Open for Questions: The State of the Union and Health Care

Kori Schulman: Good afternoon and thank you for joining us.
Following the president's State of the Union address earlier
this week senior administration officials, the president,
and the vice-president have been answering your questions in a
series of live online events.
Today we are so pleased to have with us Secretary Kathleen
Sebelius who will be answering your questions in a live
discussion on health care.
I'm Kori Schulman.
I work in the Department of New Media here at the White House.
And today we are joined by a number of folks that are
representing questions that they have been collecting from their
respective audiences and websites.
And I'm going to go around the table.
We have Leslie Kane from Medscape.
Marjorie Martin from AOL Health.
Robert Hess with Nurse.com and Gannett Education.
And Kristy Hammam with WebMd.
And to my right is of course Secretary Sebelius.
Thank you all so much for being here.
And thanks to everyone that's watching at home.
So the way that this is going to work is we are going to ask a
number of questions that are -- we are -- the folks at the table
are going to ask a number of questions of the secretary and
then there's also a live chat that's happening right
now on Facebook.
So if you go to WhiteHouse.gov/live,
you can click to join the chat, and I'll be scanning that over
the course of this round table and we'll be answering a lot of
your questions as they come in.
So with all further ado, I'm going to turn it over
to Marjorie from AOL Health to ask the first question.
Marjorie Martin: Madam Secretary, first of all, thank you for inviting us.
The response among the AOL audience has been tremendous.
They are very passionate about this topic which probably
doesn't surprise you.
We launched a page on Monday and we had 2,000 questions and
seemingly in no time.
We also did a poll just to try to find out what
the trends were.
So we got a lot of very interesting information.
The question that we got the most by far was around whether
Americans would achieve parity in the quality of their health
care with what is perceived to be the quality that members like
yourself and Congress are able to get.
So, just to read one of them: Jack from Kansas,
a state I think you know well.
Secretary Sebelius: I do.
Marjorie Martin: It says as a citizen and a taxpayer I want to know when
I can have the same health care that the Congress of the United
States and the cabinet have?
Secretary Sebelius: Well, Jack, that's a very good question.
And I think there's good news under way that one of
the features of the Affordable Care Act,
the law the president signed in March has some building toward
state based exchanges, a new marketplace where private
companies will compete around a set of benefits and those who
can't afford to pay 100% of the benefit will have some tax
credit help to get there.
And small business owners and individuals will have some new
market strength, they will be pulled together.
They don't have to join an organization or change jobs,
but they will be included in a larger pool.
In 2014 not only will Jack and his colleagues have an
opportunity to purchase coverage with those state
based exchanges, and Jack's will be run out of Kansas,
but that will be the coverage that members of Congress will
have for themselves and their families.
So it isn't sort of like it.
It isn't almost like Congress; it will be the congressional
plan starting in 2014.
Marjorie Martin: That's fantastic.
I think that will make a lot of these people very happy.
Thanks.
Secretary Sebelius: Thank you.
Kori Schulman: Okay, now I'm going to turn it over to Robert Hess of Nurse.com
and Gannett Education.
Robert Hess: By way of explanation Nurse.com and Gannett Education as well as
our print magazines' counterpart Nursing Spectrum and Nurse Week,
we specifically have programming for RN's,
the largest health care group in the United States.
And I want to thank you in advance for answering a question
I was about to ask you.
And I have to tell you that we received, for this one,
an incredibly enthusiastic response.
Secretary Sebelius: Great.
Robert Hess: Just a ton of questions.
As an administrator I am totally daily humbled by the advice and
expertise of people in my department and nurses on the
front line, the advice that they have for me as an administrator.
And we noticed that in his address the president said
he was eager to hear ideas about improving
the Affordable Care Act.
Registered nurses are direct care providers who witness
firsthand the day-to-day challenges facing caregivers
and their patients.
