President Shalala Shares Her Optimism for Health Care Reform’s Future

UM President Donna E. Shalala told a standing-room audience at the Louis Calder Memorial Library last week that even if the U.S. Supreme Court strikes down the mandate that all Americans have health insurance by 2014, the structure of the new health reforms will survive, moving the nation closer to the universal health coverage that most countries already offer.

Her optimism, Shalala explained while delivering the 11th Biennial Ralph H. and Ruth F. Gross Lecture on November 17, derives from the trillion dollars the act will pump into the health care system over the next decade to subsidize the exchanges states are setting up to provide insurance to small businesses and individuals without coverage. Though states don’t yet have the federal subsidies that will help low-income people buy into a plan, Shalala said, at least 16 already have exchanges, and even reticent states like Florida will be hard-pressed not to follow.

“We’re at one of those points in American history in which we’re…going to move forward on something very fundamental, and that is to make sure that every American family and every American has access to good health care,’’ Shalala said in her talk, “The Future of Health Care.” “Does insurance guarantee it? It does not. But let me assure you, people follow the money. When you put a trillion dollars into the health care system something’s got to happen…. Lots of other things have to follow, but it’s a very exciting period.’’

A student of – and notable player in – history and politics, Shalala began her presentation by recounting one of her favorite moments in health care history, the day in 1965 when President Lyndon B. Johnson signed Medicare and Medicaid into law at the Truman Library in Independence, Mo.

After the ceremony, where Johnson presented former President Harry S. Truman and his wife, Bess, the first Medicare cards to honor Truman’s unsuccessful effort to establish a national health insurance plan two decades earlier, a young New York Times reporter thanked Johnson “on behalf of my mother.”

When Johnson replied, “I think you should thank me on behalf of yourself,’’ the newsman assumed Johnson was thinking of the day the reporter would need Medicare himself. But, Shalala said, Johnson was transmitting “a much more significant political message.’’

He actually meant that Medicare, as well as Social Security, would enable the middle class to buy houses and cars and send their kids to college, because they wouldn’t have to worry about paying for their aging parents’ health care. The programs, Shalala said, were “life-changing” subsidies for the middle-aged and middle-class – and the beginning of a movement in America to try to provide health coverage for everyone, which today is a matter of fundamental fairness.

“You may not like the mandate that requires everyone to buy health insurance, but if one person gets off the hook then the rest of us pay. They are just shifting the cost to us,’’ she said. “That’s fundamentally unfair.’’

The nation’s longest serving secretary of the Department of Health and Human Services, Shalala is the first sitting UM president to deliver the Gross lecture, which was established in 1990 to celebrate Ralph Gross’ appreciation of the value of information. A Broward County poultry farmer, he was determined to learn why only a few of his first hatchlings survived and spent hours in the Calder Library researching nutrition and health. The feed supplements he later invented saved his business, earning him a patent and a fortune.

To honor his memory, his wife seeded a $1 million library endowment in the 1980s, and the library recognized her gift by establishing the lecture series. Since then, a person of exceptional accomplishment has made a presentation every other year with the Grosses’ daughters, Patrica Bergman and Carol Clarkson, in attendance, as they were this year.

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