Monday, May 18, 2009

“Inflection Point”

Monday, May 18th, 2009 at 4:11 pm
“Inflection Point”
This morning, Vice President Biden gave the commencement address at Wake Forest University, a slot originally scheduled for Tim Russert. The Vice President spoke at length about Russert, saying "Tim Russert enlivened and enriched our debate. He gave it meaning. He gave it substance. Along the way he made all of our lives richer." The Vice President was still wistful as he turned towards the world the graduates were inheriting:
William Butler Yeats was right. Tim used to always kid me about quoting Irish poets. He thought I quoted them because I was Irish. That's not the reason. I quote Irish poets because they're the best poets. (Laughter.)
There's a great line in one of Yeats' poems about the first rising in Ireland. It's called Easter Sunday, 1916. And the line is more applicable to your generation than it was to his Ireland in 1960. And he said: All changed, changed utterly. A terrible beauty has been born.
When I graduated, all had not changed utterly yet. Today, it has. And in the last 12 to 15 years, a terrible beauty has been born. It's a different world out there than it has been any time in the last millennia. But we have an opportunity to make it beautiful, because it is in motion. We have an opportunity to change it. But absent our leadership, it will continue to careen down the path we're going now. And that could be terrible. That, folks, is an inflection point.

Engagement, Women, Health Care, and Yarn

Monday, May 18th, 2009 at 1:12 pm
Engagement, Women, Health Care, and Yarn
Posted by Christina M. Tchen, Director of the White House Office of Public Engagement

Welcome to the Office of Public Engagement! Those of you who know Washington may have known about the Office of Public Liaison, which has been the office in the White House since the Nixon Administration that has connected the White House with public interest groups and constituencies based here in DC. Since the Inauguration, I have been the Director of the Office of Public Liaison, and our staff has had a busy hundred days reaching out to local and national groups across over four dozen different areas. But President Obama, as a community organizer himself, has always recognized the importance of engaging grass roots and grass tops, and wants this White House to be engaged in a two-way conversation with people across the country. As the President explained in the video announcing our "relaunch," we are renaming and repurposing ourselves as the Office of Public Engagement to reflect that mission – let me give you an example from an event just last week.

As America celebrated National Women’s Health Week, Health and Human Services Secretary Kathleen Sebelius and I hosted a round table discussion at Stitch DC, a local yarn store here in Washington. We were joined by 7 women small business owners who explained firsthand how skyrocketing costs are making it nearly impossible for small businesses to provide health care benefits for employees and their families.


(Photo credit: Chris Smith, Department of Health and Human Services)

Marie Connolly, who owns Stitch, discussed how difficult it was to lose employees because she was not able to offer them health care coverage. As is the case with many small business owners, Ms. Connolly was forced to choose between not providing health care insurance for her employees in order to remain competitive, or providing such benefits and risk going out of business altogether. Marie has health insurance for baby Oona (who joined us at the meeting) and her other children through her husband’s plan. Nora Connolly, Marie’s sister and business partner, recently had a harrowing health scare where she was tested for a possibly serious condition, without any health insurance. Luckily, she was fine.

Unfortunately, her situation is not unique for small business owners around the country. Angela Bradley, a small business owner from Maryland, related a similar story about being unable to provide health care to employees due to the high expense of doing so. Bradley also has lost workers to large businesses, such as Safeway, better positioned to provide health care insurance for its employees. We also heard from Leah Daniels, owner of a Washington DC cookware store, who shared that she has never worked in a job that offers health care, and currently cannot pay for health care for herself or any of her 4 employees.


(Photo credit: Chris Smith, Department of Health and Human Services)

These are just three among numerous similar stories we heard around the table which demonstrate that small businesses are struggling from high health care costs. These stories show that the health care system in America needs to be reformed to ease the burden on small businesses, and to ensure that the workers in this country, and their families, receive the health care coverage they need.

As Executive Director of the White House Council on Women and Girls, I was also interested in hearing about the effects skyrocketing health care costs have on these women and their families. It is well-documented that women are disproportionately adversely impacted by our broken health care system -– HHS just released a new report on this topic, and as always visit healthreform.gov for more information. President Obama and the White House Council on Women and Girls are committed to improving the health of all women and we know that health care reform is essential to achieving that goal.

As President Obama has said, this office serves as the front door to the White House, and we will be engaging all of you in the work it will take to change this country. The meeting I had with women small business owners this week is one of many important conversations we’ll be holding. Please stay tuned for additional blogs from me and the rest of the Office of Public Engagement staff, as we will be listening to and sharing with you the stories that we are hearing around the country.

