Eminentoes

Obama’s Nurse Ratched

HHS Secretary Kathleen Sebelius is also Obamacare's deadly enforcer and leading Democratic operative.

By 2.16.12

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Behind every powerful health care mandate under Obamacare is a power-hungry woman named Kathleen Sebelius. As the Health and Human Services Secretary, she has unprecedented power under Obamacare to control health care decisions, the approval of medical products and the national biomedical research agenda. The Secretary is not only the key player; she is the only one on the field. "The Secretary shall…" is mentioned more than 1000 times in the new health care law.

Sebelius is using that power to promote a liberal agenda and Obama's re-election.

She pushed the contraception edict. Her staff wrote the rules that decided Catholic hospitals and charities are not religious institutions. And she was the one who came up the with the "accommodation" in response to resistance to the mandate: just make the health plans pay for it even if the customers of the plan don't want it.

It is clear Sebelius cares only about imposing a worldview and policies to win support for Obamacare. A reporter asked Sebelius: "If a Catholic nonprofit is paying for your insurance coverage, isn't it paying for contraception if you are getting the coverage through that same insurer?"

Sebelius: "The federal employees health plan… costed this as no cost, free, no cost, because adding contraception and having some employees take advantage of that coverage lowers the overall cost of the health plan."

Free? She will tell insurers to suck up the cost and still force religious organization to offer the benefit. Or else.

This is not an aberration. It is quintessential Kathy: She rules by fiat and if you cross her she will crush you. And when she rebukes and bullies, Sebelius, like Nurse Ratched, claims she is doing so for our own good. As the Big Nurse said: "We do not impose certain rules and restrictions on you without a great deal of thought about their therapeutic value."

In 2002 Sebelius was the insurance commissioner in Kansas and campaigning for governor. She blocked the sale of Blue Cross Blue Shield to Anthem Health because she "thought" doing so would raise premiums. In 2003 when Sebelius was elected, Anthem decided against the merger. (Meanwhile, from 2000-2009 premiums in Kansas rose nearly 100 percent.)

Her use of power during the last days before a congressional vote on Obamacare was also Ratched-like in nature: Sebelius told the Association of Health Insurance Plans: "You can choose to continue your opposition to reform. If you do and reform goes down in defeat, we know what will happen." She threatened insurers that if they continued to blame their rate increases on the new health overhaul they could be excluded from health insurance exchanges.

Sebelius subsequently hauled in health plan execs in 2010 to explain why premiums were going up by 10-20 percent in certain states. And she tried to censor one health plan altogether when it sent a letter to Medicare customers about premium increases. She explained she was only doing this in ensure everyone gets basic care. Or a Nurse Ratched would say: "I tell you this hoping you will understand that it is entirely for your own good that we enforce discipline and order."

Last year Sebelius appeared at several fundraisers for Democrat congressional candidates and the 2012 re-election effort. Sebelius broke all campaign spending records in the 2006 re-election bid and she is regarded as a fundraising machine. In part this is due to the fact that the used the power of her office to punish enemies and reward pals. As HHS Secretary she has the power to mandate coverage, exclude health plans, reject payment for new technologies. She has shown she's not afraid to use this power to shake down and intimidate groups holding views contrary to her own and reward her allies. And since the Independent Payment Advisory Commission reports to her, she has absolute control over what Medicare and Medicaid will pay for in the years ahead.

Which is why Sebelius (who attacked Super PACs in 2010) is one of Obama's most important surrogates in the effort to raise outside money for his re-election. She has spoken at Planned Parenthood and the National Abortion Rights Action League events. Sebelius has attended fundraisers for several politicians over the past two years. And in the process she will use Obamacare as both carrot and stick to get her way.

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About the Author
Robert M. Goldberg is vice president of the Center for Medicine in the Public Interest and founder of Hands Off My H ealth, a grass roots health care empowerment network. His is new book, Tabloid Medicine: How the Internet is Being Used To Hijack Medical Science For Fear and Profit, was published last month by Kaplan.