March 24, 2009

Markell Addresses the Importance of Health Care Partnerships

NEWARK – Gov. Markell delivered the following speech Tuesday at the University of Delaware's Knowledge Based Partnership Symposium:

Thank you. It is wonderful to be here in front of so many friends, among people who have dedicated themselves to saving lives as medical professionals and enriching lives as educators.

The focus of today's session may be partnerships in health care, but today is clearly about so much more. The decisions made today, the discussions held today, the ideas to be heard today could provide solutions to one of the most pressing problems facing our state - including:

• The escalating cost and declining availability of health care.

• Delaware's role as a center for innovation and excellence.

• And demographic trends that both threaten our economic prosperity and offer the opportunity to reshape how we view our economy.

While we will spend today talking about our state's future, I need to speak briefly about the challenges we face in the immediate present. As you know, the staggering downturn in the national economy hit Delaware particularly hard, creating historic economic and financial challenges and an unprecedented budget deficit of $750 million dollars.

This deficit represents more than 20 percent of our budget and is among the largest, on a percentage basis, of any state in the nation. The shortfall is larger than every dollar spent in state support for our teachers and larger than the entire budgets of 14 state agencies, including the Department of Safety and Homeland Security. It is larger than every dollar the state spends on Medicaid.

Last week, I offered my solution to this historic challenge, a balanced budget plan which was guided by three principles.

1. Our decisions must be fiscally responsible, both now and in the long term. We would not make promises now that we could not keep in the future.

2. We must be compassionate and keep our government's core commitments to educate our children, protect our families, and improve the general health and welfare, and

3. We must spread our sacrifice so no one group would bear a disproportionate burden. What that means is that every one of you here will probably be offering a bit more and receiving a bit less in the short term until we are through this historic challenge.

The plan relies mostly on cost cutting, but it does raise revenues. It is not perfect, and there are many elements of it that I would prefer not to have had to propose. But I believe it is a responsible and reasonable approach to get us over the mountain we face and position us for prosperity in the long term.

I know that while these problems may confront us, they will not define us.

Despite these obstacles, I remain firmly convinced that our state's best days are ahead of us.

The steps we take now to shape our state's economic future, the efforts we make to get Delaware's economy moving in the right direction will be felt for years.

It is entirely possible that the national debate on health care reform could transform how America looks at medical care for generations. We all lived through President Clinton's efforts in the early 1990s to reform health care. At the time, I was an executive at the company that would grow into Nextel. Looking at that debate from the lens of a small business person, it was clear that the health insurance system even then had systemic problems with cost, availability, access and quality of care.

Even then, people were using emergency room visits as a primary care vehicle. Even then, families found themselves just one medical problem away from financial disaster.

Even then, families were worried that losing their job meant losing their health care. Even then they worried that new employers may match their salaries, but would likely never match their benefits.

The facts were clear, but the solutions were not. The debate descended into whether the nation found more compelling the complex arguments around substantial reform or a commercial featuring a couple named Harry and Louise who claimed that anything the government did would compound the problem.

In the end, inaction carried the day.

There's an unfortunate adage that sometimes things need to get much worse before there's the will to make them much better.

And over the years, while the quality of care available to many has improved, and breakthroughs in technology have made enormous leaps, the fundamental issues surrounding our health care system have indeed gotten worse.

Millions more Americans are now uninsured. Tens of millions face premiums they may not be able to pay. Billions of dollars are spent each year on uncompensated care for emergency room visits by the uninsured, which hurts hospitals' ability to remain solvent and hinders their ability to provide timely care.

In fact, the issue on uncompensated care has become so serious that the man who helped invent the Harry and Louise ads - Chip Kahn - has joined the fight in favor of reform.

Without real action at the federal level, things are likely to get worse. As fewer employees receive health care coverage through their employers, and as fewer consumers can afford paying for health coverage on their own, the number of those without health coverage rises. As the number of uninsured people increases, the health care system that treats the uninsured absorbs higher levels of uncompensated costs, which ultimately are paid by taxpayers or through increased costs and premiums paid by those who still have health coverage.

Thankfully, the President of the United States has said that a truly national health care plan could not wait another year and that he would use the power of his office to ensure that a national reform of our health care system would be done within the first year of his administration.

In his joint address to Congress, the President said that "this is a cost that now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes... So let there be no doubt, health-care reform cannot wait, it must not wait and it will not wait another year."

In looking at the outline of President Obama's plan, I see a number of core principles that the nation should embrace - cost containment, choice, flexibility and individual responsibility. The President realizes the national imperative of containing the total cost of health care policies and expanding access to coverage. He understands that families should not have to wonder whether they can afford to visit the doctor if their kids become sick or injured. Businesses should not have to worry about losing their company health plan because one employee becomes seriously ill. And taxpayers should be assured that the money they spend on health care is buying the best possible value.

