(APPLAUSE)
WE'LL GIVE EVERYBODY A FEW MINUTES
TO JUST GO AHEAD AND GRAB A SEAT.
GOOD MORNING. WELCOME TO THE 157TH LANDON LECTURES ON PUBLIC AFFAIRS.
THE LANDON LECTURES WERE BEGUN IN 1966
BY THE LATE GOVERNOR ALF LANDON
AND THE LATE K-STATE PRESIDENT JAMES MCCAIN
THE GOAL OF THE LANDON LECTURES IS TO BRING THE MOST PROMINENT PUBLIC FIGURES
HERE TO KANSAS STATE UNIVERSITY TO DISCUSS
THE PRESSING ISSUES OF THE DAY
WE ARE VERY PLEASED TODAY TO WELCOME
SECRETARY OF HEALTH AND HUMAN SERVICES, KATHLEEN SEBELIUS
TO THE LANDON PODIUM TO JOIN THE 156 PREDECESSORS
IN BRINGING THEIR THOUGHTS AND OPINIONS
ON IMPORTANT PUBLIC ISSUES
TO THE K-STATE COMMUNITY
WE DO HAVE SEVERAL DISTINGUISHED GUESTS IN ATTENDANCE
AND I WOULD LIKE TO ASK YOU TO HOLD YOUR APPLAUSE
WHILE I RECOGNIZE THESE FOLKS
AND I'LL ASK YOU TO STAND AND THEN
ONCE THEY ARE ALL STANDING WE'LL GIVE A BIG ROUND OF APPLAUSE
TO BEGIN WITH LIEUTENANT GOVERNOR TROY FINNLEY
CHEIF OF STAFF RAYANNE DAVIS FROM THE GOVERNOR'S OFFICE
ANDY TOMPKINS, PRESIDENT AND CEO OF THE KANSAS BOARD OF REGENTS
DAN JORDAN, SECRETARY OF SOCIAL AND
REHABILITATION SERVICES FOR THE STATE OF KANSAS
REGENTS KRISTINE DOWNY SCHMIT,
MILDRED EDWARDS AND DICK HEDGES
REPRESENTATIVE SYDNEY CARLIN
AND BRIGADIER GENERAL DAVID PETERSON
COMMANDER AT FORT RILEY.
FOLKS, PLEASE HELP ME WELCOME THESE FOLKS.
(APPLAUSE)
WHILE I GET TO STAND UP AND MAKE THE INTRODUCTIONS
THERE'S REALLY A LOT OF OTHER FOLKS
THAT ARE RESPONSIBLE FOR MAKING THE WHOLE
DAY A SUCCESS AND TO WORK ON
THE INVITATIONS AND SO ON. I WOULD LIKE TO INTRODUCE
THE CHAIRS OF THE LANDON LECTURES COMMITTEE
ED SEATON CHAIRMAN OF THE LANDON PATRONS AND
EDITOR-IN-CHIEF AND PUBLISHER OF THE MANHATTAN MERCURY.
AND DR. JACKIE HARTMAN
CHAIRWOMAN OF THE LANDON LECTURE SERIES AND DIRECTOR OF COMMUNITY RELATIONS AT KANSAS STATE UNIVERSITY.
PLEASE JOIN ME IN THANKING THEM.
(APPLAUSE)
WE ALSO HAVE OUR CAMPUS LEADERSHIP WITH US TODAY.
DR. BETSY COGLE PRESIDENT OF FACULTY SENATE
AND DEPARTMENT HEAD OF SOCIOLOGY, ANTHROPOLOGY AND SOCIAL WORK.
BECKY BOMENBLUS, PRESIDENT OF THE CLASSIFIED SENATE
DANNY UNRUH, STUDENT BODY PRESIDENT AND A SENIOR IN POLITICAL SCIENCE.
THANK YOU FOR BEING WITH US TODAY.
(APPLAUSE)
TODAY, I'M ESPECIALLY PLEASE TO INTRODUCE SECRETARY, KATHLEEN SEBELIUS.
SINCE TAKING OFFICE IN APRIL 2009,
SECRETARY SEBELIUS HAD BEEN A LEADER
ON SOME OF PRESIDENT OBAMA'S TOP PRIORITIES,
INCLUDING THE IMPLEMENTATION OF THE HISTORICAL AFFORDABLE CARE ACT.
SHE ALSO HAS BEEN WORKING WITH SECRETARY OF AGRICULTURE,
TOM BILLSACK ON BUILDING A 21ST CENTURY FOOD SAFETY SYSTEM
WHICH IS AN IMPORTANT AREA OF EMPHASIS
AND REASEARCH AT KANSAS STATE UNIVERSITY
AS SECRETARY OF HEALTH AND HUMAN SERVICES
SEBELIUS LEADS THE PRINCIPAL AGENCY CHARGED WITH KEEPING AMERICANS HEALTHY,
ENSURING THEY RECEIVE THE CARE THEY NEED,
AND PROVIDING CHILDREN, FAMILIES AND SENIORS WITH THE ESSENTIAL
HUMAN SERVICES THEY DEPEND ON.
SHE ALSO HAS BEEN A LEADER DURING PUBLIC HEALTH CRISIS
COORDINATING THE GOVERNMENT'S RESPONSE TO THE 2009 H1N1 VIRUS
AND HELPING TO PROVIDE RAPID MEDICAL ASSISTANCE
FOLLOWING THE OIL SPILL IN THE GULF OF MEXICO,
AND THE DEVISTATING EARTHQUAKE IN HAITI.
PRIOR TO BECOMING THE NATION'S 21ST HEALTH AND HUMAN SERVICES SECRETARY,
SEBELIUS WAS TWICE ELECTED GOVERNOR OF KANSAS
SERVING FROM 2003 - 2009.
THE DAUGHTER OF FORMER OHIO GOVERNOR JOHN GILLIGAN,
SHE WAS THE FIRST DAUGHTER OF AN ELECTED GOVERNOR
TO SERVE AS GOVERNOR IN U.S HISTORY.
AS GOVERNOR, SEBELIUS LED EFFORTS TO CREATE JOBS,
IMPROVE ACCESS TO HEALTH CARE AND
IMPROVE EDUCATION FOR KANSAS CHILDREN
HER ACCOMPLISHMENTS IN OFFICE EARNED HER
RECOGNITION IN TIME MAGAZINE
AS ONE OF THE NATION'S TOP 5 GOVERNORS
IN 2005
PRIOR TO HER SERVICE AS GOVERNOR OF KANSAS,
SEBELIUS WAS THE FIRST DEMOCRAT TO BE
ELECTED STATE INSURANCE COMMISSIONER,
SERVING IN THAT CAPACITY FROM 1995 - 2003.
HER WORK EARNED PRAISE FROM GOVERNING MAGAZINE,
WHICH NAMED HER THE 2000 PUBLIC OFFICIAL OF THE YEAR.
SEBELIUS ALSO SERVED IN THE KANSAS HOUSE OF REPRESENTATIVES
FROM 1987 - 1995.
SHE HAS A BACHELORS OF ARTS FROM TRINITY WASHINGTON UNIVERSITY,
AND A MASTERS OF PUBLIC ADMINISTRATION FROM THE UNIVERSITY OF KANSAS.
PLEASE HELP ME IN WELCOMING KATHLEEN SEBELIUS
TO KANSAS STATE UNIVERSITY
(APPLAUSE)
WELL, GOOD MORNING!
THANK YOU.
THANK YOU, THANK YOU.
WELL, I WANT TO START BY THANKING
PRESIDENT SHOLTZ
FOR NOT ONLY THAT NICE INTRODUCTION
BUT FOR YOUR LEADERSHIP OF THIS INCREDIBLE UNIVERSITY.
I DIDN'T HAVE A CHANCE TO REALLY
WORK WITH PRESIDENT SHOLTZ,
HE WAS CHOSEN AS I WAS LEAVING KANSAS,
BUT I'VE CERTAINLY WATCHED HIM IN THIS CAPACITY
AND HE'S DOING A TERRIFIC JOB.
K-STATE IS NOT ONLY IMPORTANT IN THE MANHATTAN COMMUNITY,
IT'S ONE OF THE STATE'S CROWN JEWELS,
AND I THINK IT'S A CRITICALLY IMPORTANT UNIVERSITY TO OUR NATION.
AND I'M REALLY PLEASED TO BE HERE TODAY
ALSO WITH LOTS OF MEMBERS OF THE WILDCAT FAMILY,
THE KEY MEMBERS OF THE ADMINISTRATION,
THE FACULTY WITH SUPPORTERS, ADVISERS AND STUDENTS
AND I'M ALSO DELIGHTED TO BE HERE, AT THE HOME
OF TWO OF THE NATION'S BEST COACHES,
BILL SNYDER AND FRANK MARTIN.
(APPLAUSE)
YOU KNOW, COACH SNYDER AND I HAD A CHANCE TO
WORK TOGETHER ON LOTS OF ISSUES AS GOVERNOR.
MOST PARTICULARLY ON FINDING MORE
ADULTS TO MENTOR KANSAS KIDS.
AND HE DOES A GREAT JOB,
NOT ONLY ON THE FIELD,
BUT EACH AND EVERY DAY
IN COMMUNITIES THROUGHOUT THIS STATE.
AND I HAVEN'T HAD A CHANCE TO
GET TO PERSONALLY KNOW FRANK MARTIN
BUT I'VE CERTAINLY WATCHED HIM
I'M ONE OF HIS OF LEGIONS OF FANS
AND I HAVE TO TELL YOU,
WATCHING THAT DUKE GAME THE OTHER NIGHT
A FEW MORE FREE THROWS AND
A LITTLE MORE MOJO FOR JAKE PULLEN,
K-STATE COULD BEAT ANY TEAM IN THE COUNTRY
NO QUESTION ABOUT IT.
(APPLAUSE)
BUT WHAT'S REALY IMPRESSIVE ABOUT THE COACHES IS
THEY ARE BOTH COACHING KIDS FOR LIFE SKILLS
AND NOT JUST SPORTS SKILLS
AND THAT IS REALLY WHAT UNIVERSITY COACHING IS ALL ABOUT.
YOU KNOW, I'M PLEASED TO BE BACK HERE
WITH ALL OF YOU.
IN MY NEW POSITION IN WASHINGTON I AM
REALLY GUIDED EVERY DAY BY THE WORK WE DID HERE IN KANSAS
TO BUILD A STRONGER, HEALTHIER
AND MORE PROSPEROUS STATE EVERY DAY OF THE YEAR.
IT'S GREAT TO BE HERE IN MANHATTAN.
I HAVE A REAL SOFT SPOT FOR MANHATTAN,
AND FOR K-STATE.
I MARRIED A WILDCAT
WHICH IS WHAT BROUGHT ME TO KANSAS,
SO IT WILL ALWAYS BE NEAR AND DEAR TO MY HEART.
AND ALTHOUGH I AM NOW ON THE EAST COAST
MANHATTAN, TO ME, ALWAYS MEANS KANSAS AND NOT NEW YORK.
SO, I KNOW THIS IS A TERRIFIC PLACE
TO GET A COLLEGE EDUCATION.
BUT ALSO, IT'S JUST SUCH AN IMPORTANT ENGINE
FOR OUR STATE'S ECONOMY
A STEADY SOURCE OF INNOVATION
IN SO MANY AREAS
FROM ENGINEERING TO AGRICULTURE.
AND I'M ESPECIALLY PROUD
OF THE WORK WE DID, AND THAT K-STATE WAS SELECTED
TO BE THE SIGHT OF A NEW STATE-OF-THE-ART LAB
ONE OF ONLY THREE IN THE WORLD THAT WILL PUT OUR STATE
AT THE FOREFRONT OF ANIMAL HEALTH RESEARCH
NOT ONLY IN THE COUNTRY,
BUT THROUGHOUT THE GLOBAL COMMUNITY.
OUR DEPARTMENT, HHS, OPERATES
SIMILAR LABS FOR HUMAN DISEASES
THROUGH THE CENTER FOR DISEASE CONTROL
AND THE NATION INSTITUTE OF HEALTH,
AND I KNOW HOW ABSOLUTELY CRITICAL THEY ARE
TO THE HEALTH AND SECURITY OF OUR NATION.
SO I'M GLAD TO SEE PLANS FOR THIS FACILITY
MOVING FORWARD IN THE HEARTLAND.
AND THANK YOU SO MUCH FOR INVITING ME.
