I’m really excited to be here, and I’m really energized. When you combine what you’re doing here in the state with the new leadership in Congress we have a real opportunity to improve healthcare.
For me personally, that’s really exciting. One of my big frustrations over the past two years is that we have not been allowed to have a real debate in the Senate on improving healthcare. All we got was “Health Week” . . . because if there’s any problem you can fix in just a few days, it’s healthcare!
So we’ve been denied a chance to have a real debate. I’ve also had to fight tooth and nail to prevent drastic cuts in Medicaid and public health. It’s been a full-time job just stopping bad things from passing, so I’m really excited to have a new dynamic in the Senate.
So we’ve got a new opportunity and a new dynamic, but no one is going to hand us anything. In fact, between what has NOT changed and some new obstacles, we’re gonna have to work harder and smarter than ever.
So today I want to explain how the change in Congress will change healthcare. And since we’re entering some new territory, I want to give you two guides — a viewer’s guide of what you will see from the new Senate in the coming months and an action guide on how we can tailor our approach to make the most of this new environment.
Before I do that, I want to thank the other speakers – Greg Vigdor from the Washington Health Foundation and Christina Hulet from the Governor’s office. I really want to commend Governor Gregoire for her leadership in creating the Blue Ribbon Panel.
I also want to give you a quick update on some of the last-minute action in Congress.
The “Do Nothing” Congress
We just finished up the final days of the 109th Congress. Overall, it has been a very disappointing session – especially for healthcare. The leadership wasted weeks on political distractions like flag-burning and gay marriage, while our communities went without the help they needed.
One of the biggest disappointments has been the Senate’s failure to do its most basic job – passing the annual bills that fund our government. Those bills cover everything from education to healthcare to transportation. I used my seat on the Appropriations Committee to craft bills that will meet our needs here in Washington. Unfortunately, the Republican leadership made a decision to only allow 3 of those bills to pass the Senate. Instead, they passed a continuing resolution – which means the money I secured for our state will be delayed and possibly denied.
The Labor, Health and Human Services Bill (LHHS)
That’s going to have an impact on all of you and the patients you serve. For example, the Senate never passed a Labor, Health and Human Services funding bill. It includes some critical safety net programs, Community Health Centers, Ryan White programs, prevention programs, and the Maternal and Child Health Block Grant. Because Republican leaders refused to pass this bill, these programs will limp along and may face deep cuts.
Health IT
I’m also disappointed that we were not able to reach an agreement on the Health IT bill. Here in Washington, we’ve seen how technology can reduce medical errors, lower costs, and improve outcomes.
I worked on the Health IT bill on the HELP Committee, and it passed the Senate. But the House version was different, and we couldn’t reach a compromise. The stumbling blocks were over protecting patient privacy and giving smaller and rural communities resources to put new systems in place. We couldn’t get it done this year, but I’m going to be back at it next session.
In the final hours, we were able to make some important fixes.
We Fixed the Children’s Health Insurance Program for Washington State
I’m really excited that we were able fix the S-CHIP program so it helps our state. Washington was one of the first states in the nation to expand coverage for low-income kids. I helped pass a “fix” so that our state is not penalized, and it will mean millions of dollars to help us cover vulnerable children.
Doctors’ Payments
We stopped a scheduled cut in doctors’ payments under Medicare. As you know, doctors would have faced a 5.1 percent cut in Medicare payments. We were able to block that cut and also provide a small increase for doctors who track quality.
We also extended several expiring rural health provisions to ensure greater equity for rural providers.
That’s how the last session ended. Now I want to look ahead and talk about what’s changed – and what hasn’t changed. One of the things that has NOT changed is my commitment to improving affordability, accessibility and innovation.
Several things have changed that will give me a larger voice in pushing for those priorities.
What Has Changed
We now have a new Democratic majority in the Senate. That means we’ll finally get to set the agenda. And I have a new position in the Democratic leadership as Conference Secretary. That gives me a stronger voice and a seat the table to fight for our state.
What Has NOT Changed
Other things have not changed. We only have a one-vote majority in the Senate. We still have a White House that’s on the wrong side of these issues, and they are not going to roll over. We still have a massive deficit and a tight budget. Those will squeeze our ability to make progress. We have unfinished business in the form of the FY 2007 appropriations bills. We’ll return to face a supplemental on Iraq. The President will still send us a budget in February that makes painful cuts to healthcare, which we’ll have to fight.
So what does it all mean? How will a Democratic Senate be different?
A New Approach on Healthcare
I think you’re going to see a completely different approach to healthcare in the United States Senate. When the Republican-controlled Senate worked on healthcare – it tended to ask – What’s best for drug companies, insurance companies and HMOs? Instead, Democrats are going to ask – What’s best for patients?
When we start with that approach – we’re going to have a different debate, and we’re going to get a different outcome. Let me give you a few examples.
The Medicare Prescription Drug Program
When the Republican Senate finally got to work on a prescription drug program for Medicare – they took the wrong approach. They looked at it as – what’s good for drug companies?
And what did seniors get?
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They got a confusing, complicated program that is NOT a seamless part of Medicare. -
Seniors got a program that blocks Medicare from negotiating for the best price. -
They got a plan that has a huge coverage gap. -
And poor seniors and the disabled got left behind. Dual eligibles had no transition period, and many vulnerable people got hurt.
