Text 3150, 687 rader
Skriven 2006-08-22 23:31:18 av Whitehouse Press (1:3634/12.0)
Ärende: Press Release (0608224) for Tue, 2006 Aug 22
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President Bush Discusses Health Transparency in Minnesota
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For Immediate Release
Office of the Press Secretary
August 22, 2006

President Bush Discusses Health Transparency in Minnesota
Minneapolis Marriott Southwest
Minneapolis, Minnesota


˙˙˙˙˙ Fact Sheet: Health Care Transparency: Empowering Consumers to Save on
Quality Care ˙˙˙˙˙ Executive Order: Promoting Quality and Efficient Health
Care in Federal Government Administered or Sponsored Health Care Programs
˙˙˙˙˙ In Focus: Health Care

2:41 P.M. CDT

THE PRESIDENT: Thank you very much. Thank you. Please be seated. Thank you
for coming. Thanks for the warm welcome. We've got some work to do.
(Laughter.)

Thanks for being here today. And I want to thank our panelists for joining
Secretary Leavitt and me to talk about health care. And before we do, I
want to say a couple of words about some of the guests here. First, I'm
real proud to be here with your Governor, Tim Pawlenty. Governor, thanks
for being here. (Applause.) Senator Norman Coleman is with us. Senator,
thanks for coming. (Applause.) Three members of the Congress: Jim Ramstad,
whose district we're in. (Applause.) Mark Kennedy is with us. (Applause.)
John Kline is with us, thanks for coming. (Applause.)

We've got members of the State House here. We've got local officials --
Mayor Jan Callison, the Mayor of -- Mayor, thanks for coming. (Applause.)
This is the 50th anniversary of Minnetonka, right? Yes, good.
Congratulations. Wait until you turn 60. (Laughter.) It's not as old as it
sounds. (Laughter.)

We're going to have an interesting dialogue today. I'm going the sign an
executive order after a while, but I want to explain why we're signing the
executive order to you. We've got an interesting debate in health care in
America. And I guess if I had to summarize how I view it, I would say
there's a choice between having the government make decisions or consumers
make decisions. I stand on the side of encouraging consumers. I think the
most important relationship in health care is between the patient and their
provider, the patient and the doc. (Applause.) Thank you. And health care
policy ought to be aimed at bolstering the consumer, empowering individuals
to be responsible for health care decisions -- is kind of the crux about
what we're talking about.

Obviously, all of us are concerned about costs. You know, I hear it a lot.
We talk about -- we'll hear from Jane Brown here, who helps those who need
help here in your community. She says health care costs oftentimes make it
hard for people to buy food. You talk to small business owners and one of
the big concerns they have is the cost of health care that many, in order
to stay in business, you know, have to say to their employee, you provide
for yourself. And that's troubling. It's troubling. It doesn't matter what
your political party is; it's an issue that needs to be addressed

And so the fundamental question is how do you address cost, given the
philosophy that I've just described to you? And so here are some ideas I'd
like to share with you.

One way to help small businesses address the cost of rising insurance is to
allow them to pool risk across jurisdictional boundaries. In other words,
if you're a restaurant in Minnesota, and you're a restaurant in Texas, you
ought to be allowed to pool your employees into a employee risk pool so
that the insurance is lower because of the spreading of risk. Those are
called association health plans. One idea to -- that says basically the
small business owner will be in charge of the health care for his or her
company is to encourage association health plans.

Another idea is to make sure that -- let me take a step back. There is a
very important role for the federal government in health care. And that is
to provide for the elderly and the poor. One of the things that Mike and I
have worked on, and I hope some of you have helped with, is to encourage
seniors to take a look at the new Medicare drug benefit. I was very
concerned that Medicare had gone stale and it needed to be reformed.
Medicare is a vital program, and it's an important federal program. And it
worked.

The problem is, medicine had changed and Medicare hadn't. Medicare would
pay, you know, $100,000 for an operation, but not a dime for the
prescription drugs that would prevent the operation from being needed in
the first place. And it didn't make any sense. It didn't make any sense to
the seniors, nor did it make any sense to the taxpayers. So we've changed
Medicare. And if you're a poor senior in America, the government is going
to really help you with prescription drugs. And if you're not a poor
senior, you'll save a half on your drug -- prescription drugs. It's a good
deal.

The federal government has also got a role in helping the poor through
Medicaid. And one of the tasks that I've given to Michael Leavitt is to say
to the governors, you should have the flexibility necessary to design a
Medicaid program that meets the needs of your citizens.