AS YOU CAN SEE, I STILL HAVE AN ARRAY OF PURPLE IN MY CLOSET.
IT'S GOOD TO HAVE A CHANCE
TO WEAR IT ONCE AGAIN.
IT'S A HUGE HONOR TO BE
INVITED HERE TO GIVE THE LANDON LECTURE,
TO BE HERE, WHERE SO MANY LEADERS HAVE STOOD BEFORE
IN THIS GREAT AUDITORIUM.
OF COURSE, AS PRESIDENT SHULTZ
HAS ALREADY SAID,
THE FIRST OF THOSE GREAT LEADERS WAS
GOVERNOR ALF LANDON HIMSELF.
NOW, GOVERNOR LANDON
HAD A TRUELY REMARKABLE LIFE.
HE WAS A GREAT SUCCESS IN THE OIL BUSINESS,
HE FOUGHT IN THE FIRST WORLD WAR,
IHE SERVED AS GOVERNOR OF THIS STATE,
HE RAN FOR PRESIDENT
AND EVENTUALLY BECAME ONE
OF OUR NATION'S GREATEST STATESMAN.
GOVERNOR LANDON WAS ALSO FORTUNATE
ENOUGH TO WITNESS SOME AMAZING EVENTS IN HISTORY;
THE INVENTION OF THE AUTOMOBILE,
THE DEFEAT OF FACISM,
THE CIVIL RIGHTS AND WOMEN'S RIGHTS MOVEMENTS,
TECHNOLOGICAL LEAPS THAT PUT A MAN ON THE MOON,
AND GAVE US A PERSONAL COMPUTER.
BUT I WOULD ARGUE THAT
NO AREA, WHERE OUR COUNTRY HAS MADE GREATER LEAPS
DURING GOVERNOR LANDON'S LIFETIME
AND DURING THE LAST CENTURY
WAS OUR MOVE FORWARD IN THE HEALTH FIELD.
GOVERNOR LANDON WAS BORN IN 1887. AT THAT POINT
THE AVERAGE LIFESPAN OF A PERSON WAS TO LIVE TO MID-40S
WHICH WAS ONLY ABOUT A DOZEN YEARS LONGER THAN THE
HUNTER-GATHERERS WHO WERE ON THESE PLAINS THOUSANDS OF YEARS AGO.
BUT IN 1987, WHEN GOVERNOR LANDON
PASSED AWAY JUST AFTER HIS 100TH BIRTHDAY,
THE AVERAGE LIFESPAN OF A U.S
CITIZEN HAD RISEN TO 75 YEARS.
THAT'S A REMARKABLE SPAN.
DISEASES LIKE SMALLPOX AND POLIO,
WHICH USED TO BE EVERY PARENTS GREATEST FEAR,
WERE WIPED OUT IN THIS COUNTRY.
CONDITIONS THAT HAD ONCE BEEN
A DEATH SENTENCE, BECAME MANAGEABLE.
AND THE DEATH RATE FOR CORONARY
HEART DISEASE HAD DROPPED MORE THAN 60%
FROM WORLD WAR TWO.
THE DEATH RATE FOR STROKE WAS 70% LOWER
THAN IT WAS AT THE BEGINNING OF THAT CENTURY
AND THERE ARE LOTS OF REASONS FOR THOSE GAINS IN HEALTH;
SCIENTIFIC BREAKTHROUGHS LIKE PENICILLIN PLAYED A ROLE,
SO DID PUBLIC HEALTH BREAKTHROUGHS LIKE IMPROVED SANITATION
AND CLEAN WATER.
PUBLIC POLICY BREAKTHROUGHS ALSO HELPED;
LIKE MEDICARE, WHICH PROVIDED UNPRECEDENTED SERVICE
FOR HALF OF THE SENIORS WHO, PRIOR TO 1965,
HAD NO HEALTH INSURANCE AT ALL.
SO THOSE GAINS IN HEALTH REALLY TRANSFORMED OUR COUNTRY.
BECAUSE HEALTH IS REALLY ABOUT FREEDOM BECAUSE WHEN WE LIVE LONGER,
HEALTHIER LIVES, WE'VE GOT MORE TIME TO DO OUR JOBS,
MORE TIME TO VOLUNTEER IN OUR NEIGHBORHOODS,
TO PLAY WITH OUR CHILDREN,
TO WATCH OUR GRANDCHILDREN GROW UP.
BUT HEALTH IS ALSO THE FOUNDATION OF OUR NATIONAL PROSPERITY
HEALTHY ADULTS ARE MORE PRODUCTIVE WORKERS,
HEALTHY CHILDREN ARE BETTER STUDENTS,
HEALTHY FAMILIES MAKE GREATER
CONTRIBUTIONS TO THEIR OWN COMMUNITIES.
SO, WHEN THE HEALTH OF OUR NATION IMPROVES,
WE SEE THE BENEFITS EACH AND EVERY DAY IN OUR LIVES.
TODAY I WANT TO TALK ABOUT SOME OF THE STEPS
I BELIEVE WE CAN CONTINUE TO TAKE TO MAKE PROGRESS,
SO THAT WE CAN LEAVE A HEALTHIER COUNTRY
FOR OUR CHILDREN AND OUR GRANDCHILDREN.
THE MOST SIGNIFICANT PIECE OF HEALTH
LEGISLATION PASSED IN THE PAST 45 YEARS
IS THE AFFORDABLE CARE ACT, WHICH
WAS SIGNED INTO LAW LAST MARCH.
IT LAYS THE FRAMEWORK FOR REORGANIZING HEALTHCARE,
AS WELL AS REORGANIZING OUR HEALTH INSURANCE SYSTEM.
NOW, FOR YEARS WE'VE HAD A HEALTH INSURANCE
MARKET THAT WAS CRUMBLING. EMPLOYERS WERE DROPPING COVERAGE,
PREMIUMS WERE SKYROCKETING,
CONSUMERS WERE GETTING MORE AND MORE FRUSTRATED,
AND MORE AMERICANS WERE SHUT OUT,
PRICED OUT OR DROPPED OUT OF THE MARKET ALL TOGETHER.
WITHOUT HEALTH INSURANCE, OR WITHIN SUFFICIENT HEALTH INSURANCE
TOO MANY AMERICANS WENT WITHOUT CRITICAL CARE,
OR SAW THEIR SAVINGS DISAPPEAR IN ONE ACCIDENT,
OR ONE FAMILY ILLNESS.
AND WITHOUT LEGISLATION, THE MARKET WOULD HAVE
CONTINUED TO DETERIORATE OVER TIME.
SO, OVER THE LAST EIGHT MONTHS,
SINCE THE NEW LAW WAS SIGNED
OUR DEPARTMENT HAS BEEN WORKING CLOSELY WITH
GOVERNORS AND LIEUTENANT GOVERNORS, LIKE TROY FINNLEY,
WHO IS HERE TODAY, INSURANCE COMMISSIONERS LIKE NANCY PREGGER
ACROSS THE COUNTRY
AS WELL AS HEALTHCARE PROVIDERS, AND
CONSUMER GROUPS, AND EMPLOYERS TO IMPLEMENT
THE FIRST PARTS OF THIS NEW LAW.
AND, WHILE WE'VE GOT A LONG WAY TO GO,
WE ALREADY SEE SIGNS OF PROGRESS
RIGHT HERE IN KANSAS.
SO, IN THE LAST EIGHT MONTHS WE'VE BEGUN ADDRESSING ONE OF THE
MOST UNACCEPTABLE GAPS IN THE HEALTH INSURANCE SYSTEM:
THE SO-CALLED "DONUT HOLE" FOR SENIORS
WITH PRESCRIPTION DRUG COVERAGE.
ABOUT 19,000 SENIORS IN KANSAS HAVE ALREADY GOTTEN
SOME HELP WITH THAT DRUG COVERAGE WITH A $250 CHECK MAILED THIS YEAR.
AND NEXT YEAR THEY'LL BEGIN TO SEE
A 50% DECREASE IN THE PRICE OF THOSE PRESCRIPTION DRUGS.
EVENTUALLY, THAT "DONUT HOLE" WILL BE CLOSED ALL TOGETHER.
WE'VE ALSO ESTABLISHED AN EARLY RETIREE REINSURANCE PROGRAM
THAT HELPS EMPLOYERS MAINTAIN HEALTH COVERAGE FOR THEIR EARLY RETIREES.
NOW, RIGHT NOW, A LOT OF FOLKS WHO
ARE RETIRED AREN'T YET ELIGIBLE FOR MEDICARE,
THEY'RE NOT 65 YET AND THEY RELY ON
THEIR FORMER EMPLOYERS FOR INSURANCE COVERAGE
BUT AS HEALTH CARE COSTS ROSE, MORE AND MORE EMPLOYERS
ENDED THAT RETIREE COVERAGE,
WHICH LEAVES FOLKS IN THEIR EARLY 60S WITH NOWHERE TO GO.
AND INDIVIDUAL COVERAGE FOR A 60-SOMETHING
CAN BE VERY, VERY EXPENSIVE
SO FAR 34 MAJOR KANSAS EMPLOYERS AND UNIONS
FROM SPEAR AND ARROW SYSTEMS TO SPRINT/NEXTEL
HAVE APPLIED TO BE PART OF THE PROGRAM;
TO KEEP THEIR RETIREE COVERAGE IN PLACE
AND THAT HELPS STABILIZE A VERY FRAGILE PART OF OUR MARKET.
AND WITH SUPPORT FROM OUR DEPARTMENT
KANSAS HAS ALSO SET UP A PREEXISTING CONDITION INSURANCE PLAN
WHERE ADULTS WHO HAD BEEN SHUT OUT OF THE
HEALTH CARE MARKET BECAUSE OF PREEXISTING HEALTH CONDITIONS
CAN NOW GET AFFORDABLE COVERAGE
ON THEIR WAY TO 2014
ONE KANSAN WHO WROTE ME RECENTLY WAS TYPICAL
HE AND HIS WIFE RAN A BUSINESS IN SALINA AND THEY BOUGHT
HEALTH INSURANCE YEAR IN-YEAR OUT FOR THEIR EMPLOYEES
BECAUSE THEY THOUGHT IT WAS THE RIGHT THING
TO DO, AND THEY WANTED TO KEEP THE BEST EMPLOYEES IN PLACE.
AND THEN WHEN THEY RETIRED THEY APPLIED FOR COVERAGE FROM THE SAME
COMPANY THEY HAD BEEN PURCHASING COVERAGE FROM OVER THE YEARS
BUT, BECAUSE THEY HAD MINOR HEALTH CONDITIONS,
THEY WERE DENIED COVERAGE.
AND THEY WROTE TO ME AND SAID:
"WE'RE WORRIED WE WON'T BE ABLE TO FIND INSURANCE COVERAGE AT ALL"
BUT, THANKS TO THE AFFORDABLE CARE ACT,
THERE ARE NEW OPTIONS NOW FOR RETIREES LIKE THIS COUPLE.
WE'VE CREATED A NEW PATIENT BILL OF RIGHTS THAT ESTABLISHES THE LONG
OVERDO CONSUMER PROTECTION IN THE HEATH INSURANCE MARKETS
NEW RULES THAT I SAW YEAR-IN-YEAR-OUT
WORKING AS INSURANCE COMMISSIONER.
FOR EXAMPLE, INSURANCE COMPANIES CAN NO LONGER
TAKE AWAY SOMEONE'S INSURANCE
WHEN THEY GET SICK, JUST BECAUSE OF AN
UNINTENTIONAL MISTAKE IN THEIR PAPERWORK.
AND LAST WEEK WE ANNOUNCED SOME NEW RULES: THAT COMPANIES WILL
HAVE TO MAKE SURE THAT AT LEAST 80 CENTS OF EVERY PREMIUM DOLLAR COLLECTED,
WILL BE SPENT ON QUALITY CARE AND HEALTH CARE ISSUES
AND PROVIDE THEM WITH "FORTRESS" BALANCE SHEETS.
NOT ON SALARIES AND MARKETING
AND ADMINISTRATIVE COSTS
AND THERE IS ONE REFORM THAT IS PARTICULARLY IMPORTANT TO STUDENTS HERE TODAY:
WE KNOW THAT YOUNG ADULTS IN THEIR 20S
HAVE HAD VERY LOW RATES OF HEALTH INSURANCE
AND ARE TWICE AS LIKELY TO BE
UNINSURED AS OLDER AMERICANS
PART OF THE REASON IS BECAUSE IT IS NOT ALWAYS EASY TO GET A JOB
THAT OFFERS HEALTH INSURANCE RIGHT OUT OF HIGH SCHOOL OR COLLEGE.
