Preventive Health Care Coverage Under Health Reform

Dr. Wasserman: Good afternoon.
I'm Dr. Alan Wasserman, Chairman of the Department of Medicine
and President of the George Washington University Medical
Faculty Associates.
I'd like to welcome everyone to today's event.
I am pleased to introduce our honored guests,
Nancy Freeborne-Brinton.
Nancy.
Nancy and I go way back.
[laughter]
Maggie Roberts.
The Secretary of Health and Human Services, the Honorable
Kathleen Sebelius.
[applause]
The Honorable Dr. Jill Biden.
[applause]
And it's my honor to introduce the First Lady of
the United States Michelle Obama.
[applause]
Secretary Sebelius: Well, good afternoon everyone.
It's great to have a chance to be here at George Washington,
and to have a chance to talk to all of you today about together
how we can build a better health care system that's focused on
actually keeping people healthy in the first place and talk
about some critical early benefits in the Affordable Care
Act that help us truly put prevention first.
We have two of the country's foremost health leaders with us,
our First Lady Michelle Obama, and Dr. Jill Biden, true leaders
when it comes to prevention and health and preventive services,
and they've already inspired millions of Americans with their
words and with their work.
Thank you in advance to our two other special speakers, Maggie
Roberts, who is a parent with an incredibly compelling story
about how a routine well-child visit saved their son's life,
and Nancy Freeborne, who exemplifies the committed
providers across the country and actually is right here at George
Washington Hospital, but who see the need for preventive care
each and every day.
Their stories help all of us understand the human
consequences of this new law.
And I want to thank our host, George Washington University
Hospital, who are setting a great example when it comes to
prevention, whether it's your Mammovan program or HIV
screenings at Redskins games, there is a lot of community
outreach and a lot of good work going on.
We need all of us working together in all parts of the
health care system if we're going to make our nation
healthier and our health care system stronger.
George Washington Hospital is one of the health providers
leading the way with exactly the kind of innovative approaches
we're trying to promote around the country, so we really
appreciate the leadership here.
And we need the approaches because unfortunately, too many
Americans don't get the preventive care they need to
stay healthy and keep health care costs down for all of us.
Many of us know women whose lives have been saved by having
an early mammogram, yet one in five women over 50 haven't
received a mammogram in the last two years.
We know that nothing's more important to any of us who are
parents than our children's health, but one out of eight
children hasn't seen a doctor in the last year.
So our challenge is to remove the obstacles between Americans
getting the preventive care they need, and if we fail this
challenge we all pay the price.
If we succeed, we're on our way to a much healthier America.
According to one study, if people got just five preventive
services when they needed them, colorectal and breast cancer
screening, flu vaccines, counseling to help them stop
smoking, and regular aspirin use, we would save 100,000 lives
each and every year.
So that's why President Obama knew that improving access to
preventive care was a priority in the new Affordable Care Act.
But we started a step before that.
The Recovery Act actually contains a billion dollars for
prevention, the first ever federal investment in
prevention, including funds to support some of the promising
community programs that are aimed at reducing tobacco use
and reducing obesity.
We've got 44 community models around the country that make
prevention a priority, and we're trying to learn the best
strategies, the best ways to change people's lives.
I've already had the chance to visit nine of the programs, I go
to another one next week, I know the First Lady has seen some of
these efforts, and it's really inspirational to see the
creative community collaboration that's going on to
keep people healthier.
First Lady Michelle Obama could have chosen any initiative to
focus on, but she decided to bring this country together to
ask government and employers, community groups, health
providers, parents, teachers, all of us in a national campaign
aimed at one of I think the truly health hazards of our
future, childhood obesity.
And earlier this year launching the "Let's Move" campaign, she
declared that our goal should be to end childhood obesity in a
generation, and is dedicating an enormous amount of energy and
effort to that goal.
And earlier this year, the President signed into law the
Affordable Care Act, an incredibly historic law that
gives Americans more control over their own health care.
And over the last few months our department has been working hard
with partners across the country to implement the new law, and
Americans are already seeing some of the new benefits,
whether it's the Patients' Bill of Rights that went into effect
and will be in place this fall, or the new healthcare.
gov, I hope you all have gone on and checked it out, which is the
first of a kind web site that pulls together for consumers all
of the public and private insurance options that they
have, as well as lots of other great health information.
Or the new state-based health plans which provide an
additional option for adults with preexisting
health conditions.
