What Does a Sebelius HHS Look Like?

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Since the withdrawal of Tom Daschle for Secretary of Health and Human Services due to tax non-payment issues, there has been a somewhat urgent effort to find a replacement nominee, presumably someone whose taxes have been reviewed with a fine toothed comb.  The conventional wisdom has settled on Governor Kathleen Seblius of Kansas.  This weekend, in an article carried by the Washington Post, when asked about the possibility she replied that she had "no comment", which is the Washington equivalent of the Los Angeles "we're just friends" reply in the media.  

What would a Sebelius HHS look like?  She has fought for taxing tobacco at higher rates in order to subsidize wider access to healthcare for Kansans, but it would appear that while her sentiment for healthcare reforms have been in the right place, her aims have been thwarted by a legislature that was dominated by another party and which did not take healthcare reform very seriously, according to an AP article carried in The Wichita Eagle on Saturday.

According to the article, modest goals have been achieved, including allowing more people to buy into COBRA to keep their insurance for 18 months after job loss; expanded cancer screenings and more funding for clinics.  However, hard reform has been elusive.  

Prior to being governor, she was the state's insurance commissioner, so suffice it to say, she understands the complex world of reimbursement and respective roles of all the stakeholders very well.  

But in addition to what was reported in the AP Article, the Governor's site also provides insights into her positioning:

  • Purchasing - She streamlined and consolidated Kansas' health care purchasing into a single division, all under one roof – allowing Kansas to secure the most competitive prices for state-provided health insurance by maximizing the state's purchasing power;
  • Health IT – She organized a Cost Containment Commission of business leaders, health care providers, private insurers, and patient advocates who recommended ways to increase modern health care technology such as a transition to electronic medical records, which would reduce the cost of copying forms, as well as promote consistency in care and reduce the burdensome administrative costs, indicating skills at consensus development and an understanding of the role and potential of Health IT and which produced a report called "Kansas Health Information Exchange Roadmap";  
  • Importation Kansas now participates in the I-Save-Rx initiative, which opens the door for Kansans to buy safe, lower cost prescription drugs from state-approved pharmacies in Canada and Europe.   
  • Creating Insurance Pools – She plans, if she stays, to seek ways for small business to band together in order to create greater purchasing power in getting health insurance for employees.    

In short, there is a lot with Sebelius that would have been there with Daschle – no reluctance to address tobacco, embracing the need for health IT, importation and an understanding of what it takes to negotiate lower prices, she presumably would support, as does the Administration, allowing the government to negotiate Medicare Part D prices.  Whether or not, in fact, she gets the job, or wants it, remains to be seen.   

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