I KNOW THAT BECAUSE, WHEN OUR SONS GRADUATED FROM COLLEGE
NEITHER HAD A JOB WITH HEALTH INSURANCE BENEFITS.
OUR OLDER SON WAS GOING BACK TO GRADUATE SCHOOL,
NOT QUITE SURE WHAT OUR YOUNGER SON WAS DOING,
BUT, LETS JUST SAY THAT IT DIDN'T COME WITH HEALTH INSURANCE.
BUT, AS PART OF THE NEW LAW YOUNG AMERICANS
WHO DON'T HAVE INSURANCE FROM THEIR EMPLOYERS
CAN STAY ON THEIR PARENT'S PLANS
UNTIL THEIR 26TH BIRTHDAY.
SO, WHETHER YOU'RE STILL LOOKING
FOR A JOB AFTER GRADUATION,
GOING OFF TO GRADUATE SCHOOL,
WORKING FOR A SMALL BUSINESS,
OR A NOT-FOR-PROFIT THAT
DOESN'T OFFER HEALTH INSURANCE,
YOU WON'T HAVE TO WORRY ABOUT HEALTH COVERAGE. NOW, THESE REFORMS
ARE NOT GOING TO FIX EVERY PROBLEM IN OUR HEALTH SYSTEM OVERNIGHT.
IN FACT, BECAUSE WE DIDN'T WANT TO DISRUPT THE COVERAGE
THAT OVER 180 MILLION AMERICANS ALREADY HAVE,
MANY OF THE IMPORTANT CHANGES ARE PHASED IN
OVER TIME AND DON'T TAKE EFFECT UNTIL 2014.
BUT, WE ARE STARTING TO FILL SOME OF THE BIGGEST
GAPS AND END SOME OF THE WORST ABUSES.
AND GIVE MORE CONTROL TO ALLTHE PEOPLE WHO
FELT LIKE THERE WAS NOTHING THEY COULD DO
WHEN THEIR PREMIUMS WENT UP 30%
OR THEIR CLAIMS WERE DENIED.
AND AS WE GO FORWARD I CAN TELL YOU WE ARE
LOOKING FORWARD TO WORKING WITH ALL OUR STATE PARTNERS
TO IMPLEMENT THE LAW EFFECTIVELY
AND IMPROVE IT ALONG THE WAY.
BUT, CONTRARY TO THE IMPRESSION YOU
MAY HAVE FROM WATCHING CABLE NEWS,
THERE'S A LOT MORE TO HEALTH
THAN HEALTH INSURANCE,
AND A LOT MORE PROGRESS BEING MADE TODAY
THAN JUST THE FOCUS ON THE NEW LAW.
SO, WHAT I'D REALLY LIKE TO DO WITH YOU
THIS MORNING IS SHARE WITH YOU SIX ADDITIONAL AREAS,
REFORMS, INVESTMENTS, AND TECHNOLOGIES
THAT I BELIEVE ARE ESSENTIAL
TO CREATING A HEALTHIER COUNTRY.
NOW, THIS LIST IS NOT COMPREHENSIVE;
IT'S NOT ALL WE ARE DOING AT HHS,
BUT THEY HELP TO PROVIDE SOME OF THE EXAMPLES
OF THE KIND OF WORK THAT WE CAN DO TOGETHER
TO KEEP AMERICA ON TRACK
TOWARD A HEALTHIER FUTURE.
AND, ALONG THE WAY, THEY MIGHT ANSWER
ANOTHER QUESTION SOME OF YOU MIGHT HAVE
WHICH IS: "EXACTLY WAS DOES THE DEPARTMENT
OF HEALTH AND HUMAN SERVICES DO?"
SO, LET ME START WITH MEDICAL COUNTERMEASURES.
NOW, HERE IN KANSAS,
WE DO HAVE A PROUD MILITARY TRADITION
AND THERE'S NO DOUBT THAT A STRONG MILITARY
IS STILL THE FOUNDATION
OF OUR NATIONAL DEFENSE.
BUT, INCREASINGLY, THE RANGE OF
DANGERS WE ARE FACE IS WIDENING
TO ALSO INCLUDE BIOLOGICAL, CHEMICAL,
NUCLEAR AND RADIALOGICAL HAZARDS.
WE DON'T KNOW WHERE THE NEXT
PUBLIC HEALTH CRISIS IS GOING TO COME FROM.
IT COULD BE - GOD FORBID - A DIRTY BOMB
SET OFF IN A UNIVERSITY LECTURE HALL.
IT COULD BE A NATURALLY OCCURRING "SUPER BUG"
THAT RESISTS ALL TREATMENTS.
IT COULD BE A BIOLOGICAL WEAPON WE'VE NEVER SEEN BEFORE
ASSEMBLED FROM THE BUILDING BLOCKS OF LIFE BY A TERRORIST IN A LAB.
IN ORDER TO RESPOND EFFECTIVELY WHEN THE CRISIS COMES,
WE NEED TO HAVE IN PLACE WHAT ARE CALLED MEDICAL COUNTERMEASURES.
THE VACCINES, ANTIVIRALS, DIAGNOSTICS
AND OTHER DRUGS AND EQUIPMENT
THAT OFTEN ARE OUR FIRST, AND
BEST DEFENSE AGAINST THESE THREATS.
NOW, ITS THE SAME KIND OF RESPONSE THAT OUR NEW
ANIMAL HEALTH LAB HERE IN K-STATE
WILL HELP TO IDENTIFY FOR ANIMAL CRISIS
AND WE'RE RESPONSIBLE FOR IT WHEN IT COMES TO HUMAN HEALTH.
THE PROBLEM RIGHT NOW IS THAT THERE
IS LITTLE INCENTIVE FOR THE BIG DRUG COMPANIES,
FOR THE PHARMA COMPANIES
TO PRODUCE MEDICAL COUNTERMEASURES
FOR CONDITIONS LIKE EBOLA VIRUS
OR EXPOSURE TO NON-MEDICAL RADIATION
EVEN THOUGH, IN THE EVENT OF AN OUTBREAK OR A NUCLEAR EXPLOSION,
THOS COUNTERMEASURES ARE ABSOLUTELY CRITICAL.
SO, IT'S UP TO OUR DEPARTMENT - WORKING WITH THE FEDERAL GOVERNMENT -
TO FIGURE OUT STRATEGIES TO PRODUCE STOCKPILES OF THESE IMPORTANT ANTIVIRALS
AFTER SEPTEMBER 11TH,
THE U.S GOVERNMENT CAME UP WITH A PLAN
TO MAKE UP FOR THE SHORTFALL, BUT WE STILL
AREN'T AS NIMBLE AND FLEXIBLE AS WE NEED TO BE.
SO, OVER THE LAST TWO YEARS,
WE WERE CHARGED BY PRESIDENT OBAMA
WITH CONDUCTING THE FIRST EVER COMPLETE REVIEW
OF THE OPERATION TO PRODUCE MEDICAL COUNTERMEASURES.
AND WE'VE IDENTIFIED A COUPLE OF KEY AREAS WHERE WE CAN
STRENGTHEN OUR COUNTERMEASURE PIPELINE.
FOR EXAMPLE, ONE THAT WE ARE EXPLORING - WHICH IS ACTUALLY
USED RIGHT NOW IN THE DEFENSE COMMUNITY
IS LAUNCHING A NON-PROFIT VENTURE CAPITAL
FIRM, PROVIDING STRATEGIC SUPPORT TO
THE SMALL COMPANIES THAT HAVE BIG IDEAS, BUT CAN RUN
OUT OF CAPITAL BEFORE THEY GET THAT PRODUCT TO THE MARKET
THE DEFENSE DEPARTMENT HAS USED THIS STRATEGY
VERY EFFECTIVELY IN SOME NEW WEAPONS DEVELOPMENT -
NOT SOMETHING THAT THERE IS A BIG
MARKET FOR, BUT AN IMPORTANT ISSUE.
ANOTHER AREA IS PROVIDING ADDITIONAL RESOURCES
TO THE FOOD AND DRUG ADMINISTRATION,
ONE OF OUR AGENCIES, AND THE NATIONAL
INSTITUTE OF HEALTH, ANOTHER AGENCY
MAKING IT EASIER FOR COMPANIES TO PRODUCE COUNTERMEASURES
AND NAVIGATE THE REGULATORY SYSTEM
BY CREATING CLEAR REGULATORY PATHWAYS,
ANALYZING PROMISING NEW DISCOVERIES
ON A MUCH FASTER PACE, AND HELPING IDENTIFY AND SOLVE
THE SCIENTIFIC PROBLEMS AS THEY OCURR.
THE GOAL IS GETTING GREAT IDEAS FROM
THE MICROSCOPE TO THE MARKETPLACE
IN A MUCH MORE TIMELY AND EFFICIENT MANNER.
AND, AS ALL THE ATHLETES HERE KNOW,
HOW WELL YOU PERFORM IN THE SPOTLIGHT DEPENDS ON
HOW WELL YOU PRACTICE WHEN NO ONE'S WATCHING
THE SAME IS TRUE WITH OUR
RESPONSE TO PUBLIC HEALTH CRISIS
HOW WELL WE PREPARE NOW WILL DETERMINE
HOW SUCCESSFULLY WE WILL RESPOND WHEN THE NEXT CRISIS COMES
AND WE KNOW, UNFORTUNATELY, THAT WE WILL HAVE
ANOTHER CRISIS. SO, THE REVIEW GIVES US A ROADMAP
FOR IMPROVING OUR PREPAREDNESS AND WE'RE
WORKING WITH CONGRESS TO FILL THOSE GAPS
AND, WE NEED TO FOLLOW THAT ROADMAP
TO A SAFER AND MORE SECURE FUTURE.
CANCER IS ANOTHER BIG
CHALLENGE ON OUR HORIZON
WE NEED TO PROVIDE SOME ADDITIONAL
FORCUS ON THIS DREADED DISEASE
ONE OF THE CHANGES THAT WE HAVE SEEN SINCE
THE DAYS WHEN GOVERNOR LANDON WAS BORN
IS THAT WE HAVE TO WORRY ABOUT NEW HEALTH THREATS. MANY CANCERS
DON'T BECOME DEADLY UNTIL AFTER SOMEONE'S 60TH BIRTHDAY
SO, IT WASN'T A BIG ISSUE 100 YEARS AGO
WHEN THE AVERAGE LIFESPAN WAS SHORTER THAN THAT.
BUT, NOW WHAT WE SEE IS MORE AND MORE PEOPLE
AND HALF THE MEN AND A THIRD OF THE WOMEN IN THE UNITED STATES
WILL DEVELOP CANCER IN THEIR LIFETIME.
THAT'S A LOT OF OUR POPULATION. THE GOOD NEWS IS
THAT AS CANCER IS BECOMING A MORE FREQUENTLY SEEN DIEASE
BREAKTHROUGHS IN SCIENCE ARE GIVING
US BETTER WEAPONS FOR FIGHTING THOSE CANCERS
FOR YEARS, THE MAIN APPROACH TO TREATING CANCER
WAS SIMILAR, AS THE SCIENTISTS TELL ME, TO CARPET BOMBING
WHERE YOU ATTACKED WITH RADIATION OR CHEMOTHERAPY
ALL OF THE DANGEROUS CANCER CELLS, BUT YOU ALSO
KILLED A LOT OF GOOD CELLS ALONG WITH IT AND YOU JUST HOPED
YOU WEREN'T UNBALANCED - KILLING MORE GOOD CELLS THAN THE BAD.
