When It Comes to Health, Kathleen Cares

Secretary of Health and Human Services Kathleen Sebelius
Secretary of Health and Human Services Kathleen Sebelius

By Patricia Harty, Editor-in-Chief
August / September 2013

Secretary of Health and Human Services Kathleen Sebelius (née Gilligan) on the future of American health care, her father’s influence, her Irish heritage, and other topics.

“I’m a descendant of Irish immigrants. My great-grandmother worked as a maid in the home of William Howard Taft, before he became president. Decades later, the grandson of the president and my father, the grandson of the maid, served back-to-back to represent the same district in Congress. Now, that is the American dream. It’s my story, and it’s the story of millions of others.”

Thus spoke Kathleen Sebelius addressing the Democratic National Convention at the Pepsi Center in Denver, Colorado in 2008.

When Sebelius made that speech to the delegates in support of Barack Obama, she was the very popular governor of Kansas. (Time magazine had named her one of five top governors in the country.) But because of Kansas’s term limits law, her second term as governor was her last. On April 28, 2009, she officially resigned and was sworn in as the 21st Secretary of the Department of Health and Human Services (HHS), and charged with leading the department’s some 65,000 employees.

Since assuming office, Secretary Sebelius has taken on the gargantuan task of re-shaping the U.S. health care system and leading the efforts to implement the historic Affordable Care Act. Making Obamacare work is an effort that she recently compared to the struggle for civil rights. There is no better person for the job.

Born Kathleen Gilligan in 1949, in Cincinnati, Ohio, Sebelius (her husband Gary Sebelius is a federal judge, and they have two sons, Ned and John) earned a bachelor’s degree from Washington, D.C.’s Trinity College and a master’s in public administration from the University of Kansas in 1977. While it wasn’t a foregone conclusion that she would run for political office, Sebelius and her three siblings grew up in a family concerned with education and politics, and her father, John Joyce “Jack” Gilligan, left her quite a legacy to live up to.

Jack, who served as a gunner in the U.S. Navy in WWII (he was awarded a Silver Star for gallantry in action at Okinawa), received his bachelor’s degree from the University of Notre Dame and went on to become a Xavier University English literature professor. But he also was interested in politics, a passion instilled by his father, Harry, who ran the family’s funeral service business and served as chairman of the Charter Committee Reform Group. So in 1953, when Jack was approached to run for Cincinnati City Council, he did so and won. After serving for 10 years, in 1964 he was elected to Congress as a representative for Ohio’s 1st District, serving from January 3, 1965 – January 3, 1967. He narrowly lost his re-election bid to Robert Taft, Jr., when the Republican controlled Ohio General Assembly redrew his district to favor Republicans. (As irony would have it, Jack’s grandmother had worked as a maid in the Taft household.)

Undaunted by his loss, Jack remained active in politics and won the election for the governorship of Ohio in 1970, defeating Republican Roger Cloud, serving from 1971 to 1975 and implementing reforms in education, mental health and environmental concerns.

He went on to serve as a fellow of the John F. Kennedy Institute of Politics at Harvard, and the Woodrow Wilson International Center for Scholars, Washington, D.C., and in 1999, at age 78, he was elected to the Board of Education of the Cincinnati Public Schools, a position he retired from in 2008. At 92, he remains active and vocal on politics.

Buoyed rather than intimidated by her father’s formidable career, Kathleen moved to Kansas with her husband in 1974 and quickly found her footing. She served for eight years as a representative in the Kansas Legislature and eight years as Insurance Commissioner before being elected governor, making her and her father the first father/daughter governor pair in the United States.

And like her father, who remains proud of his signature achievement, enacting the state income tax, which now accounts for about 40 percent of Ohio’s budget and which supports state and county services and schools, Sebelius is proud of her time as governor.

“I came in and the state was broke, lots of people were out of work, and there was lots of hand-wringing about how we could move forward. Having turned the state around and now being back in positive times is a pivotal moment that allows us to move forward and do better things,” she said, speaking on her gubernatorial achievements to Harvard Political Review, May 29, 2007.

When she was nominated to the job of Secretary of Health, Sebelius received many ringing endorsements. “She has an excellent mind, she makes decisions carefully and well, and her obvious empathy for the plight in which so many Americans find themselves will serve them and our country well,” Governor Phil Bredesen of Tennessee said, hailing Sebelius in a New York Times article as an “absolutely first-rate” selection for the post.

One loud note of dissension came from the Church. Sebelius, who is Roman Catholic, is pro-choice, and this did not sit well with the Church hierarchy. Archbishop Joseph F. Naumann publicly prohibited her from receiving Communion. Sebelius has said that this was “one of the most painful things I have ever experienced,” but affirmed that her position was that of upholding the rights of an inter-faith constituency.

