The mission of the Naveen Jindal School of Management’s new Center for Healthcare Leadership and Management (CHLM) is to be a thought leader for healthcare management. The center activated that mission Feb. 6 as it brought a panel of healthcare experts to the Davidson Auditorium to discuss “Healthcare Policy in the Trump Administration.” Although each of the panelists covered a rapidly changing healthcare landscape from a distinct perspective, they concurred in the belief that substantive revisions likely will not come before the end of the year.
U.S. Rep. Michael C. Burgess, MS 2000,Dr. Stephen L. Mansfield, president and CEO of Methodist Health System; and Andrew Coats, a senior policy advisor for Hall Render, a leading national healthcare-focused law firm; spoke to an audience of about 250 students, faculty, staff, healthcare providers, industry leaders and small-business owners.
Bill Sproull, president of the Richardson Chamber of Commerce, which co-sponsored the event, made opening remarks, then introduced moderator Dr. Britt Berrett, director of the CHLM as well as the Jindal School’s BS in Healthcare Management program. Berrett introduced the panelists and led them through question-and-answer sessions.
The Individual Health Insurance Market
From Lewisville, Burgess, a Republican, has represented Texas’ 26th Congressional District since 2003 and now chairs the House Energy and Commerce Subcommittee on Health. He focused on the individual health insurance market — those people who do not procure coverage from large- or small-employer group plans or government insurance such as Medicare or Medicaid.
“It’s the individual market that attracts most of the attention, and honestly, for the next several weeks, that’s where the bulk of the attention will be in Congress — that and on Medicaid,” he said.
The congressman explained that significant pieces of the Affordable Care Act — nicknamed Obamacare — would most likely be dismantled through reconciliation, a special legislative process that allows members of the Senate to expedite consideration of certain fiscally related legislation. Reconciliation works by limiting debate in order to more quickly pass laws with a simple majority instead of through regular order — those congressional rules, precedents and customs that usually require 60 votes in the Senate to end debate and pass a bill.
If reconciliation passes, as Burgess expects it will, he said Republicans in the Senate — with a slim 52-seat majority — will need more time and some bipartisan support to attempt dismantling the entire law.
“But there are some things that … can change relatively quickly,” Burgess said. “The [individual and employer] mandates, some of the taxes … and there is a growing feeling that… some elements of whatever the replacement landscape looks like… be included in the reconciliation process.”
Some of the ACA-replacement elements will pass quickly under reconciliation, Burgess indicated, including programs for health-savings accounts, tax credits and some administrative aspects of the law that make it difficult for physicians to comply. Although he does not think Medicaid can be reformed under reconciliation, he does think that much of the underlying framework for reforming it can be passed that way.
The Impact of Change on Healthcare Delivery
Next up was Mansfield who, as a leader in the healthcare delivery system, focused his discussion on the impact of potential healthcare policy changes on his industry.
“We’re all jaded by our circumstance,” he said. “My circumstance is trying to run a large and fairly complex healthcare system and trying to do that substantially impacted by decisions made by the federal government because of the Medicare and Medicaid programs.”
Mansfield introduced to the conversation some social complexities associated with healthcare delivery.
“In some cases the federal government works better if it’s a right,” he said. “In some cases free markets work better if it’s a privilege … there has to be a blend of the two.”
After describing some of the positive impacts of the ACA on healthcare systems — tax credits for small businesses, keeping children on their parents’ plans until age 26 and the provision allowing for coverage of pre-existing conditions — Mansfield proposed several solutions that could come out of the Trump Administration.
“My personal preference would be to take Obamacare and go painfully, line-by-line, and keep what works and replace what does not work,” he said. “There are components of it that need to be replaced — I would say ‘repaired’ is the right term for that. But the notion of repealing it and going two years without anything for replacement and the potential damage that does to the insurance industry, to our industry, to physicians and to the public — 22 million people who now have insurance either through the exchange or through Medicaid expansion — I think is terrible.”
