CQ Transcriptswire

SPEAKER: SECRETARY OF HEALTH AND HUMAN SERVICES KATHLEEN SEBELIUS

[*] SEBELIUS: Hello, everybody. I am delighted to have a chance to join you today, and wanted to begin by talking, a little bit, about a meeting that I just attended with the president and key members of his health care team, including myself, along with a really unprecedented group of stakeholders who came together to commit to work together on health reform.

At the White House were representatives of the key provider groups, both the Hospital Association and the Medical Society, a lot of the key industry groups, technology groups, medical device groups, pharmaceutical company representatives. And we really had the CEOs at the table, a long with the CEOs of some of the major health systems.

These are the folks who actually not only will be implementing the new health reform plan but are the building blocks for the current system.

What was truly remarkable is that a lot of the groups represented actually were major opponents to moving legislation in the early 90s. They were very much a part of the coalition who helped stop health reform. And they are very much engaged and at the table.

That’s very good news, and the president was very clear about his enthusiasm for having them there and seeing them there, but also recognizing that this is not just a photo op and a meeting today but really a beginning of a collaborative partnership that can transform the health system.

I would say that was the -- the second piece, is that everyone recognizes that the current cost of health care in America is affordable for businesses and families and government (inaudible) and it’s also unsustainable.

The cost curve trajectory is alarming and is consuming more and more each year of our domestic spending. And we cannot sustain this into the future. And we have to transform the system in order to lower costs.

What the stakeholders pledged to do today was to collaboratively work on a strategy to take costs out of the system, out of the current system. Up to $2 trillion is estimated to be saved over the next 10 years, with a whole variety of strategies that help promote quality and provide better health care outcomes for most Americans.

And stakeholders and union groups and corporate execs and providers who were there not only made a commitment to do that, but also a commitment to report back to the president on June 1 with the steps moving in this direction.

SEBELIUS: So they’re not going to wait for legislation to be passed, but feel that they can begin down this path today.

We estimate that it will save American families, who are currently paying too much for health care costs, about $2,500 a family, real dollars in the pockets of Americans that they can not only have high-quality care, but achieve some cost-savings along the way.

So today was really a breakthrough day. It was a great meeting. We made the commitment with the building block programs of Medicaid and Medicare to continue to work with the stakeholder groups to find ways that we can deliver services more efficiently and effectively, that we will partner in this effort at the government level. But having this group together, committed to work together, committed to getting a bill passed this year.

Once again, the president made it clear during the course of the meeting that this is his number one domestic agenda. He think we’re at an historic moment, and really does not see anything but passage of legislation that he can sign this year as an option he’s willing to accept.

So today was a big step, and I’m pleased you’re with us today and would be happy to take questions.

QUESTION: Madam Secretary, thanks for taking our questions today.

Cost containment on prescription drugs is the big gorilla in the room. It causes a lot of problems for a lot of people, and really takes away from their annual income.

What specific policies are being directed in that direction?

SEBELIUS: Well, actually today was not an opportunity to talk to each of the groups in the room about their specific plans. But what I can tell you is that they were all urged to, and made a commitment to put together a very specific list and, as I say, to report back.

The representatives of PhRMA were part of the conversation, not only the current president, but former Representative Tauzin was there. I think that there’s no question that having the drug companies be part of this ongoing conversation -- you know, the president himself has laid out some strategies about competitive bidding and more effective ways to get to cost strategies in the pharmaceutical industry, but again, we didn’t have time at this morning’s meeting to go around the table and get the top three or four things they’re each going to do.

QUESTION: Thank you, Madam Secretary.

To what extent are the uninsured being considered in this kind of situation? Many of our uninsured are very young adults who simply can’t afford health insurance at any price. Are there specific plans in place to deal with this population?