Now, less than three months before insurance marketplaces open for enrollment under the Affordable Care Act, Sebelius is making a heightened effort to raise awareness of the law by speaking to community leaders, news talk shows and conferences across the country. She comes across as relaxed, quick-witted and has a good sense of humor (catch her interview with Jon Stewart on YouTube).

Speaking at the NAACP convention in Orlando, Florida, on July 17, she called on the group (who have publically supported the Affordable Health Care Act) to start spreading the word and help educate individuals in their respective communities on how to get health insurance coverage and better understand the law. They should approach it with the same passion as they did in the fight for civil rights.

“You showed it early in the fight against lynching and discrimination. You showed it by showing that inalienable rights are secured in the courtroom and at the ballot box,” she said. “You showed it by supporting a health law 100 years in the making.”

The intention of the law is to deliver affordable health care to the nation’s most vulnerable populations, including young children, the elderly and those with disabilities.  Under the Affordable Health Care Act, 32 million Americans are eligible for coverage, but only if they sign up for it. (One report stated that in order to keep insurance premiums down, at least 30 million need to be enrolled).

Under the law, Sebelius is also carrying out policies that put a new focus on wellness and prevention, support the adoption of electronic medical records, help recruit and train more primary care health providers, and implement reforms that are intended to end the insurance industry’s worst abuses.

On this last point, Sebelius’s past position as Kansas’s Insurance Commissioner has served her well. Under her leadership, the HHS has formed a partnership with the Department of Justice to stamp out health care fraud. HHS claims that already this joint venture has returned record sums to the Medicare Trust Fund.

The department is also working to build a 21st century food safety system that will prevent outbreaks before they occur. And it is collaborating with the Department of Education to help states increase the quality of early childhood education programs.

Secretary Sebelius also leads the nation’s emergency health response to crises and natural disasters, including the Haiti earthquake, the Gulf oil spill, and the Joplin, Missouri tornado. And as America’s top health official, she continues to work on global health issues like polio, HIV/AIDS, and the growing costs of chronic disease around the world.

Her department is looking into gun violence prevention programs. While Sebelius is known to be a moderate on gun control, in her speech to the NAACP she talked about gun violence and referred to the case of Trayvon Martin, saying the teenager’s death was a tragedy. “But so are the tragedies of all the children we have lost because of gun violence before and since Trayvon was killed each and every day.”

Forbes has named Secretary Sebelius one of the 100 most powerful women in the world. The New York Times pegged her as most likely to be the first female U.S. president, which would be only the second time in the history of the nation that a Roman Catholic was elected to the highest office in the land.

With the clock ticking on Obamacare implementation, Sebelius is on the road, visiting with doctors and nurses and other health care professionals. Congress has repeatedly rejected the Obama administration’s request for extra funding to set up the Affordable Care Act, leaving Sebelius’s HHS with the burden of implementing the plan. Operating on what some have called a shoestring budget, Sebelius has been criticized by Republicans for lobbying for financial support from financiers with connections to health care corporations. It is an unusually tight corner for the secretary to find herself in. She made a name for herself when she refused campaign contributions from health care corporations when she was running for governor.

Unbowed by criticism or a meager budget, Sebelius is taking the implemention of Obamacare to the people, talking to as many community leaders as she can. We are grateful that she took the time to answer some questions from Irish America.

What are the biggest changes to health care Americans should be aware of? How else would you like to see the system progress?

The biggest change is that for 85% of Americans who have insurance, their coverage and benefits will be stronger than ever. Already millions of Americans have received critical preventive screenings for free. Millions of previously uninsured young people have gotten coverage on their parents’ plans. Starting in January 2014, insurance companies can’t deny you coverage if you have a pre-existing condition like diabetes or heart disease.  Women will no longer have to worry about being denied coverage of benefits or charged more just because they’re women or because of pregnancy or breast cancer. Millions of American families have received more than $1 billion in rebates from insurance companies, who now have to spend most of your premiums on your actual care, rather than on other expenses, such as CEO bonuses and marketing.

And what’s exciting is that, for Americans who don’t have insurance, or for folks who buy insurance on their own but don’t like it, better options are around the corner when the new Health Insurance Market place opens for enrollment October 1, with coverage that starts as early as January 1. All you have to do is visit HealthCare.gov to find a plan that fits your budget and needs.

In addition to giving millions of Americans better options for coverage, we’re also making important progress in turning the corner toward a health care system that focuses on wellness and prevention, instead of sickness and disease. There are incentives in the law that help providers coordinate care better and help hospitals reduce errors and costly readmissions. We’re also seeing technology driving health care innovation, like electronic health records that more doctors are using to deliver better care that patients can understand, take with them, and keep minor injuries and illnesses from developing into bigger, costlier ones.