Mansfield concluded by focusing on what he calls “the elephant in the room,” stating that Americans are less healthy than their counterparts around the globe in almost every statistical category that can be measured.
“Americans are neglectful of our health,” he said. “And then we’re supposed to fix that broken health in our broken healthcare system … to me our broken healthcare system is becoming symptomatic of our broken attention to health in America. And that, to me, is the issue that has to be addressed.”
The Insider View
Coats, prompted by Berrett to give the audience the solution to healthcare’s problems, took a different approach instead. The son of former Indiana Senator Dan Coats, who is Trump’s nominee for director of national intelligence, he described his experiences talking to Washington D.C., insiders.
“One thing I do … in Washington is talk to a lot of folks, listen to a lot of folks and members of Congress and talk about their solutions,” Coats said.
After setting the backdrop by explaining how the U.S. legislative branch got into its current state regarding the direction of healthcare reform — more specifically how the momentum shifted from the Democratic Party to the GOP — Coats informed the audience members about some of the key discussions he had with various legislators and what approaches most likely would be taken.
House Speaker Paul Ryan of Wisconsin, “if you want to get a sense of what the ACA replacement looks like, take a look at his A Better Way plan,” Coats said. “It’s a 40-page blueprint — lays out his vision.… You combine that with [Secretary of Health and Human Services nominee Tom] Price’s [H.R. 2300 – Empowering Patients First Act of 2015] plan and that, in a sense — the truth is out there. That’s probably what it’s going to look like.”
Coats briefly touched on Ryan’s vision of reforming Medicare and the dynamics surrounding it — such as the political risk of raising the eligibility age to 67. He described the Senate’s “wait and see” approach to repeal and replace ACA and offered three looming deadlines to watch for Congress to pass significant legislation, including July 30, the day before the usual congressional August recess; Sept. 30, the end of the fiscal year; and right before Christmas.
“That’s mid-December,” he said. “If I were a betting man, I’d say that’s when you see Congress finally… pass the replacement.”
Jindal School Launches Center for Healthcare Leadership and Management
Dr. Britt Berrett, director of the new Center for Healthcare Leadership and Management (CHLM), sees a “higher calling” both for himself and the center as a place for education, collaboration with business and purposeful conversations among healthcare leaders and innovators that will offer solution to what he sees as a healthcare crisis.
The Naveen Jindal School of Management recently launched the center to address significant challenges the healthcare industry is facing, including:
an aging and increasingly unhealthy population
access to care due to skyrocketing costs
uncertainty about the future of the Affordable Care Act, Medicare and Medicaid
privacy
the increasing complexity of healthcare technology.
The center will coordinate the Jindal School’s wide-ranging undergraduate, graduate and executive healthcare management programs as well as provide additional educational offerings that complement those programs and cover the entire continuum of healthcare leadership management. The extracurricular offerings include guest lectures, panel discussions, case competitions and site visits, all intended to ask — and answer — the thorniest questions related to the nation’s healthcare challenges.
“I’m inspired by the caliber and the quality of the faculty within the CHLM,” Berrett said. “The students benefit from a very rich pool of talent.”
The center’s purpose is to serve the North Texas community by becoming the definitive resource for healthcare leadership and management education in the region. It will facilitate collaboration among the school’s healthcare-related academic programs, prepare its students to be ready to meet healthcare industry challenges, and become nationally recognized as an academic thought leader.
Academic programs in the CHLM:
BS in Healthcare Management — Britt Berrett, PhD, director
MS in Healthcare Leadership and Management — Forney Fleming, MD, director
Executive MS/MBA in Healthcare Leadership and Management for Physicians — John F. McCracken, PhD, executive director
Executive MS in Healthcare Leadership and Management for Healthcare Professionals — Keith Thurgood, PhD, director
Certificate in Healthcare Leadership and Management for Physicians — Michael J. Deegan, MD, DM, director
