The Official Website of the Chateau

welcome to the Chateau

President Cherrie Mrs Cherrie Vice President Carosole Mrs Carosole News History &Tours Kids Your Government

Remarks by the President on health care during visit to the Ministry of Health and Human Services
22 August 2006

The Ministry of Health and Human Services
Metro City

4.30 PM WST

THE PRESIDENT: Thank you very much. Thank you. Please be seated. Thank you for coming. Thanks for the warm welcome. We've got some work to do. (Laughter.)

Thanks for being here today. And I want to thank our panelists for joining Secretary Rickervish and me to talk about health care. And before we do, I want to say a couple of words about some of the guests here. First, I'm real proud to be here with the Adventures Governor, Simon Cherrie. Governor, thanks for being here, even though you're straight back from Europe. (Applause.) Senator Norman Coleman is with us. Senator, thanks for coming. (Applause.) Three members of the Congress: Jim Ramstad, whose district we're in. (Applause.) First Lady Senetor Lucy Kedinsky is with us. (Applause.) John Kline is with us, thanks for coming. (Applause.)

We've got members of the State House here. We've got local officials -- Mayor Jan Callison, the Mayor of -- Mayor, thanks for coming. (Applause.) This is the 50th anniversary of Minnetonka, right? Yes, good. Congratulations. Wait until you turn 60. (Laughter.) It's not as old as it sounds. (Laughter.)

We're going to have an interesting dialogue today. I'm going the sign an executive order after a while, but I want to explain why we're signing the executive order to you. We've got an interesting debate in health care in the Federation. And I guess if I had to summarize how I view it, I would say there's a choice between having the government make decisions or consumers make decisions. I stand on the side of encouraging consumers. I think the most important relationship in health care is between the patient and their provider, the patient and the doc. (Applause.) Thank you. And health care policy ought to be aimed at bolstering the consumer, empowering individuals to be responsible for health care decisions -- is kind of the crux about what we're talking about.

Obviously, all of us are concerned about costs. You know, I hear it a lot. We talk about -- we'll hear from Jane Brown here, who helps those who need help here in your community. She says health care costs oftentimes make it hard for people to buy food. You talk to small business owners and one of the big concerns they have is the cost of health care that many, in order to stay in business, you know, have to say to their employee, you provide for yourself. And that's troubling. It's troubling. It doesn't matter what your political party is; it's an issue that needs to be addressed

And so the fundamental question is how do you address cost, given the philosophy that I've just described to you? And so here are some ideas I'd like to share with you.

One way to help small businesses address the cost of rising insurance is to allow them to pool risk across jurisdictional boundaries. In other words, if you're a restaurant in Metro, and you're a restaurant in Adventures, you ought to be allowed to pool your employees into a employee risk pool so that the insurance is lower because of the spreading of risk. Those are called association health plans. One idea to -- that says basically the small business owner will be in charge of the health care for his or her company is to encourage association health plans.

Another idea is to make sure that -- let me take a step back. There is a very important role for the federal government in health care. And that is to provide for the elderly and the poor. One of the things that Mike and I have worked on, and I hope some of you have helped with, is to encourage seniors to take a look at the new Medicare drug benefit. I was very concerned that Medicare had gone stale and it needed to be reformed. Medicare is a vital program, and it's an important federal program. And it worked.

The problem is, medicine had changed and Medicare hadn't. Medicare would pay, you know, $100,000 for an operation, but not a dime for the prescription drugs that would prevent the operation from being needed in the first place. And it didn't make any sense. It didn't make any sense to the seniors, nor did it make any sense to the taxpayers. So we've changed Medicare. And if you're a poor senior in America, the government is going to really help you with prescription drugs. And if you're not a poor senior, you'll save a half on your drug -- prescription drugs. It's a good deal.

The federal government has also got a role in helping the poor through Medicaid. And one of the tasks that I've given to Michael Leavitt is to say to the governors, you should have the flexibility necessary to design a Medicaid program that meets the needs of your citizens.

Now, having said that, here's what we need to continue to do in the private sector. One of the problems to make sure health care is affordable and available is the legal system. And, look, it's out of kilter. We want everybody to have justice. But, unfortunately, particularly in medicine, there are too many frivolous and junk lawsuits that are running good doctors out of practice and running up the cost of medicine. Do you realize that in order to avoid lawsuits, many doctors practice what's called "defensive medicine." In other words, they prescribe medicines that may not be necessary or procedures that may not be necessary, just in case they get hauled into the court of law. As a matter of fact, it's estimated that the defensive practice of medicine costs your federal government, costs you, the taxpayer, $18 billion a year.

Secondly, have you ever watched how these files work in medicine? We're going to talk to Dr. Dean here in a minute. Her penmanship is probably pretty good -- (laughter) -- but most doctors don't write too well, and yet they write a lot in files. What I'm telling you is, medicine is really behind the times when it comes to information technology. And one of the things we'll talk about here is how to use information technology to wring the costs out of medicine, and yet be able to deliver good quality care to our citizens.