Now, having said that, here's what we need to continue to do in the private
sector. One of the problems to make sure health care is affordable and
available is the legal system. And, look, it's out of kilter. We want
everybody to have justice. But, unfortunately, particularly in medicine,
there are too many frivolous and junk lawsuits that are running good
doctors out of practice and running up the cost of medicine. Do you realize
that in order to avoid lawsuits, many doctors practice what's called
"defensive medicine." In other words, they prescribe medicines that may not
be necessary or procedures that may not be necessary, just in case they get
hauled into the court of law. As a matter of fact, it's estimated that the
defensive practice of medicine costs your federal government, costs you,
the taxpayer, $28 billion a year.

Now, when I first went to Washington, I said, well, this is an issue that
ought to be solved at the state level, until I realized the budgetary
impact that these lawsuits are having on you, the taxpayer. And so I went
to Congress and worked with the House and we got a good medical liability
reform law out of the House. Unfortunately, it's stuck in the Senate. The
trial lawyers are tough in Washington, by the way; they really don't want
to see medical liability reform. But if you're interested in making sure
the system works, if you want people to have access to affordable health
care and have doctors that are around to practice to begin with, you need
to have strong medical liability reform in order to make the health care
system work.

Thirdly, have you ever watched how these files work in medicine? We're
going to talk to Dr. Dean here in a minute. Her penmanship is probably
pretty good -- (laughter) -- but most doctors don't write too well, and yet
they write a lot in files. What I'm telling you is, medicine is really
behind the times when it comes to information technology. And one of the
things we'll talk about here is how to use information technology to wring
the costs out of medicine, and yet be able to deliver good quality care to
our citizens.

It's estimated that between 25 -- that we can reduce costs by 25 to 30
percent with the advent of what we call medical -- electric medical
records, so each person has got their own electronic medical record that
you've got to add on -- in other words, we'll be passing information from
provider to provider via the Internet, via new technology as opposed to
handwritten files that are carried from one office to the other.

We're going to spend some time talking about that. It's a -- it is a
practical way to help control medical costs so people have got health care
that's available and affordable.

Fourthly, we've got to make sure that we have plans that encourage consumer
saving, in other words, insurance plans, products for people to be able to
use in order to get health care that encourages savings. One idea is health
savings accounts. These are plans where you buy a high deductible,
catastrophic plan. You contribute money tax-free. But you're the consumer,
you're the decision-maker when it comes to health care. You decide. You
decide what doctor you see. Think about the system today as a third-party
payer, how many of you have got insurance and you never really cared about
the cost because somebody else is paying the bill, right? You don't really
care about the quality, because some person in an office somewhere is
paying the bill on your behalf. It's called a third-party payer system.
It's the prevalent system today.

One of the things we're trying to encourage is the design of new
opportunities for citizens to be able to get quality health care where
they're in charge of the decision-making, that encourages people to make
rational savings. If we have more consumer involvement in health care, then
it makes sense, if that's the goal, then it makes sense to make sure that
consumers have got rational data from which to make choices. And that's not
the case today in medicine, really, when you think about it.

I don't know how many of you all have ever said, gosh, I wonder how much
this procedure is going to cost me, or before I go to see this person, I
want to know how much it costs, or maybe I need to know what this hospital
charges. I doubt many of you have done that. I think the new trend in
medicine is going to be to encourage transparency in pricing, as well as
transparency in quality. And that's the subject of today's discussion. How
do we encourage consumerism. What do you do? Well, one thing you do is you
make sure people understand their options, how much something costs. And if
they decide to make a purchase, what do they expect, what are the
expectations from the consumer?

The federal government has got a lot to do with this, because we spend a
lot of money in health care. When you really think about Medicaid and
Medicare, veterans' benefits, Department of Defense. And one of the
initiatives Mike is now going to undertake is, say, in order to do business
with the federal government, you've got to show us your prices, and you've
got to help us develop a qualitative standard so the people that we're
trying to help know what they're getting.

And so here are some practical ways to address the rising cost of medicine.
These are ways that basically say, we want you, the consumer, in charge,
that there is such thing as a market, and that markets function. You
remember Lasik surgery, eye surgery? It's a place where -- it was a
procedure that cost a lot of money when it first came on, and yet there was
quite a bit of competition -- people said, look, I'm good at this, why
don't you come to my shop, or you notice docs were advertising. All of a
sudden the cost of laser surgery has dropped precipitously. It's now an
affordable procedure. Markets work when consumers have got options to make
in the marketplace.