Betty, an RN from Elkins Park, Pennsylvania,
asked if the administration plans to seek the input or
front-line nurses like her in the ongoing discussion of the
health care reform.
Secretary Sebelius: Well, absolutely, I think that not only would we welcome Betty,
but Betty's colleagues across the country.
We have some key leaders in the Department of Health and Human
Services who are nurses.
So, Mary Wakefield who runs our administration for services
administration which runs everything from the community
health centers to the workforce issues is a nurse.
Marilyn Tavenner who is the Deputy Administrator of Centers
for Medicare and Medicaid Services is a nurse.
So what Betty needs to know, first of all,
she has some very key allies who are running major parts
of this new program.
We also have a whole host of commissions and board and
outreach opportunities and we would love to have input from
those nurses who are delivering the care day in and day out,
who know best, how the new system and particularly the new
delivery system, how to keep people healthy in the first
place, how to use everything from medical home models to
bundled care, what folks get out of the hospital to reduce
readmissions, and we look forward to having those ideas
and those strategies as we make a transformation in health care.
Robert Hess: We are a big fan of Mary Wakefield;
we'd love to help you find those nurses.
Secretary Sebelius: That's great. Perfect.
Kori Schulman: I'm going to turn it over to Kristy of WebMd.
Kristy Hamman: Thank you for having us here today.
WebMd has been actively covering and following
health care reform legislation.
We've polled our audience and they have cited health care as
the most impactful health story of the past year.
And we've opened up our site or questions,
following the president's State of the Union address.
I wanted to start off with a question related to you,
a comment that the president made of his address Tuesday.
He said he's not willing to go back to the days when insurance
companies could deny people coverage because
of preexisting conditions.
The topic of preexisting conditions generated
many questions.
Michelle K. says, I'm being denied covered now because
of a preexisting condition but I thought the new law
did away with that.
Secretary Sebelius: Well, Michelle is probably an adult
is my guess by the question.
And the way the new law is working is starting in 2011
health plans can no longer deny children who have preexisting
health conditions coverage.
And that has been a long standing legal discrimination
where a family might get a plan but the child who had a
preexisting health condition, anything from asthma to diabetes
to being a cancer survivor, could be turned down and not
covered under that family plan.
That stops this year.
What will happen in 2014 then these new exchange market places
are up and running and there are options for other,
no company will be able to have an exclusion for adults.
So it's a phased-in program, but it's a critical end to what has
been a practice for a long time where the people who needed
coverage the most were not able to get coverage and often locked
out of the marketplace.
In the meantime, every state has a new high-risk insurance pool
up and operating, thanks to the Affordable Care Act.
The prices have to be the market prices so they can't be charged
150% or 200%; still pretty expensive coverage.
But if an adult has been uninsured for six months and
turned down in the market they do have now and this is a bridge
strategy to get adults with preexisting health conditions
from 2011 to 2014, there is an additional option right now in
every state in the country.
Kristy Hamman: Thank you.
I think that's really helpful to -- I think the confusion
has been around what's in effect now versus 2014.
Secretary Sebelius: You bet.
Kori Schulman: Thanks. Now to Leslie Kane of Medscape.
Leslie Kane: Hi, I'm Leslie Kane. I'm editorial director of Medscape.
And Medscape is the leading source for clinical and business
information for physicians and health care professionals.
Medscape gets more than 2 million physician visits per month.
And I'm here with my colleague Kristy Hamman from our consumer
site WebMd.
And my question is -- and thank you for having us here today.
This is from a cardiologist from Kentucky.
It's great that President Obama is going to look at dealing with
frivolous lawsuits.
How big an impact do you expect this to make on health care
costs and is it likely that he would look at capping
noneconomic damages or other tactics for tort reform?
Secretary Sebelius: Well, the president has said pretty consistently that he
does not support caps.
And so, federal program which would preempt state laws -- you
know, there are some states with caps on various kinds of damages
and there are other states that are not.
