A conversation with former US Health Secretary, Kathleen Sebelius

Q. Are you looking forward to speaking at St Luke’s Symposium 2016?

A. As one of the many Americans who proudly claim Irish heritage, I am so honored to be receiving an Honorary Fellowship at the Royal College of Physicians of Ireland, one of the most prestigious medical teaching institutions in the country. My husband and I will have the opportunity to spend a few days in the beautiful country. I also learned during my tenure as health minister in the United States that many countries share similar challenges with aging populations and rising costs and any dialogue with medical leaders is always beneficial.

I look forward to spending some time visiting historical sights and celebrating my Irish heritage. I look forward to the exchange with some of the prestigious health leaders in Ireland and seeing what ideas I can bring back to share in the US. I am thrilled to receive Honorary Fellowship and join the celebration.

Q. What topics will you discuss at the Medicine in Changing Times day.

A. The theme of the Medicine in Changing Times event, and my address will focus on some major changes in the United States during the current administration with both the passage of the Affordable Care Act and the explosion of science and technology. I also want to talk a bit about issues we share in common with Ireland and our need, in an increasingly globalized world, to share lessons learned and to accelerate the pace of improvements in health care.

Q. What is your reflection on the Irish healthcare system.

A. The right of every Irish citizen to healthcare has been long established. And in the US, we are finally trying to achieve that very worthwhile goal. Citizens in Ireland have longer life expectancy than in the US even though less is spent per capita on healthcare. So the US could learn much from the Irish health system. Both countries are dealing with disparities in care, high drug costs and the long-term effects of the two conditions underlying most chronic diseases: smoking and obesity. The current global focus on non-communicable diseases is an effort that could benefit both of our countries.

Q. What three changes could have a positive impact on health and healthcare?

A. Reducing even further the high smoking rate in Ireland can pay major health dividends.

Obesity continues to be a major issue in Ireland with 25% of the population in that category — still well below the US rate. But the impact of weight on various chronic illnesses demand increased focus for children and adults on healthier habits of eating and exercise.

With scientific breakthroughs making life-saving cures within reach for many diseases, a global focus on drug pricing should be a top priority. It’s important to balance a pricing environment that continues to reward and incentivise research and development, but also keeps new medicines available to individuals and government programs. Ireland could help take a leadership role in these discussions.

Q. Do you think that elements of the Affordable Care Act, if implemented here, would be significant?

A. The Affordable Care Act had 3 basic goals: affordable health insurance for the relatively small portion of the US population without coverage in the workplace; reforming the delivery system to focus on better population health and the right care for every person, every time, and finally, reducing the rate of health care inflation through improvements to the system.

Since Ireland enjoys a system of universal care, much of the insurance focus of the Affordable Care Act is not applicable to the country. But the other major goals of improving population heath and care for all patients, and lowering costs are widely applicable to systems across the globe. And our shift to new quality measures and payments systems are worthwhile lessons to share.

Kathleen Sebelius is speaking at the Medicine in Changing Times event on Saturday, 22 October 2016. Register your place at www.rcpi.ie/stlukes2016/