The White House and Republican Congress created a bill that didn’t put seniors first, and we’ve seen the result.
Health Insurance Example
We saw that same approach on health insurance. In May the Senate finally focused on the high cost of health insurance. It was real opportunity to help protect patients and make sure that insurance would be more affordable and accessible. But Republicans focused on protecting insurance companies. Their proposals put insurance companies first, and patients last.
What happened? We got a bill that would have denied services to nearly 2 million people in our state.
That’s why I was proud to stand with Governor Gregoire, Mike Kreidler, the Washington State Medical Association, and many others to defeat that bad bill.
So for years we’ve had a Senate that tended to look at health policy as a way to help industries. Democrats are going to put the focus back where it belongs – on helping patients.
Now I’m not looking to demonize stakeholders. We don’t want to punish anyone. We all know that drug companies work to save lives and treat disease. And we have some great examples of HMOs who get it right — like Group Health — where it’s about managing care not just managing costs.
I think that if we put patients first it will be good for everyone, and that’s what Democrats will do.
Specific Priorities
Now let me turn to some of the specific things we’ll be working on.
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Part D One of the first issues we’ll deal with is the Medicare Drug Program. I’ve held 18 roundtables in our state where I’ve sat down with seniors, doctors, pharmacists and advocates to tackle the problems with Part D. In January, one of the first things Democrats will do is push to allow Medicare to negotiate for the best prices. We’re also going to tackle the coverage gap. Stem Cells Then we’re going to turn to Stem Cells. Once again we’ll try to make sure that promising science is not blocked because of politics. Mental Health Parity We’re also going to push for mental health parity. Washington state has set a great example here – and I want to thank – Randy Revelle for his great leadership. Fight for Medicaid and Public Health We’re also going to fight to maintain Medicaid and our public health infrastructure. Prevention And you’ll see a new focus on prevention. We need to shift from treating diseases to preventing diseases. And we need to shift the incentives – away from encouraging overuse and toward rewarding efficiency and healthy outcomes. Those are some of the priorities you’ll see from the new Democratic Senate. Finally, let me offer a few things you can do help move these healthcare solutions forward. I’ve got three to share. |
3 Ways to Help Us Force Change on Healthcare in Congress
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1. Create Models of Success First, keep building successful models here in the state. In Washington, D.C., there is strong resistance to any new healthcare care solution that sounds like a big-government, big-bureaucracy program. You can help show there is another way. Today the best models and success stories are not coming from Washington, D.C. They’re coming from places like Washington state and Massachusetts – where people are working together to make progress. As you do that, you’re creating models that I can promote at the national level in Washington, D.C. I’m really proud of the partnerships you’ve built.
So first, keep building the partnerships and keep creating success stories here that I can push for in Washington, D.C. 2. Put a Human Face on Medicaid Second, put a human face on Medicaid. People see it as a government program for the poor, which it is. But it does so much more.
Too often — in the other Washington — they use language that makes it seem like we’re just moving around numbers on a page. They talk about cutting Medicaid “by just a few percent” or “slowing its rate of growth.” That sounds painless, but it’s not. We’ve got to show that there are real people behind those numbers. I’ve got an assignment for you. In February, the President is going to release his budget proposal. And I expect it will be more of the same cuts he’s proposed every year. He’s going to make it sound like it’s just numbers on a page. We need to show how it affects people’s lives. When the Administration talks about “cutting spending” in Medicaid, we all need to stand up and say, “What you really mean is cutting healthcare for children.” Or when someone in the Administration talks about “limiting entitlements,” let’s have local providers stand up and say, “Hey, you’re really talking about the healthcare my patients rely on.” Friends, if we let them get away with using words that leave people behind, then we’re going to get budgets that leave people behind. If we let them make this a debate about numbers, then the numbers win. If we make this a debate about people, then people will win. So the second thing you can do is put a human face on Medicare, Medicaid and safety net programs to prevent more budget cuts. 3. Send Me Examples Finally, keep in touch with me. Make sure my office knows what you’re doing, what’s working, and where you need help. As I gear up for some of these budget fights next year, I’m going to need local examples that show the impact of budget cuts. I’m going to need your help to show how changes in Washington, D.C. will affect families here in Washington state. You’re on the frontlines, and you can help me tell that story and protect our state. Join My Healthcare List-Serve So that we can keep in touch, I’m creating a new healthcare list-serve. If you give your business card to my staff, I’ll send you updates on what’s happening on healthcare and other issues. You can also sign up on my website. You can check the box for healthcare updates. |
Conclusion
Friends, in conclusion, I think we have a real opportunity to make progress. I think a lot of the stars are aligning. Just this summer, we saw a great example in Massachusetts. People from both parties, the governor, Senator Kennedy, businesses, consumers and hospitals all came together to make history with a new universal health program.
They showed that we can expand access without a big government-run, bureaucratic plan. And it started because they had an open and candid discussion that focused on helping patients. That’s the type of effort I want to bring to Washington, D.C. I’m going to need your help to do it, and I’m looking forward to being your partner in this new Congress.
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