Thank you very much. It’s a pleasure to be with you tonight—to honor Dr’s McMullan and Wopat and Leda Garside—people who have given so much of themselves to help make others healthy.

 

The French philosopher Voltaire had it right when he said: "Those who are occupied in the restoration of health to others, by the joint exertion of skill and humanity, are above all the great of the earth."

I’m no philosopher, but I want to add my congratulations to this year’s award winners, and say thank you for committing your time and talent to this great calling.

 

Thank you for your skill.

 

Thank your for your humanity.

Thank you for making Oregon a better place for all of us.

 

I also want to thank the Oregon Health Forum for this opportunity to talk with you about the health care issues we face today, and the strategy I’m proposing to deal with some of those issues. My goal is to do exactly what these award recipients have done with their lives and careers—help keep Oregonians healthy.

 

The message I want to bring you this evening is simply this: We must continue our efforts to make Oregon a place where every citizen has access to the basic health care he or she needs: quality health care, available right in the citizen’s home community.

 

It must also be affordable care. No Oregonian should face financial ruin because of illness or injury. No Oregonian should face the choice between filling a prescription and paying the rent. No parent should endure the pain of trying to care for a sick child without the help of a health-care professional, or without the right medicine, just because the family cannot afford insurance.

That’s my vision for Oregon. I know it’s your vision, too.

 

To achieve that vision, I propose that we work together on the following objectives:

 

Three years ago, when I took office, we took important steps toward making the Oregon vision of health care a reality. We’ve made some notable progress.

 

In August of 2003, we created the Oregon Prescription Drug Program. It’s is a bulk-purchasing program that uses the state’s buying power to save money on medicine for low-income people over age 54. State and local agencies can also participate in the program.

 

Because we can contract to buy medicines in bulk, and because the program offers incentives for people to buy the most effective, most affordable medicines, participants can save up to 60 percent on each prescription.

 

Those are real savings – that makes a real difference in people’s lives.

 

Last year, I fought to expand the program to include all low-income people and private businesses, which would have enabled even more Oregonians to save money on prescription drugs.

 

Unfortunately, the legislature didn’t pass that bill. But I will continue my effort to expand this important program, and I’ll again make it one of my highest health-care priorities.

 

I’m pursuing this initiative because I believe that the state government has an obligation to do everything possible to apply downward pressure on the price of prescription drugs. The time to expand this program is now. The time to help more people save money on prescription drugs is now.

 

As Governor, I am committed to creating more family-wage jobs for Oregonians. The reason is simple – when a person has a family-wage job, most of his or her every day problems become more manageable. It is also a fact, that when the economy is expanding, and more people have jobs, the government has more resources to serve the needs of its citizens.

 

I’ve been equally determined to create access to the education and skills that we need to compete successfully in the global economy. This was the subject of my remarks at the Business Economic Summit in Portland this past Monday. We must make a more coordinated effort to have our citizens better understand why a greater investment in education and skills training is the key to a better future for them and their families and for Oregon.

 

My passion for creating jobs extends into the field of health care. Our state cannot stay healthy without the necessary professionals. In 2003, I launched the Healthcare Workforce Initiative, which is a partnership between the public and private sector—a partnership whose mission is to strengthen Oregon’s health care workforce, in both numbers and quality.

 

Our partners in this important undertaking include the Oregon Center for Nursing, OHSU, the Community College Health Action Plan, the Oregon Simulation Alliance, and many others.

During the past three years, we have expanded education in health care by increasing the use of simulation units and improving access to innovative training models in our colleges and universities.

I’m happy to report we’ve made real progress. In nursing, for example, 45 percent more men and women are graduating from RN education programs than in 2003. Other health care occupations need our attention. We must do more to address the issue of staff retention, by providing more clinical training opportunities, training more faculty, and directing more funding to health education.

 

To strengthen this initiative, I have directed the Healthcare Workforce Initiative Advisory Committee to intensify its efforts with our private-sector partners. I want them to set priorities toward achieving even greater increases in the number of trained health care staff and recruit the people to fill them.

 

This will be good for all of Oregon, both our urban and rural communities. It will ensure that we have the trained staff necessary to meet our demand for health care. It’s very simple – we can’t provide quality health care without highly trained, professional people.

