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Kathleen Sebelius: One Colleague’s Take

February 22nd, 2009

Kansas Democratic Governor Kathleen Sebelius is said to be President Obama’s top choice to be the new Secretary of Health and Human Services. What will Gov. Sebelius bring to the table if she is indeed nominated and confirmed? A former close colleague of Sebelius, Terri Vaughan, highlights the value of the Governor’s experience as her state’s insurance commissioner. Vaughan, the new CEO of the National Association of Insurance Commissioners, wrote the following in response to a request by the Health Affairs Blog for her take on Sebelius:

An insurance commissioner is a great choice for Secretary of HHS, because his or her direct contact with consumers provides unique insight into the challenges faced not only by consumers, but by states regarding health insurance issues. Health insurance is an important part of an insurance commissioner’s responsibilities–and they are on the front line dealing with consumers who face challenges paying for health care. They understand how the marketplace works and they understand how difficult it is to find a solution. Insurance commissioners are regularly consulted by their governors and state legislators because of their hands-on experience.

Governor Sebelius was an extraordinary commissioner. While she was Kansas Insurance Commissioner for eight years, she chaired the NAIC’s Health Insurance Committee and was President of the NAIC in 2001. In those capacities, she not only dealt with the challenges faced by Kansans, but she also played the lead role in developing NAIC policies around health insurance. For example, she was active nationally in the implementation of the Health Insurance Portability and Accountability Act. She worked with multiple state commissioners with a variety of markets to develop NAIC recommendations around the issues. She understands the insurance markets locally and nationally. 

Having worked with Kathleen during her eight years as commissioner (including being the NAIC Vice President while she was President), I am aware of her incredible talents at forging a consensus on difficult issues. I can’t imagine a better choice.

In a follow-up interview, Vaughn highlighted Sebelius’ ability to bridge gaps between stakeholders with seemingly opposing interests. As an example, she highlighted Sebelius’ role in forging the NAIC’s policy on consumer privacy. One dispute concerned how and when insurers would be able to disclose an individual’s personal health information – and whether such disclosure would necessitate an “opt-in” or an “opt-out” standard. “As you can imagine, there were several divergent opinions on this issue from consumer privacy advocates, industry groups and others. Kathleen somehow pulled everyone together and came up with a standard that was essentially opt-in, but which established exceptions that allowed insurers to conduct basic business functions,” said Vaughan, former Iowa state insurance commissioner.

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1 Trackback for “Kathleen Sebelius: One Colleague’s Take”

  1. Sebelius Versus Wall Street Journal (and the truth) | John Graham | NCPA
    October 1st, 2010 at 9:16 am

1 Response to “Kathleen Sebelius: One Colleague’s Take”

  1. Bruce Boissonnault Says:

    Nothing says inequality like “separate but equal,” in health care or in education.

    The dirty little secret is that we already have a two tier health care system in the US, a comprehensive one for those who can afford to pay, and an illusory system for those who can’t. What is most surprising is how many people do not yet fathom that they will not have access to comprehensive health care when they need it most – if they lose their job, experience a costly medical problem with hollow insurance coverage, or if they simply can’t afford to buy insurance.

    Any prospective candidate for HHS Secretary, including Governor Sebelius, must confront head-on the fact that health care in this country operates like professional sports stadiums. We all are taxed to subsidize them, but many can’t afford the price of admission. Successful reform involves turning the system upside down—making a system that serves the people first, instead of the reverse. It is potentially the most important post in the cabinet.

    Failure to properly reform the US health care system will have ramifications that extend far beyond health care. Our credit crisis and our trade debt explosion and the potential for long-term civil unrest all are linked to the structure of our health care system.

    New York’s Commonwealth Fund reported that 72 million adults under age 65 had problems paying medical bills or were paying off medical debt in 2007, up from 58 million in 2005. Things are getting much worse today. Paying for health care is crowding out even the most basic family obligations like making mortgage payments.

    Health care also represents an unfair “export tax” on US products and services because the US (uniquely) tacks the cost of health care for employees and family members directly into US companies’ payroll expenses. This means employers can gain a cost advantage if they export jobs and if they gut their health insurance coverage offerings to domestic employees.

    Employers also gain a cost advantage if they recruit only younger, healthier workers than their competitors in order to minimize their health care cost exposure, thereby potentially leaving many people in our society without a dignified means to pay their own way and without access to health care.

    We already know from experience what health care reform failure looks like. US health care reform failure looks like mental health reform. Until 1960, institutional care for the severely mental ill was the standard of care. Beginning in 1960, pharmaceutical advances allowed many more people to be mainstreamed into the community (theoretically leading to enriched lives), but as governments cost-shifted responsibility for care of the mentally ill away from government institutions and onto sick individuals and their families, government failed to add key resources to community-based mental health services; and, government failed to ensure there was an infrastructure to replace inpatient options.

    What was the result? Mental hospitals emptied. Mentally ill among the homeless and prison populations exploded.

    Today, we are following a similar course in dealing with the spiraling cost of health care for the majority of Americans, but this time, we won’t disenfranchise a limited group of mentally ill patients and their families. Instead, we risk alienating the majority of Americans who create value and do the real work in this country.

    Health care is integral to the very fabric of our civilized society. We are unraveling that fabric one thread at a time; and we do so at our own peril.

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