Health Care Blog

Director Orszag on Health Care and Fiscal Discipline

Posted by Jesse Lee on May 29, 2009 at 3:17 PM EDT

OMB Director Orszag explains why the fiscal problems the President inherited don't preclude health reform, but rather necessitate it.

Read the full post.

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Streaming at 1:00: Health Care Stakeholder Meeting - Physicians

Posted by Jesse Lee on May 27, 2009 at 12:34 PM EDT

At 1:00 White House Office of Health Reform Director Nancy-Ann DeParle will be leading another Health Care Stakeholder Discussion, this time with over 30 physician leaders from around the country, including deans of medical schools, CEOs of teaching hospitals, leaders of specialty societies, chairs of academic departments, and several private practice physicians.

Watch it streamed at WhiteHouse.gov/live

UPDATE: This event has now concluded but Rebecca Adelman, our reliable HHS correspondent, reports back:

Over 30 physician leaders from across the country, including deans of medical schools, CEOs of teaching hospitals, leaders in medical specialties, and practicing physicians gathered on the third floor of the Old Executive Office Building today to talk in very specific terms about ways to reduce health care costs, assure quality health care and improve the experience of practicing medicine in America. Director of the White House office of Health Reform Nancy-Ann DeParle opened the event along side four physicians working on health care reform in the Administration: Dr. Dora Hughes, Dr. Zeke Emanuel, Dr. Bob Kocher and Dr. Kavita Patel.

The discussion, moderated by DeParle and the four physicians, touched on a wide range of issues affecting the practice of medicine. Dr. Kocher began the discussion by outlining the President’s vision for health care reform: a health care system that guarantees choice of doctors and plans, invests in prevention and wellness, improves patient safety and quality of care, and assures affordable health coverage for all Americans. Dr. Emanuel then asked for specific ideas from the physicians "in the trenches" on how to improve quality and keep health care costs down. From there, the spirited conversation centered on concrete ways that hospitals and medical practices could be more efficient, notably by incorporating health information technology, and many spoke of the need for new financial incentives instead of fee for service.

There was wide agreement that health care reform must address the shortage of primary care physicians, as debt from medical school is discouraging new physicians from choosing primary care as a specialty. Dr. Hughes also asked the group to weigh in on the role of the government in health care reform, and many doctors responded that encouraging personal responsibility and increasing education are ways the government could help improve public health and prevent chronic diseases. Thanking the doctors at the conclusion of the 90 minute meeting, Nancy-Ann DeParle called the meeting both "invigorating" and "helpful."

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Engagement, Women, Health Care, and Yarn

Posted by Christina M. Tchen on May 18, 2009 at 1:12 PM EDT

Posted by Christina M. Tchen, Director of the White House Office of Public Engagement

Welcome to the Office of Public Engagement! Those of you who know Washington may have known about the Office of Public Liaison, which has been the office in the White House since the Nixon Administration that has connected the White House with public interest groups and constituencies based here in DC. Since the Inauguration, I have been the Director of the Office of Public Liaison, and our staff has had a busy hundred days reaching out to local and national groups across over four dozen different areas. But President Obama, as a community organizer himself, has always recognized the importance of engaging grass roots and grass tops, and wants this White House to be engaged in a two-way conversation with people across the country. As the President explained in the video announcing our "relaunch," we are renaming and repurposing ourselves as the Office of Public Engagement to reflect that mission – let me give you an example from an event just last week.

As America celebrated National Women’s Health Week, Health and Human Services Secretary Kathleen Sebelius and I hosted a round table discussion at Stitch DC, a local yarn store here in Washington. We were joined by 7 women small business owners who explained firsthand how skyrocketing costs are making it nearly impossible for small businesses to provide health care benefits for employees and their families.

(Photo credit: Chris Smith, Department of Health and Human Services)

Marie Connolly, who owns Stitch, discussed how difficult it was to lose employees because she was not able to offer them health care coverage. As is the case with many small business owners, Ms. Connolly was forced to choose between not providing health care insurance for her employees in order to remain competitive, or providing such benefits and risk going out of business altogether. Marie has health insurance for baby Oona (who joined us at the meeting) and her other children through her husband’s plan. Nora Connolly, Marie’s sister and business partner, recently had a harrowing health scare where she was tested for a possibly serious condition, without any health insurance. Luckily, she was fine.