We've got a long way to go, but already you can see a more
consumer friendly health insurance market taking place.
But we knew we needed to make it easier for Americans, whether
they had health insurance or not, to get screenings, go to
doctor visits, get vaccines that keep them out of the emergency
rooms and hospital beds.
And that's why the Affordable Care Act also contains an
historic $15 billion prevention and public health fund that help
communities do everything from building parks and creating
community gardens to dealing with the underlying chronic
health diseases.
Yesterday we announced $30 million from that first wave of
funding that will soon be available for community
organizations to make HIV testing more widely available in
communities throughout the country.
The new law also helps eliminate co-pays for preventive care in
Medicaid and Medicare, and Medicare beneficiaries starting
in January will now have a yearly wellness checkup that
they can use to keep our seniors healthier in the future.
So it's in our best interests as a country to make recommended
preventive care widely available, to make it
affordable, and to make it convenient for
American consumers.
And that's what we're trying to do.
So again, thanks to everybody for being here.
It's my opportunity to turn over the podium to
Dr. Nancy Freeborne.
She actually has worked as a physician's assistant here at GW
for a number of years, and got so committed to the work that
she actually now has a doctorate in public health.
So teaches and walks the walk, talks the talk, and here at
George Washington Hospital, Dr. Freeborne.
[applause]
Dr.Freeborne: Hello.
Thank you, Secretary Sebelius.
My name is Nancy Freeborne.
During my 25 years as a physician assistant I've seen
both how necessary preventive services are for my patients and
how difficult it can be to get my patients the care they need.
In my experience, patients face two big hurdles to getting the
preventive care they need.
First you have to convince them that the inconvenience or
sometimes discomfort of a mammogram or a colonoscopy is
worth it, and that it might just save their life.
Second you have to make sure that they have the
money to pay for it.
In my professional life I have worked with many types of
patients, many of whom had health insurance, but often
their health insurance just didn't provide enough coverage
for preventive services.
For seniors on limited incomes, and the working families who
live paycheck to paycheck, even a modest co-pay can be too much.
Often the choice comes down to preventive care or their
groceries or their metro fare.
Thanks to the Affordable Care Act, fewer Americans will have
to make those hard choices.
It will be easier for primary care providers like me to make
sure that our patients get the preventive care they
need before it's too late.
Now to tell us a little more about how the Affordable Care
Act will help is Dr. Jill Biden.
[applause]
Dr.Biden: Thank you.
It's a pleasure to be here with all of you today.
I think it's safe to say that everyone in this room knows one
of the best ways to improve the quality of life and control
health care costs is to prevent the illness in the first place.
We are proud that our Administration is working hard
to ensure that the health care system will increase
preventative care like mammograms.
It also, it seems so obvious that focusing on prevention and
early treatment makes more sense than trying to play catch-up
with potentially deadly disease.
We know that prevention, screening and early detection
can save lives.
I'm sure each of you knows someone who is battling cancer
or has done so in the past.
Far too many of us have lost a loved one to some form of this
disease, or seen a colleague or a friend endure
painful treatments.
I've been involved in efforts to combat breast cancer since 1993,
when four of my close friends were diagnosed
with breast cancer.
One of those friends lost her battle, and I realized what a
terrible adversary breast cancer could be.
I struggled with what I could do to help.
I decided that I would use my experience as an educator to
teach young women about the importance of breast cancer
education and early detection.
But the reality is only 67% of women aged 40 or older have had
a mammogram in the last two years.
If 90% of the women who are 40 years old or older received
breast cancer screening, about 4,000 lives could
be saved annually.
Michelle and I hope that all women will do what they can to
prevent and treat breast cancer.
I know I'm here today for the friends who I have lost, but
also for the future, for my daughter, for my
daughters-in-law, for my sisters, my nieces, my
granddaughters, and so many other women who I love.
But this just isn't about breast cancer.
This year alone roughly one and a half million Americans will be
diagnosed with some form of cancer, with almost half of new
cases occurring in those under the age of 65.
And nearly one out of every two Americans born today will be
diagnosed with cancer at some point in their lifetime, so we
don't have time to lose.
This is why the Affordable Care Act ensures access to cancer
prevention services like cervical screening and
colonoscopies.
Estimates are that effective cancer screening, early
treatment, and risk reduction could reduce the death rate due
to cancer by 29%.
