1. Keith J. Mueller, Ph.D. Interim Dean, College of Public Health University of Nebraska Medical Center August 31, 2009 Washington, DC

2.  Starting with Teddy Roosevelt  Franklin Roosevelt and Social Security  Harry Truman and fear of socialism  Lyndon Johnson and Medicare/Medicaid  Richard Nixon loses Wilbur Mills to scandal  Jimmy Carter tries to start with children  George H.W. Bush and tax credits as a starter  Bill Clinton and the Health Security Act (first time committees reported out)  ???

3.  Affordable coverage  Foundation for expenditure control  Workforce improvement

4.  Critical to Rural  Focused on individual and small employers  Critical role of exchange and outreach  Federal pieces: guaranteed issues, guaranteed renewability, no pre-existing; predicated on individual mandate

5.  How to guarantee access to an affordable plan that:  uses local providers  is there long term  Need public plan for that?  Role and size of Medicaid  Enforcing a mandate

6.  Wellness trumps everything else, but is elusive  Pricing a difficult way to get this done  Shifting the delivery system to ACO’s and PCMH’s

7.  Primary care focus, will it work?  A national commission  Should there be state commissions?

8.  Rural Road Map

9.  Public Health  Integrated Services  Use of technology  Workforce training

10.  Health care for people requires grass roots led innovation  Broaden focus to populations and places

12.  http://www.unmc.edu/publichealth/ healthservices.htm http://www.unmc.edu/publichealth/ healthservices.htm  http://www.unmc.edu/ruprihealth/  http://www.unmc.edu/publichealth/ chparhr.htm