BUT, THANKS TO THE PROGRESS SCIENCE
HAS MADE CRACKING THE GENETIC CODE
WE NOW HAVE THE POSSIBILITY OF DEVELOPING
MORE EFFECTIVE, TARGETED THERAPIES
FOR EXAMPLE, WE'VE GOT A NEW DRUG THAT
NIH IS TESTING RIGHT NOW - PERCEPTON
THAT WILL CUT THE RISK OF EARLY BREAST
CANCER RECURRENCE IN HALF
FOR PATIENTS WHO TUMORS
HAVE A CERTAIN GENETIC MARKER
AND IT SHOWS INCREDIBLE SIGNS OF PROMISE
BUT TO SPEED THE DEVELOPMENT OF THE NEW TREATMENTS
WE'VE CREATED WHAT WE CALL
A CANCER GENOME ATLAS
AT THE NATIONAL INSTITUTES OF HEALTH
USES FUNDS FROM THE RECOVERY ACT
AND WE'RE EXPANDING A COMPREHENSIVE DATABASE
OF THE DNA CHANGES OF 20 MAJOR TUMOR TYPES
IT WOULD UNLEASH A NEW GENERATION OF CANCER TREATMENTS
TARGETED AT AN INDIVIDUAL'S SPECIFIC TUMOR
AND WE'VE JUST EGUN TO TRAVEL DOWN THESE RESEARCH AVENUES
BUT WE NEED TO KEEP PUSHING FORWARD
SO, THE CONTINUED INVESTMENT IN THAT
SCIENTIFIC RESEARCH IS SO ESSENTIAL
JUST AS I BEGAN THIS SPEECH THIS MORNING
20 MORE AMERICANS HAVE DIED OF CANCER
AND IF WE CAN SPEED UP THE NEXT GENERATION OF TARGETED THERAPIES
WE CAN STRIKE A HUGE BLOW AGAINST A DISEASE THAT NOW KILLS MORE AMERICANS
THAN ANY OTHER DISEASE
BEYOND HEART DISEASE.
TO BE A HEALTHIER COUNTRY
WE NEED NEW CURES AND TREATMENTS
FOR SURE, SO WE'VE TALKED ABOUT
COUNTERMEASURES, WE'VE TALKED ABOUT
THINGS TO PREVENT CANCER, SO WE ABSOLUTELY
HAVE TO IMPROVE THE WAY WE DELIVER HEALTH CARE
FOR EXAMPLE, EVERY YEAR TENS OF THOUSANDS OF AMERICANS
DIE FROM WHAT ARE REFEREED TO AS "HEALTH CARE ASSOCIATED INFECTIONS"
MORE THAN DIE FROM HOMICIDES AND
CAR ACCIDENTS COMBINED.
NOW, THESE ARE THE INFECTIONS THAT
DON'T TAKE YOU TO THE HOSPITAL
THESE ARE THE INFECTIONS THAT KILL
OR INJURE YOU ONCE YOU ARE IN THE HOSPITAL
AND THEY ARE ONE OF THE
TOP TEN KILLERS OF AMERICANS TODAY.
DOCTORS AT JOHN HOPKINS HAVE DEVELOPED
AN INCREDIBLY EFFECTIVE TOOL
FOR SAVING LIVES IN HOSPITALS AND IN NURSING
HOMES AND IN HEALTH CARE CENTERS
IT DOESN'T TAKE A NEW INVESTMENT IN EQUIPMENT
IT DOESN'T TAKE NEW TRAINING, IT DOESN'T TAKE NEW PERSONNEL
IT IS REALLY A CHECKLIST
OF PRODIGALS AND PROCEDURES
THAT HAVE TO BE FOLLOWED IN EVERY ROOM
EVERY TIME, BY EVERY PROVIDER
BASIC STEPS LIKE WASHING HANDS WITH SOAP
AND WEARING A STERILE MASK
DOING IT EACH AND EVERY TIME
WHEN IN CONTACT WITH PATIENTS
NOW IT'S HARD TO IMAGINE THAT SUCH A SIMPLE
PROCEDURE COULD MAKE A BIG DIFFERENCE,
BUT WHEN IT WAS TESTED IN MICHIGAN HOSPITALS
AND USED BY DOCTORS WHO INSERT CATHETERS INTO A MAJOR VEIN,
THE RESULTS WERE INCREDIBLE
IN 18 MONTHS, INFECTIONS WERE DOWN
66%, 1,500 LIVES WERE SAVED
AND COSTS WENT DOWN BY 200 MILLION DOLLARS
JUST WITH A SMALL GROUP OF PROJECTS
AND SO IF YOU HEAR THOSE NUMBERS YOU MUST THINK
THAT EVERY OPERATING ROOM USES A CHECKLIST
UNFORTUNATELY THAT'S NOT THE CASE.
THE TRUTH IS THAT INNOVATIONS TRAVEL WAY
TOO SLOWLY IN OUR HEALTH CARE SYSTEM
RECENT RESEARCH SHOWS THAT IT
TAKES 17 YEARS THAT'S 1-7, 17 YEARS
FROM THE DISCOVERS OF AN EFFECTIVE TREATMENT
OR PROCEDURE TO BE INCORPORATED INTO PRODIGAL
BY COMPARISON FOR MANY OF YOU TODAY IT TAKES SECONDS
FOR YOUR FRIEND IN CALIFORNIA TO LEARN ON FACEBOOK
THAT YOU'RE IN A NEW RELATIONSHIP
OR THAT "IT'S COMPLICATED"
BUT IT CAN TAKE YEARS FOR A HOSPITAL IN CALIFORNIA
TO LEARN HOW A HOSPITAL IN KANSAS IS IMPROVING CARE.
ONE OF THE BEST WAYS WE CAN BECOME A HEALTHIER COUNTRY
IS TO SPEED UP THE RATE AT WHICH LIFESAVING INNOVATIONS AND TREATMENTS
LIKE THE CHECKLIST ARE ADOPTED UNIVERSALLY
AND IT STARTS WITH CREATING INCENTIVES THAT ACTUALLY
REWARD BETTER CARE
SO, IF YOU LOOK AT THE NEW HEALTH CARE LAW
YOU'LL SEE THAT THERE IS PROVISION AFTER PROVISION THAT GIVE INCENTIVES
TO DOCTORS AND HOSPITALS TO PROVIDE BETTER CARE
AND ACTUALLY BE REIMBURSED FOR THAT CARE
AND TO UNDERSTAND THE POTENTIAL OF THOSE CHANGES
JUST THINK ABOUT THE MICHIGAN EXAMPLE
ONE QUALITY MEASURE, ONE KIND OF PROCEDURE
SAVED 1,500 LIVES IN 18 MONTHS
MULTIPLY THAT BY 50 STATES FOR JUST THAT ONE PROCEDURE.
WE KNOW THAT WE CAN DO A BETTER JOB OF DELIVERING HEALTH CARE
WE CAN START TO SEE THE DIFFERENCE THAT THESE CHANGES CAN MAKE.
ANOTHER AREA WHERE THE HEALTH INDUSTRY IS, FRANKLY, WAY BEHIND
OTHER INDUSTRIES IN AMERICA IS USING TECHNOLOGY.
ANOTHER STEP THAT IS GOING TO HELP US DRAMATICALLY
IMPROVE THE QUALITY OF HEALTH CARE IS ADOPTING ELECTRONIC MEDICAL RECORDS
FOR ALL HOSPITALS
AND ALL DOCTORS.
NOW, IN INDUSTRY AFTER INDUSTRY
WE'VE SEEN THE POWER OF TECHNOLOGY
BRING DOWN COST AND IMPROVE THE CUSTOMER EXPERIENCE.
IMAGINE GOING BACK TO THE DAYS
WHEN YOU WERE AT A GROCERY STORE
AND SOMEBODY WAS HAND-ADDING
ALL THE HAND-WRITTEN PRICE TAGS
OR WAITING FOR A BANK TO OPEN SO YOU COULD
CASH YOUR CHECK AND ACTUALLY HAVE CASH FOR THE DAY
WE CANNOT IMAGINE THOSE
SYSTEMS GOING BACKWARDS
BUT HEALTH CARE IS DIFFERENT
AND IT SHOULDN'T BE
IN FACT, WE'VE ALREADY SEEN THE POWER OF ELECTRONIC
HEALTH RECORDS ACROSS THE COUNTRY
CUTTING HEALTH CARE COSTS, REDUCING PAPERWORK, IMPROVING OUTPUTS
AND ACTUALLY GIVING PATIENTS MORE ACCESS TO THEIR HEALTH INFORMATION
FOUR MONTHS AGO, I WAS IN CINCINNATI AND I VISITED
THE NEONATAL WARD OF CINCINNATI CHILDREN'S HOSPITAL
DOES SOME OF THE MOST COMPLICATED PROCEDURES
IN THE COUNTRY ON THESE TINY INFANTS
THEY'VE GONE 1,000 DAYS WITHOUT A
SERIOUS SAFETY INCIDENT
A RECORD THEY DIRECTLY CREDITED TO
ELECTRONIC HEALTH RECORDS
BECAUSE EVERY PROVIDER IN TOUCH WITH EVERY BABY
HAD TO CODE IN THE MEDICINE, CODE IN THE PROCEDURE
AND WAS CHECKED ON A REGULAR BASIS AND, ACTUALLY,
THEY WERE DENIED ACCESS IF THEY PUT IN THE WRONG CODE
AT THE WRONG TIME.
A BIG PART OF MY JOB
NOW IS TRAVELING AROUND THE
COUNTRY, TALKING TO DOCTORS AND NURSES
AND I HAVEN'T MET A SINGLE HEALTH CARE PROVIDER
WHO USES A HIGH QUALITY ELECTRONIC HEALTH RECORD
SAID "BOY, I WISH I COULD GO BACK TO THE DAYS
WHEN WE HAD THOSE GREAT PAPER FILES
THAT WAS REALLY THE BEST WAY TO PRACTICE"
AND YET HERE'S WHERE WE ARE IN THIS COUNTRY
2 IN 10 DOCTORS AND 1 IN 10 HOSPITALS
DON'T EVEN USE A BASIC ELECTRONIC MEDICAL SYSTEM TODAY
HOW MANY OF YOU HAVE GONE TO THE SCHOOL CLINIC
OR TO YOUR DOCTORS OFFICE AND BEEN HANDED THE INFAMOUS CLIPBOARD
WHERE YOU, ONCE AGAIN, RECORD ALL
OF YOUR HEALTH DATA
WHICH SOMEBODY HAS ON FILE SOMEWHERE
BUT IT HAS NOT BEEN TRANSFERRED.
AND THERE ARE SOME REASONS FOR THIS
IT'S NOT EASY TO LEARN A NEW TECHNOLOGY
ESPECIALLY IF YOU'RE A DOCTOR IN A SMALL PRACTICE
THAT DOESN'T HAVE AN I.T. DEPARTMENT.
AND, SOMETIMES, IF YOU'RE A DOCTOR IN A SMALL PRACTICE
AND YOU'RE SOMEWHERE IN RURAL KANSAS
YOU ARE THE I.T. DEPARTMENT SO, THERE'S A CHALLENGE OF BEING
ABLE TO SHARE INFORMATION WITH OTHER PROVIDERS SECURELY
EVEN IF THEY HAVE A DIFFERENT SYSTEM AND IF YOU CAN'T
GET INFORMATION FROM YOUR PATENTS OTHER DOCTORS
ELECTRONIC RECORDS LOSE
A LOT OF THEIR VALUE
AND THERE'S THE FACT THAT
THESE SYSTEMS CAN BE EXPENSIVE
EVEN IF THEY PAY
OFF IN THE LONG RUN
SO, WHAT'S HAPPENED OVER THE LAST TWO YEARS
IS AN UNPRECEDENTED EFFORT TO REMOVE SOME OF THOSE BARRIERS
TO MOVE MEDICINE INTO THE TECHNOLOGICAL AGE.
WE'VE CREATED HEALTH I.T. REGIONAL EXTENSION CENTERS
ACROSS THE COUNTRY, MODELED EXACTLY AFTER
THE AGRICULTURE EXTENSION CENTERS
WHERE THERE ARE TEAMS READY TO COME
AND VISIT WITH SMALL PROVIDERS AND SMALL HOSPITALS
TO BE THE BOOTS ON THE GROUND, TO
PROVIDE THE TECHNOLOGICAL EXPERTISE
WE KNOW HOW EFFECTIVE THAT IS WHEN
TEAMS FROM THE FARM EXTENSION SERVICE CAN COME
TO A FARMER'S LAND, LOOK AT THE SEEDS THEY'RE USING,
LOOK AT THE DIRT, FIGURE OUT WHAT'S WORKING AND WHAT'S NOT
AND WE WANT TO APPLY THAT SAME KIND OF HANDS
ON TECHNOLOGY TO THE MEDICAL FIELD
THE HEALTH I.T. CENTERS, ACTUALLY, PROVIDE THAT KIND OF SUPPORT
AND ONE OF THEM IS GOING TO BE LOCATED RIGHT DOWN THE ROAD, IN TOPEKA.
