Belshe: 'Window is open' for health reform

California and the rest of the nation have a golden opportunity to improve health care coverage, delivery and value in the coming decades thanks to the federal push for health care reform, the state’s secretary of health and human services said Wednesday, Oct. 27, 2010.

"The policy window is open," Kimberly Belshé, MPP, told an audience of more than 200 people at Western University of Health Sciences. "They don’t open very often, so when they do, we need to make the best of it."   View the Video >>

Belshé, Gov. Arnold Schwarzenegger’s chief health care adviser, was the featured speaker at the 2nd annual Dr. Philip Pumerantz Distinguished Lectureship, held in WesternU’s Health Education Center. More than 200 students, faculty, staff and guests — and dozens of others tuned in to the University’s webcast of the event — heard as the secretary spoke on "Federal Health Reform Implementation: Windows of Opportunity, and a Look Ahead."

After opening with a brief shout-out to her hometown San Francisco Giants, who were playing in (and won) Game 1 of the World Series against the Texas Rangers Wednesday, Belshé said a slew of factors come into play when considering what’s needed to provide broader health care coverage in California, improve its quality, and lower its price, all of which are the goals of the federal health care reform legislation.

Several challenges stand in the way of reaching those goals, notably the nation’s and the state’s fiscal crises, transitions in political power, the "pending" status of many federal health care policies, and what Belshé described as "parochial interests" – those who continue to benefit from the present health-care system and are not anxious to see it change.

More providers also are needed, she said, but they also must be the right type of providers: "Caring, and concerned about the future of health care in our state."

Specific to California, she continued, legislators and bureaucrats must endeavor to understand new eligible populations for health care coverage; establish systems for health-care enrollment; facilitate transitions between public programs; and ensure adequate provider capacity.

She also stressed the critical role prevention, wellness and community engagement must play in any meaningful health care reform, and criticized efforts by some in Congress to undercut funding for such programs. A variety of factors come into play in health care, she said, not just symptoms and diagnoses. "Community and environment matters."

Fundamentally, Belshé said, California must live up to these requirements if health care is to change in a meaningful way:

 – Policy leadership and strategic direction.

 – Action and endurance, especially recognizing that 2014 – when most major reforms are scheduled to take effect – is coming up fast. "We like to say 2014 is now," she said.

 – Sustained adherence to the principle of shared responsibility

 – A commitment to Medi-Cal.

 – Recognition that expanded coverage must be accompanied by better value.

 – Expanded workforce capacity, making coverage a reality in terms of access, and by ensuring the technical expertise of providers.

Belshé praised WesternU not only for its many health professions programs – "This university is in an amazing position in terms of contributing capacity in provider types" – but also for its philosophy and its commitment to interprofessional education.

"It’s the compassion and caring. It’s the working across disciplines. It’s focusing not just on the head, but also the heart," she said.

Belshé concluded by saying that true health care reform requires a "social consensus" that such reform is a priority. "Success in terms of health outcomes depends upon sustaining this broader vision," she said. "We must build and sustain public support and compliance with the new responsibilities required.

"If our state is smart and strategic … I think California has an opportunity to do something that is extraordinary."