
President Shalala addressed UM faculty, staff, and students for half an hour and then fielded questions from the audience. Photo credit: Andrew Innerarity.
Six months after President Obama signed his landmark health care overhaul into law, many Americans remain puzzled over how the bill affects them. But on Wednesday before a capacity audience at the University of Miami Fieldhouse, UM President Donna E. Shalala did her part to help hundreds of faculty, staff, and students better understand the legislation, discussing how the bill will change the landscape of public health nationally and at the institution she leads.
“It’s not as popular as many people thought it was going to be with the American public,” Shalala said of the new law, noting that only 50 percent of Americans are currently supportive of the legislation. “People are very concerned with the fact that it’s gong to be mandatory now for everybody to take health insurance. But the fact is unless we all have health insurance, those of us that do have health insurance are paying for all of the others” who lack coverage.
Drawing upon the knowledge and skills that made her the nation’s longest-serving secretary of health and human services, Shalala said much of the high costs incurred by hospitals come from absorbing the cost of people who are either uninsured or underinsured.
It is a cost-shifting reality that other U.S. presidents before Obama were well aware of, Shalala said, noting attempts by former Presidents Franklin D. Roosevelt and Harry Truman to win passage of universal health coverage and how the American Medical Association defeated the efforts in both cases.

Faculty, staff, and students asked President Shalala several questions on health care reform during the question-and-answer phase of her discussion.
She said the health reform bill’s primary provision—in which the uninsured and self-employed would be able to purchase insurance through state-based health insurance exchanges—will not affect UM employees at all, because they are covered through the University’s health care plan and will not be allowed to purchase insurance in such a way.
Shalala noted that a number of UM graduate students and seniors won’t have to purchase student health insurance because of a provision of the bill that allows dependent children up to age 26 to stay on their parents’ policy. She projected that UM, during its annual Open Enrollment period, would probably pick up an additional 500 insured people because of that rule.
During the question-and-answer portion of her talk, President Shalala said it is unlikely that the cost of health insurance would ever decrease, but said there are measures everyone could take to help minimize cost increases, such as using generic prescription drugs instead of brand name drugs, taking advantage of preventive health care programs, and being disciplined about the use of technology.
She related a personal story as an example of using medical technology more efficiently, noting that she convinced her physician to take an X-ray of her injured ankle rather than order an MRI, a much more expensive procedure.
President Shalala urged employees to ask questions of their health care providers and to take advantage of UM’s own preventive benefits that are built into their health care plans.
UM, she said, hopes to institute more improvements to make health care more accessible to its workers, including putting an ambulatory care facility on the Coral Gables campus.
Shalala also called on the nation to use its nursing workforce more efficiently for chronic care management as a way to improve the quality and efficiency of health care.
Elizabeth Meggs, a sponsored programs specialist on the Coral Gables campus, said she attended the forum because she wanted to get a clearer perspective on health care reform.
“It was helpful, particularly the part about young adults being able to stay on their parents’ health plans,” Meggs said. “I’m glad President Shalala did it.”
An archived video of President Shalala’s talk will be available soon on the UM Benefits Administration website.