SEBELIUS: Well, absolutely. That’s what a key purpose of passing health reform this year is all about is to make sure that all Americans -- the estimated 46 million Americans who don’t have coverage are able to access high-quality, affordable coverage. And certainly for the lower-income groups, there is a lot of discussion about providing some subsidy to assist in their coverage situation, but also stabilizing the coverage that’s currently available.

Millions of Americans are underinsured, so they have some kind of plan that has a huge deductible that may or may not ever be affordable by that family, and a huge gap in preventive services and wellness strategies for the family. A number of people are terrified that if costs continue to rise, their employers will drop coverage, or they’ll have to drop coverage in the individual market.

So I think we have a whole spectrum of Americans, most of whom know the current system doesn’t work for them, and that’s really what health reform is all about.

QUESTION: Madam Secretary, what specifically would it take to get that $2,500-a-family savings and on what timetable?

SEBELIUS: Well, the discussion today, John (ph), was if indeed we were able to achieve the success that the stakeholders in the room today felt was very achievable, we’re talking about cutting about 1.5 percent out of the rising cost of health care, about $2 trillion over the next decade.

SEBELIUS: Every time we talk about numbers, it’s really what happens in the next decade. So that would achieve the kind of individualized savings of $2,500 per family.

QUESTION: There’s been a previous tension between the insurance companies who say they would -- well, they’d be willing to accept people with preexisting conditions if there was a universal -- a universal requirement.

And I’m wondering whether -- where the president, if he’s thought at all about that bargain that you guys had previously been offered?

SEBELIUS: Well, again, that wasn’t one of the discussions in the room today, although there were representatives of both the American health plans there and other key stakeholders.

I would say that, as you probably know well, the president’s plan did not include an individual mandate that he talked about during the course of the campaign.

Having said that, he has made it clear that, as Congress engages on this issue, he’s open to all serious ideas. And I think there certainly are some members of the House and perhaps some members of the Senate who are talking about an individual mandate, as the legislation gets framed.

What the president is very committed to, and makes it clear, over and over again, is that cherry-picking by health plans cannot continue into the future, that we cannot have a system that, basically, the health insurers decide who gets covered and who doesn’t, by either medically underwriting their conditions or making the costs so prohibitive that people with preexisting health conditions are driven out of the marketplace.

So I think any piece of legislation that is going to be signed by the president will have that as a principal component. Whether or not the ultimate legislation has an individual mandate, sort of, the personal responsibility piece or not...

QUESTION: Thank you, Madam Secretary.

QUESTION: Many of the under-insured or uninsured Americans today are young adults, especially college students. Will this omnibus effort contain specific policies directed toward making student care more accessible?

SEBELIUS: Well, again, a lot of the legislative specifics have not been addressed. And I think that there’s no question that there is some system currently for those in college that is providing that is provided by the higher education systems that it may not be comprehensive coverage, but at least it is some coverage.

As a parent of two fairly recent college grads, that piece was in place. What I think often, though, happens is the next step, when those college students graduate and may or may not have a job -- may or may not have a job at all -- but may or may not have a job with health benefits attached. Then often the college student who has a degree, as part of their graduation present no longer has health coverage. And I think there’s no question that that is a group of individuals, frankly, we want in the marketplace, because most frequently they are young and healthy, and having numbers of folks in the insurance pool who actually help level the cost from those who desperately need care because they have some illness or preexisting condition. So any time there’s comprehensive reform being discussed, we definitely want to make sure young and healthy Americans are included in the system.

QUESTION: Hi, Madam Secretary.

I’m curious, you know, how todays’ meeting will affect the legislative effort and the interaction with Congress.

SEBELIUS: Well, the president asked for the individuals in the room to work with him. And I think that he has every expectation that in addition to beginning beginning to tackle the cost side of this puzzle, that he wants their involvement, help and support on the legislative side of the puzzle.

So everything from specific communication strategies, we keep one another apprised as the legislation moves through both the House and the Senate of, you know, what the objections are, what the goals are, what the positions are taken by these various stakeholder groups.