 

I was not surprised when reading the other day that unpaid medical bills are the leading cause of bankruptcy in America. Here in Oregon, more than 600,000 of our fellow citizens have no health coverage – that’s one of every six of us. Half of these uninsured owe money to a hospital, and a third live with the fear of being forced into bankruptcy because of debt from health care billings.

Families USA, a group that advocates for consumers in the field of health care, released a study recently that shows just how costly it is, both to our economy and our quality of life, to have so many people without health care coverage.

 

In Oregon, people who have health insurance – pay on the average – an additional $1,128 a year for health insurance, due to the cost of caring for the uninsured. That’s an additional 10 percent added onto the average family’s annual health insurance premium.

 

Clearly, we can do more to reduce this cost shift and see that those 600,000 uninsured, obtain adequate health care coverage and do not have to access the hospital emergency room as their primary source of health care. I remain committed to the Oregon Health Plan and believe its framework continues to be one of our major assets in providing health care coverage to low income Oregonians.

 

As you know, the Oregon Health Plan pays for a set of health services that appear on a prioritized list reflecting the efficacy of the service performed and the relative cost of the services.

 

Since 2002, more than 75,000 people have stopped receiving benefits under the OHP-Standard program, primarily because of budget cuts made in response to the past recession. Hospitals and managed-care providers now pay "provider fees" to pay for the Oregon Health Plan "Standard" program. The fees they pay also leverage federal matching dollars.

 

One of my highest priorities is to seek federal approval to use this prioritized list to create a new approach to helping adults under the Oregon Health Plan Standard program–people who suffer chronic health conditions.

 

Those who suffer from chronic illness are the most vulnerable--and the most costly to treat—regardless of who is paying the bill. We need to assure that those with chronic illness get the care they need and that those services are both economical and effective, in other words doing those things that have a proven track record and that will know will work.

 

I propose to make such care available to more people—people who now must go to emergency rooms because they have no health care coverage, people who contribute to that 10-percent premium increase that all Oregonians with insurance must pay.

 

Let me speak for a minute about keeping Oregonians healthy, and the challenges we face in our effort to educate people about how to live more healthy lives. As everyone in this room knows, chronic diseases are among the major causes of death and disability in America—heart disease, cancer, lung disease and diabetes. It’s no coincidence that these conditions are the ones that most severely affect the cost of health care for all Oregonians.

 

Everyone in this room also knows that we can reduce the suffering and cost of these diseases by not smoking, by exercising regularly, and by eating a balanced low-fat diet. People who know how to keep themselves healthy and safe are not only healthier individuals, but they also reduce the costs of our health care system.

 

I believe that state government bears a responsibility—a responsibility we share with health professionals in all sectors—to help our citizens understand and avoid the health hazards that destroy lives and drive up the cost of health care.

 

That is why I have directed the Oregon Health Policy Commission to intensify its efforts to keeping Oregon’s kids healthy, specifically in fighting childhood obesity.

 

I’m also committed to fighting tobacco use, especially among juveniles, by restoring funding to Oregon’s Tobacco Use Reduction Account. This will ensure that these revenues go to the purpose for which they were intended–fighting tobacco use.

 

Although I understand that the reduction in state general fund revenues required diversion of some of these revenues to other purposes in the past, it is clear that without additional investment in tobacco prevention programs, we’ll not only fall behind in our efforts to keep Oregonians healthy, but also in our efforts to make health care more affordable.

 

The time has come to use every available resource to end this threat to our public health, and not only ensure that our young people never light up that first cigarette, but also help current smokers to quit.

 

Finally, I want to say a few words about children. You’ve probably heard me say that I want to put kids at the head of the line. That’s true whether we’re talking about education, health care, or any other program.

 

Sadly, more than 117,000 of Oregon’s kids under age 19 are without health insurance, and the number is growing.

 

A recent survey found that only one in three uninsured kids visited a primary care provider in the past year, and only one in five had received dental care.

 

We estimate that nearly 50 percent of these uninsured children may be eligible for one of Oregon’s publicly funded health programs, but are not enrolled.

 

I want to repeat that. Eligible, but are not enrolled!

 

Thousands of parents never enroll their children in group-coverage under their employers’ plans because their families cannot afford the co-pays or other shared costs.

 

We cannot let this trend continue. It’s unacceptable to me and I know it is unacceptable to you.

Lack of access to adequate medical care--for what ever reason--creates a terrible burden for children—delayed diagnoses of treatable conditions that become acute, chronic or life-threatening; poor performance in school; and missing out on the opportunity to become a happy, healthy, productive adult.

