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Secretary of Health and Human Services Kathleen Sebelius held a conference call on health care reform for regional media early this afternoon. Part of the purpose of the conference call was to promote reports released by HHS on the status quo of health care in each of the fifty states. After her opening remarks Secretary Sebelius took questions from media in on the conference call.

Secretary of Health and Human Services Kathleen Sebelius:  Good afternoon everybody. And, um, I appreciate you joining us today. Um, as you know, here in Washington people are working hard to push forward health reform and we know that there’s some urgency about this from citizens across this country.

Um, since two thousand health insurance premiums have doubled and health care premiums are growing three times faster than wages. But unfortunately quality of care is going down as those costs continue to rise. So, even with, for people who have, uh, access to health care, uh, all it takes is a stroke of bad luck to become one of the nearly forty-six million uninsured or the millions who have health care and are having trouble affording it.

Today, uh, at the Department of Health and Human Services we’ve released fifty new reports on the health care status quo in every state around the country. The new reports are available on our web site, http://www.healthreform.gov. And they pretty clearly outline the challenges that we have. Um, the reports include statistics on the percentage of residents in each state without insurance, the increase in the costs of premiums, and the overall quality for health care in each state. And they use some of the most current data available.

Uh, unfortunately the reports are a clear demonstration that there are problems with health care in every state. Whether they’re rural, urban, East coast, West coast, it really doesn’t matter. The health crisis impacts all of America. The additional reports out today are from our Agency for Health Research and Quality. And frankly states get a pretty mixed review for the quality of care they provide.

Uh, these are more than just numbers and facts, more than statistics on a page. They represent real people and families in states across the country who are struggling. Uh, what we know is every day in America families are being crushed by the high cost of health care that threatens their financial stability, leaves them exposed to higher premiums and deductibles, and puts them at risk for possible loss of health insurance as employers struggle to provide adequate health coverage.

So now Americans are demanding reform that protects what works and fixes what’s broken. And in Congress, um, a number of members of the House and Senators from both sides of the aisle are working hard to make reform a reality. We were encouraged that just yesterday a bipartisan group of leading Senators, including  the top Democrat and the top Republican on the Finance Committee, Max Baucus and Chuck Grassley, recommitted to working together on health reform this year.

So I’m confident that we are gonna get a bill passed and to the President’s desk. And the statistics that we’re releasing today should help to inform people about the serious challenges that we face and why we can’t wait for reform to happen.

Um, again the reports are on our web site healthreform.gov.  And they are a state by state look at what’s going on in quality and cost. So with that I’d, I’d be willing to, um, answer some questions. I think we have about…

Media questions:

Question: Hi  Secretary, uh, thank you very much for taking the call. Um, I am wondering what the chance are of getting a, um, public option through this year?

Secretary Sebelius: Well Jenna, as you know the President has made it pretty clear that, um, he actually believes in market strategies and feels very strongly that having a public option compete with private insurers is the best way to have cost containment. Um, I’m pleased that the House bill which has been drafted, and I testified to earlier this week, um, the outlines of the Senate bill from the Health Committee, both have public options. Uh, we haven’t seen the specific language from the Finance bill yet, but I, I think it’s clear that, um, with the bill coming forward the public option is definitely part of the strategy.

Question: [garbled] Secretary, um, we’re, in Virginia particularly small businesses make up seventy-one per cent. And I’m wondering how the health care plan that’s being developed is going to help smaller businesses and people who work with them in developing a health care option for their employees?

Secretary Sebelius: [garbled] That’s a great question. Um, as you know, not only in Virginia, but in every state across the country small business owners are the majority of employers. And it’s the, um, kind of backbone of our economy. And frankly, in the current system they are the ones offering, I mean, often bearing the brunt of, um, the cost curve. Uh, they get squeezed out of the marketplace more quickly if one or two employees have some kind of pre-existing condition. They pay higher costs because they don’t have the volume to leverage, uh, big discounts. And, um, often they, they don’t get to keep or attract the best employees because employees follow health care. And while over close to sixty per cent of small business owners as recently as five years ago provided coverage, we’re now down to thirty-eight per cent. Um, so it’s, uh, they’re at a competitive disadvantage. So health reform I think offers a lot to small business owners. First of all it kind of pool, in the new health exchange, will give some, uh, affordable options, uh, for small business owners that they don’t have now, gives them choice. The elimination of pre-existing condition will mean that they can actually come into the marketplace without their costs, uh, skyrocketing. All of the proposals, and the President has made it very clear his proposal, um, includes some tax incentives for small business owners who offer insurance coverage. And I think that even if, um,  the kind of pay or play employer mandate ends up in either the House or Senate bill, it’s part of the House bill, but there is an exemption, uh, for small businesses. So I think there’s a, there’s a good deal of focus, um, of beneficial outcomes for small business owners. And at the end of the day costs have to go down for everybody, but I think it’s a, it’s a workforce issue that will make them more competitive with their, in this global marketplace.

Question: In your report [garbled] you document, uh, the number of businesses that are dropping health insurance benefits. Uh, if there’s a public option won’t that cause more businesses to, to drop, uh, offer, offering health insurance benefits and just tell their employees to go the public option?