Wednesday, May 13, 2009

Health Care Reform: “Urgency and Determination”

Wednesday, May 13th, 2009 at 1:12 pm
Health Care Reform: “Urgency and Determination”

This morning the President, Speaker Pelosi, and Leadership from the House of Representatives emerged from a meeting together with a new target on moving forward with health reform: pass legislation through the House by July 31st. The President spoke to the press after the Speaker in the South Drive at the Oval Office, telling them that "this is a gorgeous day and an encouraging day":
On health care, as Speaker Pelosi just mentioned, the House is working to pass a comprehensive health care reform bill by July 31st, before they head out for the August recess. And that's the kind of urgency and determination that we need to achieve what I believe will be historic legislation.
As I've said before, and as all Americans know, our health care system is broken. It's unsustainable for families, for businesses. It is unsustainable for the federal government and state governments.
We've had a lot of discussions in this town about deficits and people across the political spectrum like to throw barbs back and forth about debt and deficits. The fact of the matter is the most significant driver by far of our long-term debt and our long-term deficits is ever-escalating health care costs. And if we don't reform how health care is delivered in this country, then we are not going to be able to get a handle on that.
Now, in addition to the implications for the federal budget, obviously we're also thinking about the millions of American families out there who are struggling to pay premiums that have doubled over the last decade -- rising four times the rate of their wages -- and 46 million Americans who don't have any health insurance at all.

(President Barack Obama meets with Speaker Nancy Pelosi, House Majority Leader Steny Hoyer, and House
Education and Labor Committee Chair Rep. George Miller, in the Oval Office Wednesday, May 13, 2009.
House Energy and Commerce Committee Chair Rep. Henry Waxman, and House Ways and Means Committee
Chair Rep. Charlie Rangel also attended the meeting but are not in the photo.
Official White house Photo by Pete Souza.)
The President also re-emphasized the necessity of getting final legislation passed by both the House and the Senate and signed this year. In closing, the President laid out his basic principles:
In the coming weeks and months, I believe that the House and Senate will be engaged in a difficult issue, and I'm committed to building a transparent process to get this moving. But whatever plans emerge, both from the House and the Senate, I do believe that they've got to uphold three basic principles: first, that the rising cost of health care has to be brought down; second, that Americans have to be able to choose their own doctor and their own plan; and third, all Americans have to have quality, affordable health care.
UPDATE: The President also just sent out his first email to those who have signed up for updates here at WhiteHouse.gov. If you have not signed up yet, do so here to get alerts on health care and other important issues. Read today’s email below:
Good afternoon,
You are receiving this email because you signed up at WhiteHouse.gov. My staff and I plan to use these messages as a way to directly communicate about important issues and opportunities, and today I have some encouraging updates about health care reform.
The Vice President and I just met with leaders from the House of Representatives and received their commitment to pass a comprehensive health care reform bill by July 31.
We also have an unprecedented commitment from health care industry leaders, many of whom opposed health reform in the past. Monday, I met with some of these health care stakeholders, and they pledged to do their part to reduce the health care spending growth rate, saving more than two trillion dollars over the next ten years -- around $2,500 for each American family. Then on Tuesday, leaders from some of America's top companies came to the White House to showcase innovative ways to reduce health care costs by improving the health of their workers.
Now the House and Senate are beginning a critical debate that will determine the health of our nation's economy and its families. This process should be transparent and inclusive and its product must drive down costs, assure quality and affordable health care for everyone, and guarantee all of us a choice of doctors and plans.
Reforming health care should also involve you. Think of other people who may want to stay up to date on health care reform and other national issues and tell them to join us here:
http://www.whitehouse.gov/EmailUpdates
Health care reform can't come soon enough. We spend more on health care than any country, but families continue to struggle with skyrocketing premiums and nearly 46 million are without insurance entirely. It is a priority for the American people and a pillar of the new foundation we are seeking to build for our economy.
We'll continue to keep you posted about this and other important issues.
Thank you,
Barack Obama
P.S. If you'd like to get more in-depth information about health reform and how you can participate, be sure to visit http://www.HealthReform.gov

Streaming Now: Food Safety Working Group Listening Session

Wednesday, May 13th, 2009 at 8:34 am
Streaming Now: Food Safety Working Group Listening Session – Give Your Suggestions
[UPDATE: The live-stream has concluded, we will keep you updated on the reports back from the rest of the day. In the meantime, see the Food Safety Working Group's new website.]

Starting at 9:00 AM Eastern:
Watch the opening of the Food Safety Working Group Listening Session at WhiteHouse.gov/live, kicked off by Secretary Sebelius and Secretary Vilsack, the co-chairs of the Working Group.
Have a suggestion for reforming food safety policy? Drop it in our comment form, or let the Working Group know on twitter (hashtag #WHsafefood) or at our Facebook page.
In his March 14th Weekly Address, the President announced the creation of the Food Safety Working Group, chaired by the Secretaries of the Department of Health and Human Services and the Department of Agriculture. As the President said, the working group "will bring together cabinet secretaries and senior officials to advise me on how we can upgrade our food safety laws for the 21st century; foster coordination throughout government; and ensure that we are not just designing laws that will keep the American people safe, but enforcing them."
The White House Listening Session today is intended as an opportunity to engage stakeholders in a conversation to help shape the principles guiding reform. The opening remarks will be followed by smaller group breakout sessions with Administration and Congressional staff and stakeholders to discuss how to address major challenges and opportunities in this area. Along with the ideas and exchanges from the breakouts, Working Group staff will be sifting through your comments from all of the channels above to find valuable ideas and get a hint of what people interested in this topic are thinking.

