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Keith J. Mueller, Ph.D.
Interim Dean, College of Public Health
University of Nebraska Medical Center
August 31, 2009
Washington, DC
Starting with Teddy Roosevelt
Franklin Roosevelt and Social Security
Harry Truman and fear of socialism
Lyndon Johnson and Medicare/Medicaid
Richard Nixon loses Wilbur Mills to scandal
Jimmy Carter tries to start with children
George H.W. Bush and tax credits as a starter
Bill Clinton and the Health Security Act (first time committees reported out)
???
Critical to Rural
Focused on individual and small employers
Critical role of exchange and outreach
Federal pieces: guaranteed issues, guaranteed renewability, no pre-existing; predicated on individual mandate
How to guarantee access to an affordable plan that:
uses local providers
is there long term
Need public plan for that?
Role and size of Medicaid
Enforcing a mandate
Wellness trumps everything else, but is elusive
Pricing a difficult way to get this done
Shifting the delivery system to ACO’s and PCMH’s