Speech
Governor's Health Care Summit
Remarks of Governor Judy Martz
MSU - Bozeman
5/17/2002
Good morning, and thank you for joining me here today at this landmark event. It is heartening to look around the room and to see a group of dedicated, committed professionals come together to find new and innovative solutions for our health care industry.
I’d like to start by introducing a few key members of my cabinet and staff. First and foremost, my partner in this administration, Lieutenant Governor Karl Ohs. Karl, will you stand and be recognized?
The Lieutenant Governor will remain with you to lead your discussions throughout the day. Thank you for being here.
Also here today are key members of my cabinet and staff. As I call your name, will you please stand and be recognized:
Director of the Department of Public Health and Human Services, Gail Gray;
Commissioner of the Department of Labor, Wendy Keating;
Chief policy advisor, Mike Foster;
and my Health policy advisor, Jean Branscum.
In addition, we have a number of individuals who have provided technical assistance in planning this event. I would like to specifically thank and recognize Linda Ashworth from my office. If you have a question about a meeting location, registration, or other questions, Linda would be glad to help out. Linda, will you please stand and be recognized?
In your packets, you’ll note a list of organizations and individuals who have provided advice and support for this conference. Their support ranges from serving on the conference advisory committee, to serving as breakout session leaders, speakers and facilitators.
If you have the chance to visit with any of these individuals, I hope you’ll take time to thank them for providing these services with the goal of improving health care opportunities for all Montanans.
Please join me in giving all of these individuals a round of applause for their participation in this monumental effort.
It seems as though, every day, health care and health insurance has become increasingly unaffordable – not just for the eighteen point five (l8.5) percent of our friends and neighbors who are uninsured, but for more and more working people as well.
We all can appreciate some of the reasons behind rising costs. Advances in health care technologies and prescription drugs have allowed us to live longer and brought a better quality of life.
We should appreciate the fact that health care provides some of the best paying jobs in our state.
Yet, we must ask the hard questions that will bring forward solutions to the three-legged stool of health care... affordability, accessibility and measurability.
Solutions to these three issues are obviously not simple. If it were, the 2001 Montana Legislature would not have created a special interim subcommittee to study the issue and we would not be here today.
Health care is not inexpensive, and for those hard-working low wage earners in our state, it becomes even more of a burden, as they try to balance the needs of their families and make sure they get preventive medical care.
My friends in the provider community tell me that uninsured Montanans do get medical treatment when they really need it. However, the big problem is that when these folks really need it – they show up in the emergency room which is costly.
This decision makes complete sense to hard working Montana families just trying to make ends meet. Lacking health insurance or the ability to pay, they delay care and do not get treated early in a doctor's office or a clinic. But when they end up in the emergency room, it causes a tremendous cost shift in their care, I'm told as high as thirty (30) to thirty-three (33) percent.
The problems go beyond the cost of health care. Accessibility is also a real issue in a rural state like ours.
Although this does not affect all of our residents, many people have trouble getting to a doctor's office in their hometown. To receive specialty care, most Montanans have to travel large distances from rural communities to larger cities like Billings, Missoula, or Great Falls.
[Personal anecdote – individuals you may know of who have been flown from Butte to larger community for services.]
At the same time, we are trying to maintain our rural medical and hospital facilities. We must find better ways to collaborate and not duplicate costly services, and be sure that our rural facilities are being used for the services they are equipped to handle.
We must measure the care and treatment that is being provided to be sure it is of the high quality and results in positive outcomes.
I challenge each of you to reflect on how we deliver health care services today and question if our system can change.
Consider the idea of creating an inventory of the medical services that are available in our great state. If we had an inventory of all of the services currently available, where they are located and offered by our excellent hospitals and medical facilities, perhaps we could figure out how to better work together and create more centers of excellence.
Let's think about how we can work together to identify those services, like heart surgery, where it makes sense to be provided in regions of our state, rather than in each community.
Again, these three issues, affordability, accessibility, and measurability, are key. However, in addition, changes in the economy, have thrown a monkey wrench into the picture.
There can be no doubt that Montana is going through a very difficult time. Simply put, we are spending more money than we make.
While the long-term solution to our problems is a healthy vibrant economy that will produce more jobs and revenue, in the short term we are experiencing the very painful realities of learning to live within our means.
Nowhere are these realities more apparent than in the area of medical and human services provided through the Department of Public Health and Human Services (DPHHS). Demand for the help DPHHS provides to children, the elderly, people with disabilities and the poor is increasing rapidly.
The department has already taken a number of steps to contain costs and in some cases reduce services in order to stay within its budget.
While we are committed to continuing our efforts to provide human services more efficiently, it is clear we are rapidly approaching a decision point. We must either eliminate much of assistance we provide or find a way to pay for it. After looking at the options available to us, we have concluded that additional large-scale reductions in the medical care and services provided to needy Montanans are not in the best interests of our state.
The sick, poor and disabled people helped by our programs are truly in need and we have a civic and moral duty to do what we can to assist them. The human consequences of not helping them are too horrible to contemplate.
The issue is not about adding and expanding programs in an open-ended commitment of new public money. The issue is about paying adequately for the assistance we already provide and protecting our most vulnerable citizens.
I have asked my staff and those who are concerned about cuts in health care to step out of the box and look for new solutions to the needs of our vulnerable Montanans.
The individuals in DPHHS have done just that and I want to sincerely thank them for their dedication and commitment in this area.
Stepping out of the box, staff are exploring a way to better fund existing services through a proposal that is similar to the Intergovernmental Transfer used to add funding to nursing homes in the last year.
Called the Medicaid Investment/Incentive Assessment, it involves assessing a fee on gross proceeds of certain medical services and using it to match with federal Medicaid funds and returning it to Medical providers in the form of increased provider rates or elimination of proposed cuts.
If you want further information on this concept, Director Gray and Deputy Director John Chappuis will be available throughout the day for your questions.
Other things we are doing to work with private industry and consumers to explore other new and innovative ways include:
Applying for a State Planning Grant to conduct an in-depth analysis of the uninsured population to determine the most effective options for providing the uninsured access to affordable health care.
Forming study groups, like the Blue Ribbon Task Force on Health Care Workforce Strategies, and the Alcohol, Tobacco and Other Drug Control Policy Task Force that I initiated with Attorney General Mike McGrath. Many of you are assisting in these efforts to develop strategies and I look forward to hearing your recommendations in August.
And, from the prevention perspective, last month, I announced my Strong Families/Healthy Families Initiative – to encourage Montanans to develop healthy lifestyles through exercise and diet that will prevent future health problems.
I also want to recognize that many groups are also working hard on these issues, are looking for ways to collaborate and are exploring your own innovative ideas.
One example is the launching of state foundation to assist low-waged, uninsured Montanans get access to affordable health care and health insurance.
There is no question that the healthcare industry has issues, but I firmly believe that, with the group we have here today, we can find as many, if not more solutions. I strongly encourage each and every one of you to look outside the box.
I've tried to outline a few concerns and areas that I believe should be discussed throughout the day, and I think you will see from our agenda we have speakers and facilitators to lead the discussion on these various issues.
We have brought together some of the best minds, talent and expertise to one place today. We have brought you here to talk about solutions, not complain about problems. We have asked you here because, quite simply, our Montana families need you. They need your innovative ideas and progressive solutions to make this state a better place for all of us.
So, thank you for coming, and for committing your time and your talent to this important task. I look forward to getting back together at the end of the day and hearing the reports of the various workgroups.
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