Unfortunately, her situation is not unique for small business owners around the country. Angela Bradley, a small business owner from Maryland, related a similar story about being unable to provide health care to employees due to the high expense of doing so. Bradley also has lost workers to large businesses, such as Safeway, better positioned to provide health care insurance for its employees. We also heard from Leah Daniels, owner of a Washington DC cookware store, who shared that she has never worked in a job that offers health care, and currently cannot pay for health care for herself or any of her 4 employees.

(Photo credit: Chris Smith, Department of Health and Human Services)

These are just three among numerous similar stories we heard around the table which demonstrate that small businesses are struggling from high health care costs. These stories show that the health care system in America needs to be reformed to ease the burden on small businesses, and to ensure that the workers in this country, and their families, receive the health care coverage they need.

As Executive Director of the White House Council on Women and Girls, I was also interested in hearing about the effects skyrocketing health care costs have on these women and their families. It is well-documented that women are disproportionately adversely impacted by our broken health care system -– HHS just released a new report on this topic, and as always visit healthreform.gov for more information. President Obama and the White House Council on Women and Girls are committed to improving the health of all women and we know that health care reform is essential to achieving that goal.

As President Obama has said, this office serves as the front door to the White House, and we will be engaging all of you in the work it will take to change this country. The meeting I had with women small business owners this week is one of many important conversations we’ll be holding. Please stay tuned for additional blogs from me and the rest of the Office of Public Engagement staff, as we will be listening to and sharing with you the stories that we are hearing around the country.

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Weekly Address: Two Pillars of a New Foundation

Posted by Jesse Lee on May 15, 2009 at 11:59 PM EDT

This week the President discusses breakthroughs on two issues where stakeholders from all sides, who once opposed each other, are coming together for real reform. On health care and energy, solutions would provide key pillars for a new foundation for the country.

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download .mp3 or .mp4 (53.8 Mb) | also available here | read transcript

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Health Reform: “Urgency and Determination”

Posted by Jesse Lee on May 13, 2009 at 1:12 PM EDT

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download .mp4 (92.6 MB) | read the transcript

This morning the President, Speaker Pelosi, and Leadership from the House of Representatives emerged from a meeting together with a new target on moving forward with health reform: pass legislation through the House by July 31^st. The President spoke to the press after the Speaker in the South Drive at the Oval Office, telling them that "this is a gorgeous day and an encouraging day":

On health care, as Speaker Pelosi just mentioned, the House is working to pass a comprehensive health care reform bill by July 31st, before they head out for the August recess. And that's the kind of urgency and determination that we need to achieve what I believe will be historic legislation.

As I've said before, and as all Americans know, our health care system is broken. It's unsustainable for families, for businesses. It is unsustainable for the federal government and state governments.

We've had a lot of discussions in this town about deficits and people across the political spectrum like to throw barbs back and forth about debt and deficits. The fact of the matter is the most significant driver by far of our long-term debt and our long-term deficits is ever-escalating health care costs. And if we don't reform how health care is delivered in this country, then we are not going to be able to get a handle on that.

Now, in addition to the implications for the federal budget, obviously we're also thinking about the millions of American families out there who are struggling to pay premiums that have doubled over the last decade -- rising four times the rate of their wages -- and 46 million Americans who don't have any health insurance at all.

<(President Barack Obama meets with Speaker Nancy Pelosi, House Majority Leader Steny Hoyer, and House Education and Labor Committee Chair Rep. George Miller, in the Oval Office Wednesday, May 13, 2009. House Energy and Commerce Committee Chair Rep. Henry Waxman, and House Ways and Means Committee Chair Rep. Charlie Rangel also attended the meeting but are not in the photo.Official White house Photo by Pete Souza.)

The President also re-emphasized the necessity of getting final legislation passed by both the House and the Senate and signed this year. In closing, the President laid out his basic principles:

In the coming weeks and months, I believe that the House and Senate will be engaged in a difficult issue, and I'm committed to building a transparent process to get this moving. But whatever plans emerge, both from the House and the Senate, I do believe that they've got to uphold three basic principles: first, that the rising cost of health care has to be brought down; second, that Americans have to be able to choose their own doctor and their own plan; and third, all Americans have to have quality, affordable health care.

