Governor Christine Gregoire on Rural Health

Good afternoon, and thank you, Mary [Selecky] for the introduction. Mary has a big job, but I know I can count on her to never forget the basics. If you check Mary’s purse and pockets -- and probably the trunk of her car too -- you might find enough bottles of hand sanitizer to meet the needs of the entire population of Spokane. Can we count on Mary? You bet we can!

I’m honored to be here today to speak to a group of men and women who, more than anybody, understand the challenge of keeping our people healthy. I understand we have in the audience today a person who is a terrific example of the kind of men and women I’m talking about. Dr. John Anderson…Can you please give a wave to show us where you are? Thank you, Doctor, and welcome.

Dr. Anderson came to Washington to be a rural doctor in 1976. He was recruited for the National Health Service by Doctor Roger Rosenblatt at the University of Washington Medical School. I might add that largely because of Dr. Rosenblatt, our rural medicine program at the UW is considered the best in the nation. Dr. Rosenblatt, I think you’re in the audience too. Can you please give us a wave?

Dr. Anderson knows on a daily basis the challenges all of you face in rural health care in Washington, Oregon, Idaho, Montana, and Alaska. Like all of you, he has to be all things to all people because there just aren’t enough of you – whatever your “official role” in health care might be. As Dr. Anderson points out, there is a scarcity of resources. In his case, that means something as basic as no cardiologist or urologist just down the street. He and his staff have to figure out how to get somebody to Seattle or Spokane for the help they need – and quickly.

Like the rest of you, Dr. Anderson is always fighting time and distance. And like the rest of you, he has to worry a lot more than his city cousins do about the financial resources of his patients too. Rural patients often don’t have the greatest health care insurance – if they have it at all. Dr. Anderson spends a lot of time talking with patients, looking for ways for them to get healthier before the cost of their care runs into real money. And Dr. Anderson is no stranger to giving free care, or care that is well below its real cost. In rural areas, home visits still happen, and Dr. Anderson has done hundreds of them since he began his practice, and he still does.

But like all of you here today – Dr. Anderson wouldn’t trade his life for anything. For him, and for all of you, it’s all about the people you serve – up close and personal. It’s about the relationships, and the multiple ways you find to keep our rural citizens healthy. So there is absolutely no doubt in my mind that you agree with me when I say: In a nation as wealthy as this one, it is our moral responsibility to give every citizen access to quality, affordable-health care that keeps them out of emergency rooms and shields them from an early death or disability.

Getting there is a lot more complicated, to say the least.
But quality affordable health care is a must if we're going to ensure that:
…Our families are healthy so our children can learn and our parents can work…
…Our businesses can compete globally…
…And the cost of health care doesn’t break the budget: the family, business, and state budget.

I learned a long time ago that we couldn’t wait for the other Washington to help. So we are doing what we can in this Washington. In 2006, I chaired the Blue Ribbon Commission on Health Care, and we brought in health-care experts and leaders from all over the state. Out of that work came confirmation of my five-point strategy to improve our health care system in Washington. The goal? Improve quality and make health care affordable. So we are trying to move quickly.

We are moving to an evidence-based health care model to drive up quality and drive down cost…

We are moving to better manage -- and head off -- the need for chronic-care. Chronic care patients are just five percent of all health consumers, yet they consume 50 percent of the health care dollar.

We are moving to create a system of electronic medical records for both patients and providers – a system where the patient’s privacy is protected but doctors can go on a computer and access them anytime, anywhere. This is a cost issue and a safety issue too! This has special significance for rural health consumers. It’s key to providing better access to health care in rural areas because it drives down costs and drives up quality. We are now setting up a health record system modeled after the banking industry so that if I'm a patient in Seattle but have an accident in Spokane, the ER docs in Spokane can access my medical records as easily as they can withdraw money from an ATM. Last year, the state began distributing grants to providers so that even small practices can set up electronic health records and join a broader system.

We are moving to make health care more transparent. When people buy cars, they can easily find information to make a good buy. We should have the same kind of information about health care, especially if we expect consumers to actively manage their health. And transparency rewards providers who do a good job.

We are moving to promote wellness. No other strategy can compare when it comes to reducing costs and improving quality of life.

Of course, our public health system plays a central role in this endeavor, and we are stepping up with improvements. For example, last year we funded $50 million in tobacco prevention, and increased funding for family planning and STD screening/treatment services. In 2005, we formed a public health task force to hear from the community and state and local governments about how to strengthen our public health system. That led to an additional $20 million investment. For the first time, we tied investment to performance outcomes measured by immunization rates, communicable disease, and other markers. I very much appreciate the public health community's willingness and work to tie dollars to outcomes. This kind of public policy saves money in the long run and makes us accountable to the people we serve.

Last spring, I introduced a new, state-sponsored prescription drug-discount card to save Washingtonians -- including thousands of pre-Medicare seniors -- an average 20 percent on brand-name drugs and 60 percent on generic drugs. This is proving to be a real success. These discounts have saved prescription-buyers $2.7 million, and more than 75,000 Washingtonians have signed up for the program. We’ve tried to get the word out about the prescription drug card, and expect to have thousands more signed up this year. I urge all of you to help us spread the word.

I have to say I am very disappointed that the White House has once again vetoed the expansion of the State Children’s Health Insurance Program, which provides health care for kids. And now, sadly, we are fighting a new battle with the White House. I testified last month to a congressional House committee against some incredibly short-sighted and expensive Medicaid regulations that are kicking in now. They will hurt children, people with disabilities and seniors, and cost our state an estimated $90 million the first year alone.

By the way, the new regulations even include a reduction in funding to finance medical educations, which will surely impact rural health systems. Governors across the board – Democrats and Republicans – strongly oppose the new regulations, and we are holding congressional feet to the fire to overturn them. This is a $15 billion cost shift to the states, and it is outrageous.

As it is, we in this Washington are reaching our goal to give every Washington child access to health care by 2010. In the past three years, we have provided health care to an additional 84,000 Washington children. Of course, you and I both know there is more to it than just having coverage. We also need to make sure the kids can get in to see a doctor. I heard the concern last year of pediatric providers who could not afford to treat these kids. That’s why we added $29 million for pediatric services, and also added $26 million to help pay for childhood immunizations. We are now one of just nine states with universal immunization coverage.

This year, even as we clamped down on spending to make sure we left a healthy reserve, we passed legislation to improve safety for patients. We will do that by strengthening the licensing and disciplinary standards for all health care providers. We will also provide real-time information to doctors and pharmacists to reduce medication errors.

Doing the work required to keep our citizens healthy is not easy. But I know that we will get there working together.

I know that many, many health professionals just like Dr. Anderson are in our rural communities, and in them to stay.

I’m truly thankful for that, and for all the dedicated people in this room who work so hard, and who do so much to help our rural citizens get healthy and stay that way.

We couldn’t get along without you.