Christopher Koller may be an assistant professor of community health while on campus, but when he canceled class Sept. 22, he had a good reason: The White House had called.
Koller serves full-time as Rhode Island's health insurance commissioner and went to Washington to attend a meeting with President Barack Obama.
Koller was among about 35 insurance regulators who gathered in the Old Executive Office Building for a private meeting with the president and about 20 members of his senior staff, according to Koller. Students had the day off from Koller's graduate-level PHP 2400: "The U.S. Health Care System: Case Studies in Financing, Delivery, Regulation and Public Health."
To mark the six-month anniversary of the passage of the Patient Protection and Affordable Care Act, Obama held counsel with the people on whom he relies to execute health care reform: state insurance officials. Secretary of Health and Human Services Kathleen Sebelius and Secretary of Labor Hilda Solis headed the first 30 minutes of the one-hour meeting, while Obama joined the discussion for the second half.
According to Koller, Obama presented the group of insurance regulators with three guiding points. First, the chief goal of reform is to make health care better for patients. Second, the states, not the federal government, are responsible for enforcing the reforms. Third, slow is all right if it helps programs work — taking the time to enact effective strategies is time well spent.
Obama then encouraged regulators to lead with courage, Koller said. Obama's message, Koller paraphrased, was: "Hold insurers accountable and don't make compromises for compromise's sake. Don't shrink from what you have to do."
Both Obama and his staff are fully aware of the key role states play in effecting health care reform, Koller said.
Rhode Island has already taken a step in this direction that other states have not. In 2004, Gov. Donald Carcieri '65 announced the creation of the Office of the Health Insurance Commissioner and put Koller in charge. This unburdened the Department of Business Regulation, which handled all insurance issues until that time, and set up an office to deal specifically with health insurance policy and delivery. Rhode Island remains the only state with a separate office dealing in health insurance regulation.
Koller summarized the mission of his office with a comparative point.
"If you can't afford auto insurance, you take a bus. But if you can't afford health insurance, we force your providers to care for you," he said.
This year has presented Koller and students in PHP 2400 with a unique opportunity not just to talk about the structure and performance of the U.S. health care system, but also ato see how the new reforms play out.
As a teacher, one of Koller's primary goals is to make sure his students are exposed to a balance of professional and academic material, he said. Koller's course gives students an exclusive look at the health care system — its financial machinery, the range in quality of care and the various players involved — from an insider's perspective. Koller said he also benefits from teaching because it allows him to take a step back from his government work.
But just as Koller holds insurance companies accountable in Rhode Island, his students don't get free passes either — after he returned from his White House trip, students were required to attend a makeup lecture.