WE'RE ALSO PROVIDING GRANTS TO HELP STATES
CREATE A FRAMEWORK - A STATEWIDE FRAMEWORK
FOR DOCS AND HOSPITALS
TO EXCHANGE INFORMATION
WITH FULL PROTECTIONS ON PATIENT PRIVACY
THE GOOD NEWS IS: HERE IS KANSAS
WE HAD DONE A LOT OF WORK IN THIS AREA
SO, WE'RE WELL AHEAD OF MANY STATES IN THE COUNTRY
AND READY TO GO. WE'RE PROVIDING BONUS PAYMENTS
TO HOSPITALS AND DOCTORS TO ADOPT ELECTRONIC HEALTH RECORDS
AND HELPING THEM TO USE THOSE RECORD
KEEPERS FOR IMPROVING PATIENT CARE
NOW, TOGETHER, THESE EFFORTS ARE GOING
TO KNOCK DOWN MANY OF THE OBSTACLES
STANDING IN THE WAY OF BUILDING
A 21ST CENTURY HEALTH CARE SYSTEM
USING TECHNOLOGY TO IMPROVE RESULTS AND LOWER COSTS
JUST LIKE EVERY OTHER ENTERPRISE
THE RESULT IS THAT DOCTORS ARE GOING TO HAVE
MORE TIME TO SPEND WITH THEIR PATIENTS,
MORE TOOLS TO DO THEIR JOB OF PATIENT CARE,
MORE ABILITY TO COORDINATE THAT PATIENT CARE
AND AMERICA, ACTUALLY, HAS A GREAT OPPORTUNITY TO BE A WORLD
LEADER IN ONE OF THE GROWING INDUSTRIES OF THE FUTURE:
THE TECHNOLOGY OF HEALTH INFORMATION
WE KNOW, AGAIN, THAT HEALTH AND WELLNESS IS IMPORTANT;
IT'S AN IMPORTANT BUILDING BLOCK
IF WE WANT A HEALTHIER COUNTRY
WE CAN'T JUST FOCUS ON WHAT HAPPENS IN A DOCTOR'S OFFICE
OR WHEN YOU GET TO THE HOSPITAL
WE ALSO NEED TO PAY ATTENTION TO THE AIR WE BREATH,
THE FOOD WE EAT AND THE LIFESTYLES WE LIVE.
NOW, RIGHT NOW, IN AMERICA, WE HAVE AN OBESITY EPIDEMIC.
2 IN 3 ADULTS IN AMERICA AND 1 IN 3 OF OUR CHILDREN
ARE OVERWEIGHT OR OBESE.
THIS ISN'T A FASHION CRISIS,
IT IS A VERY SERIOUS HEALTH CRISIS.
OBESITY BRINGS WITH IT A FAR HIGHER RISK OF HEART DIEASE,
STROKE AND CERTAIN CANCERS.
AND IT'S THE BIGGEST PREDICTOR OF DIABETES
WHICH CAN HAVE CRIPPLING EFFECTS THROUGHOUT A LIFE.
AND THAT'S WHY THE ADMINISTRATION HAS LAUNCHED A REALLY BROAD AGENDA
TO HELP AMERICANS MAKE HEALTHIER CHOICES.
FROM THE FIRST LADIES "LET'S MOVE" CAMPAIGN TO THE INVESTMENTS
WE'RE MAKING IN SOME OF THE MOST PROMISING COMMUNITY STRATEGIES FOR REDUCING OBESITY
LIKE BRINGING SUPERMARKETS TO "FOOD DESERTS"
AND FOR A FARM ECONOMY LIKE KANSAS,
LINKING LOCAL GROCERS TO PURCHASERS CAN NOT ONLY
IMPROVE HELP BUT ALSO HELP THAT ECONOMY IN THE FIRST PLACE.
ONE OF THE BIGGEST OBSTACLES WE KNOW TO EATING HEALTHIER CHOICES
IS KNOWING, REALLY, WHAT FOODS ARE THE HEALTHIEST.
MOST PEOPLE KNOW THAT FRESH FRUITS AND VEGETABLES
ARE BETTER THAN A CHEESEBURGER AND FRENCH FRIES
THEY MIGHT NOT TASTE BETTER,
BUT THEY ARE BETTER FOR YOU.
BUT IT'S HARD TO GUESS THAT A TUNA MELT
FROM THE FAST FOOD CHAIN
HAS MORE FAT THAN A STICK OF BUTTER
IF YOU WOULD SIT DOWN AND JUST EAT THAT AT YOUR KITCHEN TABLE
OR TO PICK OUT THE HEALTHY
CEREAL FROM AN ARRAY OF 50 CHOICES
WHILE YOU COULD GO TO A FOOD CHAIN'S WEBSITE, OR TRY
TO READ THE TINY NUTRITION FACTS ON THE BACK OF PACKAGES,
MOST PEOPLE DON'T HAVE THE TIME
AND, FRANKLY, DON'T HAVE THE INTEREST.
BUT, WE KNOW THAT GIVING CONSUMERS SOME ADDITIONAL TOOLS
AND SOME INFORMATION ABOUT THE FOODS THEY EAT CAN BE HELPFUL
SO, PART OF THE AFFORDABLE CARE ACT WILL HAVE CHAIN RESTAURANTS
BEGIN TO DISPLAY CALORIES FOR THE OFFERINGS ON THEIR MENU
SO PEOPLE ACTUALLY GET A CHANCE TO SEE WHAT CHOICES THEY ARE MAKING.
WE'RE WORKING WITH FOOD MANUFACTURERS AND GROCERS
TO PUT EASY TO READ, EASY TO IDENTIFY LABELING
ON THE FRONT OF PACKAGES.
SO, WHEN YOU GO TO THE GROCERY STORE AFTER A LONG DAY OF STUDYING OR WORK
YOU CAN ACTUALLY FIGURE OUT MUCH MORE EASILY WHAT IS THE HEALTHIER OPTION.
THE TRUTH IS THAT MOST FOLKS
REALLY WANT TO EAT HEALTHIER DIETS
MAYBE NOT IN AGGIEVILLE AT 3AM, BUT MOST
OF THE TIME YOU WANT TO EAT A HEALTHIER DIET.
BUT THE CHALLENGE IS TO MAKE A HEALTHY CHOICE MORE CONVENIENT,
MORE AFFORDABLE, AND EASILY ACCESSIBLE
THAT'S REALLY WHAT WE'RE TRYING TO DO.
AND FINALLY I REALLY WANT TO SPEND A MINUTE JUST TALKING ABOUT FOOD SAFETY
AT THE SAME TIME WE'RE WORKING
ON KEEPING AMERICANS HEALTHIER
WE NEED TO PUT A NEW FOCUS ON KEEPING OUR FOOD SAFE AN AREA THAT,
AS PRESIDENT SHULTZ SAYS, IT ONE OF THE HALLMARKS HERE AT KANSAS STATE UNIVERSITY.
EVERY YEAR, MILLIONS OF AMERICANS
SUFFER FROM FOOD-BORN ILLNESSES.
HUNDREDS OF THOUSANDS ARE HOSPITALIZED
AND THOUSANDS OF PEOPLE DIE
AND THE WAY OUR FOOD SAFETY SYSTEM WORKS
IN AMERICA TODAY DOESN'T MAKE A LOT OF SENSE.
LOCAL HEALTH OFFICIALS BEGIN TO
SEE AN UPTICK IN PEOPLE GETTING SICK
AND THEY MIGHT SUSPECT A FOOD-BORN ILLNESS.
THEY THEN NOTIFY OUR REGIONAL FOLKS AT THE CENTER FOR DISEASE CONTROL
THAT SOMETHING IS GOING ON WHO THEN SEND
INVESTIGATORS WHO TRY TO PINPOINT THE SOURCE OF THE OUTBREAK
AND, EVENTUALLY, THE FOOD AND
DRUG ADMINISTRATION IS NOTIFIED
THEY INVESTIGATE THE SOURCE AND THEY BEGIN
TO WARN THE COUNTRY ABOUT THE FOOD OF CONCERN
STILL, THE FOOD AND DRUG ADMINISTRATION
HAS NO RECALL POWERS OF ITS OWN.
THEY CAN PROVIDE THE WARNING, BUT THEY CAN'T
GET THE FOOD MANDATORILY OFF SHELVES
THAT'S A VOLUNTARY ACTIVITY.
IN OTHER WORDS, WE'RE STILL WORKING BACKWARDS.
WE CHASE THE OUTBREAKS AFTER THEY OCCUR
AND WE ARE TRYING - ALWAYS SCRAMBLING - TO CATCH UP WITH WHAT'S MAKING PEOPLE SICK.
NOT ONLY DOES IT CAUSE A LOT OF ANXIETY AND CONCERN
WHO ARE SHOPPING AND TRYING TO FIGURE OUT WHAT'S GOING ON,
IT ALSO CAUSES MAJOR DISRUPTIONS AND
ECONOMIC LOSES FOR FARMERS AND PRODUCERS.
EVERY TIME SOMEONE GETS A TAINTED FOOD PRODUCT
AND PEOPLE GET SICK, THE ENTIRE INDUSTRY SUFFERS.
IN FARM STATES LIKE KANSAS WE UNDERSTAND
THE IMPORTANCE OF A SAFE A SECURE FOOD SUPPLY BETTER THAN ANYONE ELSE.
AND WE'VE SEEN FIRST HAND HOW PRODUCERS
CAN TAKE A HUGE ECONOMIC LOSS
IF FOLKS ARE SCARED AWAY FROM BUYING A PRODUCT
EVEN IF THERE IS NO SCIENTIFIC EVIDENCE BEHIND IT.
SO, THE PROBLEM IS THAT WE'VE BEEN MONITORING
A 21ST CENTURY FOOD SYSTEM WITH 20TH CENTURY TOOLS
TODAY, NEARLY 1/2 OF OUR FRUIT AND 3/4 OF OUR SEAFOOD
COMES FROM OVERSEAS
WHETHER IT'S TROPICAL FRUIT FROM MEXICO
OR CHILEAN SEA BASS YOU ENJOY IN A RESTAURANT
BUT, MANY OF THE IMPORTERS DO NOT HAVE THE SAME
SCRICT SAFETY STANDARDS THAT WE HAVE HERE IN THE UNITED STATES.
AND AS THE FOD SYSTEM HAS EVOLVED, OUR METHODS FOR
MONITORING WHAT'S BEING SURVED IN PEOPLE'S KITCHENS HAS NOT.
THE LAST SIGNIFICANT FOOD SAFETY RELATED CHANGES
OF THE FOOD, DRUG AND COSMETIC ACT
TOOK PLACE IN THE LATE 30'S BEFORE MANY
OF THE STUDENT'S GRANDPARENTS WERE BORN
AND SO ONE OF THE BIGGEST CHALLENGES
AS SECRETARY OF HEALTH AND HUMAN SERVICES
HAS BEEN WORKING IN CLOSE COLLABORATION
WITH AGRICULTURE SECRETARY TOM VILSACK
A FORMER GOVERNOR FROM ANOTHER FARM STATE - IOWA
TO BUILD A 21ST CENTURY FOOD SAFETY SYSTEM
IT'S BEEN A TOP PRIORITY OF THE PRESIDENT
AND WE WANT TO MOVE FORWARD WITH A SYSTEM
WHERE WE CAN PREVENT OUTBREAKS IN THE FIRST PLACE
OR CATCH THEM EARLY, MUCH CLOSER TO THEIR SOURCE
AND GIVE PEOPLE THE INFORMATION THEY NEED
AT EVERY STEP ALONG THE WAY
THERE'S LEGISLATION PENDING RIGHT NOW
IN THE UNITED STATES SENATE
THAT WOULD BE THE BIGGEST UPDATE
TO THE FOOD SAFETY EFFORTS IN DECADES
WE HOPE IT WILL PASS SOON SO THAT
WE CAN START REDUCING THESE PREVENTABLE DEATHS
SO, I'VE JUST TALKED ABOUT SIX AREAS
STEPS WE CAN TAKE TO BECOME A HEALTHIER COUNTRY:
STRENGTHENING OUR MEDICAL COUNTERMEASURES,
PURSUING TARGETED THERAPIES AGAINST CANCER,
REDUCING HEALTHCARE ASSOCIATED INFECTIONS,
SWITCHING TO ELECTRONIC HEALTH RECORDS,
PUTTING BETTER NUTRITIONAL INFORMATION IN PEOPLE'S HANDS,
AND BUILDING A 21ST CENTURY FOOD SAFETY SYSTEM.
