Governor�s Health Care Summit

October 25, 2005

Remarks of Gov. Christine Gregoire (as prepared)
Governor�s Health Care Summit, Seattle, WA
Oct. 25, 2005

Thank you all for coming.

I want to thank my health care team for organizing this event.

I�d like to recognize my agency directors:

� Steve Hill at the Health Care Authority,

� Mary Selecky at the Department of Health,

� Robin Arnold Williams at the Department of Social and Health Services

� and Doug Porter at the Health Recovery Services Administration.

I�d also like to thank Mayor Greg Nickels and the Seattle Center for hosting us.

We�re here today because we have a health care crisis.

And we need to work together to address it. I admit others have tried and failed.

It�s time for honesty, openness, creativity, tenacity and courage.

I�m not willing to stand by while:

� 600,000 people go without health insurance in this state;

� many others are underinsured;

� thousands of children have no coverage; good employers are struggling;

� and Medicaid and state employee health costs nearly doubled in the last five years.

The burden on the state�s budget is squeezing out funding for education, infrastructure improvements and public safety.

This is a nationwide crisis begging for a national solution. But I don�t see one coming.

That�s why I called this summit. To take charge of our health care system.

Last session we got off to a good start by working together to address our immediate problems.

At a time of health care cuts and rollbacks, we made investments to strengthen our system.

While many states around the country cut their enrollments, we added people.

We also:

� Initiated a new, state-sponsored prescription drug consortium to reduce costs for many uninsured and underinsured people.

� We retained the Basic Health Plan for 100,000, even for 17,200 adults whose coverage was at risk for elimination this year.

� We fought to keep grants to community clinics at Fiscal Year 2004 levels, preserving the health care safety net for many uninsured and underinsured people, who rely on these clinics for their health care.

� We stabilized an important avenue of care for many seniors by raising the wages of home care workers.

� We adopted mental health parity and restored $80 million in mental health funding cuts by the federal government.

� We increased Medicaid reimbursement rates for hospitals by 1.3% each year of the biennium.

� And, we put 40,000 more children on health insurance.

I�m often asked what I like most about being Governor, and I tell them about the day, shortly after I took office, that I issued an order that restored health coverage for over 30,000 children.

I remember it well because I called both my daughters soon after, and because it put us on the path to insuring every child by 2010.

I�m proud to work with a legislature that�s on the same page. We worked together to pass legislation to cover nearly 10,000 additional children.

I know every parent wants the same thing for their kids - as I do for my two daughters - the best health coverage they can get, throughout their lives.

And I want our children to know we�re tackling the big problems in health care now, instead of passing our problems on to their generation.

I want us to address our health care problems now for the long haul.

Like you, I want accessible, affordable, quality health care for everyone in this state.

No employee should live in fear of being dropped from coverage.

No employer should live in fear of going bankrupt trying to pay for coverage.



For 20 years we�ve dealt with rising health care costs by finding ways to pass it on.

From businesses to government to individuals to communities and back again.

We have heard enough of the quick-fixes and political promises.

We can�t spend our way out of our health care crisis.

We have to confront the real issues of why costs are spiraling out of control.

I�m focusing on five major changes:

First, we should significantly increase our use of evidence-based medicine.

We�re going to look at results, not watch television commercials, to determine the best care options.

Second, I want us to better manage chronic care by working to keep more people out of it, because right now 5% of people consume 50% of our health care costs.

Third, people who purchase health care should be empowered with a more transparent system that lets them be informed consumers - shopping for health care by price and quality.

Fourth, we must bring our health care systems into the 21st century.

Let�s use our new technology to eliminate waste, trim down administrative costs and get more efficient, timely delivery of care.

And fifth, we need to take responsibility for both our personal health and everyone�s health by promoting healthy lifestyles and choices in our schools, workplaces and communities.

These five things will improve the quality of health in our state.

And in doing so, will help contain costs, improve quality and open up more access to our system.

The first change, practicing evidence-based medicine, means eliminating ineffective and dated treatments by focusing on treatments that work.

In the book Epidemic of Care, authors George Halvorson and George Isham present findings from a national survey of 135 doctors who were asked how they would treat a particular condition for a patient.

The survey response included 82 separate treatments. Same patient. Same condition. And some of the responses included treatments that were out-of-date, or not effective.

Why? Some doctors graduated yesterday. Some 20 years ago.

Some read an article about a new drug. Some have been prescribing the same treatment for years.

In Washington we have the same challenge: different treatments prescribed in different places � with different outcomes.

We need to evaluate medical procedures and recommend only treatments that have a demonstrated history of effectiveness and results.

A recent RAND study says that patients receive the most recommended care for their condition only 55% of the time.

Shifting towards evidence-based care, we can and we will do much better.

Evidence-based care also means having standards for delivery of care.

Because we should expect the same standard of care whether we�re in Seattle or Ritzville. Yakima or Vancouver.

A good example is the State Department of Health�s Diabetes Collaborative, which sets uniform guidelines for best practices and most effective treatments.

Giving us better, more quality care.

