Health and Human Services Secretary Kathleen Sebelius on Tuesday dismissed predictions that the Patient Protection and Affordable Care Act passed in March would be repealed. She spoke at the National Forum on Quality Improvement in Healthcare, in Orlando, presented by the Institute for Healthcare Improvement.
The Secretary urged providers to maintain PPACA's momentum, and show their support "because we are at an absolute pivotal moment."
"Those of you in the room who are committed to making these ideas work in hospitals and health centers – we need that passion more than ever today," she told an estimated 6,000 hospital executives, physicians, nurses, and other providers.
While most Americans have focused on parts of the bill dealing with access to care and insurance pieces of the puzzle, Sebelius said, they should be reminded that the legislation also is geared to "improving the quality of healthcare and changing the delivery system, so we stop doing things that don't work for patients and start doing things that we know work.
"It's about care, about care that's safe, timely, effective, efficient, equitable and patient-centered."
With a subtle tone of impatience in her voice, she admonished providers to work harder to be creative about improving delivery of care.
"Too many patients year in and out are hurt or killed because of adverse events that occur in the nation's hospital and other healthcare settings. And we have nearly two million Americans every year who acquire hospital-related infections, contributing to close to 100,000 deaths and as much as $33 billion in additional healthcare costs.
"And at the same time, almost 30% of our healthcare spending, nearly $700 billion a year, is for services that we think are really questionable about improving peoples' health. We're not even sure that they work."
At a meeting with news media after her talk, Sebelius was asked what efforts the Obama administration is undertaking to counter efforts to repeal key pieces of the legislation.
She pointed to enhanced benefits for Medicare beneficiaries, who, she said have been "lied to" by opponents of healthcare reform about what would happen to their coverage after the legislation passed.
"We're in the middle of open enrollment, which began the 15th of November to the end of December," Sebelius said. "And this was really the first opportunity to confront some of the misinformation to Medicare beneficiaries.
"They've been told terrible things about what was going to happen to their plans, their choice, their prices, their doctor, and not until they had the book in their hands and could make choices for 2011, were we able to say, it isn't true, you basically have been lied to. This is the information, here are your choices...And make it clear, there are additional benefits, there are more choices; the prices are better."
In her keynote, Sebelius repeatedly praised the IHI, whose founder and director for 20 years was Donald Berwick, MD, whom the Obama administration hired away to direct the Centers for Medicare and Medicaid Services.
"I had to go and apologize to IHI staff personally for stealing Don Berwick," she said, but Berwick "is absolutely the right leader at this historic moment," in part because many of his ideas about improving care are now embedded in the new healthcare law.
Because of work done at IHI and by others, Sebelius said, providers know that major improvements are possible.
"We know that one in four heart attack patients and one in five heart failure patients are back in the hospital within 30 day after leaving in the first place. Most of those folks have never seen or had a follow-up from a healthcare provider in the interim period," she said.
"Now, that's very costly. But we can't forget that there's also a human expense. No one I know wants to spend more time in the hospital or watch their loved ones get more ill or, God forbid, to die because of the illness that they got in the hospital, not what brought them to the hospital in the first place."
While Sebelius acknowledged efforts by the IHI to find better ways of delivering care in ways that avoid errors in care that cause patient harm, she noted two recent reports – a study in the New England Journal of Medicine showing that in 10 North Carolina hospitals "harms remain common, with little evidence of widespread improvement," and another by the U.S. Office of Inspector General.
These reports, Sebelius said, "make it very clear that we have a long way to go. You see these trends every day in the faces of your patients and the numbers at the bottom lines of your budgets. But you wouldn't be here today if you didn't have optimism that every one of us has a role and a responsibility in improving care."
In dispelling rumors that much of the healthcare reform legislation could be gutted, Sebelius pledged that the new Centers for Medicare and Medicaid Services Innovation Center, funded $10 billion to develop new payment and delivery of care models, is a reality.
"It's already been appropriated. It's available too, so those of you who hear the discussion of defunding – whatever – this money is there, and it's going to be invested in improvement in healthcare."
In fact, she said, the center has "not wasting any time getting started" and has launched four programs, most of them targeting improvements in care for the poor and elderly, such as those "dual eligibles," who qualify for both Medicare, because of their age, as well as Medicaid because of their income level.
Sebelius closed her talk saying that she sees the Affordable Care Act as "a toolkit at our disposal."
Providing "Better health, better care, at lower per capita cost for every American every day is what the new system should be all about. We've made progress, but we have a long way to go," she said.