Secretary Sebelius: Well, Eric, the way that the public option is, is being crafted it really is available for, um, those who do not have coverage right now. And, um, I think there, there is concern about the so called dumping, but, uh, frankly the President has made it pretty clear that he really wants to encourage a system that builds on what we have. That if people have coverage that they like, that’s affordable, a relationship with a doctor that, um, is good for you and your family [garbled] want to keep it. So the, the exchange, the new marketplace is really for, uh, those Americans who have no insurance coverage at all or who are, um, un, underinsured at this point, uh, because of the cost prohibitive nature of the coverage.

Question: Yes Secretary, is there any form of ranking here? How do we know how our states are comparing to other states, for example, in the number of uninsured, um, the costs of premiums etcetera?

Secretary Sebelius:  Um, at this point Mary Joe, there isn’t a, a, you know, comparison. These are
really state by state reports. So, there wasn’t an attempt to, um, either on the quality reports or the, uh, cost in coverage side to rank these, uh, in order of one to fifty. Uh, but really give a snapshot for citizens, business owners, policy makers in that state an idea of, of really what’s happening within the borders. Be a good math project for somebody to go through and, you know, calculate this, but, um, that wasn’t part of the, what we do here at the department.

Question: Madame Secretary, there’s a lot of talk about bipartisanship. I’m just wondering, if the Democrats have the votes to pass what they want, why don’t you just do it? The Republicans have said that they want to kill this project, a lot of them have. Why don’t the Democrats pass what they think is the best proposal and to hell with bipartisan…, bipartisanship?

Secretary Sebelius: Well, I, I, I think, um, while the, the votes may be there because the majority is, is pretty hefty in the House, um, of Democratic support. The reality in the Senate is basically you need sixty votes, uh, in order to move procedurally to a vote of anything, so there’s more of a, a kind of procedural requirement for bipartisanship. But I think at the end of the day health care is probably the most personal issue to every American. It, it really, uh, affects businesses and governments and families. Um, and I would hope, and I think the President is very hopeful and keeps pushing for this, that this, uh, doesn’t break down along partisan lines, but it, it’s an American issue. It’s the one that we really have to figure out a strategy that’s uniquely American. We have a, uh, an insurance system right now that doesn’t look like any other country in the world. We want to build on what we have and fix what’s broken. But, um, I’m still hopeful that, uh, Republicans will be engaged and involved, as they are right now in the Senate Finance Committee. I mean, I think that sets a great example. I’m hopeful we’ll have some House Republicans who end up, uh, becoming part of this solution in moving forward on health reform. This isn’t really a Democratic issue and it shouldn’t be a Democratic bill. It should be a bill that really finds a solution to this challenge for all Americans.

Question: Yes, Madame Secretary, you spoke about a number of, uh, countries, how we’re different than those, uh, countries. Yet many of these, uh, industrialized countries around the world do better with their health care plans than the United States. Which countries, uh, systems are you specifically looking at in developing a better system for the United States?

Secretary Sebelius: Um, I did not suggest that we were looking to other nations to develop a better system. I said I thought we needed kind of an American solution because our, our health system is different than most countries around the world. I do think we have a lot to learn from other countries about health outcomes and cost effective, uh, strategies that produce better outcomes. So, um, one of the efforts in health reform is really to help promote, incentivize higher quality care for each and every American. It exists in some pockets of the country. Uh, some systems work enormously well, with doctors and hospitals in a collaborative strategy. Others don’t work very well at all. And though we spend twice as much as any nation on Earth, and yet our health outcomes don’t, um, show it, don’t show those results. So I think we, we will continue to learn from what is cost effective and, more importantly, what’s effective for patients in terms of medical strategies and try to use Medicare and the payment system and the incentives we have here in the Department of Health and Human Services to, uh, improve the quality of care for everyone.

Question: Yes, thank you Madame Secretary. One alternative to the public option that’s been proposed is regional cooperatives. Uh, isn’t that a little bit like putting all the sheep in separate pens to keep them from ganging up on the wolves?

Secretary Sebelius: [laughter] Um, well, I think the, uh, there was a discussion, I think early on in the Senate about, um, actually multiple cooperatives being one alternative, uh, to look at for competition. Uh, my understanding is that recently the, the CBO, the Congressional Budget Office has suggested that they don’t think that’s, um, either a feasible idea or an effective strategy, so I, I think that the conversation going on right now is, is a national, um, option. As you know the President and the administration very strongly support, um, not a cooperative strategy, but a, a true public option that would be a, um, a benefit program run by the government that can compete side by side with private insurers and help hold down costs and offer some choice to consumers.

Question: Is making it mandatory for all Americans to purchase health insurance being seriously considered? If so, will there be a waiver for those whose religious beliefs preclude them from going to doctors or hospitals, or for individuals who believe in natural or holistic to health and are taking preventative measures such as healthy diet or regular exercise, making them less likely to need medical assistance than someone with risky behaviors?

Secretary Sebelius: Um, the, I, I think there is discussion in both the House and Senate, um, of some kind of an individual mandate. Um, it was part of the Massachusetts strategy when they passed their proposal. I know that there, um, in the House version of the bill is a specific exemption for, um, economic hardship for, uh, the ability of someone to opt out based on, um, the fact that they, whatever the price, they still can’t afford it. I have not seen the specific language, particularly about the religious issue I assume [garbled] Christian Science, Scientists and others who don’t access the traditional health care system. Um, but that’s a very good point. I, I don’t know if that language is in the bill. I, I can take a look at it, but I think that’s one we can share with the committee members….[end]