System Overhaul
The global economy is on life support, unemployment is marching upward, wars rage on in Iraq and Afghanistan, and the federal deficit is approaching $1 trillion. By necessity, President Obama will push campaign promises to lower healthcare costs and provide affordable, accessible health insurance to all Americans to the end of his “to do” list, right?
Not necessarily.
“If we want to overcome our economic challenges, we must also finally address our healthcare challenge,” Obama said in a Dec. 11, 2008, speech in which he nominated former Sen. Tom Daschle (D-S.D.) to be his secretary of Health and Human Services and appointed him director of a new White House Office on Health Reform.
What this aggressive pursuit of healthcare change means for hospital medicine is still unclear, say health policy experts and hospitalists, because the Obama administration’s plan isn’t concrete and will change as it moves through Congress and the forums of public debate. Even so, some experts think an Obama healthcare overhaul would mean more revenue and information technology advancements for hospitals as well as significantly more patients as millions of newly insured Americans flood a system beset by a dwindling number of primary-care physicians.
For hospitalists and other physicians, the Obama plan could mean:
- Access to more information on what therapies work best for patients.
- A focus on preventative care.
- Greater emphasis on care-management programs and medical homes, especially for people with chronic conditions.
“He will lay out a bold vision on what he wants to do over time, and then he will enact it in several steps,” says Karen Davis, PhD, president of the Commonwealth Fund, a private healthcare research organization. “He’s certainly said it won’t be business as usual.”
Key Healthcare Officials in President Obama’s Administration
TOM DASCHLE
The secretary of Health and Human Services and director of a new White House Office on Health Reform is a former Democratic congressman and senator from South Dakota. He co-authored a book with Jeanne Lambrew this year, “Critical: What We Can Do About the Health-Care Crisis.” Obama has called the book “groundbreaking.” Prior to joining the Obama team, Daschle, 61, was a public policy adviser at Alston & Bird, a legal and lobbying firm. He remains a distinguished senior fellow at the Center for American Progress, where he’s pursued his interest in healthcare policy.
JEANNE LAMBREW
The deputy director of a new White House Office on Health Reform is an associate professor at the Lyndon B. Johnson School of Public Affairs at the University of Texas in Austin, and a senior fellow at the Center for American Progress. A co-author of the book Critical: What We Can Do About the Health-Care Crisis, Lambrew was a health policy advisor to President Clinton during his second term and helped establish the State Children’s Health Insurance Program.
PETER ORSZAG
The director of the Office of Management and Budget is a Princeton University graduate who has a Ph.D. from the London School of Economics. Prior to joining the Obama administration, Orszag, 39, directed the Con-gressional Budget Office and shifted a large part of its focus to healthcare issues. Orszag says the top fiscal threat facing the nation is escalating healthcare spending.
Sources: Obama-Biden transition Web site, www.change.gov; Center for American Progress; Congressional Quarterly
Right to Work
Obama says he will work immediately to expand eligibility for the State Children’s Health Insurance Program (SCHIP) and, in light of the recession, direct more federal money to states’ Medicaid programs, says Joseph Newhouse, PhD, a professor of health policy at Harvard University. Indeed, in the months before she was named deputy director of the White House’s new office on health reform, Jeanne Lambrew urged Congress to pass legislation that would boost federal funding for Medicaid and SCHIP.
