patients can get and at what cost, and whether we doctors can still afford to take care of them.
Sylvia Burwell said at a recent Atlantic magazine event that the Affordable Care Act “is about improving access…about improving the quality of health care.”
Unfortunately, there is no evidence that the new law does either one.
Contrast Burwell’s abstract statement to the practical wisdom of Senator John Barrasso, M.D., a practicing orthopedist for many years and former Wyoming Physician of the Year.
He wrote in Investor’s Business Daily about how ObamaCare interferes with the real world doctor/patient relationship: “I continue to hear from my patients in Wyoming. They have always had my home phone number. They are anxious and angry. They know what they wanted from health care reform: access to quality, affordable care…That's not what they got with this law. Now, many face losing the doctor who has always been there for them.”
Dr. Barrasso would make a terrific HHS secretary, unfortunately, President Obama would likely never consider such a move.
Sylvia Burwell may be a capable budget director, and her track record with the Clinton administration, the Gates and Walmart Foundations certainly shows that she is an able politician, but where is the evidence that she can manage a health care system that is becoming more complex by the day?
In the era of personalized health care, where genetic advances in cancer research and risk assessment predict both diseases and their expensive treatments on a patient by patient basis, the one-size-fits-all insurance model is becoming increasingly out of date. The more complex our health care solutions, the more unaffordable or inadequate ObamaCare will be.
Sylvia Burwell may do a better job presenting the latest insurance numbers to the public, but she will be no more qualified in deciding whether an 11-year-old like Sarah Murnaghan should get a life-saving lung transplant with adult lungs than Kathleen Sebelius was.
HHS needs a physician or at least a bio-engineer to navigate through the treacherous ObamaCare waters, not another insurance expert to sell us yet another policy to cover our mammograms and our colonoscopies even as our collective ship sinks