And that's what this executive order is going to do. I'm going to have Mike
describe the executive order to you here in a minute. But it's an order
that basically commits the federal government to work with state and local
and docs and hospitals to lead the way and be a part of this new movement
about transparency in pricing and quality.

Have I done it all right?

SECRETARY LEAVITT: You've done a good job, Mr. President. (Laughter.)

THE PRESIDENT: That's what he's supposed to say. (Applause.)

* * * * *

THE PRESIDENT: There's a lot of savings, by the way, when you're not
writing things down on paper. Just ask some of the more modern businesses
here in Minnesota, where you're unemployment rate is, like, really low
because of the productivity of your companies. One reason why is they use
information technology.

Sorry, Secretary.

* * * * *

THE PRESIDENT: Yes. Why don't you talk to them about electronic medical
records? I didn't do a very good job of describing it.

SECRETARY LEAVITT: When --

THE PRESIDENT: I'll give it a stab, and then you come back in.

SECRETARY LEAVITT: All right. Got you. (Laughter.)

THE PRESIDENT: So one of these days, you're going to have all your medical
records on a little key that you can then plug into a computer, and all of
a sudden, information is at the provider's fingertips, which makes the
system a lot more efficient, which means less costly, but also saves on
medical errors. But the problem we face is that the -- we've got to develop
a standard language. Medicine is a fairly complicated -- got a complicated
dictionary, let's put it that way. So what's the procedure on that, Mike?

* * * * *

SECRETARY LEAVITT: My mother went to the doctor the other day. She told me
that she filled out her name, address, insurance company name, birth date,
telephone number -- seven different times. Now, that's not necessary --

THE PRESIDENT: My mother wouldn't have so patient as your mother.
(Laughter.) Hope she's not watching. (Laughter.) Good job, Michael.

Michael Howe is an interesting character here. He is an entrepreneur who's
come up with a unique idea on how to help people have affordable and
available health care.

Michael, did you start your deal -- like, are you the classic entrepreneur,
start in the garage?

MR. HOWE: No, actually, I have to give credit, there were other groups.
There were physicians and entrepreneurs that devised the mechanism, devised
the innovation that MinuteClinic really represents.

THE PRESIDENT: Okay, well, tell people what MinuteClinic is. If you haven't
heard about it, it's worth listening.

* * * * *

THE PRESIDENT: What's process management? Tell people what that is.

MR. HOWE: Well, the interesting thing is, you can go through, and when you
do something -- strep test, a strep throat test -- if you do thousands of
strep throat tests, you can --

THE PRESIDENT: You've got a problem, if there's thousands of strep tests.
(Laughter.)

MR. HOWE: You do. You have a problem. But you also have an opportunity.

THE PRESIDENT: Yes, right. Okay. (Laughter.) That's the spirit. (Laughter.)
Sorry. Go ahead.

MR. HOWE: No, no, it's all right. You have an opportunity to measure the
effectiveness of one provider, versus a next. You have an opportunity to
measure treatment protocols.

* * * * *

THE PRESIDENT: So do you have one in a shopping mall?

MR. HOWE: Absolutely. We have one in the Eden Prairie Mall right over here
in Minnesota.

THE PRESIDENT: Really? Isn't that interesting.

MR. HOWE: And the idea --

THE PRESIDENT: A person walking down there looking, and says, here's the --
if you need help, here are the costs.

MR. HOWE: That's right.

THE PRESIDENT: Posted right there for them to see on --

MR. HOWE: Absolutely. And to compare it to where they go. It's also
right-sized. And what I mean by that, it's a small facility, it's focused
on a very specific scope of practice, common family ailments that some
estimates are as high as 40 percent of the medical visits in today's
society are covered by these conditions.

So this is an opportunity to provide a higher-quality care, transparent
pricing, but also much more affordable. Our prices are 40 to 50 percent of
what it would cost anywhere else.

THE PRESIDENT: And are people going?

MR. HOWE: Well, in the last six years, we've completed 500,000 patient
visits, we've had no malpractice claims, consumers tell us that their
patient satisfaction runs between 97 and 98 percent, 99.6 percent of our
patients tell us they'd use the service again, refer it to family and
friend. Clearly, the providers we selected do a tremendous job making the
emotional connection that delivers the end result that we're really looking
for.

* * * * *

THE PRESIDENT: Well, in order to have electronic medical records, there has
to be a standardization in medicine to begin with.