NOW, THEY'RE ALL TOP PRIORITIES FOR OUR WORK
AND AREAS WHERE WE ARE EITHER CURRENTLY MAKING
OR PLAN TO MAKE SIGNIFICANT PROGRESS
THEY'RE ALSO GOALS THAT
MOST AMERICANS CAN SUPPORT
MAKING SURE WE HAVE AN ADEQUATE SUPPLY OF VACCINE
AND ANTIVIRALS FOR THE NEXT PUBLIC HEALTH CRISIS
ISN'T A DEMOCRATIC STRATEGY OR A REPUBLICAN
STRATEGY, IT'S AN AMERICAN STRATEGY.
THE NEW FOOD SAFETY BILL HAS
STRONG SUPPORT FROM BOTH PARTIES
WE CAN ALL GET BEHIND SAVING LIVES AND LOWERING
COSTS BY REDUCING HOSPITAL ERRORS
AND YET, YOU RARELY HEAR ABOUT
THOSE STORIES IN THE NEWSPAPER
AND THAT'S NOT SURPRISING. THERE WILL ALWAYS BE MORE COVERAGE
ON POLITICAL BATTLES THAN AREAS WHERE THERE IS A LOT IF AGREEMENT.
A PLANE CRASH THAT KILLS 200 PEOPLE
WILL ALWAYS BE A MORE DRAMATIC STORY
THAN A HOSPITAL CHECKLIST THAT SAVES 2,000 LIVES
BUT, IT'S IMPORTANT THAT WE DON'T LOSE SIGHT OF THESE OPPORTUNITIES
BECAUSE IT'S THESE STEPS, AND STEPS LIKE THEM
THAT WILL DETERMINE WHETHER WE CONTINUE
TO MAKE THE SAME KINDS OF GAINS IN HEALTH CARE
THAT WE HAVE MADE OVER THE LAST CENTURY.
WE SHOULD NEVER FALL INTO THE TRAP OF
BECOMING CONVINCED THAT PROGRESS IS GUARANTEED.
RECENTLY. THER'S SOME PRETTY DIRE NEWS ON THE HORIZON. EXPERTS HAVE
SAID THAT WE ARE RAISING THE FIRST GENERATION OF AMERICAN CHILDREN
IN 200 YEARS TO HAVE A SHORTER
LIFESPAN THAN THEIR PARENTS
AND AFTER THE ENORMOUS GAINS
WE'VE MADE IN HEALTH DURING THE LAST CENTURY
OUR MOMENTUM IS IN DANGER OF
SLOWING TO A HAULT AND EVEN REVERSING
BUT, IT DOESN'T HAVE TO. IF WE WORK
TOGETHER ON THE AREAS WE AGREE ON,
COMPROMISE IN THE AREAS WE DON'T,
AND MAKE HEALTH A TOP NATIONAL PRIORITY,
I'M CONFIDENT THAT THE STUDENTS HERE TODAY
WILL BE ABLE TO LOOK BACK AT THE END OF THEIR LIFETIMES
AS DID GOVERNOR LANDON AT THE END OF HIS
AND KNOW THAT THEY ARE LEAVING THEIR CHILDREN AND GRANDCHILDREN
A STRONGER, HEALTHIER,
AND MORE PROSPEROUS AMERICA.
THANK YOU SO MUCH FOR HAVING ME HERE TODAY.
(APPLAUSE)
THANK YOU. I'VE ALREADY TOLD THE PRESIDENT
HE GETS THE TOUGH QUESTIONS
WELL, IT FALLS TO ME TO MODERATE HERE FOR THE NEXT
FEW MINUTES SO, WE HAVE MICROPHONES ON EACH SIDE
SO, IF YOU HAVE A QUESTION, WE'D ASK YOU
TO COME DOWN AND ASK AT THE MICROPHONE
AFTER WE HAVE QUESTIONS FROM THE AUDIENCE
AT LARGE WE WILL SHUT THIS PART DOWN AND THE MEDIA
WILL HAVE A CHANCE TO MEET WITH THE
SECRETARY FOR A FEW MINUTES AFTER THAT
WHAT QUESTIONS MIGHT WE HAVE? YES, SIR.
HELLO SECRETARY SEBELIUS.
SEBELIUS: HI.
WELCOME BACK TO KANSAS.
I'M ONE OF THE PEDIATRICIANS HERE IN TOWN
AND I ENJOYED YOUR PRESENTATION GREATLY, BUT YOU OBVIOUSLY AVOIDED
ANY TALK ABOUT THE HEALTH CARE BILL THAT PASSED IN MARCH
OTHER THAN YOUR INITIAL SIX POINTS THAT YOU MENTIONED.
SO, IN VIEW OF THE ELECTION THAT JUST OCCURRED,
AND THE FEELINGS THROUGHOUT THE COUNTRY
OF DISSATISFACTION WITH THE HEALTHCARE BILL
WHICH SEEM QUITE OBVIOUS, AND THE FACT THAT NOT ONE
REPUBLICAN VOTED FOR THE BILL AS IT CURRENTLY IS WRITTEN
DO YOU FEEL THE BILL WILL BE REPEALED?
OR DO YOU FEEL IT WILL BE AMENDED?
AND I COULDN'T AGREE WITH YOU MORE ON YOUR OTHER SIX POINTS
ABOUT WHAT YOU DO IN THE HEALTH AND HUMAN SERVICES DEPARTMENT.
BUT, THERE OBVIOUSLY ARE PROBLEMS WITH THE BILL AS IT IS WRITTEN
AND IF YOU COULD SPEND SOME TIME ADDRESSING THAT.
ONE OTHER QUESTION: HOW MUCH OF THE BILL DOES HUMAN
HEALTH AND SERVICES ACTUALLY HAVE INPUT INTO
THE LEGISLATION WHEN IT WAS FINALLY WRITTEN
DID YOU PERSONALLY INTERJECT A LOT OF THE NATURE OF THE BILL?
AND MAYBE YOU CAN GO FROM THERE.
SEBELIUS: SURE.
I THINK THAT I DID TRY TO COVER SOME OF THE MAIN
FEATURES OF THE BILL THAT ARE BEING IMPLEMENTED RIGHT AWAY.
I THINK MOST PEOPLE WOULD AGREE WITH THOSE - IN ANY BILL
BUT, WHAT ELSE IS IN THE BILL NEEDS TO BE ADDRESSED.
SURE, THERE ARE LOTS OF FEATURES OF THE BILL
I WOULD SAY IT'S BASICALLY TWO PARTS.
KIND OF THE INSURANCE MARKET CHANGES
THAT ARE SOME OF THE IMMEDIATE CHANGES I ADDRESSED EARLIER
AND BUILDS OVER TIME TO A NEW
STATE-RUN HEALTH INSURANCE EXCHANGE
WHICH ACTUALLY I THINK, AGAIN, HAS BROAD SUPPORT
WHEN PEOPLE UNDERSTAND WHAT IT IS
TO REPLACE THE PARTS OF THE MARKET - PARTICULARLY FOR
INDIVIDUALS BUYING THEIR OWN COVERAGE AND SMALL BUSINESS OWNERS
WHERE THEY CAN BE IN LARGER POOLS
AND HAVE MORE COMPETITIVE CHOICES -
A STATE-RUN PROGRAM WHAT WE ARE DPOING RIGHT NOW IS WORKING WITH
GOVERNORS AND INSURANCE COMMISSIONERS AROUND THE COUNTRY
TO MAKE DETERMINATIONS AS TO
WHETHER OR NOT TO RUN THOSE EXCHANGES.
THE REST OF THE BILL DEALS WITH
A LOT OF THE UNDERLYING HEALTH CHANGES
MORE INVESTMENTS IN WORK FORCE
AS YOU KNOW WE DON'T HAVE ENOUGH PRIMARY CARE DOCS,
WE DON'T HAVE ENOUGH PEDIATRICIANS AND GERONTOLOGISTS
THERE'S A MAJOR INVESTMENT IN THE WORKFORCE.
THERE'S A MAJOR INVESTMENT IN COMMUNITY HEALTH CENTERS
THEY'LL DOUBLE, IN TIME, OVER THE COURSE OF THE NEXT 10 YEARS
THERE ARE INCENTIVES IN PLACE SO WE CAN USE THE PUBLIC
MEDICARE AND MEDICAID TO MAKE SOME OF THE CHANGES THAT WE'VE TALKED ABOUT
SO, I DON'T HAVE ANY QUESTION THAT
I THINK THE BILL IS LIKELY TO BE CHANGED OVER TIME.
I THINK THAT THE TALK ABOUT REPEAL IS ONE THAT THE
NEW CONGRESS WILL DECIDE. VOTERS ARE PROBABLY IN THE HOUSE TRYING TO PASS A VOTE TO REPEAL THE BILL
I DON'T THINK THEY ARE THERE IN THE SENATE .
I DON'T THINK THE PRESIDENT WOULD SIGN
A BILL THAT REPEALS THE HEALTHCARE ACT.
SO, IN THE MEANTIME, I THINK WE'LL WORK ON MAKING IT BETTER
MEDICARE WAS PASSED 45 YEARS AGO, AND IT DOESN'T LOOK
MUCH LIKE IT DID THEN - IT SET A PLATFORM.
SO, I THINK THERE ARE GONNA BE LOTS
OF AREAS THAT WE CAN WORK ON TOGETHER.
BUT MOST PEOPLE WHO I TALKED TO,
ONCE THEY LISTENED TO THE FEATURES OF THE BILL,
WANT A LOT OF THOSE IMPROVEMENTS TO GO FORWARD
SO, I THINK THERE WILL BE A ROBUST DEBATE
WE'VE SET A PLATFORM AND WE'LL CONTINUE
TO IMPLEMENT IT
TO YOUR FINAL QUESTION: "HOW MUCH INPUT?"
THERE WERE FIVE COMITIES IN CONGRESS,
TWO IN THE SENATE, AND THREE IN THE HOUSE
WHO ACTUALLY HAD DRAFTING AUTHORITY AND WROTE PARTS OF THE BILL
BUT, WE WERE CERTAINLY VERY ENGAGED AND INVOLVED
AND I CAN TELL YOU WE ARE FRONT AND CENTER WITH THE IMPLEMENTATION.
THERE ARE ABOUT 3,000 REFERENCES TO "THE SECRETARY SHALL DOT-DOT-DOT"
THAT HAPPENS TO BE ME.
SO WE ARE - (LAUGHTER) MAN: THERE'S AN AWFUL LOT OF REFERENCES
TO "THE SECRETARY WILL DO THIS"
AND I WAS AMAZED, JUST LOOKING THROUGH THE BILL
HOW MUCH POWER YOU WILL HAVE IN IMPLEMENTING THE BILL
WELL, WE'RE WORKING VERY CLOSELY WITH PROVIDER COMMUNITIES,
WITH THE AMA, WITH THE NURSES ASSOCIATION,
WITH THE HOSPITAL ASSOCIATION AND OTHERS TO
GET INPIUT AS THESE INITIAL REGS ARE WRITTEN
AND WE'LL CONTINUE TO DO THAT
I MEAN THAT'S…THANK YOU.
GOOD DAY SEBELIUS, I'M A PSYCHOLOGIST
PRACTICING IN THE STATE OF KANSAS
AND MY QUESTION IS ABOUT MEDICARE
AND I'M AWARE OF THE NURSING HOME LOBBY
I WAS WONDERING IF YOU ARE PLANNING
ANY CHANGES IN THE WAY MEDICARE IS IMPLEMENTED
SO THAT MORE PEOPLE ARE SUPPORTED THROUGH MEDICARE
FOR STAYING IN THEIR HOMES AS OPPOSED TO A NURSING HOME?
WELL, ACTUALLY, MEDICARE - AS YOU KNOW - DOES NOT
HAVE A LONG TERM CARE COMPONENT.
MOST PEOPLE WHO END UP ON PUBLIC ASSISTANCE
AT THE LAST DAYS OF THEIR LIVES
ARE MEDICAID ELIGIBLE AND THAT OFTEN IS
WHAT PAYS FOR NURSING HOME CARE.
THERE IS A MAJOR PROJECT UNDERWAY AND, ACTUALLY, WE
DID A LOT OF WORK ON IT HERE IN KANSAS
AND THAT PROGRAM IS EXPANDING NATIONALLY AND
THAT'S CALLED "THE MONEY FOLLOWS THE PERSON"
WHERE AND EFFORT IS BEING MADE TO PROVIDE MUCH MORE
OF A CONTINUUM OF CARE WITHIN COMMUNITIES.
