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AFL-CIO / Kaiser Permanente Health Care Forum National Labor College

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AFL-CIO / Kaiser Permanente Health Care Forum
National Labor College

(As Prepared)

Thank you very much John Sweeney, and thanks to everyone who is with us today from the labor community, as well as to our friends from the Kaiser Foundation.

In Maryland, we've partnered with our colleagues in organized labor to accomplish what I believe are very important things for working families in our State. The nation's first living wage law. Fair Share. Unemployment protections for part-time employees. Tough new reforms to crack down on businesses which misclassify their employees as contractors to deprive them of rights and benefits. And that's just the short list.

We've also made significant progress together on health care - this issue which says something not only about our economic potential, but about who we are as a people.

It was Hubert Humphrey who said that, quote "the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life" - the vulnerable citizens who Humphrey argued are often overlooked.

I think we'd all agree that you can't be a society that respects and honors the dignity of every individual if 47 million of your fellow citizens don't have health care;

You can't be a society that believes there is no such thing as a spare citizen if you're willing to allow a 12 year old boy to pass away because his parents couldn't afford to treat a toothache;

You can't have an upwardly mobile middle class, if your citizens can't afford rising medical bills, or if families have to choose between buying prescription drugs for their parents or food for their children.

And you can't reach your potential as a nation if small businesses can't afford to provide health insurance to their workers, and workers can't afford to provide health care for their families.

We are very fortunate to have a President who understands this, who believes in this, and who has the courage and the will to fight day and night so that we finally have meaningful national health care reform in this country.

Speaking as a governor in a State where roughly 22% of our budget is dedicated to health care expenses, where our citizens, their employers and their government spend $36 billion on health care each year, and where the rate of health care spending is outpacing the growth of our economy, I can personally attest to urgent need for federal action. We can't afford to wait another decade (or decades) to combat rising costs, poor access, and mediocre quality.

The President's leadership on this issue is important for another reason as well. In a world where we face an array of new threats to our security - be they the threats of bio-terror, global pandemic, or the foreign chemical invasion of cocaine and heroin - our efforts on public health are fundamental to our ability to protect our homeland and prepare for emergency situations.

I've been asked to speak today from a state's perspective on health care, and I wanted to use our brief time together to share a few of our experiences in Maryland.


Our mission statement in the State of Maryland is: to strengthen and grow the ranks of an upwardly mobile middle class; to improve public safety and public education in every part of our State; and to expand opportunity: the opportunity to learn, to earn, and to enjoy the health of the people we love and the environment we love.

Health care is connected with each of these priorities, and it's deeply interwoven within the greatest challenges that our country faces in the 21st century: the challenge of leading in security, the challenge of leading in sustainability, and the challenge of leading in the ways we grow and protect the skills and health of our workforce.

The notion that every child deserves a healthy start is something which I believe is universal to all Americans, perhaps to all humanity. It's a notion which has inspired us in the State of Maryland to set the big goal of becoming the first state to eliminate childhood hunger.

It's a notion which has driven us as well to fight to provide health coverage to tens of thousands of additional children since we took office two and a half years ago.

One of our top children's health priorities is dental. You may be familiar with Deamonte Driver, the 12 year old boy who died tragically when an untreated toothache spread to his brain. We've resolved to do everything within our power to prevent this from happening again,…

… and so we've increased our incentives to dentists to get them to provide services to more vulnerable kids. We've developed a training program with the University of Maryland Dental School and the Maryland State Dental Association to improve risk assessment and treatment of young children. We're investing in new public dental clinics and removing red tape which had previously prevented hygienists from providing critical services at these clinics. And we're investing in school based dental initiatives like the Deamonte Driver Dental Project, through which we bring dentists to public schools and offer diagnostic, preventative, and restorative dental services to vulnerable children.

At the other end of the spectrum, we've made it a priority to protect our vulnerable seniors by closing the Medicare donut hole so none of our parents will be forced to choose between paying for prescription medications and paying their electric bill.