You know, it's interesting, isn't it, it's an interesting idea he had, and
it's meeting a consumer need. That stands in stark contrast to the
government making the decisions for you, is to make different options
available to patients, and you're providing health care at a 40 percent or
50 percent --

MR. HOWE: It's half the cost.

THE PRESIDENT: Yes, it's great. Thanks for doing what you're doing. And
you're in other states?

MR. HOWE: Yes, we have 86 clinics across 11 states at this point. We
anticipate some very significant growth over the next few years.

THE PRESIDENT: Yes, you ought to.

MR. HOWE: We're going to drive them very hard.

THE PRESIDENT: Nothing better than being with an entrepreneur, isn't it?
(Laughter.) Thanks, Michael.

Marilyn, thanks for joining us.

MS. CARLSON NELSON: Delighted to be here.

THE PRESIDENT: We're thrilled you're here. Chairman of the Board, CEO of
one of Minnesota's great companies, Carlson Companies. Thanks for joining
us. What's on your mind?

MS. CARLSON NELSON: Well, first of all, I want to say thank you. I think
we've been waiting at Carlson and in this community for about 20 years to
hear what we've just heard, and that is inoperability, standards, quality
standards, incentives.

At Carlson, we've worked with the Business Health Care Action Group for --
I think we started almost 20 years ago now -- to look at how to incentivize
providers to have more transparency. We've worked on involving and engaging
our employee base in preventative -- various kinds of preventative
activities. But recently we've put in several innovations -- one, I have to
say, a MinuteClinic in our headquarters.

THE PRESIDENT: You saved 50 percent, I hope? (Laughter.)

MS. CARLSON NELSON: Actually, we did the research. It looked as if a cost
to us and our employees was about $40 to $50 through MinuteClinic for this
certain set of services; it was, like, $100 in the doctor's office, and
dramatically more than that in the emergency room, where a lot of people
end up going for that kind of care.

* * * * *

THE PRESIDENT: This is an issue that we're focusing on the core problem,
and that is, we're dealing with an industry that really is not modern, that
needs help in the legal profession, and that needs more consumerism. You
know, you mentioned preventative health. There's nothing that will cause
somebody to take good care of their body than a -- than having an insurance
program that encourages savings. You make rational decisions and you
exercise, and you don't smoke, and watch your drinking, it's amazing how
your health improves. If you walk two miles every day, it really makes a
big difference.

And if you have policies that say there's an incentive for you, you benefit
from making that kind of rational decision, you monetarily benefit, like
the health savings accounts, it helps with prevention. If people really
watched what they ate, it's amazing how health care costs would also go
down in America, as well.

Yes, Michael.

SECRETARY LEAVITT: Mr. President, there is -- this is a good thing for our
health, and it's a good thing for the system. It's also an economic
imperative that we do it.

THE PRESIDENT: Yes.

SECRETARY LEAVITT: What Carlson suggested I'm hearing from employers all
over the country. Health care is now 16 percent of our gross domestic
product. And it's headed for 20 percent. And there's really not a place on
the economic leader board for a country that continues to spend more and
more and more in one sector.

I was looking at the -- and it's hitting consumers. I was looking in my
home state at the teachers. They've got the largest increase --

THE PRESIDENT: What is your home state?

SECRETARY LEAVITT: That's Utah, by the way. (Laughter.) And yet the
teachers, many of them end up having less take-home pay because of the cost
of health care.

* * * * *

THE PRESIDENT: Jim Chase, what do you do, Jim?

MR. CHASE: Well, Mr. President, I work with an organization here in
Minnesota that's been working on many of the things that you and Secretary
Leavitt have talked about, and we're quite excited to have you here today.

* * * * *

THE PRESIDENT: And so, like, what is your group -- what's the name of your
group?

MR. CHASE: We're called Minnesota --

THE PRESIDENT: I know, but -- (laughter.)

MR. CHASE: Minnesota Community Measurement. We've been a nonprofit that's
been together for about three years.

THE PRESIDENT: Really? And so the local folks came together and said, let's
give old Jim some work and figure out how to do -- (laughter) -- have a
health care system that works well?

MR. CHASE: My work came later. (Laughter.) But I think what's exciting is
that we're actually seeing some changes now. Being able to measure this,
we're seeing the results change. And it's very encouraging, I think, for
the providers out there who are -- that's what they were in this for, was
to find ways to treat their patients better.

* * * * *

THE PRESIDENT: So, like, how many community measurement groups are there in
the country, do you suspect? It sounds like it's pretty unique.

