Keehan: Affordable Care Act goes beyond myths to effect health care changes


Sister Carol Keehan speaks at the Hall of Philosophy on Friday. Keehan is president and CEO of the Catholic Health Association of the United States. Photo by Eve Edelheit.

Emily Perper | Staff Writer

Sister Carol Keehan might be one of Time’s 100 Most Influential People, but she’s not bragging about it.

“Lady Gaga, a couple of dictators — I have to tell you, it is not the communion of saints,” she joked. “It’s not that I’m not grateful to Time, but it’s much nicer to have the Cross for the Church and the (Pontiff) from Pope Benedict.”

Those aren’t her only awards. Keehan also received the American Hospital Association’s Trustee Award and the American Cardinals’ Encouragement Award, among others. In addition, she is the president and CEO of the Catholic Health Association of the United States. She has worked in medical administration for more than 35 years and is a part of the finance committee of the Archdiocese of Washington.

Keehan spent her time at 2 p.m. Friday in the Hall of Philosophy debunking misconceptions about the Patient Protection and Affordable Care Act throughout her lecture, “Will U.S Health Reform Advance Maternal and Child Wellbeing?”

This was Keehan’s first visit to Chautauqua.

“I think what you do here is so very important for the soul of our country, as well as for the kinds of support and good works which you inspire and foster,” she said.

Keehan began with current context of health care in the United States, a system challenging for women insured and uninsured alike.

According to Keehan, there are currently 50.7 million uninsured people in the United States, the highest number in the history of the census collection; of those, 27 million are women, and 48 percent of these women did not see a doctor, fill a prescription or attend a follow-up appointment due to cost.

“While we may have some of the world’s best medical facilities — if you can get access to them — we’re not protecting the world’s best health care system,” Keehan said. “We find in metrics like quality of care, access to care, efficiency, equity and longevity; we score below all other industrialized nations, and we are spending twice as much per capita.”

In 2010, the Commonwealth Fund surveyed 11 industrialized nations. The results demonstrated adults living in the United States were the most likely to forgo medical care because of cost, Keehan said, and 35 percent of people in U.S. spent more than $1,000 for health care in 2010, aside from paying for health insurance.

“As someone who has spent her whole life in health care, I am saddened to share many of these statistics because I have great belief in what our health care system has done and can do if we deal with the structure of our systems, particularly the financial structure,” Keehan said.

She added she is confident in the Affordable Care Act to effect these changes.

She shared the prediction of the Commonwealth Fund May 2011: the implemented health reform will insure nearly all uninsured women by 2014.

Parts of the Affordable Care Act especially excite Keehan. One aspect is the elimination of a lifetime limit on benefits.

“For the most vulnerable among us, this is a huge issue,” she said. “For people who have major health problems, this can be one of the most frightening things to live with.”

Another aspect is the elimination of denial of insurance based on a pre-existing condition. Keehan shared the story of a successful working woman whose husband had multiple sclerosis and child had cerebral palsy. Both were soon to reach their benefit limits, and the woman could not switch jobs to renew her limit because her family members’ conditions were pre-existing. For her, these reforms were literally lifesaving.

In addition, parents can now keep their children on their medical insurance until they are 26 years old. Such a change allowed one farmer to receive the $3,000-per-month medication his condition demanded and retain his livelihood, Keehan explained.

Former U.S. Rep. Kathy Dahlkemper, who was responsible for that aspect of the Affordable Care Act, was in the audience of the Hall of Philosophy, and the audience applauded her efforts.

Keehan elaborated upon several more changes included in the Affordable Care Act.

First, insurance companies must prove fraud to cancel a policy.

Second, insurance companies must allow an appeal before they can deny a claim.

Also, important preventative services, like colonoscopies, must be administered even if the patient cannot afford a co-pay. Keehan called this “one of her favorite (changes).”

In addition, patients can choose their primary care physician, including obstetricians and pediatricians, no matter if he or she is out of their network.

The current health care system benefits stockholders of insurance companies more than policyholders, Keehan said. But a new process, the minimum medical loss ratio, will change this.

“This minimum medical loss ratio means an insurance company must spend between 80 and 85 percent of the premium they collect for medical care and quality improvement, not profits, bonuses or excessive salaries,” she said.

Keehan also spent time debunking myths about the new changes to health care.

One myth is that the Act will destroy Medicare.

“The truth is that it actually lengthens the viability of the Medicare trust fund into … 2029,” she said.

Another myth is that insurance companies will no longer offer Medicare advantages.

“Insurance companies are not looking to leave this market,” she said. “They know they will have to adjust to making less profit on it than they have in the past.”

In addition, it is not true that doctors will no longer take Medicare patients; in fact, one study showed that “doctors are more likely to drop private insurance patients than the Medicare patient,” Keehan said.

The rumors of “death panels,” the government having control over which tests and treatments doctors can administer to a particular patient, are completely false, Keehan said.

“The reality is that there is absolutely nothing in this bill that does any of that,” she said. “The bill does support the use of palliative care and it does support people’s choice of what they want if they have a terminal condition.”

And rather than increase, the cost of family insurance will be impacted favorably as minimum medical care cost is implemented — a positive change for families, individuals and employers, Keehan said.

“We do not need the top five insurers in this country having an $11.7 billion profit off health care,” Keehan said. “Much more of that can be better utilized by reasonable coverage, lower costs and making insurance what it was really intended to be when it began in our country.”

Keehan said she and others recognize that women are the primary health care deciders and providers in their families.

There are 18,000 unnecessary deaths each year in the U.S. due to a lack of access to health care; the examples Keehan gave focused on women in the advanced stages of cancer, who didn’t have access to preventative care.

Stress, which exacerbates many medical conditions, will also be alleviated significantly if women can rest assured that their health needs and those of their families will be taken care of, Keehan added.

Governments have a responsibility to their citizens, as do employers to their employees, she said. Insurance providers must take care to perform their services effectively and efficiently. The public at large must make sure to improve its lifestyle, to work toward becoming a healthier nation overall.

“As a nation, I have always felt that we were as smart and as compassionate as any other nation and that if we put our mind to it, we could take as good a care of our citizens as other nations do — and even better,” Keehan said.