THAT'S ONE OF THE MISSING PIECES. YOU CAN'T REALLY
HAVE FOLKS STAY IN THEIR HOME COMMUNITIES
UNLESS THEY HAVE SERVICES AVAILABLE. MANY PEOPLE
WOULD PREFER TO BE INDEPENDENT FOR A LONGER PERIOD OF TIME
SOME NEED HELP WITH ACTIVITIES OF DAILY LIVING: HELP MAKING
LUNCH OR TO MAKE SURE THEY ARE BEEING CARED FOR ADEQUATELY
OR TAKE THEIR MEDS. SO, THOSE PROGRAMS
ARE REALLY BEING LOOKED AT
AND A LOT MORE RESOURCES ARE BEING
SHIFTED, PARTICULARLY TO STATES LIKE KANSAS
WHO HAS BEGUN TO CREATE THAT CONTINUUM OF CARE
ANOTHER PEICE OF THE AFFORDABLE CARE ACT IS
THE SO-CALLED "CLASS LEGISLATION"
AND WHAT CLASS DOES IS SET UP A
VOLUNTARY EMPLOYEE CHECK OFF WHERE AN
EMPLOYEE, OVER A FIVE-YEAR PERIOD OF TIME
CAN BUILD, ESSENTIALLY, A SAVINGS
ACCOUNT OF THEIR OWN TO THEN USE FOR
A WHOLE VARIETY OF COMMUNITY CARE SERVICES
IT'S NOT A LONG TERM CARE INSURANCE POLICY
IT REALLY RECOGNIZES THAT A LOT OF PEOPLE WOULD
LIKE TO HAVE RESIDENTIAL CARE, HOME HEALTHCARE,
OPPORTUNITIES TO STAY IN THEIR OWN HOMES.
SO, THAT IS PART OF THE SYSTEM WE'RE LOOKING AT
BUT, AGING IN PLACE IS ONE OF THE HALLMARKS, I THINK,
OF A LOT OF THE LEGISLATION MOVING FORWARD
BECAUSE PEOPLE WOULD PREFER TO DO THAT
AND THE GOOD NEWS FOR KANSAS IS THAT KATHY GREENLY
WHO WAS THE SECRETARY OF AGING HERE
IN KANSAS AND WORKED IN OUR ADMINISTRATION
IS NOW THE ASSISTANT SECRETARY FOR AGING
IN WASHINGTON. SHE BRING THE SENSE OF COMMUNITY SERVICE WITH HER
AND HAS DONE A LOT TO BEGIN TO TRANSFORM
THAT AGENCY, WHICH IS ALSO UNDER OUR OFFICE.
-THANK YOU
-SURE
SECRETARY SEBELIUS,
THANK YOU FOR COMING TO GIVE THIS VERY INFORMATIVE LECTURE
WE'RE VERY PROUD TO SAY YOU'RE A KANSAN.
MY QUESTION IS IN RELATION TO THE INFORMATION TECHNOLOGY.
AND, WITH RESPECT TO THE HEALTH
INFORMATION EXCHANGE MOVEMENT
HOW IS THAT PROGRESSING AND HAVE EXPERIMENTS,
LIKE THOSE OCCURRING IN MICHIGAN, BEEN SUCCESSFUL?
WELL, I THINK A COUPLE THINGS HAVE HAPPENED,
FOR YEARS WE HAVE TALKED ABOUT ELECTRONIC HEALTH RECORDS
AND THE PROBLEM WAS THAT THERE WAS NO NATIONAL PLATFORM
AND WHAT A LOT OF PEOPLE WERE RELUCTANT TO DO IS
INVEST IN MAJOR SYSTEMS FOR ELECTRONIC HEALTH RECORDS
AND NOT BE SURE IF THEY WERE GONNA BE ABLE TO TALK TO THE DOCTOR IN THE NEXT TOWN,
STANDARDS HAVE NOW BEEN SET NATIONALLY.
THERE ARE NOW PRODUCTS AVAILABLE THAT MEET THOSE STANDARDS
AND THAT GIVES CONFIDENCE TO FOLKS TO
BEGIN TO INVEST AND THEN THE SYSTEM OF
STATE NETWORKS AND INFORMATION EXCHANGES
IS, I THINK, PART OF THAT FRAMEWORK TO PROVIDE TECHNICAL ASSISTANCE
AND SUPPORT. SO, WE'RE REALLY HOPING THAT ONCE THE
FINANCIAL INCENTIVES ARE AVAILABLE,
AND THEY START IN JANUARY OF 2011, THAT WE ARE GOING TO SEE A
MAJOR TRANSFORMATION WHERE PEOPLE - BOTH DOCTORS AND HOSPITALS -
ARE GOING TO NOT ONLY HAVE THE CONFIDENCE THAT
THEY'VE GOT A SYSTEM IN PLACE TO EXCHANGE INFORMATION
BUT THE PRIVACY STANDARDS ARE IN PLACE AND
WILL BEGIN TO MAKE THE SWITCH TO ELECTRONIC HEALTH RECORDS.
NO QUESTION THAT THEY CAN REDUCE ERROR RATE DRAMATICALLY.
NO QUESTION THAT PROVIDERS SAY
YOU KNOW, THEY CAN JUST DELIVER A LOT BETTER CARE
IF THEY CAN PULL ALL THE INFORMATION ABOUT WHAT TESTS
THEIR PATIENT HAS RECEIVED FROM OTHER PROVIDERS,
WHAT MEDICATIONS THEY'RE ON,
THAT INFORMATION CAN BE TRANSFERRED
SAFELY AND SECURELY TO PROVIDERS.
I THINK IT'S A REAL OPPORTUNITY FOR US TO
HAVE FAR BETTER CARE DELIVERY IN THE VERY NEAR FUTURE.
HI, (INAUDIBLE) GRADUATED 2005 - POLITICAL SCIENCE,
GEOGRAPHY MY QUESTION IS:
WITH REGARDS TO THE CONSTITUTIONALITY -
WELL, FIRST I GUESS I WOULD LIKE YOU TO TALK ABOUT
THE REQUIREMENTS OF SOMEONE WHO DOESN'T HAVE HEALTH
INSURANCE; WHAT THEY ARE GOING TO BE REQUIRED TO DO IN 2014
AND THEN WHETHER A CONSTITUTIONAL AMENDMENT
SHOULD BE ENACTED TO POSSIBLY MAKE IT MORE
LAWFUL I GUESS. THAT'S MY QUESTION.
WELL, THEY…IN 2014 THE ASSUMPTION IS THAT
IN ORDER TO HAVE A VIABLE INSURANCE MARKET
YOU NEED TO HAVE EVERYBODY IN.
SO, IF YOU GET RID OF THE RULES FOR INSURANCE COMPANIES
THAT SAY YOU CAN'T ELIMINATE PEOPLE
BECAUSE OF THEIR HEALTH CONDITIONS
WE HAVE TO HAVE A MECHANISM TO MAKE SURE
THAT HEALTHY PEOPLE, AS WELL AS SICK PEOPLE,
CAN BUY INSURANCE OR NOBODY
WOULD BUY IT UNTIL THEY GET SICK
THEN YOU WOULD HAVE A TOTALLY UNAFFORDABLE SYSTEM
I THINK THE BEST COMPARISON PROBABLY IS
IF YOU THINK ABOUT CAR INSURANCE, IF YOU WERE
ONLY BUYING CAR INSURANCE ONCE YOU HAD A WRECK
YOU'D HAVE A PRETTY UNSTABLE MARKETPLACE
YOU REALLY NEED PEOPLE IN THE SYSTEM
SO THE THEORY IS THAT EVERYBODY HAS RESPONSIBILITY
EMPLOYERS WHO HAVE 50 OR MORE EMPLOYEES
ARE GOING TO BE EXPECTED TO PROVIDE
INSURANCE COVERAGE FOR THEIR EMPLOYEES
OR THEY WILL PAY INTO A POOL RECOGNIZING
THAT THOSE EMPLOYEES ARE OFTEN NOW
GETTING TAXPAYER SUPPORTED INSURANCE COVERAGE
OR THEIR KIDS ARE, SO KIND OF A POOL THAT PAYS BACK
THE TAXPAYERS. YOU KNOW, MEDICARE WILL BE IN PLACE
MEDICAID WOULD BE EXPANDED TO COVER PEOPLE UP TO 133%
OF POVERTY LEVELS. THE FINAL PIECE IS IF YOU ARE AN
INDIVIDUAL WITHOUT A FINANCIAL HARDSHIP EXEMPTION
YOU WILL HAVE AN OPPORTUNITY TO PURCHASE
AFFORDABLE COVERAGE IN A LARGER POOL,
YOU'LL HAVE FINANCIAL SUBSIDIES THAT WILL BE
AVAILABLE TO YOU, BUT IT'S A JOINT RESPONSIBILITY
THAT EVERYBODY COMES INTO THE POOL, THAT
EVERY INDIVIDUAL BE OFFERED, BY PRIVATE INSURERS,
IN A STATE-RUN EXCHANGE SYSTEM.
THERE ARE CHALLENGES THAT ARE BEING BROUGHT ABOUT
THAT PEICE OF THE INSURANCE BIIL: WHETHER
OR NOT IT IS CONSTITUTIONAL TO
SAY THAT INDIVIDUALS MUST HAVE HEALTH INSURANCE
AND THE REAL ISSUE IS WHETHER
OR NOT THE COMMERCE CLAUSE GIVES CONGRESS
THE AUTHORITY TO AFFECT ISSUES THAT DEAL WITH INSURANCE.
THERE'S A LAWSUIT IN VIRGINIA, ONE IN FLORIDA
ONE IN MICHIGAN, THE ONLY RULING SO FAR
HAS BEEN A MICHIGAN FEDERAL JUDGE WHO
SAID ON THE MERITS THAT HE FOUND THE INDIVIDUAL MANDATE
TO BE CONSTITUTIONAL. HE SAID "YES, IT IS."
THE VIRGINIA AND THE FLORIDA JUDGE HAVE NOT YET RULED.
THEY HAVE HAD PROCEDURAL MOTIONS, BUT THOSE
RULING ARE LIKELY TO COME AND MY GUESS IS
THE CASE WILL WORK ITS WAY UP INTO THE SUPREME COURT
BECAUSE THIS IS A FAIRLY NOVEL POINT IN LAW.
THE ASSUMPTION IS THAT IF YOU HAVE A
FUNCTIONING INSURANCE MARKET
YOU MUST HAVE FOLKS WHO ARE SICK
AND NEED THE COVERAGE TO PAY FOR LONG-TERM ILLNESS
AND PEOPLE WHO ARE ACTUALLY PURCHASING COVERAGE WHO
MAY BE SICK AT SOME POINT IN THEIR LIFETIME
AND, IN THE MEANTIME, WHAT WE HAVE AS
TAXPAYERS IS ESSENTIALLY FOOTING THAT BILL
IF YOU HAVE HEALTH INSURANCE TODAY, YOU'RE
PAYING ABOUT $1,000 ADDITION FOR YOUR HEALTH INSURANCE
FOR THE HEALTHCARE DELIVERED TO FOLKS WHO
DON'T HAVE HEALTHCARE, BECAUSE YOU PAY MORE FOR HOSPITALS,
YOU PAY MORE FOR YOUR DOCTORS VISIT,
AND YOU PAY MORE AS TAX PAYERS FOR THE SYSTEM
OF SUPPORT FOR FOLKS WHO ARE COMING
THROUGH EMERGENCY ROOM DOORS
AND ABOUT 156 MILLION DOLLARS IN UNCOMPENSATED CARE
TO HOSPITALS ALONE, SO THOSE COST ARE NOW BEING SHIFTED
INTO CERTAIN PAYING GROUPS AND THIS WOULD
ADD A PERSONAL RESPONSIBILITY PIECE OF THAT PUZZLE
-WE ARE RUNNING SHORT ON TIME, SO WE ARE
GOING TO DO ONE MORE QUESTION OVER HERE
AND ONE OVER HERE AND
WE'LL HAVE TO CALL IT QUITS, SO…
THANK YOU, SECRETARY, FOR COMING.
