Governor Gary Locke’s Remarks
Washington Health Foundation Health Leadership Summit
October 28, 2003

Good afternoon. It’s a pleasure to be here.

I want to congratulate the Washington Health Foundation for its great work in health care. And especially for the tremendous effort that brings us here today.

There have been some 44 “Community RoundTable” meetings. More than 1200 participants. Meetings in all 39 Washington counties. Nearly 10,000 individual responses. All of these responses have been analyzed to arrive at the nine dominant values you’ve deliberated over today.

As a result of the Foundation’s effort, we now have a much better picture of community priorities in health care.

I also want to thank all of you for coming here today, not only to gather with colleagues and share ideas, but also to roll up your sleeves and make this a working meeting.

There is a broad range of strong and sometimes contrary opinions among all of us. But I know we are all in complete agreement on one thing: We simply must improve health care delivery in our state and nation.

Here in Washington, we have a strong track record. We have been national leaders in health care and continue to be.

We’ve led the nation in extending coverage to our most vulnerable citizens through Medicaid and Basic Health. And the Children’s Health Insurance Program offers coverage to children within 250 percent whereas most states cover up to only 200 percent..

We’ve reformed the individual health insurance market when the major carriers stop selling new policies. We’ve forced that market to be more accessible and more affordable.

We’ve addressed consumer insurance issues through the Patient’s Bill of Rights which are among the first in the nation.

And this year we did something about skyrocketing prescription drug costs and passed our landmark prescription drug legislation to lower the costs of drugs paid for by the state for low-income individuals and make low prices available to seniors.

Yet we know that in spite of our best efforts, we face a health care crisis in our state, just like every other state.

The Foundation’s surveys tell the story. Only 42% in our state give our health care system a positive rating. And a full 50% think our health care system needs either to significantly change or be completely overhauled.

We face access, cost and quality problems. Too many in our state don’t have any health insurance. That means there are close to 650,000 people in our state who don’t have health insurance coverage of any kind.

People without health insurance go without adequate medical care. What little care they do get usually comes too late. They are likely to be sicker and likely to die sooner.

Some of the challenges relate to eligibility for and enrollment in programs. About 60% of the children who are uninsured in our state are below 200% of the federal poverty level. Most or all of these children are eligible for some kind of coverage, but they are not enrolled. They are not enrolled because their parents don’t know they are eligible. Or because there are both real and perceived difficulties in enrolling. We need to work harder to get already available assistance to those who need it.

Our rural communities struggle with reduced resources. Economic changes have placed severe financial pressure on many communities. A higher proportion of vulnerable citizens in these communities means higher dependence on strained government programs. Many rural communities lack an adequate tax base to support public health care facilities.

There are shameful disparities in the quality of health care based on race, ethnicity, and gender. Such disparities translate into inferior health care.

Good health care must not be allowed to devolve into a privilege for the fortunate few. We need a solution that serves everyone—and we need it right away.

We know that we want to build a health care system that serves us all. But the solution is hardly simple and we need a national solution. I think health care reform in our state must feature four primary characteristics—reflected in many of the values you’ve been considering today.

First, Responsibility—Personal responsibility, governmental responsibility, social and community responsibility, business responsibility. Everyone must step up and take part in slaying this dragon. That is the only way we will prevail. Nobody gets to sit this one out. It concerns us all, and it is everyone’s responsibility.

Second, Partnership—Health care reform is a joint effort among critical partners. Government, employers, the individual, the medical community - we must work together and be part of the solutions. We will solve this problem by joining hands, not by pointing fingers or clenching fists.

Third, Fairness—We must work toward a more fair system, free of disparities and privilege. Fairness also entails accountability, and personal responsibility. Fairness must also be reflected in the proper allotment and allocation of resources.

Finally, Efficiency. The system must work. That may mean system redesign. It certainly includes simplifying, and improving performance. Community-based solutions to health care have many advantages—including efficiency. We don’t need more bureaucracy. We need a health care system that works. And works well.

Responsibility, Partnership, Fairness and Efficiency. If we can build a health care system with these characteristics, we will be succeeding. We will succeed in creating a healthier Washington for ourselves, our children, and generations beyond.

Thank you.