To assist Marylanders of all ages, we're one of a handful of states that has chosen to offer assistance to small businesses so that they can purchase health insurance for their employees. Thus far, we're assisting nearly 200 small businesses, and we believe we can leverage this initiative to serve as many as 10,000 Marylanders.

And with a government that works we've been able to expand heath coverage - even in difficult times - to nearly 45,000 Marylanders who previously did not have health insurance.

Our overarching goal in the State of Maryland is to keep costs down and efficiency up, while still constantly improving on the quality of care provided to our citizens. No easy task, but with Maryland being home to some of the world's leading hospitals and experts in the medical profession, we believe that the talent exists in our State to make it happen. To tap into this talent, we've created a "Health Quality and Cost Council" to advise us on a number of issues.

Another strategy we've found promising is so-called "pay for performance." It's based on the simple idea that we can encourage innovation, improve the quality of health care in our State, and reduce costs if we incentivize hospitals and providers to show improvement.


Another approach that we're implementing to improve care for our families is what is sometimes referred to as "Health Information Technology" or Health IT. By digitizing medical records and utilizing the technology which allows them to flow safely from one computer system to another, we believe that it's possible to reduce medical errors, improve the quality of health care available to virtually every citizen, and to save our State millions of dollars while we're at it.

Health IT is an area where the President has demonstrated significant leadership in making it a part of the American Recovery and Reinvestment Act. We hope it will continue to be a part of whatever health care package is ultimately passed in Washington.

The President's Health IT vision calls for the creation of a national health information database. In Maryland we're building what we hope will be the cornerstone: the nation's first comprehensive, sustainable health information exchange linking together all the physicians, hospitals, medical laboratories and pharmacies in our State.

We're basing our efforts on an initiative we created to fight crime called "Dashboard." Dashboard integrates data from our prison system, parole and probation, firearms registries, our fingerprints systems, mug shots, DNA, motor vehicle records, and other databases which provide law enforcement and government officials with information that can be essential to saving lives and preventing crime. In some cases we are having to take data stored on 3x5 index cards and bring it into the digital age. The key here is that we're able to safely and securely share important information in real-time.

Our recent national efforts to monitor the H1N1 outbreak were a reminder of how something as basic as sharing information can be vital to the public's health and safety.

Fundamental to all of this is converting paper records to electronic records. The American Recovery and Reinvestment Act, as you may recall, provides a "carrot and stick" approach to encourage more health care providers who serve Medicare and Medicaid patients to keep their records electronically. In Maryland, we've tried to take the ball and run with it further by requiring all health care providers to transition from paper to electronic records. I'm told we're the first state in America that's doing this.


Sharing information is fundamental not only to our efforts to contain costs and improve care; we believe that it has an inherent value to our efforts to protect our homeland and prepare our State for emergency situations - both natural and manmade.

One of the lessons we learned from the H1N1 situation is the intrinsic value of being able to monitor emergency room activity and to allow emergency rooms to talk to each other. So-called "bio-surveillance."

We are the first state to monitor emergency room activity in each of the 46 acute care hospitals in our State, through an initiative we call ESSENCE: a statewide bio-surveillance system which tracks things like "patients showing up at hospitals with flu like symptoms."

By sharing emergency room information, we have the ability to respond quickly to epidemics as they enter and move throughout our State. And should, God forbid, we ever face a bio-terror attack, it will allow us to detect outbreaks early, when we have the best shot at containing them.


The ancient Greeks said that "healing is [not only] a matter of time, but it is sometimes a matter of opportunity."1

As Americans, we are fortunate to be led at this point in our history by a President who is willing to seize this once-in-a-generation opportunity to get something meaningful done on health care - even as it means absorbing the hits and navigating through this political minefield we see at the national level

And we are fortunate to have the dedicated work of Kaiser, the AFL-CIO, and so many others who share this commitment to our families.

It's an honor to join you today. Thanks very much.

1 Hippocrates

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