What are you most excited about right now, with all the different reform elements in motion?

What’s exciting is that millions of families and small businesses – many of whom don’t have insurance or are looking for a better deal – will have access, some for the first time, to quality, affordable options in just a few months. The new online Health Insurance Market-place at HealthCare.gov will provide millions of families and small businesses a new way to find health coverage that fits their needs and their budgets. All plans in the Marketplace must cover a set of essential health benefits, including doctor visits, prescription drugs, and mental health services. Discrimination based on gender or pre-existing conditions will be outlawed. And many individuals, families and small businesses will qualify for a break on the costs of their monthly premiums.

For the first time in history, in every state insurance companies will have to compete for business based on price and service – not lock out, dump out, or price out of the market anyone who might get sick. And the Marketplace will provide Americans with security and peace of mind knowing that they don’t have to worry about losing coverage if they’re laid off or change jobs.

And in just a couple of months, we have the chance to help our family, friends, and neighbors finally find that security and peace of mind. That’s why we’re doing everything we can to spread the word.

To get ready for October 1 when the marketplace opens for enrollment, people can visit HealthCare.gov today to sign up for information and updates. It’s not your typical government website – it’s much easier to use and understand.  And it’s the best way to find out about those benefits that will be available as early as January 1, 2014. There’s a web chat feature to help answer your questions – just like what you see when you’re shopping online. And if you don’t have access to a computer, there’s a 24/7 customer call center ready to answer your questions in 150 languages.
We know lots of people need information. We can all do our part to help them find it, so I hope you join me in spreading the word about HealthCare.gov.

Your father was serving in the House of Representatives when Medicare was originally passed in 1965. Many middle-aged Americans are worried that it won’t be around when they reach retirement age. What do you think?

My dad is 92 years old now – and Medicare is there for him, just as it was for the countless seniors who are able to enter their golden years with basic security of health care. And after recently turning 65, I signed up for Medicare Part A and it’s certainly a personal issue for me now. And let’s be clear. The Affordable Care Act actually strengthens Medicare, and adds years to its solvency. For our seniors it’s closing the Medicare donut hole – saving more than six million seniors hundreds of dollars on prescription drugs. The law also provides free, critical wellness and preventive screenings, like prostate cancer screenings and cholesterol checks. The law also roots out waste and fraud in Medicare, saving taxpayer dollars from wasteful insurance subsidies and reinvesting those savings back into the system. Medicare is stronger than ever – and it will remain a  source of peace of mind, security, and a guaranteed benefit earned after a lifetime of hard work.

Do you think that the national focus can be shifted towards prevention rather than treatment?

Yes. Making sure people have access to affordable health insurance is key to the preventive care they need to stay healthy. And the Affordable Care Act goes one step further in trying to make it even easier for Americans to get the preventive care they need by eliminating co-pays and deductibles on many recommended services. After all, you’re more likely to get a blood pressure or diabetes screening or mammogram when you don’t have to pay a co-pay. You’re more likely to talk to your doctor about ways to stay fit and work on your diet when your insurance company covers the cost of the appointment.

And we’ve worked really hard on a first-of-its-kind National Prevention Strategy, which guides our efforts to help individuals, families, and communities promote healthy lifestyles and improve health outcomes. From reducing tobacco  use to fighting obesity, we’re engaging public and private sector partners to find ways to address the chronic diseases – such as heart disease and diabetes – that can reduce health care disparities, and control the cost of care while we improve the quality of it.

How did your father influence you? What did you learn from his political career and from growing up with a father in politics?

My father first ran for office in Ohio when I was 5 years old. He served in City Council, in Congress and as governor and was an active leader on civil rights, anti-war efforts and always looked out for “the least of these” – those most vulnerable in our society who needed to have a policy champion. He went right from military service in World War II to community and public service. He taught my siblings and me that public service was an important way to make a contribution to our communities and that it was important to have a strong moral code as a guidepost, even if our positions were unpopular. He loved serving in Congress when some of the most important social legislation was passed, including Medicare, Medicaid and the Voting Rights Act.

Do you know where in Ireland your ancestors are from? Have you been to Ireland, and if not, are you planning a visit?

Both my mother and my father have roots in Ireland, in counties Sligo and Cork. My father’s family name is  Gilligan, and his mother was a Joyce. My mother’s family name is Dixon. I have been to Ireland a couple of times, but not recently. I would love to return sometime soon.

How do you keep healthy?

I have been very fortunate to be born in good health and not get sick very often. I exercise regularly, try to eat a healthy diet, get some sleep and try to find ways to reduce stress, though it doesn’t always work! My health motivation is that if I feel better, I’m able to be a better worker, and I’m able to do much more of what I like to do.

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