Q: How many people will this help?
A: We think there are about 1.2 million young Americans who may qualify for this benefit. I think the feedback that we have gotten so far is enormously positive from families and young adults.
Q: As secretary, you have fought against health insurers on premium increases, policy rescissions, and pre-existing condition exclusions. Do you view this role as similar to your past work as Kansas insurance commissioner?
A: Well, it’s familiar, and that’s good news. I kind of know the ropes. As insurance commissioner I worked at the national level, and worked with a lot of the major insurers. But the way this bill is set up, it’s a very state-friendly bill. So we still assume that states are the best place for regulation, and we at HHS can stand behind the states. We think the states are the best place to run a high-risk pool or to set up a state [insurance] exchange. But in the event they don’t want to do that, the folks at HHS will work on behalf of consumers in that state. I get to work with a lot of my old colleagues, and I’m very familiar with the kind of work they’re doing and the kind of regulatory oversight that’s so important to protect people against what may be egregious activities [by] insurance companies.
Q: Why isn’t health care reform more popular in the public opinion polls?
A: There’s still a lot of confusion about what actually the law does and what it doesn’t do. One of the challenges we have, along with implementation, is to explain to people a lot of what they heard about -- that government was going to take over your health plan, or there would be some sort of a death panel -- a whole variety of scare tactics and misinformation that were intentionally put out into the public and driven with about $200 million worth of ads. People have a lot of misconceptions.
But what I find is that the more they learn about the law -- about the fact it’s really returning some authority back to consumers, helping them get some control over their own health decisions, giving people choices they didn’t have, using the kind of clout of our office to put together helpful information and oversight -- the more positive they feel about the bill.
Q: What’s the one thing in the reform law that you wish more Americans knew about?
A: One of the really exciting features that isn’t an immediate payoff, but I think may have the best long-term bang for our buck, is the real shift we’re making from what we have now as a sickness care system into a real health care system. A lot of benefits, a lot of the framework is getting everybody a health home, making sure that preventive care doesn’t have financial barriers. Trying to intervene early, get more primary care docs, more nurse practitioners, more people who work hard at keeping their patients healthy [rather] than waiting till they get to hospital and treating them when they’re sick.
We spend a whole lot of money compared with most countries around the world, and our health results are pretty mediocre. I’m a big believer that if we can refigure our health incentives, look at quality outcomes, and hopefully get people in healthier condition and keep them there, that overall we’ll have much higher quality at a lower cost and better results.