 

Children shouldn’t carry such a burden. Children deserve and have a right to be healthy. Whether we approve of the choices their parents may have made – we must never forget that children do not make choices about their health care. They depend upon adults. Their parent, upon you and me.

 

Next month, I will announce what I call the Healthy Kids Plan—a doable and realistic plan that will ensure basic medical care for all children in Oregon, up to the age of 19.

 

Our goal is to enroll all eligible kids and keep them enrolled. It will provide an opportunity for families to obtain affordable, state-sponsored group coverage for their kids–an opportunity that will be available to low-income parents whose incomes are too high to qualify for federal programs.

 

That’s all I’ll say about the plan for now, except to add that it involves the coordination of all existing government benefits into one Healthy Kids Plan. I promise to provide more details next month in my State of the State Address.

 

The bottom line is that we cannot afford to fail our children by allowing so many of them to live a life without access to health care. No society can expect to achieve and maintain prosperity while compromising the health of its children.

 

Before closing, I want to address something that I know is on many of your minds—the issue of rebalancing the Department of Human Services budget. Some of you may wonder how I can talk about innovative new plans for extending health care to more low-income people and providing care to kids, when DHS faces a shortfall of money.

 

I won’t minimize the significance of the forecasted $172-million shortfall, but I can reassure you tonight, that at the end of the biennium on June 30, 2007, the Department of Human Services will have a balanced budget. My intention is to work with the legislature to balance the budget without cutting essential services to the Oregonians who rely on DHS’s social safety net.

 

But I also believe we must better understand the reasons and facts surrounding the projected shortfall. First, remember that the ’05-’07 DHS budget was based on a forecast that used caseload data as of March 2005.

 

We are currently reviewing both the methodology surrounding the forecast and actual caseload experience since July 2005. We will have the results of that caseload review by the second week of February.

 

Second, to improve the credibility and reliability of the forecasting models, we are proposing closer monitoring and more frequent review of trends in caseload management and comparisons to actual experience. We have also put in place the appropriate personnel and expertise in helping us manage the department’s finances.

 

During the coming months, we will see new revenue forecasts, changing economic conditions, and new budget forecasts for DHS—all of which will affect the outlook for DHS programs, particularly the Medicaid program.

 

The DHS rebalance issue is fundamentally a management issue and not a political one. As I said, I will work with the legislature and, after we have developed current data on caseload experience, and implemented the necessary management changes, I will review the various options to ensure that this problem does not stand in the way of progress on health care in Oregon and our efforts to provide services to our most vulnerable citizens.

 

I do not have to tell you, that this issue has its roots in a decade-long federal policy that seeks to reduce the federal share of the costs of health care for low-income people, and shifting those costs to the states.

 

If anything, the DHS matter underscores the need to think in new ways about health care in Oregon and throughout the nation.

 

The inability of the federal government to address health care costs and coverage only intensifies the need for the states to continue to be the crucibles for health-care reform.

 

If Washington, DC cannot or will not act to bring down the cost of prescriptions drugs for all Americans, then Oregon must do it for Oregonians.

 

If Washington, DC cannot or will not act to contain the runaway costs of health insurance for all Americans, then Oregon must do it for Oregonians.

 

If Washington, DC cannot or will not act to ensure that children receive essential health care for all Americans, then Oregon must do it for Oregon’s kids.

 

My goal for my next term as your governor is to implement policies that will help all Oregonians handle the cost of being healthy. This is no longer just a cause for the very poor. It’s a cause for all people in all walks of life.

 

Middle-class wage-earners and business people feel the impact of out-of-control prescription drug costs and health insurance premiums just the same as low income people do. They incur higher insurance premiums because of the cost shift, including higher co-pays and deductibles as well as reductions in other parts of their compensation package, such as—lower wages, fewer vacation days and reductions in employer contributions to their retirement accounts.

 

They know the consequences of having 600,000 Oregonians with no health care coverage. They see it every week and month in their paychecks.

 

It’s for them, as well as for the poor, the aged and those with disabilities that I pursue this common vision for health care we all share – not with the belief that we can accomplish all of it overnight, but with the determination to make a real difference now.

 

These are my goals as your Governor:

 

These are the goals that I invite you to help me achieve.

 

Thank you very much.