Reform: You like it, you like it—don't you?

Dr. Howard Koh got to channel his inner Sally Field this week. Speaking on Monday to senior public health officials from across the country, Koh, assistant secretary for Health at HHS, heaped praise on his audience and colleagues and got a little love in return.

The former commissioner of public health for Massachusetts warmed attendees at the annual meeting of the American Public Health Association by reflecting “This is my meeting and you are my people.”

“This is tremendous to feel the commitment of everybody at this meeting and particularly here in this session to health equity,” Koh added.

He went on to note that he last addressed the organization a year ago shortly after enactment of the Patient Protection and Affordable Care Act. Since that time, his department has implemented both a strategic action plan for health disparities and a national prevention strategy.

Additionally, he noted, some of the most popular provisions of the law already have gone into effect, including a ban on insurers restricting coverage for children with pre-existing conditions and Medicare paying for free wellness visits.

“These are just some of the signs of progress due to health reform,” Koh said. “And you know what, if I were a politician, at this point I would expect overwhelming applause.”

After a round of boisterous applause from the assembled public health officials, Koh added, “not being politician, I appreciate it anyway.”

The moment conjured up images of Field in her Academy Award acceptance speech for 1984's “Places in the Heart.”

“I haven't had an orthodox career, and I've wanted more than anything to have your respect,” she said. “The first time I didn't feel it, but this time I feel it, and I can't deny the fact that you like me, right now, you like me!”

It was not unprecedented for a senior official in any administration to both offer praise and seek praise from a group of passionate advocates visiting Washington. But the moment also indicated possible creeping defensiveness among Obama administration officials regarding the 2010 healthcare law and puzzlement that it is still opposed by a majority of the public 19 months after enactment.

Or as Koh phrased it to the gathered public health officials, “(You) know that we are in an extraordinary time where we are receiving a range of reactions to health reform across the country.”



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