Quite simply, cancer prevention can save lives.
We are fortunate enough today to have individuals who have come
to share their stories with all of us, stories that can
illustrate better than any speeches why we need
preventive services.
Maggie Roberts is here today from California.
Maggie brought her son John to a regularly scheduled checkup when
he was a toddler.
When the doctors pushed on his abdomen, they discovered a lump
and he was diagnosed with cancer.
Maggie, you must have been scared to death.
Fortunately, John was able to receive the proper treatment and
the care he needed, and now he is a healthy 12-year-old, but
that routine checkup saved his life.
Congratulations.
[laughter]
Thank you, Maggie, for joining us today, and for
sharing your personal story.
It's my pleasure to welcome Maggie Roberts to the podium.
[applause]
Ms. Roberts: Hi.
My name is Maggie Roberts, and I'm so honored to be here today
to talk about the importance in making sure every American and
especially every American child has access to preventive care.
As teachers, my husband and I are lucky to have good health
insurance that covered the well-baby checks that we took my
son to, and without those visits he probably
wouldn't be here today.
After John was born, we brought him to the pediatrician every --
at three months, six months, and nine months.
At his 12-month visit, his pediatrician found a mass
inside his stomach.
The mass turned out to be a large cancerous tumor, a Stage
III neuroblastoma, and the next day we were at Children's
Hospital Los Angeles.
Within days he was in surgery, followed by six months of
chemotherapy, followed by more surgery.
Today John is 12 years old and in remission.
[applause]
But the surprising thing is he had no symptoms.
At his nine-month check he was fine.
As a mother you blow your little bubbles on your son's stomach
and everything was fine, but the pediatrician, after kneading his
stomach for quite a while found the mass, and therefore we were
very lucky, because we had preventive care and those
well-baby checks that we had this found.
Going to Children's Hospital Los Angeles is a life
changing experience.
We are so lucky to have come out on the positive side of this
experience, but to see those children there who suffer
because they did not have preventive care and the
long-term effects on not only the children but their
families is devastating.
So now I would like to introduce the First Lady Michelle Obama,
to tell us a little bit more about how the Affordable Care
Act can help children better have access to preventive care
and the fight against cancer just like my son had.
Thank you.
[applause]
The First Lady: Well, It's hard to top that.
It's good to have everyone here.
I want to start by thanking Maggie for sharing her story and
for that wonderful introduction, I want to thank both her and
Nancy for sharing their stories it really puts a face
on this issue.
Today, Maggie's son is living a healthy, happy life and is
pretty handsome --
[laughter]
as well.
I'm sure he is highly embaressed by all of this.
[laughter]
It will be over soon.
[laughter]
But too many families in this country aren't so lucky.
Too many people aren't getting the checkups and screenings they
need to catch a disease like cancer in the early stages so it
can be treated.
And that's why I want to thank everyone here for being with us
today and serving as such a powerful example of just how
important prevention is for this country for every single family.
I also want to thank Kathleen and Jill my partners in crime
for all the work that they are doing.
I also want to recognize Congresswoman Capps who I
believe is here and Congresswoman Matsui who worked
so hard to help make health care reform a reality.
Four months ago, the Affordable Care Act was signed into law.
After decades of trying, this landmark bill finally puts in
place comprehensive health insurance reforms that will give
families the control they need over their health care.
It is all that anybody ask.
Once it takes full effect, this reform will help lower costs,
hold insurance companies accountable, and give our
families the security of knowing that their insurance coverage
will be there when they need it most.
It starts by making it illegal for insurance companies to drop
your coverage when you are sick, or deny your children coverage
because of a preexisting condition.
And it also focuses as you have heard on prevention.
Because we know that the best way to keep our families healthy
and cut health care costs is to keep people from getting sick in
the first place.
That's why today, we're taking an unprecedented step towards
implementing a provision that requires all new private health
insurance plans to cover recommended preventive services
like mammograms, colonoscopies, cervical screenings, treatment
for high blood pressure, childhood immunizations, and
measuring BMI body mass index.
These services would come without a deductible,
co-pay or coinsurance.
Two weeks ago, we announced a similar requirement for
Medicare, and today's announcement expands this
concept even further.
Because we know that services like these will go a long way in
preventing chronic illnesses like diabetes, heart disease,
and high-blood pressure that consume over 75 percent of the
health care spending in this country.