And he -- he made it very clear that he wants them at the table; not just at the table today in the Roosevelt Room to have this nice discussion and go to a photo-op, but at the table to make reform a reality this year. QUESTION: Hi, Madame Secretary.

SEBELIUS: Hi.

QUESTION: You made a point of saying that the previous obstacles were in the room today, the people that thwarted the plan -- the attempt to do this during President Clinton’s term. So what do you see as down the road the obstacles ahead? What are going to be the big problems this time?

SEBELIUS: Well, as you know, one of the things that always happens is, it’s easier to get everybody joining together around a 30,000-foot view. Once the details begin to be identified, that’s where tension often begins.

And I think the difference is, first, to have everybody in the room right now before the bill gets written. That has never happened before and that’s really an historic difference of approach that this president wisely decided to make. He wants stakeholders and members of Congress and representatives of various government unions and consumers and other involved in the process of crafting the legislation.

So that’s a big difference from before. And I think -- I think there’s no question that, you know, everybody right now says, “I want to help pass health -- health reform.” And underlying and often said piece of that is, “As long as it looks like I want it to look.”

So having -- making sure that we fully vet ideas and issues, but around some basic principles. And the president again made that very clear today, that his notion is that health reform has to be available to all Americans, less than universal coverage is not really an option.

It has to aim at lowering costs. So not only those Americans who currently don’t have coverage, but a lot of families who have coverage who are terrified that with the rising cost they will lose it next week, next month, next year, and our businesses are less competitive than they should be because they’re competing in a global marketplace.

So universal coverage, lower the cost, and drive high quality care. Again, we can’t just keep paying for what we’re paying for right now. We can’t just bring more people into a system where the costs are really too often focused on care that isn’t the highest quality, on buying drugs and repeating procedures that we know don’t work.

So we’ve got to use best practices and the best comparative research information to make sure that we transform the health system.

There’s a personal piece of this, too, that I think is so critical, that we’ve got to drive home a message that people have to take some responsibilities. Insurers have to come to the table with a different kind of marketing strategy than before, where we’re not going to continue to eliminate people because of preexisting health conditions, and not going to allow costs to rise to such a degree that it becomes unaffordable.

But individuals have a way to lower their own health costs by making some personal choices about tobacco and exercise and nutrition that can have a huge impact long term on the stability of this whole system.

So transforming health care, not just providing health insurance, is a part of the conversation today and certainly part of our challenge moving forward.

QUESTION: Hi, thank you, Madam Secretary.

SEBELIUS: Hi, Carley (ph).

QUESTION: The differences in health care vary dramatically regionally and in our state-by-state basis, so will these national cost reduction plans take note of disparities into account?

SEBELIUS: The -- I think it’s safe to say that as these national groups look for ways to cut costs, it won’t eliminate the national variation that we see region to region, state to state. But I think the good news is if they are committed to more efficient delivery of services, more effective strategies that can help not only produce better health outcomes, but lower costs, it will have an impact across the country regardless of the cost variations.

QUESTION: Hi, Secretary Sebelius. Thank you.

SEBELIUS: Hi, Martha.

QUESTION: What do these groups want off the table in exchange for what they are offering?

SEBELIUS: Well, it was an interesting conversation because I kept waiting for that to be the big ask. You know, what is the tradeoff of having these groups in the room?

What I was very pleased about was there was no quid pro quo, except the fact that I think everyone in the room who basically spend their full-time jobs on delivering health care and, you know, their jobs are being a part of this system, understand that what’s in place right now is unaffordable, unsustainable, and really unacceptable to most of the American public.

So my sense is one of the really positive outcomes of this conversation is we really have a broad-based coalition that has never been together before, of not only people who are running the current system, but lots of individuals who would like to be part of the system, moving in the same direction.

Thank you.

END

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May 11, 2009 15:04 ET .EOF

Source: CQ Transcriptions

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