So he doesn't believe that the feds should take over
that legal jurisdiction.
At the time he directed us at the Department of Health and
Human Services to work with proposals across the country.
And we right now have about 13 programs under way where people
are really gathering data on everything from faster way to
remedy an injured patient to making sure that we increase
patient's safety standards, gathering data on what actually
works to both lower costs but improve patient safety
along the way.
And I think he's in the process of developing additional
proposals which he thinks can be very helpful in this area.
Its malpractice insurance rates are a tiny fraction of health
care costs, but I think a lot of physicians also feel there's a
defensive medicine practice and I'm not sure that anybody can
quantify what that means or how many tests may be taken,
how many strategies may be employed,
because of defensive medicine, but I think to try and eliminate
that, compensate patients increase safety standards,
and give doctors who are practicing the peace of mind
that they should deserve as they deliver patient care is
really the goal.
Leslie Kane: Thank you.
I think that will be great step and our readers will
definitely appreciate it.
Kori Schulman: If you're just joining us we have a live chat that's
happening right now on Facebook.
Go to White House.gov/live. I'm scanning the chat.
We've got a lot of great questions coming in.
This one comes from Sam Pelk.
Sam says, Secretary Sibelius, prevention is the new buzz word
in health care reform.
I'm a resident in the specialty of preventive medicine and I'm
wondering what your agencies prepare to do to support an
appropriate workforce to support these prevention initiatives
beyond expanding primary care?
Secretary Sebelius: Well, I think that's a great question.
We've had a looming shortage I think of providers on the
horizon for really decades.
And the first time the recovery act and now the Affordable Care
Act are really helping us look at that pipeline.
But there's no question we need certainly more
primary care physicians.
We need more nurse practitioners and registered nurses.
We need additional gerontologists and mental
health professionals and a host of community health workers who
actually can be very effective in the strategies of intervening
at a much earlier stage, yet treating people early,
avoiding that acute care situation.
So, a lot of the steps in the Affordable Care Act actually
promote that workforce pipeline.
We have funding to train about 16,000 additional primary care
providers in the next five years.
We are doubling the number of practitioners in the health
service core, so that in exchange for serving in an
underserved area we'll pay scholarships and help people
with their practitioner loans, encouraging,
reaching into minority communities for culturally
competent providers.
But I think training the whole host of workers so you have a
continuum of care, it's not just medical providers,
but it really is community health workers and others who
can be effective in medical home model,
keeping people who have been dismissed from the hospital for
instance, making sure that they are filling their prescription,
taking their medication, that often can be a very
effective strategy.
Kori Schulman: Great. Well, now I'm going to turn it back over to Robert from
Nurse.com and Gannett Education.
Robert Hess: Following up on the education thing.
When I was younger, as a college graduate,
I was a nursing assistant who went back to school to
become an RN.
My wife is a physician and the two of us,
we probably consumed more college credits
than anyone I know.
But something that's dear to our heart and our company that we
worked with, Johnson and Johnson campaign for nursing future,
has to do with the fact that nurses need to go
back to school.
The federal government projects a shortage of nurses within the
next decade, but there's currently a shortage nursing
faculty available to teach the next generation of nurses.
Barbara, a nursing instructor from Seattle Washington,
would like to know the administration's specific
plan to alleviate the severe shortage of nursing faculty.
Secretary Sebelius: Well, you can't train more nurses unless you have nursing
faculty to do that training.
And again that is I think part of this pipeline.
There are additional funds this year that HRSA is a putting out
the door, specifically for nursing faculty.
There also is a brand new workforce commission which
is about to get to work.
One of the things that I think is still lacking is an accurate
mapping of where the providers are going to be needed,
what the specialties are in geographic location by specialty
area and then having a very strategic plan to not just
educate more folks of various kinds,
but really match the need to the training that's given.
So that commission has just been appointed.
They hopefully will start working very soon.