I'D LIKE TO STATE THAT - YOU KNOW MY OPINION IS THAT
THERE WILL BE SOME CHANGES IN
THE NEW PLAN AS IT GOES THROUGH
BUT AT THE SAME TIME I WOULD LIKE TO COMMEND YOU
FOR PUTTING SOMETHING ON THE TABLE
WHICH, I THINK, NEEDS TO BE ON THE TABLE
I THINK THAT - I SERVE ON A COMMITTEE
OF A BOARD OF DIRECTORS OF A CORPORATION THAT
HAVE SEEN THEIR PREMIUMS INCREASE 49%
IN TWO YEARS. THAT IS UN - CANNOT BE
SUSTAINED FOREVER AND EVER
AND IT HAS HURT OUR EMPLOYEES
SO, WHAT I WOULD…I SERVE AS AN EX-OFFICIAL ON A
HOSPITAL BOARD THAT HAVE SEEN CHARITY GIVEN OUT
EVERY YEAR - OVER $1.5 MILLION IN A RURAL AREA
BECAUSE THEY DIDN'T HAVE INSURANCE.
UNDER YOUR PLAN, WILL THAT BE TAKEN AWAY
SO THAT THE HOSPITALS WILL NOT BE
HIT ON THAT TYPE OF COST?
WELL, AS YOU KNOW, THE FEDERAL LAW,
WELL BEFORE THE AFFORDABLE CARE ACT,
MANDATES THAT HOSPITALS REALLY ACCEPT ALL COMERS
SO IF SOMEONE SHOWS UP AT THE DOORS OF A HOSPITAL,
AND PRESENTS AN ILLNESS, YOU DON'T
CHECK THEIR INSURANCE AT THE DOOR AND SAY "NO, YOU GO DOWN THE STREET."
OR "GO SIT ON THE SIDEWALK." SO HOSPITALS ARE CURRENTLY,
YOU SAY YOU SEE IT IN YOUR HOSPITALS,
THAT TOTAL IS ABOUT $56 BILLION
IN "UNCOMPENSATED" CARE.
AND WHAT HAPPENS IS THAT CARE ISN'T TOTALLY UNCOMPENSATED
IT REALLY IS PAYED FOR BY PEOPLE WHO HAVE INSURANCE
WHO ARE PAYING A SHARE OF THAT COST
TO KEEP THOSE HOSPITAL DOORS OPEN
SO, I THINK THAT THE BILL ANTICIPATES THAT
THERE IS FINALLY GOING TO BE A PAYMENT SYSTEM
UNDER EVERYBODY AND NO LONGER WILL WE
JUST BE TAKING IT FROM ONE GROUP AND SHIFTING IT TO ANOTHER
THERE WILL BE MORE OF A
PERSONAL RESPONSIBILITY PIECE.
AND I THINK IN YOUR EXAMPLE OF
THE PREMIUM INCREASES,
WHAT WE KNOW IS THAT THERE ARE
ALSO UNDERLYING HEALTH INCREASES
ALONG THE WAY. AS THOSE COSTS SKYROCKET,
IN YOUR CASE, 50% INCREASE ALMOST IN TWO YEARS
EMPLOYERS, PARTICULARLY SMALLER EMPLOYERS,
ARE DROPPING THAT COVERAGE
BECAUSE IT AFFECTS THEIR BOTTOM LINE,
SO THEY CAN'T PAY IT.
WE HAVE THE HIGHEST NUMBER OF UNINSURED
AND SOME OF THIS IS CLEARLY THE ECONOMY
BUT 50 MILLION AMERICANS RIGHT NOW HAVE NO
INSURANCE COVERAGE. THE HIGHEST NUMBER
THAT WE'VE EVER HAD IN THIS COUNTRY.
SO, THE CYCLE THAT YOU'RE EXPLAINING
OF HIGHER COSTS, INCREASED RATES,
INCREASED HOSPITAL EXPENDITURES
IS LIKELY TO ACCELERATE BECAUSE
FOLKS WHO DROP COVERAGE FIRST ARE
OFTEN YOUNG AND HEALTHY,
AND PEOPLE WHO ARE OLDER OR SICKER
ARE IN A SITUATION WHERE THEY ARE
REALLY FRIGHTENED TO DROP COVERAGE, SO
WE GET A SMALLER POOL, BUT A
MORE RISK SELECTED POOL
OF PEOPLE WHO WILL USE HEALTHCARE
SERVICES EVEN MORE.
GOOD MORNING, SECRETARY SEBELIUS, AND
THANK YOU FOR COMING BACK TO KANSAS.
GOOD MORNING, PRESIDENT SHULTZ.
I HAVE A DUAL ROLE IN SERVING
AS THE EXECUTIVE DIRECTOR FOR THE KANSAS
AFRICAN-AMERICAN AFFAIRS COMMISSION
AND ALSO SERVING ON OUR
KANSAS BOARD OF REGENTS.
MY QUESTION IS: GIVEN THE HEALTHCARE
REFORM ACT AND SOME OF THE
CHANGES THAT HAVE TAKEN PLACE THAT
WOULD ALLOW US TO LEVERAGE
SOME OF OUR RESOURCES
IN ORER TO IMPROVE HEALTH STATUS
I SEE A MOVEMENT AWAY FROM
DISPARITIES AND REALLY UNDERSTANDING
DISPARITIES AS THEY ARE
IMPACTING OUR HEALTHCARE
NEEDS, AS WELL AS OUR SYSTEM.
WHAT WILL HAPPEN, GIVEN THE ACT
WITH THE OFFICE OF MINORITY HEALTH
AND HOW WILL THAT IMPACT OUR FOCUS ON DISPARITIES?
AND SECONDLY, WE CELEBRATE SOME OF THE
THINGS THAT ARE TAKING PLACE
WITHIN OUR REGENTS SYSTEM WITH REGARD TO
PREPARING OUR STUDENTS TO BECOME
THE PROFESSIONALS THAT ARE NEEDED
IN THE FUTURE TO ADDRESS SOME OF THE HEALTHCARE NEEDS.
WHAT ARE SOME OF THE OTHER THINGS
THAT YOU WOULD RECOMMEND TO THE STATE OF KANSAS
AND OUR EDUCATIONAL, POST-EDUCATIONAL
SYSTEM TO BE WELL PREPARED?
WELL, FIRST OF ALL, THANK YOU
FOR YOUR DUAL SERVICE.
BOTH OF THOSE EFFORTS ARE INCREDIBLY
IMPORTANT, NOT ONLY THE AFRICAN-AMERICAN COMMISSION
BUT THE BOARD OF REGENTS IS A HUGELY IMPORTANT
ROLE, SO THANK YOU FOR DOING BOTH.
THE HEALTH DISPARITY ISSUE IS ONE THAT
I THINK WE ABSOLUTELY NEED TO CONTINUE TO FOCUS ON
THERE IS A MAJOR GAP IN
DELIVERY OF HEALTH SERVICES,
AND IN ACCESS TO HEALTH SERVICES, AND IN,
FRANKLY, THE KIND OF TREATMENT YOU GET
WHEN YOU ACCESS THE HEALTHCARE SYSTEM
DEPENDING ON YOUR RACE, ETHNICITY, AND ECONOMIC STATUS.
AND WE'RE SPENDING A GOOD DEAL OF
TIME AND ENERGY LOOKING AT WHERE THOSE GAPS ARE
OR, FIRST OF ALL, TRYING TO FILL THE
ACCESS GAPS, SO I MENTIONED
COMMUNITY HEALTH CENTER SIZE AND THE FACT
THAT THERE WILL BE MORE COMMUNITY HEALTH CENTERS
NOT ONLY IN URBAN COMMUNITIES
BUT ALSO IN RURAL COMMUNITIES
WHICH ARE PLACES WHERE FOLKS DO NOT
HAVE ACCESS TO A PRIMARY CARE PROVIDER
AND THAT GAP NEEDS TO BE FILLED. WE'RE LOOKING
VERY CAREFULLY AT WHAT ARE THE RESEARCH ISSUES
THAT WE CAN LEARN ABOUT. WHY THERE IS
SUCH A DISPARITY IN ADULT MALES
IN DIABETES RATES FOR INSTANCE,
AND SPEND MORE TIME AND ENERGY.
IT WILL HELP TO HAVE EVERYONE WITH SOME
HEALTH INSURANCE COVERAGE
NO DOUBT ABOUT IT, THAT WILL MAKE A MAJOR LEAP FORWARD,
BUT HAVING INSURANCE ACCESS DOESN'T NECESSARILY
GUARANTEE HEALTHCARE ACCESS OR, PARTICULARLY,
HEALTHCARE ACCESS THAT IS EQUAL.
SO, A LOT OF TIME AND ENERGY IS BEING SPENT
LOOKING AT THE DATA THAT INDICATES
WHAT SOME OF THE BARRIERS ARE.
WE KNOW ONE OF THE BARRIERS IS WORK FORCE.
HAVING A CULTURALLY COMPETENT WORK FORCE
AND HAVING WORK FORCE THAT IS
MORE DIVERSE THAN THE WORK FORCE
OF THE CURRENT DAY IS IMPORTANT.
SO, THERE ARE ALSO EFFORTS TO RECRUIT
MORE MINORITY PROVIDERS, TO RECRUIT
PROVIDERS WHO SPEAK LANGUAGES OTHER THAN ENGLISH
TO MAKE SURE THAT HEALTHCARE DELIVERY
CAN CONNECT WITH COMMUNITIES WE ARE TRYING
TO REACH. THAT, I THINK WILL CONTINUE.
IF YOU LOOK AT THE ECONOMIC DATA, IN WHAT HAS BEEN
THE WORST ECONOMIC DOWN TURN SINCE THE GREAT DEPRESSION,
THE ONE INDUSTRY THAT CONTINUES
TO GROW IS HEALTH CARE
AND SO, IF YOUR STUDENTS ARE LOOKING AT THE FUTURE,
WHETHER IT'S TO BE A DIRECT CARE PROVIDER AT ANY LEVEL
EVERYTHING FROM CERTAINLY DOCTORS AND NURSES,
NURSE PRACTITIONERS, AND SPECIALISTS, TO
COMMUNITY HEALTH WORKERS ARE BEING
HIRED IN COMMUNITIES ACROSS THE COUNTRY
BECAUSE WE HAVE AN AGING POPULATION AND BECAUSE
WE HAVE A SYSTEM THAT WE ARE TRYING TO SHIFT
FROM A SICK-CARE SYSTEM TO MORE
A HEALTH-CARE SYSTEM
FOCUSED ON PRIMARY AND PREVENTIVE CARE
IN THE FIRST PLACE, SO THE WHOLE
SPECTRUM OF HEALTH WORKERS IS
GOING TO GROW. WE TALKED ABOUT HEALTH TECHNOLOGY.
THERE ARE A HUGE NUMBER OF GREAT JOB
POSSIBILITIES IN THAT AREA.
AND WE HAVE ONE OF THEM; WE HAVE SURNER
RIGHT HERE IN THE KANSAS CITY AREA
WHICH IS ONE OF THE INTERNATIONAL LEADERS
IN HEALTH INFORMATION TECHNOLOGY
BEFORE IT WAS COOL, THEY WERE TALKING ABOUT IT
BUT IF THE UNITED STATES ACTUALLY ENGAGES
IN THIS ELECTRONIC HEALTH RECORD,
THAT WILL BE A GROWING AREA
AND I THINK THE RESEARCH POSSIBILITIES THAT WE
TALKED ABOUT CERTAINLY THE RESEARCH AND SCIENCE
BEING DONE ON EVERYTHING FROM MEDICAL
COUNTERMEASURES TO LIFESAVING DRUGS
IS A HUGE GROWTH AREA
AS WE'VE UNLOCKED THIS HUMAN GENOME.
NATIONAL INSTITUTES OF HEALTH IS NOW HEADED BY
DR. FRANCIS COLLINS WHO WON A NOBEL PRIZE IN MEDICINE
FOR HIS WORK IN MAPPING THE HUMAN GENOME,
HE'S THE HEAD OF OUR RESEARCH DIVISION.
AND THE WORK THAT'S GOING ON FOR RESEARCHERS
IN TRYING TO UNLOCK THE POSSIBILITIES
OF CURES BASED ON WHAT WE NOW KNOW ABOUT
DNA IS EXTRAORDINARY. SO, I'D SAY
ANY NUMBER OF THOSE HEALTH AREAS
FROM BASIC TECHNOLOGY, CARE WORKERS, SPECIALISTS,
IS GOING TO BE A GROWING AREA
AND AN AREA IN DEMAND WELL INTO THE FUTURE.
THANK YOU.
WELL, FOLKS, WE APPRECIATE EVERYBODY COMING OUT TODAY
PLEASE JOIN ME IN THANKING, ONCE AGAIN, SECRETARY SEBELIUS.
(APPLAUSE)