Today, the Center for American Progress Action Fund released Change for America: A Progressive Blueprint for the 44th President, “to help guide the presidential transition process and steer the government in a new, more progressive direction.”
Among the various chapters on economic policy, foreign policy, and environmental policy is a detailed examination of how the new head of the Department of Health and Human Services (HHS) — Sen. Tom Daschle (D-SD), and Gov. Howard Dean (D-NH) are both being considered for the position — can expand health care coverage and simultaneously take steps to lower health care spending.
At a panel discussion unveiling the project, CAPAF Senior Fellow Jeane Lambrew outlined five concrete steps the new HHS secretary can take to address the health care crisis:
1. Reverse Bush’s August 17th SCHIP directive: Going beyond simply vetoing SCHIP expansion, in August 2007, President Bush issued a directive that required states with already expanded coverage to higher-income children “to limit eligibility to those who were uninsured for the previous 12 months.” As a result, states that have had their expansions blocked or have had to scale back plans to cover more children. The new HHS secretary should immediately reverse this policy.
2. Strengthen consumer protections in private plans: The Bush administration encouraged greater private plan participation in public programs, at the expense of consumer protections. Private insurers have scaled back Medicare benefits to discourage high-cost enrollees, used aggressive tactics to sign beneficiaries up for private insurance, and engaged in unscrupulous marketing practices. The new HHS secretary could issue clear guidelines that would protect high-cost beneficiaries, set standards for supplemental benefits and strengthen guidance on marketing.
3. Increasing scientific integrity: From limiting federal funding for embryonic stem cell research to deleting references to condom use from the Centers for Disease control and Prevention website, the Bush-run HHS consistently placed conservative ideology ahead of scientific integrity. The new HHS secretary should assert that all programs be held to the highest standards of medical accuracy, free from political interference and in accordance with leading ethical guidelines.
4. Prioritize prevention: 70 percent of deaths and 78 percent of health care costs are attributed to chronic diseases, many of which are preventable. Recent studies suggest that investing $10 per person per year in prevention could result in a savings of $16 billion, a return of $5.60 for every $1 invested. The new HHS secretary should establish a new council that would set prevention priorities, promote healthy lifestyles, and develop policy for all HHS programs. CAPAF has proposed ‘A Wellness Trust Fund’ that pools funding and directly pays for high-priority preventive and certain public health services.
5. Improve health infrastructure: The aging baby-boomer population pose enormous capacity and infrastructure challenges. The U.S. has fewer than 7,000 certified geriatricians, yet needs 14,000, and this discrepancy will grow up to a difference of 36,000 between available and needed geriatricians by 2030. The new HHS secretary should examine federal leverage points that can increase the supply of geriatricians by investing in federal scholarship and loan repayment programs, boosting capacity in nursing education, and enacting strategies that would increase wages and benefits for direct care workers.
In short, the Department of Health and Human Services is well positioned to take executive action to reverse Bush’s regressive initiatives. With control of a budget that comprises nearly 1/4 of all federal outlays and finances about 35 percent of the $2.6 trillion health system, the new HHS secretary has considerable authority to meet the challenges ahead.