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Secretary of Health and Human Services Kathleen Sebelius was in Seattle this week, to hear about local efforts to make the medical system more efficient.
Sebelius is in charge of implementing the new national health care law – and defending it. The Affordable Care Act has been under fierce attack by Republicans and their allies. Democrats and their supporters recently hired political strategists to launch a campaign in defense of the law.
At the same time, Sebelius has been trying to sell it across the country, alongside sympathetic mayors and governors.
In Seattle, Sebelius sat at the head of a round-table discussion (although the table was shaped more like a U), with Governor Chris Gregoire and Dr. Gary Kaplan, the chairman and CEO of Virginia Mason Medical Center.
"I think it's appropriate ... that we’re here at Virginia Mason, because what's going on here can be a model for reform across the country," said Sebelius.
Virginia Mason has been learning how to be more efficient from the Japanese system at Toyota Motors, to improve quality and save money. That theme -- efficiency can bring quality and cost savings -- is in line with the message Sebelius wants to spread.
"We can actually have better care for patients, at a lower cost. It's happening in various parts of the country. It just hasn't happened to scale," she said.
She says the talk so far has been about health insurance, but she sees a transformation in medicine and public health.
A panel of local health care leaders
Each of the dozen leaders (one of them a business owner) gave examples of improvements that can save money. Nobody offered criticisms or complaints about the law.
Dr. Michael Soman of Group Health Cooperative explained how primary care can be improved and keep people healthier. Dr. Jeff Thompson, the Chief Medical Officer for the state's Medicaid system said he's been able to boost generic drug use to 81 percent. And Dr. David Flum of the University of Washington talked about how surgical checklists are reducing mistakes at hospitals across Washington during surgeries.
Sebelius says the federal government can’t dictate these kinds of changes:
"I think our role is to figure out how we can help lift them, highlight them, and accelerate the rate of adoption," she said.
Selling points -- who's benefiting vs. the big picture
When asked why public support is stuck below 50 percent, Sebelius said people still don’t understand what it really does. She ticked off a list of the law's benefits, to specific groups of consumers, as she's done in many public appearances.
At her side, Governor Chris Gregoire piped up with a spirited defense of the law.
"If we didn’t have health care reform, are we satisfied with the status quo? That’s all we have to ask ourselves in Washington state," she said, and offered a reminder of problems with health care.
As N.C. Aizenman reported this week in the Washington Post, Democrats have left themselves an interesting challenge: If the law works, it’ll be apparent only after the 2012 election.
Robert Blendon, a polling analyst with the Harvard School of Public Health told the Post, it doesn't matter how many people benefit from the law's early, and generally most-popular, features. Nor does it matter how aggressively advocates publicize these gains. "People who are worried about this bill are worried about its aggregate impact - Will it cost too much? Will it add to the deficit? Will it increase taxes?" he said. "You just can't answer their doubts until the overall plan goes into effect."