But nursing faculty, funding more nursing faculty,
encouraging more people to go back to school and get those
nurses, we just met recently with former HHS Secretary Donna
Shalala who just led a major national study as you are well
aware, on the future of nursing.
And it deals with everything from allowing providers to
practice to the scope of their education,
which is now restricted in too many states,
as well as dealing with the faculty issue.
And we are working very closely with her on implementation
steps that we can take within our administrative authority to
encourage the acceleration of those plans.
Robert Hess: I think that's good news for the potential nurses that can't
get into nursing school because there aren't spots because there
are no faculty.
Secretary Sebelius: You bet.
Kori Schulman: Kristy from WebMd.
Kristy Hamman: Sure, we've received a lot of personal stories,
some of them heart breaking, frankly,
from people who are facing sky rocketing premiums and they
either can't afford them or they are afraid they are not going to
be able to afford them in the future.
And so, here's an example of a question Miranda in
Colorado says.
You know what if premiums are too expensive,
how is a new plan going to keep costs down so
they are affordable?
Secretary Sebelius: Well, it's a great question, and you know,
insurance premiums have been sky rocketing.
They are up about 133% over the last decade.
And in many instances, particularly employees who have
employer base coverage, often they are paying not only more
substantially more for their share of the premium,
but they are paying a lot more out of pocket.
A lot of the expenses have been shifted.
So it's sort of a double whammy.
Two things are going on.
One is again, building toward this new market.
There will be a more competitive marketplace.
And that in and of itself will help contain costs.
Competition as opposed to monopolies really does help
in this instance.
And everyone in the new exchange will have a choice of at least
two plans.
And, we also have helped to give additional resources to state
insurance commissioners.
Insurance is regulated at the state level.
And in too many cases the insurance regulator didn't have
the staff, the wherewithal, the expertise to really question
company rates, look at the underlying data,
make sure that there was a careful balance between keeping
the company solvent, but also keeping people in the
marketplace and that the rates were fair and justifiable.
So those resources have been part of the new
Affordable Care Act.
A more rigorous review.
And already are paying dividends.
So in Connecticut, rates that were initially submitted by the
largest insurancer were denied.
The company came back and cut the rate request by two-thirds.
In California, they pulled the rate all together and came back
with a much different structure.
And in fact we are demonstrated to be using the wrong trend.
Not only was the rate almost 40% of an increase but it was the
wrong trend line used by the company.
So when the actuaries looked at it they couldn't even justify.
So those help.
We also have a new website, Healthcare.gov, that is
up and running.
And a consumer can go on the website, by zip code,
put in a little information.
And for the first time ever in history,
get a snapshot of what is being sold in that marketplace for his
or her age group and what the prices are.
We find that the insurance market,
you can often get more information about the toaster
you're going to buy than the insurance plan you're purchasing
for yourselves or your family.
Those days are over.
And just having some transparency,
lining up plans side by side, measuring rates side by side
in and of itself has begun to change some
of the marketing tactics.
We find that companies don't want to be the highest price
plan in the marketplace.
And once you can see them side by side it's beginning
to make a difference.
So competition will help.
More rigorous rate review will help.
And frankly some of the efforts that we're going to get under
way in terms of improving overall health care will
help the underlying costs.
Kristy Hamman: Thank you.
Secretary Sebelius: Sure.
Kori Schulman: We've got a live conversation that's
happening right now on Facebook.
If you want to join the chat and ask your question for Secretary
Sebelius, go to WhiteHouse.gov/live.
There's a link to join the Facebook chat.
We just got a question that comes from Susan Keys.
Susan asks what initiatives are planned to support the
development of innovative uses of technology for
promoting health.
Secretary Sebelius: Oh, Susan, that's a great question.
And I think some of these groups represented around the table are
already using technology to involve consumers in
their choices and in their health plans,
but there are lots of really exciting things on the horizon.