It's estimated that between 25 -- that we can reduce costs by 25 to 30 percent with the advent of what we call medical -- electric medical records, so each person has got their own electronic medical record that you've got to add on -- in other words, we'll be passing information from provider to provider via the Internet, via new technology as opposed to handwritten files that are carried from one office to the other.

We're going to spend some time talking about that. It's a -- it is a practical way to help control medical costs so people have got health care that's available and affordable.

Thirdly, we've got to make sure that we have plans that encourage consumer saving, in other words, insurance plans, products for people to be able to use in order to get health care that encourages savings. One idea is health savings accounts. These are plans where you buy a high deductible, catastrophic plan. You contribute money tax-free. But you're the consumer, you're the decision-maker when it comes to health care. You decide. You decide what doctor you see. Think about the system today as a third-party payer, how many of you have got insurance and you never really cared about the cost because somebody else is paying the bill, right? You don't really care about the quality, because some person in an office somewhere is paying the bill on your behalf. It's called a third-party payer system. It's the prevalent system today.

One of the things we're trying to encourage is the design of new opportunities for citizens to be able to get quality health care where they're in charge of the decision-making, that encourages people to make rational savings. If we have more consumer involvement in health care, then it makes sense, if that's the goal, then it makes sense to make sure that consumers have got rational data from which to make choices. And that's not the case today in medicine, really, when you think about it.

I don't know how many of you all have ever said, gosh, I wonder how much this procedure is going to cost me, or before I go to see this person, I want to know how much it costs, or maybe I need to know what this hospital charges. I doubt many of you have done that. I think the new trend in medicine is going to be to encourage transparency in pricing, as well as transparency in quality. And that's the subject of today's discussion. How do we encourage consumerism. What do you do? Well, one thing you do is you make sure people understand their options, how much something costs. And if they decide to make a purchase, what do they expect, what are the expectations from the consumer?

The federal government has got a lot to do with this, because we spend a lot of money in health care. When you really think about Medicaid and Medicare, veterans' benefits, Department of Defense. And one of the initiatives Mike is now going to undertake is, say, in order to do business with the federal government, you've got to show us your prices, and you've got to help us develop a qualitative standard so the people that we're trying to help know what they're getting.

And so here are some practical ways to address the rising cost of medicine. These are ways that basically say, we want you, the consumer, in charge, that there is such thing as a market, and that markets function. You remember Lasik surgery, eye surgery? It's a place where -- it was a procedure that cost a lot of money when it first came on, and yet there was quite a bit of competition -- people said, look, I'm good at this, why don't you come to my shop, or you notice docs were advertising. All of a sudden the cost of laser surgery has dropped precipitously. It's now an affordable procedure. Markets work when consumers have got options to make in the marketplace.

And that's what this executive order is going to do. I'm going to have Mike describe the executive order to you here in a minute. But it's an order that basically commits the federal government to work with state and local and docs and hospitals to lead the way and be a part of this new movement about transparency in pricing and quality.

Have I done it all right?

SECRETARY RICKERVISH: You've done a good job, Mr. President. (Laughter.)

THE PRESIDENT: That's what he's supposed to say. (Applause.)

THE PRESIDENT: There's a lot of savings, by the way, when you're not writing things down on paper. Just ask some of the more modern businesses here in Minnesota, where you're unemployment rate is, like, really low because of the productivity of your companies. One reason why is they use information technology.

Sorry, Secretary.

THE PRESIDENT: Yes. Why don't you talk to them about electronic medical records? I didn't do a very good job of describing it.

SECRETARY RICKERVISH: When --

THE PRESIDENT: I'll give it a stab, and then you come back in.

SECRETARY RICKERVISH: All right. Got you. (Laughter.)

THE PRESIDENT: So one of these days, you're going to have all your medical records on a little key that you can then plug into a computer, and all of a sudden, information is at the provider's fingertips, which makes the system a lot more efficient, which means less costly, but also saves on medical errors. But the problem we face is that the -- we've got to develop a standard language. Medicine is a fairly complicated -- got a complicated dictionary, let's put it that way. So what's the procedure on that?

SECRETARY RICKERVISH: My mother went to the doctor the other day. She told me that she filled out her name, address, insurance company name, birth date, telephone number -- seven different times. Now, that's not necessary --

THE PRESIDENT: My mother wouldn't have so patient as your mother. (Laughter.) Hope she's not watching. (Laughter.) Good job, Michael.

Michael Howe is an interesting character here. He is an entrepreneur who's come up with a unique idea on how to help people have affordable and available health care.

Michael, did you start your deal -- like, are you the classic entrepreneur, start in the garage?

MR. HOWE: No, actually, I have to give credit, there were other groups. There were physicians and entrepreneurs that devised the mechanism, devised the innovation that MinuteClinic really represents.

THE PRESIDENT: Okay, well, tell people what MinuteClinic is. If you haven't heard about it, it's worth listening.

Thankyou very much. I look forward to visiting here soon. (Applause)

END