We support the President's belief that without action, the vicious cycle of higher costs and less affordable coverage will continue to threaten the competitiveness of our nation's businesses and the financial stability of our families. And most importantly, it will keep millions from enjoying the benefits of good health.

We believe that any federal plan must focus on prevention, must leverage technology to reduce unnecessary expenses and must make every effort to cut administrative steps to bring costs under control. It should incent people to take individual responsibility for their own health because doing so drives down the cost for all.

And it should ensure that no person would lose their current coverage because of reforms.

Those are the principles that should guide the national debate. They are the principals on which our support is based.

The benefits from a national health care reform, if successful, should be many. However, we must remain alert and aware of unintended consequences. For example, since coming on-line in 2007, the Delaware Health Information Network has connected doctors with critical test results for thousands of patients. It leverages some of the state's largest hospitals and over 2,600 medical professionals to ensure patient information is clear and more accessible to each doctor offering care. There are some questions over how this breakthrough technology will interact with the President's included in the federal stimulus package of $19.5 billion for a new national information technology infrastructure.

We will also need to know how, if implemented, a public insurance plan would compete with the private insurers with whom employers currently negotiate; and would need to move quickly to understand the scores of national regulations that could be re-written at the national level that state and local governments would need to navigate.

As the national debate over health care takes shape, we need to focus intensely on preparing Delaware's economy to make the most of the opportunities before us to innovate and grow.

It's time we realized that Delaware will never be able to win the battle of the big check against other states. We will never be able to outbid other governments to lure large companies to our state. We will never be able to hand over hundreds of acres of property to large industry, or offer a major metropolitan center to incubate new business. But what looks like a weakness - our size - is very much our strength.

We can be more flexible, more responsive and more dedicated to companies than large states could ever possibly be. We can get our Congressional delegation together with company executives and have an action plan in place in the time it would take businesses in some larger states to determine who they should even call. We can offer a sense of community, where business and citizens can support each other, grow together and tackle problems as allies, not opponents. We can lead the nation's economic recovery, because we can simply run faster than others.

And there is no better example of this than the group we celebrate today - the Delaware Health Sciences Alliance, a collaboration between the University of Delaware, Thomas Jefferson University, Christina Health Care Systems and Nemours. These outstanding institutions will now be teaming up on a variety of issues, including delivery of services, public wellness campaigns and education in a way that could be critical to our economic growth and our status as a state as a center for innovation and excellence.

I do want to thank them for taking this bold step forward; for recognizing that progress is a shared enterprise and that with the weaknesses in the finance and manufacturing industries that helped support our state's economy for so long, that collaborative efforts in the life sciences, biotechnology, and health and medical services industries are a critical path forward.

This Alliance embodies the best of what Delaware has to offer. It will combine the individual strengths of each institution to form something much stronger. It will increase the quality of education opportunities in health care and give Delawareans access to cutting edge medical training.

It will prepare a new generation of workers to offer quality care to the thousands of new Delawareans who have come to our state, and will come to our state, to live in retirement.

It will turn this demographic challenge into an opportunity for innovation, including the launch of what could emerge as a national leader in rehabilitation services.

It will embrace Delaware's history as a center for research while looking to a future where innovation comes not from within the silo of a single company but from the collaborative efforts of some our state's best minds, united in purpose and facing forward together.

It is an exciting effort and, even with the challenges we face, a truly exciting time.

No matter how hard we work in the short-term, decades from now, people will look back on this time not as the moment that we overcame the state's largest budget shortfall, or the time when we made government more efficient and effective, although both will be true.

Instead, I believe history will mark this as the time that Delaware moved boldly into the new economy with efforts like the Health Sciences Alliances, the Delaware Center for Cancer Biology, the Delaware Rehabilitation Institute, and the Delaware Valley Institute for Clinical and Translational Sciences helping to point the way forward.

As I said before, I remain firmly convinced that our state's best days are ahead of us. These problems do confront us, but they will not define us. All over the state, people ask me what they can do to help.

By the careers you have chosen, by your support of initiatives like the Health Science Alliance and by being a part of this debate, you are doing your part.

But I want to ask you to do a bit more.

I ask you today to keep challenging the prevailing wisdom that our hands are tied until the national economy improves.

I ask you to continue creating new solutions, by sharing your ideas with us on how to create a more efficient, effective, responsive and responsible economy that launches dozens of small businesses able to serve our growing population.

I ask you to commit to volunteering during these difficult times, to strengthen our community through service.

If we do this, we will get through this difficult period and get our economy moving again.

We will leverage our resources to make Delaware a center for innovation and opportunity.

We will turn our small size to our advantage and be more nimble, more responsive and simply more energetic than anyone else around us to recruit and retain new jobs.

We will leverage our sense of community and our collective wisdom to eliminate obstacles before they become limits to growth.

We will foster companies who know their purpose and want to create not just jobs but quality careers for Delawareans.

And we can, and will, move together with a purpose that makes clear that we have the power to define our future for generations.