We are right now working with Johnson and Johnson on a text
for babies to a strategy where pregnant women are given cell
phones and regular updates involving prenatal care advice,
you know, what should happen in the first month,
what kind of vitamins, what kind of information?
Recognizing that everybody has a cell phone and that that's an
easy fast way to get information,
and so far the early results look very promises.
Certainly transparency, so the kind of website that I just
talked about on Healthcare.gov which has never been put
together before anywhere in the country,
making it a lot easier for people to get information,
compare information.
I think that we have a whole series of now hospital data
that's beginning to be published.
So consumers will have a lot more information about not only
costs hospital to hospital, but what the infection rates
are like, what kinds of outcomes there are.
We are also putting together community health data which I
again I think can be very exciting.
I'm hopeful that eventually we'll get to the point where
business leaders and community leaders make decisions about
where to expand and grow businesses as much on health
information as they do right now on test scores,
because it is a significant factor for a healthy workforce.
So assembling community data and actually driving some
competition among city leaders, saying what you want to do is
have the healthiest community in America,
the healthiest workforce in America.
So we're really looking at all kinds of ways that we can be
much more innovative.
And frankly, the whole goal is patient center care.
The more patients and consumers know about
their own health care.
The electronic medical records strategy is part of this where
there are now encouragement to doctors in hospitals to really
shift from a paper file system to an electronic record system.
The goal is not only to have better patient care,
but to give people access to their own health information,
things that they are really not able to have or monitor now.
So there are lots of other ideas,
but technology is very much part of I think this new
transformation of the health system.
Kori Schulman: Okay, now, I'm going to turn it over to Marjorie
from AOL Health.
Marjorie Martin: Madam Secretary, one of the most popular areas of AOL is
contin. on prevention, people are consuming it
at higher and higher rates.
And that is a nice segue into a question that we have from
Pamela of California asking if preventive care is a focus
of this plan and even further if we would ever
consider giving tax breaks to people for a living in
a more healthy way.
Secretary Sebelius: Well, that's a great question.
One of the first steps, part of the patient's bill of rights
initiatives that actually kicked into gear this year
deals with preventive care.
And any health plan that is new and offered after January 1st of
this year and for all Medicare beneficiaries no longer will
there be any co-pays for a whole variety of preventive care,
whether that's a mammogram in a cancer screening,
or a flu shot for kids or a you know updated pediatric visit.
Those are need to be encouraged.
And the goal really is to take down what may be a financial
barrier for some to actually access preventive services.
And Medicare beneficiaries for the first time will also not
have co-pays associated with that kind of prevention care.
There is a portion of the Affordable Care Act that
recognition that private have often been real leaders in
prevention and wellness.
So there are tax credits that will encourage more private
companies to actually get into that whole area to make
it easier for their employees to exercise,
easier for their employees to eat healthy diets.
We certainly are working closely with school systems and others
in terms of our children's health issues.
It's been really pretty alarming to look at not only what's often
served in school cafeterias but the lack of physical education.
That too often is a part of the kids' curriculum.
So they have become very engaged and involved.
And I know a lot of moms around the country have been very much
part of that struggle.
So right now we spend 75 cents of every health dollar dealing
with chronic disease.
Much of which is preventable.
And the goal really is to shift to a health and wellness system
and away from an acute care system.
We do acute care very well in this country.
We have not really had a lot of success or a lot of focus.
About 8 cents of every dollar is on any kind
of prevention strategy.
So we'd sort of like to change those incentives a bit and
actually encourage not only individuals,
but employers and others to take this very seriously.
Marjorie Martin: Just a quick follow-up.
Going from the 75 to 8 do you foresee a 50/50?
Do you think that would happen in terms of the portions of the
dollar going to each?
Secretary Sebelius: Well, I'm certainly hopeful.
I think that -- I mean what we know is underlying a lot of
those chronic conditions are two primary factors,
obesity and smoking.
And the efforts have been redoubled to go really
aggressively after tobacco use which dropped pretty
dramatically in this country and then has been frozen at
about 20%, among kids and adults.