MR. CHASE: Yes. There are several that have started. In fact, we are --
we're pleased to be working with Secretary Leavitt in the Ambulatory
Quality Alliance that has formed nationally, that are bringing together, to
start with, six sites around the country that are in various stages of
pulling together this kind of information.

* * * * *

THE PRESIDENT: Good work. Thanks. It must be exciting to be kind of on the
leading edge of substantial change.

MR. CHASE: It keeps us busy. (Laughter.)

THE PRESIDENT: That's good. I know the feeling. (Laughter and applause.)

We are joined by Doctor Laura Dean, OB/GYN. I will start off by telling you
a startling statistic: there are 1,600 counties in the United States
without an OB/GYN. I mean, we're talking about availability and
affordability, obviously, 1,600 counties have got a series problem.

Thanks for hanging in there.

DR. DEAN: You're welcome.

THE PRESIDENT: A lot of OB/GYNs are leaving the practice because they're
getting sued out of existence, pure and simple. I can't put it any more
plainly than that. If you want to have OB/GYNs in America, we need medical
liability reform to protect these good people. (Applause.)

Step up, Doc. How long have you been practicing?

DR. DEAN: I've been practicing obstetrics and gynecology for 10 years in
the community of Stillwater, and I've delivered more than 1,500 babies.

THE PRESIDENT: Really?

DR. DEAN: Yes, sir.

THE PRESIDENT: That's good. (Laughter.) What's on your mind?

DR. DEAN: Well, I, certainly, as a physician, my goal is to help my
patients make good decisions about their health care. And I'm excited about
what you're here to talk about today, because I've been providing them with
all kinds of medical information to help make decisions, but the financial
piece has been missing. And people need that piece in order to make good
and whole decisions.

THE PRESIDENT: So, like, are you going to put on the window, you know, Dr.
Laura Dean, a hundred bucks? (Laughter.) How does it -- are you an
individual practitioner?

DR. DEAN: I'm in a group practice with family practice doctors, other
OB/GYNs, internists, pediatricians.

* * * * *

THE PRESIDENT: See, it's interesting, isn't it, kind of a mind set change.
It used to be you'd go in and just take whatever they gave you, because
somebody else is paying the bill. And if we can get a system down where
people are able to have a good program, a good product, good insurance, but
where the consumer has more to say with what's purchased or not, all of a
sudden the dynamic begins to change, and costs begin to go down.

You know, the good doc here volunteered to us all you don't need this
procedure.

That cost -- that saves money over time. The whole system benefits if we
have a thousand providers making that same decision on an hourly basis. And
so what Laura is saying is if consumers have more information from which to
make decisions, all of a sudden, costs begin to become less of a burden on
the system, I think is what you're saying.

DR. DEAN: Absolutely.

THE PRESIDENT: Lawsuits bothering you? Obviously, look, I led the witness.
(Laughter.) Not even a lawyer. (Laughter.)

DR. DEAN: Certainly it is something looming over the heads of physicians
every day, the thought about lawsuits, really, maybe ordering tests to
protect yourself and to make sure -- I have many colleagues, similar in age
to me, which is not real old yet, in practice of medicine --

THE PRESIDENT: Twenty-seven. (Laughter.)

DR. DEAN: -- who have stopped delivering babies, have stopped performing
surgery.

THE PRESIDENT: It's a problem, you've got a problem. It is a problem when
society starts losing good souls that otherwise would be OB/GYNs. It's a
real problem, and we better do something about it. It's one thing to have
good law; we want good law. But these frivolous lawsuits are a real problem
for the people of Minnesota and all across the United States. It's serious
business. These trial lawyers need to back off and these politicians in the
United States Senate, people like Coleman, need to step up, and he will.
(Laughter.) And he has. (Applause.)

No, he's been strong, he's been strong on medical liability reform. I'm not
trying to turn this thing into a political deal. I'm just telling you, for
the sake of this country, for the sake of good medicine, we better get some
good medical liability reform out of the United States Senate. (Applause.)

Thanks, Dr. Dean.

DR. DEAN: Thank you.

THE PRESIDENT: Thanks for practicing. One of the wonderful things about
America is our health care providers are fantastic people. They really are
decent, honorable people who've answered a higher calling. And we
appreciate --

DR. DEAN: Thank you, thank you, sir. (Applause.)

THE PRESIDENT: Speaking about a higher calling, Jane Brown, Executive
Director, Second Harvest Heartland. Has anybody ever heard of Second
Harvest Heartland? Good. So you don't need to tell them what you do.
Actually, you're feeding people that need help.

