Former U.S. Secretary of Health and Human Services Kathleen Sebelius and author and political commentator Avik Roy engaged in discussion about the future of health care delivery in the U.S. and the important role osteopathic physicians play in tackling these challenges at the LEAD (Leadership, Education, Advocacy & Development) conference Jan. 25-26 in Austin, Texas.
The DO caught up with Sebelius in Austin to talk about the patient-physician relationship and her predictions on how health care is set to progress in the U.S. This is an edited transcript of our conversation.
What can be done on the policy side to support the patient-physician relationship?
The relationship between doctors and their patients is critical to making sure people stay healthy in the first place and have appropriate interventions at the point that they may be ill.
Any interference in that—whether it’s an insurance company blocking benefits or making decisions that put a barrier in place, or policies that make it more difficult for doctor accessibility—is detrimental to the health of the population.
I think it’s really important that we work on access to care. Too many people don’t have a doctor-patient relationship because they don’t have a doctor. They don’t have access to the systems.
Providers like to be paid, not surprisingly. People will access physicians appropriately if they have a payment system. We know from years of research that they won’t seek medical attention if they don’t have a payment system until they get in very serious condition. Having a payment base and fewer barriers to make sure that physicians are able to give appropriate medical advice is critical.
What do you think the current Trump administration will do to evolve reform and make incremental improvements and large-scale changes to health care?
I think we have two things going on right now. During the Obama administration, which I’m most familiar with, there was another big step forward on access to care for a portion of the population that didn’t have readily available insurance in a work place.
There were also some medical advancements that may have years of impact. The digital medical information will enhance and advance health care delivery. I think we’ve seen incredible scientific breakthroughs. In terms of health reform, what we’ve seen so far in the first year in the Trump administration is trying to take a step back on access to care, and repealing the framework that provided affordable care to a lot of people.
That wasn’t successful; so now the effort is to do the same thing, restrict care through a whole variety of administration policies.
We’ve already seen uninsured American numbers tick up. For the first time since 2008, we had more uninsured in 2017 than we did in 2016—that’s not good news. That’s not good news for providers and that’s not good news for the country. I think that seems to be a determined effort of this administration. If they can’t pass legislation which makes it more difficult for people to purchase coverage, then the policies will shrink that coverage.
What are you most optimistic about in terms of creating and promoting health for all Americans?
I do think now there is a framework for a newer and very important discussion in this country to shift from being disease-focused to health-focused, and to keep people healthier in the first place.
It’s not only a health issue, but also an economic issue for the country. We spend a lot more than most countries on health care, yet our health results don’t really look as good compared to a lot of our economic competitors.
I think it’s being seriously engaged at the national level in terms of how you use financial incentives to drive more appropriate care at an early basis. I think that and scientific breakthroughs make it possible that we’re looking at health strategies that we never even imagined 10 years ago, where people will live and manage diseases that were once killers as chronic diseases, and where we can look at extending life dramatically for millions of people.
Hopefully at the same time, we can change the trajectory of chronic illness with many of our seniors. Looking at health, wellness and well-being issues, becoming one of the healthier countries in the world will be a great advancement.