And we really need, if we can lower the smoking rate from 20%
to 12% that dramatically changes then health costs
into the history.
If we really have some success on rates of obesity and then can
particularly affect the rates of children,
we will have many fewer diabetics,
we'll have fewer heart disease, we'll have so the costs will
automatically begin to balance because we won't be spending the
kind of money we are right now on treating chronic conditions,
treating acute care.
We'll have longer and healthier life styles and
more importantly, for this country, I think,
a much more prosperous workforce,
a healthier workforce.
And then that will be good for America.
Kori Schulman: Thank you. Leslie with Medscape.
Leslie Kane: Okay, thank you.
Medscape has been hearing a lot from physicians about
concern over Medicare reimbursement rates.
And so we -- no surprise, I'm sure.
We have a question from an internist in Colorado.
It says one thing President Obama didn't mention was the
sustainable growth rate and fixing the Medicare physician
payment formula.
A number of physicians have stopped taking Medicare/Medicaid
patients because of the rates paid.
How do you envision this being addressed in 2011?
Secretary Sebelius: Well, I'm really hopeful that the sustainable growth rate and
the payment rate for providers in Medicare is something that
really will get some bipartisan support.
It's totally unacceptable that we have 47 million Americans
depending on this very important plan to deliver services,
and yet providers don't know from week to week or month to
month if they actually will be reimbursed.
And the president has said from the day he got inaugurated,
this is an issue that is -- has got to be dealt with and it has
to be dealt with long-term.
Right now we have again a one year fix which at least takes
us into next year.
But he's very determined and has charged me as secretary to you
know reach out to members, both of the house and senate,
republicans and democrats, and figure out a long-term fix for
this issue.
So doctors and nurses and other providers understand that we
will be good payors, we will be permanent payors and we think
these services are critical to the people of America.
We have to fix this problem.
And just to remind some of the listeners and viewers who might
not be aware of this, this isn't a problem that arose
with the Affordable Care Act.
In fact it has nothing to do with the Affordable Care Act.
It dates back about ten years, the balance budget amendment.
And unfortunately should have been fixed a long time ago.
Congress has never really fixed it long-term.
It just sort of fixes it a year at a time.
We need a permanent strategy and a fix and a payment that
is really guaranteed on into the future.
Leslie Kane: Well, I think there will be a lot of cheering if could happen.
(laughter)
Secretary Sebelius: I can hear them.
Kori Schulman: Now I'm going to turn it back over to Kristy with WebMd.
Kristy Hamman: All right. Thank you.
Secretary when we last had the opportunity to talk this was a
question that was coming up a lot and it's still a great
interest to our audience and it really deals with
quality of care.
This is from Jim R. in Texas, and he says I already have insurance
through my employer.
I want to know how you're going to make coverage available to
more people and not impact quality.
Secretary Sebelius: Well, actually I'm very optimistic that we can improve
quality and I know that a lot of the conversation up until now
has focused on that kind of insurance market changes which
were part of the immediate changes in the Affordable Care
Act, particularly for those people in the individual and
small group market.
What I think is going to be a major focus for years going
forward is looking at the kind of care, whole delivery system.
Are we delivering the right care to the right patient at
the right time?
Is going into any hospital in America going to produce
a positive result?
Right now, we have way too many hospital based
infections for instance.
About 100,000 people a year die not from what brought them to
the hospital but what happens to them in the hospital.
We know there are strategies to make that better but we've never
really taken that to scale.
We know that way too many people who are released from the
hospital are back in within 30 days, preventable readmissions.
Some of those folks have a health crisis.
A lot of them just didn't get the proper follow-up care,
haven't filled a prescription.
Haven't followed a strategy and nobody really has checked up on
them in a long-term.
We know we can do a lot better job on how heart attack victims
are treated initially and what can prevent
the second heart attack.