UPDATE: The President also just sent out his first email to those who have signed up for updates here at WhiteHouse.gov. If you have not signed up yet, do so here to get alerts on health care and other important issues. Read today’s email below:

Good afternoon,

You are receiving this email because you signed up at WhiteHouse.gov. My staff and I plan to use these messages as a way to directly communicate about important issues and opportunities, and today I have some encouraging updates about health care reform.

The Vice President and I just met with leaders from the House of Representatives and received their commitment to pass a comprehensive health care reform bill by July 31.

We also have an unprecedented commitment from health care industry leaders, many of whom opposed health reform in the past. Monday, I met with some of these health care stakeholders, and they pledged to do their part to reduce the health care spending growth rate, saving more than two trillion dollars over the next ten years -- around $2,500 for each American family. Then on Tuesday, leaders from some of America's top companies came to the White House to showcase innovative ways to reduce health care costs by improving the health of their workers.

Now the House and Senate are beginning a critical debate that will determine the health of our nation's economy and its families. This process should be transparent and inclusive and its product must drive down costs, assure quality and affordable health care for everyone, and guarantee all of us a choice of doctors and plans.

Reforming health care should also involve you. Think of other people who may want to stay up to date on health care reform and other national issues and tell them to join us here:

/EmailUpdates

Health care reform can't come soon enough. We spend more on health care than any country, but families continue to struggle with skyrocketing premiums and nearly 46 million are without insurance entirely. It is a priority for the American people and a pillar of the new foundation we are seeking to build for our economy.

We'll continue to keep you posted about this and other important issues.

Thank you,
Barack Obama

P.S. If you'd like to get more in-depth information about health reform and how you can participate, be sure to visit http://www.HealthReform.gov

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Attacking Health Care Costs from All Angles

Posted by Jesse Lee on May 12, 2009 at 3:41 PM EDT
Yesterday, the President held a landmark meeting with a wide array of leaders in the health care field – insurance companies, hospitals, pharmaceutical companies, medical device manufacturers, and providers –who pledged to work together to control costs in health care to the tune of $2 trillion in savings over the next ten years. Today, the President held another meeting with five employers, a state health department, and a union to discuss innovative ideas that are being implemented in the workplace to improve the health of workers and reduce the rising rate of health care spending.

(President Barack Obama listens to Safeway President and Chief Executive Officer Steve Burd during a meeting with business leaders in the Roosevelt Room of the White House to discuss employer health care costs, May 12, 2009. Official White House Photo by Pete Souza.)

The President directed the Office of Personnel Management to work with the Office of Health Reform, the National Economic Council, the Department of Labor, and the Office of Management and Budget to examine successful employer wellness and prevention practices that lower health care costs and improve employees’ health, and to explore possibilities of developing a plan for federal employees and their workplaces.

