Life after health care reform

Vanderbilt’s Health Care Conference and Career Fair featured keynote speaker Nancy-Ann DeParle, Deputy Chief of Staff to President Barack Obama, who laid out contrasting views of the U.S. health care system before and after passage of the reform law.

On October 28, the Vanderbilt Health Care ConferencNancy-Ann DeParlee and Career Fair hosted more than 500 participants and 35 companies at a one-day session in Nashville. Headlining the event was Nancy-Ann DeParle, Deputy Chief of Staff to President Barack Obama. This event marked the fourth annual student-organized conference, which is designed for anyone interested in the intersection of business and health care. (For photos of the event, visit the Vanderbilt Business Multimedia Gallery.)

Drawing on her experience as Director of the White House Office of Health Reform, DeParle outlined the contrast in the national health care system prior to passage of the 2009 Patient Protection and Affordable Care Act and what it will look like once the plan is fully implemented:


  • Health Insurance Premiums Doubled: Family premiums for employer coverage rose from nearly $6,000 to over $13,000 between 1999 and 2000.
  • Insured Americans and Businesses Paid a Hidden Tax: Up to $1,000 of uncompensated care was shifted from the uninsured to already-insured families. In 2008, we spent $43 billion on uncompensated care.
  • Millions Lacked Quality, Affordable Health Care: 50 million Americans were uninsured in 2009, millions more lacked access to quality care, preventive services, and catastrophic protection when ill or injured.
  • People with Pre-Existing Conditions Were Locked Out: 50-129 million Americans have a pre-existing condition that could limit access to insurance.

“Even after spending almost twice as much per capita on health care as every other industrialized country in the world, we continue to rank near the bottom when it comes to health care outcomes. Those of you working in health care understand that this is bad for business. Imagine you’re selling cars. If cars become more expensive, but the quality stays the same, or even gets worse, you don’t need an MBA…to realize that you’re in trouble,” DeParle said. 

“Health care isn’t like most other industries. If people can’t afford insurance, they don’t stop coming to the hospital. They just stop paying for the care they receive. So to tweak the analogy that I just used, not only are customers not buying cars, but you have to hand them out for free. That’s not sustainable.”


  • Allows young adults to stay on their parents’ policies: More than 1 million 18-to-26 year olds have benefitted.
  • Gives uninsured with pre-existing conditions affordable insurance: The Pre-Existing Condition Insurance Plan has covered over 30,000 people and is a bridge to 2014 when discriminating against anyone with a pre-existing condition will be illegal.
  • Protects retiree coverage: Provides $5 billion to keep coverage affordable for early retirees in over 6,600 plans.
  • Expands Community Health Centers and workforce: Clinics can serve nearly 20 million more Americans, adding 16,000 primary care providers over the next 5 years.
  • Holds health insurers accountable: Implements Patients Bill of Rights, eliminates double-digit rate hikes without review, guarantees that overhead expenses are held in check, and promotes pricing transparency among health plans on
  • Creates a competitive and affordable insurance marketplace: Starting in 2014, consumers will be offered the same health plan choices as Members of Congress. Tax credits and Medicare coverage will be made available to ensure that coverage is affordable for families and small businesses. The law also protects existing employer-based coverage while ensuring that all Americans who can afford it get health insurance, increasing the insurance purchasing pool, ending pre-existing condition exclusions, and eliminating the ‘hidden tax’ of cost shifting.
  • Lowers cost and improves quality: Health care fraud persecutions are up 85% and billions have already been saved. The law promotes prevention and offers incentives to reduce hospital readmissions and healthcare-acquired conditions. It also provides tax credits to small businesses and relief for seniors. There has been record low growth in national health spending in 2009 and 2010.

“I’m not saying it’s going to be easy for us to make all of these changes. But what I’m saying is the framework is there and the incentives are there in this new law,” DeParle said. 

“Do we embrace this new law, this new world of health reform, as a first step and work together to make it better? Or do we fight to restore an unsustainable status quo that left millions of our neighbors on their own in their time of need?”

Published Nov 17, 2011 in Vanderbilt Business Intelligence
Copyright 2011 Vanderbilt Owen Graduate School of Management