Former US Department of Health and Human Services Secretary Kathleen Sebelius joined Aspen Institute President and CEO Walter Isaacson for the concluding conversation of Spotlight: Health, the health-focused event series kickoff to the 2014 Aspen Ideas Festival. Keeping with the theme of the Festival, Sebelius was asked to predict how the state of US healthcare is likely to change by 2024.
“I hope — and I think it’s a very good likelihood — that fee-for-service will be a thing of the past,” she said. “I know there’s an effort right now to see what can be locked in by December of 2016, and the tools are there to do that, so you make that shift. And frankly, if Medicare moves, the market moves.”
While admitting that the disastrous rollout of the online marketplace, Healthcare.gov, caught her by surprise, Sebelius emphasized that the Affordable Care Act has had a profound impact, even years before the marketplace launch.
“I think this is the untold story of the Affordable Care Act. … Costs in health care are rising at the lowest level in 50 years,” she said. “And that’s not just in the private insurance market. Medicare costs have never been lower.”
But even the eventual success of the online marketplace — which exceeded its projected enrollment — has not swayed politicians who have acted out of a rancor for the president and his ideas, Sebelius said. Even beyond Obamacare, politicians have threatened to slash the budgets of the Centers for Disease Control and Prevention and the National Institutes of Health — the “gold standard” of health research in the world, she added.
“We have to stand up, I think, as taxpayers, and say, ‘Nothing could be worse, in this economy, looking into the future, than cutting research and innovation in this day and age,’” Sebelius said. “And you can’t do it without new money.”
“We need new money at the table. So we need to both put CDC back where it belonged, but also fund research and innovation, which countries all around us, our global competitors understand, which is why they’re doubling down on research dollars right now, as we are leveling out of research dollars,” she said. “It is dangerous for our country. It’s bad for young scientists who are moving overseas so that they can do the kind of research and grants that they want. And it’s just, frankly, a stupid economic proposition. [It] makes no sense.”