The second change I want us to make is to reduce chronic care.

We can keep folks out of the emergency room by making better use of predictive and preventative medicine.

Right now, our system is more �sick care� than �health care.�

Geared more toward the emergency room and the doctor�s office � than to the classroom, gym and community.

Many diseases, like cardiovascular disease and Type II diabetes, can be prevented by understanding and following a path towards a healthier lifestyle.

It won�t be true in every case, but evidence clearly shows us this stuff works.

For instance, we know that a diabetic patient will do far better if their lipid levels and their blood pressure is controlled and monitored.

But only 40-60% of our diabetic patients are adequately monitored and treated for these indicators.

We know that exercise reduces the chances of contracting certain diseases or minimizes the effects, but exercise is rarely the prescription issued.

We have the science. We have the tools.

We need a system that says: The emergency room should be the last resort, not the front line of our health care system.

And I want to increase the use of preventative medicine and promote early treatment.

I know how important early treatments can be.

It�s because of my own experience that I feel expanding preventative and predictive medicine is so important.

The third change I want to make is to get more transparency in health care information.

I want to empower people by giving everyone clean, objective information about the quality and effectiveness of the health care delivery system.

When we buy a car, we have easy access to information about the quality, reliability and efficiency of various brands we are considering.

We need that same kind of information in the health care system.

I want the state to assist groups that are working with health plans to get this information into a common database so both health plans and consumers have accurate, consistent, relevant information.

Fourth on my list is improving our health information technology.

Right now we�re trying to deliver 21st century care with 20th century systems.

We�re wasting too much time and money on duplicate and unnecessary procedures because our system doesn�t allow adequate sharing of information.

My aunt was hospitalized because she had several doctors prescribing different treatments and medications.

She had to be hospitalized � but once we got her to one doctor and one set of prescriptions, and she got much better.

Medical testing is another place we�re wasting money.

It�s estimated that 30% of all medical testing doesn�t have to be done, primarily because basic testing information is not getting from primary care providers to specialists.

With more information sharing, we�ll reduce costs, enhance quality, and also lower medication ordering errors.

And finally, I want people to have the information and the encouragement they need to take more personal responsibility for their health.

Like Ben Franklin says: �an ounce of prevention is worth a pound of cure.�

Or, as my Department of Health Director Mary Selecky says, �an ounce of prevention takes a ton of hard work.�

It�s about wellness!

It�s about getting your flu shot, covering your cough and washing your hands.

It�s also about staying home when you�re sick, so others can stay healthy.

And going to the doctor when you need to.

I want to note our public health employees and thank them for looking after our state�s collective health, and their efforts preparing us for emergencies like an outbreak of pandemic flu.

I�m promoting healthy living and raising public awareness through campaigns like my Community Health Bowl that I kicked off with the Washington Health Foundation last month.

Our goal is a million miles walked by Washingtonians by October 30. I�ve got my pedometer!

But prevention is not all about the fun stuff of walking, swimming and biking.

There are other key education areas we need to focus on to prevent high-risk activities.

We�ll continue our battle to against teen smoking, and curtailing smoking among adults.

Recently, we made progress by moving from 10th to 9th among the 50 states for low smoking rates.

Ninth is great. First is where we need to be. Let's keep going!

Vaccinations are critical to prevention and we�re going to get children the shots they need by focusing on Well Child initiatives.

As I�ve laid out today, I have some very ambitious goals on health care.

I�ll make sure our state leads the way by refocusing our own health care system.

We spend $8 billion a year covering 1.3 million people.

We�ll make smart purchasing decisions, promote wellness and reward consumers and providers who provide more quality care at less cost.

We�re the biggest player in the Washington health care market and I want us to use our influence to model accessible, quality, cost-effective care.

We�ll also continue to make investments in the future of health care.

With the legislature�s help, we created the Life Sciences Discovery Fund earlier this year, which could be worth as much as $1 billion over the next 10-15 years.

The life sciences is on the cutting edge of predictive and preventive medicine.

It�s about finding cures to some of our most challenging diagnoses - cancer, Parkinsons, Alzheimers.

It is about healthier agricultural products, which our state is known for throughout the world.

With our two major research universities - WSU and the UW - with the Fred Hutchison Cancer Research Center, the Gates Foundation, the PNNL lab in the Tri-Cities, our Nobel laureates and forward thinking businesses and entrepreneurs throughout the state -

we have �the right stuff� to succeed in life sciences.

I�m not going to let this train leave the station without us leading it!

Our health care crisis presents many challenges, but if we stick together, we can move forward.

We will all have to do our part - providers, doctors, hospitals, nurses, public health professionals, consumers and government.

Our task will take a shared vision and a united effort to achieve.

But we can do this. We have to do this.

Getting by just isn�t good enough.

This is about real people with real needs.

Real choices and real costs.

I�m ready to make some changes that will fix our system for the long haul.

Working together we�ll improve access to care, get more quality care, reduce costs, increase efficiency, and insure all our children by 2010.

Let�s go to work!

Thank you.