So there are a number of health related goals in proving the
overall health of America.
Prevention strategies, we already talked about that will
be part of the framework of the Affordable Care Act.
And frankly the Medicare and Medicaid systems which touch
every hospital, touch most providers,
have a major role in improving the quality
of health for all Americans.
And we really intend to follow that directive.
Kristy Hamman: Thank you.
Secretary Sebelius: Sure.
Kori Schulman: We've got about five minutes and see if we can get just a couple
more questions in.
We'll see if we can get just a couple more in.
Marjorie, do you want to take the next one?
Marjorie Martin: I would love to.
Probably the third most popular question we had from our members
at AOL is -- was really a lot of enthusiasm for the reformed plan
and the idea of having coverage for everyone.
And a lot of questions, I would have attributed it to one person
because we heard this a lot is why do we have to wait 2014?
Secretary Sebelius: Well, it's a good question and I know that 2014 in some ways
seems like a long way down the road.
I can tell you for the teams that are coming together in
every state around the country to build the new exchanges,
it seems like tomorrow.
So there's a little bit of a look.
Insurance is a, you know, not only complex issue,
but the goal is really to build a stable system in the future
and to not disrupt coverage going forward.
So it was really a balance of how you fix some of the features
of the current marketplace that don't work very well.
So changing some of the rules, getting rid of all plans right
now, you know, get rid of the ability of an insurance company
to rescind your coverage if you've made a technical mistake.
That is no longer allowed by law.
All plans must offer young adults coverage on their family
plan up to the age of 26.
That goes into effect.
The elimination of discrimination of
children with preexisting conditions hits right away.
The elimination of a lifetime cap on policies
goes in right away.
And so part of it to sort of fix some of the market strategies
for the people who have insurance right now to begin
to offer some bridge strategies, so the high risk adult pool that
wasn't in place before and some help for people to get
additional coverage and building some of the workforce that we
are going to need to take care of the additional patients,
developing additional community health centers that will be
available throughout the country.
So by the time we hit 2014, an additional 30 to 35 million
Americans have coverage options, we really have a framework that
is able to deal with those folks and doesn't really debilitate
the system by sort of overloading it all at
the same time.
Marjorie Martin: Thank you.
Secretary Sebelius: Sure.
Kori Schulman: I'm going to turn it over to Robert for the last question.
Robert Hess: As an enthusiastic consumer of health care myself,
being blessed with parents who are in their 80's,
who are consuming --
Secretary Sebelius: My Dad will be 90 in March, so...
Robert Hess: Rona from Chestnut Hill, Massachusetts would like to
know how, given their increased numbers in life expectancy,
senior citizens will be able to meet their own long-term
care needs when the cost of care is still
unaffordable to most of them.
Secretary Sebelius: The long-term care needs or health care needs?
Robert Hess: The long-term care needs.
Secretary Sebelius: Well, right now, as you know, the feature in the Affordable
Care Act that deals with long-term care is really
a new program call the class act.
And what the class act anticipates is people being
able to set aside voluntarily a portion of their income and then
draw that income down sort of out of their savings account in
the future to buy a variety of residential care services.
What we hear from people all over the country and I
certainly, you know my parents were in this situation,
folks aren't enthusiastic about necessarily being in
a nursing home.
What they want to do is age in place,
have support services to live independently for as long as
possible, and some folks are forced into a nursing home
setting because they don't have help at home,
and they don't have help with daily living some of the this
is really a plan to provide a continuum of care and provide
assistance for a lot more Americans as they live longer
and healthier to really have support in a residential
community setting.
Kori Schulman: Well, thank you so much, Secretary, for joining us.
Thanks to the readers of Medscape, AOL Health,
Nurse.com and Gannett Education and WebMd,
and especially all of you that have been asking your questions
and engaging in the dialogue on Facebook.
If you joined us late this video will be posted
on WhiteHouse.gov very soon.
So check back and have a good afternoon.
Thanks.