Advice to the Obama Administration

A few months ago, I was asked to highlight key issues that the next
president should address. This was well before the election.
Here is what I said:

I would advise the next president to move quickly to formulate a plan
to cover all Americans with health insurance. It needs to be a
bipartisan consensus plan because nothing else has a chance of passing
Congress. Lots of good ideas have been proposed and debated for many
years; put them together and move on with the heavy lifting of
negotiating with Congress.

Increase the budgets for the federal health agencies — in particular
the Food and Drug Administration, the Centers for Disease Control and
Prevention, and the National Institutes of Health. A huge increase in
their budgets would be a rounding error for the rest of the budget, and
it would make a big impact on the public’s health. Avoid playing
politics with the Medicare and Medicaid programs. These gigantic
programs need a respite from tinkering, and the staffs running the
programs need to be rebuilt and strengthened.

Finally, ignore anyone who says that the U.S. Department of Health and
Human Services should be reorganized. Recent reorganizations have
caused more harm than good. Instead, pick people to run the department
and its agencies who are skilled in leading large government units; it
is not like a private business or a university.

Now at the beginning of 2009, I’d add that the plan for health reform
should include a strong emphasis on quality. An investment in
measurement and improvement of health care quality and patient safety is
clearly an essential element of overall reform. This should include
funding for expanding the work of the Agency for Healthcare Research and
Quality, and for other key activities.

It is an exciting time for our nation. The incoming Obama
Administration is bring us all a sense of hope and opportunity.

I am more hopeful than I have been in many, many years that we might be
on the verge of making a dramatic improvement in health care and in the
health of the American people.

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