Finally, Sebelius is resigning! What took her so long! And who is replacing her? Sylvia Matthews Burwell was just announced by President Obama as her replacement as the next Secretary of Health and Human Services, to be the new face of health care because of her experience dealing with the complexities of the federal budget and has managed large organizations. Her current job is the director of the Office of Management and Budget. Burwell says that the ACA has improved access to health care and treatment. She needs to look at the real numbers and who the ACA has helped and who it has been affected negatively. Read my blog next week.

First, what in Sebelius’ resume allows one to perceive that she had the qualifications to be the Secretary of Health and Human Services (HHS) in the first place and why chose Burwell as her replacement? Heck, I have a better C.V./resume to head up the HHS. Actually, there are dozens of well-educated and experienced people who would better handle the HHS. Most of my students from the Healthcare Management program at Johns Hopkins Carey School of business would be better choices for the job. Why not offer the opportunity to Dr. Ben Carson, at least as a fig leaf to start compromise and solution?

One also has to consider the future of healthcare in the US. If one is honest about what will be sustainable in this country, it will be a single payment system. The ACA is a nice attempt but as we have pointed out, the numbers don’t work out for a long term sustainable system. Unless, we raise corporate and personal taxes as the Europeans have done. According to Becker’s Hospital Review, a report issued eight months ago by Gerald Friedman, PhD, a professor of economics at the University of Massachusetts at Amherst, concluded that the health care system could save $1.8 trillion over 10 years if the US adopted a single-payer system.

Also, the nonpartisan advocacy group Public Citizen stated in their new report that universal health care, a single payer system, would offer three major advantages. It would:

1. Equalize health care costs for businesses
2. 2. Take billions of dollars of expense out of the health care system
3. 3. End what is known as “job lock”, which is a term used for employees that don’t switch jobs or start new ventures because they will lose their health insurance.

Previous discussion has led to dead ends whenever it was brought up before Congress. However, Vermont will be the test case as they attempt to go forward with their proposed single payer system.

It is also interesting after my discussion in last week’s blog commenting on WellPoint’s suggestion that they were probably going to have to increase premiums by double digits next year due to the older sicker population of people signing up for the exchanges. As further evidence of this statement, Express Scripts a pharmacy benefits manager has found that health insurance marketplace enrollees use slightly more specialty medications than those enrolled in health plans outside of the exchanges (1.1% versus 0.75%). One interesting extension of the statistic is that more than 6 in every 1000 prescriptions covered by the exchanges were for HIV medication, nearly 4 times as high as the rate for other types of commercial plans (Becker’s Hospital Review). These results suggest that the new enrollees in the ACA may be sicker than the general population and have above average medication usage.

Lastly, I look at my state of Maryland. What a horrific experience with the health care exchange. The roll out and development of the exchange was the responsibility of the Lieutenant Governor, who is now running for Governor. The exchange was a complete failure and resulted in the need to purchase another web site software, etc. with the resultant cost to the taxpayer about $125 million, including the cost of paying Ravens payers, actors and other famous people to push for potential enrollees to sign up for the ACA. And this State is considering him for Governor!!!! If the people in the State of Maryland vote for this pagliaccio and he wins the governorship, they deserve the heartache in store for them.

It is interesting to read in April 18 issue of The Week magazine that England’s National Health Service is getting a new chief executive, Simon Stevens, who served as health advisor to Former Prime Minister Tony Blair and had run the U.S. United Health Group for the last six years. This major insurance company serves more customers than the population of the entire U.K. At least the British system has chosen a person with the correct qualifications.

We will spend time discussing the British health care system in future blogs as we discuss sustainability.

Wake up America!