And good preventative care will also help tackle an issue that
is particularly important to me as First Lady and as a mother --
as kathleen said the issue of childhood obesity
in America today.
Right now, nearly a third of the children in this country are
either overweight or obese.
A third of them will suffer from diabetes at some point in their
lifetime - and for the African American and Hispanic
communities, that number goes up to half.
And a recent study found that treating obesity-related
diseases costs our nation $147 billion per year.
None of us wants this kind of future for our kids
or for this nation.
That's why, earlier this year, we started the Let's Move
campaign with one simple mission: and that was to end
this epidemic of childhood obesity in a generation so that
children born today reach would grow up at
a healthy weight.
I first came to this issue several years ago as a Mom.
When I was living a regular normal life a long time ago.
[laughter]
Like many other families in this country, we were rushing
around from place to place, I wasn't cooking enough we were
eating out a little bit too much having our way with snacks and
deserts it was shameless.
[laughter]
We were not paying attention to how much Television the kids
were watching.
[laughter]
And I don't think they were getting enough
exercise as they should.
So, when I brought my daughters for an annual well-child visit,
our pediatrician kind of waved the flag and said, that I might
want to keep an eye on my child's BMI.
Now, to be honest, I quite sure about BMI.
I sort of knew about it as an adult but never really thought
about it as a concern for my kids but as many of you know
it's a way of gauging whether or not your child is within a
healthy weight range for his or her height and age
and growth pattern.
I was fortunate that our pediatrician practiced medicine
in a predominantly urban community, and who was paying
attention to the trends of obesity in
African-American communities.
Because I never would have thought to ask for a
screening myself.
I was like any mother my kids were perfect.
They still are.
[laughter]
That's how most parent think it's hard to
recognize the problem early enough.
That's why today's announcement is so important for both parents
as well and for our health care professionals.
As doctors, nurses and health care practitioners, you all are
trusted members of the community.
And we need your help to educating parents and families
about the tools available to them.
That's why one of the key partnerships we've established
as part of Let's Move.
is with the American Academy of Pediatrics.
Together with the broader medical community, we are
working to educate doctors and nurses along with the academy
across the country about obesity, and asking to help
ensure that they regularly monitor children's BMI.
We're working to provide nutrition counseling to help
families make healthy choices for their kids right
from the beginning.
And we've worked together to develop a new program through
which doctors will be able to write an actual prescription for
parents laying out simple things they can do to help their kids
eat right and stay on track.
But we also know that a child's health can be shaped before he
or she ever even had has his or her first
appointment with a doctor.
We know the impact that things like good prenatal care and
breastfeeding can have on the life and health of a child -
including on their chances of becoming obese later in life.
That's why I'm so glad that the Affordable Care Act includes
screenings for an array of conditions that affect pregnant
women and their babies - everything from folic acid to
iron deficiency to vaccines.
And it also makes it easier for women to breast-feed once
they've go back to work.
And that is a real advancement for mothers.
But in the end, of course, no matter how many times you push
these tests as doctors - no matter how much information you
provide - it will ultimately be up to parents to help their
children live healthy lives.
That's why today I want to send a message to every mom and dad
out there who is watching may read this or get on the web site
- it is just important we cant emphasis enough that these
prenatal screenings, these BMI measurements, these things are
included in your health care plan.
It's important for people to understand that.
And these screening are very important.
And that's why I'm encouraging everyone to visit healthcare.gov
to get customized information and learn about the
choices they can make to stay healthy.
Ultimately, each of us needs to be part of the solution
on this one.
Each of us needs to take responsibility for
our own health.
Each of us needs to use all of the tools available to us to
ensure that our kids get every possible chance to lead happy,
healthy lives.
And with these new provisions, we can keep also keep costs
down, and we can hold insurance companies accountable.
We can give families the security of knowing that their
insurance coverage will be there when they need it most, and we
can provide preventive services that will help keep
all of us healthy.
These are terrific tools, we just need to make sure people
understand the changes they know how to implement them and they
have the courage to reach out to their health care provider and
ask questions and get the information they need.
So we are asking all of our health care providers everyone
who has information to step up and help make sure people
understand these new provisions and we are on our way to
insuring we have wonder out comes in the years to come.
So thank you everyone.
Thank you for your efforts for your hard work.
Thank you to George Washington you remain a trusted neighbor
and partner and so many things.
It is always a pleasure to be here.
Thank you so much.
[applause]