Commentary

Reform Repeal "A Step Backwards"


 

Dr. Louis W. Sullivan is respected as an elder statesman on many aspects of medicine, from public health strategies to recruiting more minorities to the health professions. The founding dean of the Morehouse School of Medicine, Atlanta, also happens to be a former Secretary of the Dept. of Health and Human Services (HHS) under the Republican administration of George H.W. Bush.

He’s also making it clear that he disagrees with talk about getting rid of Medicare or Medicaid, or gutting the Affordable Care Act. Dr. Sullivan spoke Monday at the American Association of Cancer Research’s Science of Cancer Health Disparities meeting in Washington.

Photo courtesy Flickr user mariko/Creative Commons license

While addressing many of the challenges to eliminating disparities in the quality of care that minorities receive in America, compared with whites, he listed access to care as one of the biggest issues. The Affordable Care Act goes a long way toward helping ease the access problem, said Dr. Sullivan, who was HHS secretary from 1989 to 1993.

Politics have always played a role in attempts to reform health delivery in America, he said, noting that the first President Bush had delivered his own overhaul plan in 1992 (for a description, see Dr. Sullivan’s 1992 New England Journal of Medicine article, here). But that plan was dead on arrival because it was an election year, said Dr. Sullivan.

He has made no secret of his support for the Affordable Care Act, but he expressed exasperation with the ways things have gone since its passage. ”There’s too much political ideology in our system,” he said.

The cost of doing nothing from 1992 to the present has been a ballooning percentage of gross domestic product being devoted to more and more health spending. Despite all that spending, the United States ranks near the bottom among industrialized nations for many measures of health. “We should be the healthiest nation on earth — far from it,” Dr. Sullivan said, sounding like he might be bucking for an appointment in the Obama administration.

I spoke with Dr. Sullivan after his talk and asked him if he agreed with those who wanted to repeal the Affordable Care Act. Definitely not, he said. The health reform law is not perfect, but, he said, “we should start with this and then work to improve it.”

Added Dr. Sullivan, “To repeal would be a step backwards as a nation.”

—Alicia Ault (on Twitter @aliciaault)

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