More generally, the discussion was designed to expand on the theme that the health care system in America needs comprehensive reform, including a much greater focus on wellness and prevention. As the President stated in his remarks afterwards, "what we've done here today is to gather together some of these stories and best practices to make sure that they are going to be informing the health care reform discussions that take place here in Washington." If these companies have been able to implement proven measures in the private sector, "there’s no reason why we can’t do that for the country as a whole." The White House fact sheet details the attendees and the kinds of practices they have been implementing:
- H.E.R.E.I.U. Welfare Fund(Dr. Jerry Reeves, Chief Medical Officer): The Hotel Employees and Restaurant Employees International Union (H.E.R.E.I.U.) Welfare Fund offers multi-employer health insurance coverage for 90,000 eligible employees and their family members. It redesigned its health benefits and health plan administration and implemented wellness and chronic disease management programs to generate millions of dollars in overall savings. The H.E.R.E.I.U. Welfare Fund has also aligned incentives with desired behaviors by informing patients which physicians were high-performing, providing performance bonuses to high-performing doctors, and giving pregnant patients incentives to receive prenatal care. These initiatives have effectively engaged workers to improve their health through widespread use of employee risk assessments, risk-based interventions, and behavior change programs. The H.E.R.E.I.U. Welfare Fund also has worksite pharmacies that give out free generic drugs for chronic conditions and provide special care centers for workers and family members who have high cost and complex chronic conditions.
- Johnson & Johnson (Bill Weldon, Chairman of the Board and CEO): Johnson & Johnson has one of the longest-running workplace health programs in the United States. The company has a sophisticated set of disease management and prevention interventions, risk-based incentives, pedometers/exercise goals, treadmills available for offices, and other health related programs. According to its recent employee health scorecard for United States employees, at the end of 2007, Johnson & Johnson continued to make health improvement progress and its health initiatives avoided an estimated $15.9 million in health care costs in 2007. As well, from the late 1990s to 2006 in the United States, smoking declined from 12 percent of its workforce to four percent, high blood pressure dropped from 14 percent to six percent, and high cholesterol went from 19 percent to six percent. A 2002 Rand study found that Johnson & Johnson’s initiatives had improved employee health and employees had saved an average of $225 per year because of a reduced need for doctor visits.
- Microsoft (Cecily Hall, Director of US Benefits): Microsoft creates personalized health goals and has a staff of doctors that makes house calls to avoid emergency room visits. Its obesity program assigns employees to a primary care doctor, behavior health specialist, and nutritionist, and Microsoft provides free meals consistent with diet recommendations to eat on site or to take home. The result of its initiatives has been very low premium growth and a healthier workforce than other companies with workers of similar age. Microsoft has been continually recognized as one of Fortune’s 100 Best Places to Work.
- Ohio Department of Health (Dr. Alvin Jackson, Director of Ohio Department of Health): The State of Ohio created a "Take Charge! Live Well!" program to reduce health risk factors for state workers, with more than 50 percent of eligible workers participating. Until 2005, health care programs for state employees in Ohio focused on disease management and improving the health of high-risk groups. After reviewing data, the state discovered that while 27 percent of total health care costs were related to high-risk employees, 44 percent of costs were associated with preventable conditions. Ohio’s "Take Charge! Live Well!" comprehensive health management program includes online and telephone health assessments, health coaching, online health improvement program, on-site employee health screenings (offered at about 40 locations), preventive care, chronic condition management, and monetary incentives of up to $100 in incentive payments, or $200 when spouses are enrolled, if employees complete a health assessment and participate in a health improvement program.
- Pitney Bowes (Murray Martin, Chairman of the Board, President, and CEO): Pitney Bowes offers onsite comprehensive health clinics and fitness centers, redesigned food merchandizing and prices in their cafeterias, incentives management for the health of their employees, and low cost drugs for chronic diseases. The company has also adopted infection control practices and offers low-cost or no-cost preventive screenings and immunizations on-site and off-site. The company’s initiatives and its commitment to increase employee participation in managing their own health have resulted in $40 million in savings over the last nine years.
- REI (Sally Jewell, President and CEO): REI offers health benefits to all of its full and part-time workers and has been continually recognized as one of Fortune’s 100 Best Places to Work. The company offers employees support for outdoor activities ranging from outdoor gear and apparel discounts, free rentals, and outdoor challenge grants. REI employees can earn extra healthy lifestyle dollars to put toward the cost of coverage by engaging in specific "good behaviors," such as getting regular aerobic exercise. REI also supports personal health goals and provides equipment support, discounts, and time off so employees can achieve their goals.
- Safeway (Steve Burd, President and CEO): Safeway has innovated in benefit design to reward employees’ healthy behaviors and improve adherence to recommended treatments for chronic diseases. Over 74 percent of Safeway’s 30,000 nonunion workers have signed up for its "Healthy Measures" program. Under this program, participants undergo screening tests (including cholesterol, blood pressure, and weight control), and employees who score well pay lower health premiums. Safeway has saved millions by making employees accountable for their weight, smoking, cholesterol, and blood pressure. The company also has a free fitness center at its headquarters, offers gym membership discounts, and provides a 24-hour nurse health hotline. In 2006, Safeway’s efforts reduced their total health care spending by 13 percent, and employees who signed up have saved more than 20 percent on their premiums.
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