MS. BROWN: That's correct, sir.

THE PRESIDENT: Actually, if people need -- I presume it's okay for me to
say, you could use some contributions?

MS. BROWN: Oh, my, yes. That's a wonderful thing for you to say.
(Laughter.)

THE PRESIDENT: Seriously. I know -- I know Marilyn will help you. (Laughter
and applause.)

MS. BROWN: Thank you for that. (Applause.)

THE PRESIDENT: She has. (Applause.)

MS. CARLSON NELSON: Yes. (Laughter.)

THE PRESIDENT: She has been helping. As has corporate Minnesota.

MS. BROWN: Yes, corporate Minnesota has been very good to us. And the
Carlson Companies are wonderful.

Second Harvest Heartland is a food bank, and we have 800 agencies that get
their food from us, so every little bit helps, so thank you for that.

THE PRESIDENT: Yes. Well, we were talking -- actually, the reason that this
subject came up is I was asking her whether or not she had enough product
to help people who need help, and the answer is never enough.

MS. BROWN: Never enough, no, nowhere near enough yet.

THE PRESIDENT: Yes. But you've done some interesting things through health
care.

MS. BROWN: We have. We have -- Marilyn and I were contrasting -- she has a
huge company; there are 76 employees at Second Harvest Heartland, and 66
who receive their health insurance through our organization. And this last
year, we offered an HEALTH SAVINGS ACCOUNTS for the first time as one of
the options, and 15 percent -- or 10 of those employees -- opted to take
it. And I'm one of those who opted to take it.

THE PRESIDENT: Everybody understand what that is? It's, again, a
high-deductible, catastrophic plan, and that the person and/or company can
put money in tax-free to cover up to the deductible.

MS. BROWN: That's great.

THE PRESIDENT: Which actually saves money.

MS. BROWN: It saves money. It does so many things, and that's why we've
chosen it.

* * * * *

THE PRESIDENT: And you contribute into the savings account?

MS. BROWN: Yes. As the employer, yes, we do.

THE PRESIDENT: One hundred percent?

MS. BROWN: No. It's a shared responsibility, and that's very important,
that there's a shared responsibility in that.

* * * * *

THE PRESIDENT: Right, right. This is a -- Jane has given her employees a
very interesting option, and that is a consumer-driven plan where there is
a incentive to save, to be a good shopper, and to make rational choices
about how you live your life. And if you live a healthy lifestyle, you're
going to spend less money out of the money she has contributed into their
health account. But the money is yours. In other words, there's a
catastrophic plan available. You may pay the first $3,000 -- the $3,000 is
on the company, and anything above $3,000 goes to the insurance company.

So you can see, if you don't spend the $3,000, and you're able to roll it
over, tax free, and then there's another $3,000 contributed next year, and
you roll over money you save, pretty soon you've got a good health savings
account, because the government doesn't tax any of it. It doesn't tax the
money going in, it doesn't tax the earnings, and it doesn't tax the money
coming out.

And if you change jobs -- by the way, which is an interesting statistic in
our society today. Somebody told me the other day that people change jobs
about eight times before they're 32 years old. That wasn't the case when we
were growing up.

MS. BROWN: No, it wasn't. (Laughter.)

THE PRESIDENT: Anyway, doesn't it make sense to have a plan that you can
carry with you? That's called portability. And so what Jane has provided
her employees is something that encourages consumerism, but also helps meet
their needs, and that's what medicine has got to do. It's got to meet the
needs of the consumer, not the government. And that's what we're talking
about, innovative ideas, innovative ways to help control costs in health
care.

And I hope you've gained something from this conversation. At the very
least, please leave with the notion that we're thinking differently,
because you need to think differently. The system right now needs reform
and needs to be fixed. And you're fortunate in the state of Minnesota that
you've got leadership at the state and local and the corporate and
individual level that is willing to think differently to help a new system
evolve. And it's coming, and it's going to make a huge difference for
people's lives.

And I want to thank all our panelists for joining us today. It's been a
fascinating conversation. God bless you all. (Applause.)

Oh, wait a minute, now I'm going to sign an executive order. And I think
you'll find this interesting. It doesn't take very long, and we usually
have people stand behind me when I do it. (Laughter.)

You ready, Pawlenty?

(The executive order is signed.)

THE PRESIDENT: Done. (Applause.)

END 3:27 P.M. CDT

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