Poetry, Music and Spoken Word

Poetry, Music and Spoken Word
Tonight, the President and the First Lady will host an evening celebrating poetry, music and the spoken word. This event is designed around the theme of dialogue, showing how dialogue is important in every aspect of who we are as Americans and as human beings, and demonstrating how communication is a constant throughout the ages. The hope is also that this evening's gathering helps ensure that all voices are heard, particularly voices that are often not heard. We are fortunate to have a wide variety of upcoming and legendary performers such as Joshua Bennett, James Earl Jones, Eric Lewis, Jamaica Heolimeleikalani Osorio, Mayda Del Valle and Esperanza Spalding.

We have invited students from American, Gallaudet, Georgetown, and Howard Universities to participate in the event. And of course we also invite you to join us, as we're streaming the event live at 7pm on WhiteHouse.gov/live.

Tuesday, May 12, 2009

OMB Director Orszag Corrects the Record on the OMB & EPA

Tuesday, May 12th, 2009 at 4:31 pm
OMB Director Orszag Corrects the Record on the OMB & EPA
In a post entitled "Clearing the Air":
Media reports today are suggesting that OMB has found fault with EPA’s proposed finding that emissions of greenhouse gases from motor vehicles contribute to air pollution that endangers public health and welfare. Any reports suggesting that OMB was opposed to the finding are unfounded.

The quotations circulating in the press are from a document in which OMB simply collated and collected disparate comments from various agencies during the inter-agency review process of the proposed finding. These collected comments were not necessarily internally consistent, since they came from multiple sources, and they do not necessarily represent the views of either OMB or the Administration. In other words, we simply receive comments from various agencies and pass them along to EPA for consideration, regardless of the substantive merit of those comments. In general, passing along these types of comments to an agency proposing a finding often helps to improve the quality of the notice.

Perhaps more importantly, OMB concluded review of the preliminary finding several weeks ago, which then allowed EPA to move forward with the proposed finding. As I wrote on this blog on April 17, the "proposed finding is carefully rooted in both law and science." I also noted: "By itself, the EPA’s proposed finding imposes no regulation. (Indeed, by itself, it requires nothing at all.) If and when the endangerment finding is made final, the EPA will turn to the question whether and how to regulate greenhouse gas emissions from new automobiles."

The bottom line is that OMB would have not concluded review, which allows the finding to move forward, if we had concerns about whether EPA’s finding was consistent with either the law or the underlying science. The press reports to the contrary are simply false.
Yet another reason to check Director Orszag’s blog regularly.

Addressing Health Care Costs From All Angles

Tuesday, May 12th, 2009 at 3:41 pm
Addressing Health Care Costs From All Angles
Yesterday, the President held a landmark meeting with a wide array of leaders in the health care field – insurance companies, hospitals, pharmaceutical companies, medical device manufacturers, and providers –who pledged to work together to control costs in health care to the tune of $2 trillion in savings over the next ten years. Today, the President held another meeting with five employers, a state health department, and a union to discuss innovative ideas that are being implemented in the workplace to improve the health of workers and reduce the rising rate of health care spending.

(President Barack Obama listens to Safeway President and Chief Executive Officer Steve Burd during a meeting
with business leaders in the Roosevelt Room of the White House to discuss employer health care costs,
May 12, 2009. Official White House Photo by Pete Souza.)
The President directed the Office of Personnel Management to work with the Office of Health Reform, the National Economic Council, the Department of Labor, and the Office of Management and Budget to examine successful employer wellness and prevention practices that lower health care costs and improve employees’ health, and to explore possibilities of developing a plan for federal employees and their workplaces.

More generally, the discussion was designed to expand on the theme that the health care system in America needs comprehensive reform, including a much greater focus on wellness and prevention. As the President stated in his remarks afterwards, "what we've done here today is to gather together some of these stories and best practices to make sure that they are going to be informing the health care reform discussions that take place here in Washington." If these companies have been able to implement proven measures in the private sector, "there’s no reason why we can’t do that for the country as a whole." The White House fact sheet details the attendees and the kinds of practices they have been implementing:
H.E.R.E.I.U. Welfare Fund (Dr. Jerry Reeves, Chief Medical Officer): The Hotel Employees and Restaurant Employees International Union (H.E.R.E.I.U.) Welfare Fund offers multi-employer health insurance coverage for 90,000 eligible employees and their family members. It redesigned its health benefits and health plan administration and implemented wellness and chronic disease management programs to generate millions of dollars in overall savings. The H.E.R.E.I.U. Welfare Fund has also aligned incentives with desired behaviors by informing patients which physicians were high-performing, providing performance bonuses to high-performing doctors, and giving pregnant patients incentives to receive prenatal care. These initiatives have effectively engaged workers to improve their health through widespread use of employee risk assessments, risk-based interventions, and behavior change programs. The H.E.RE.I.U. Welfare Fund also has worksite pharmacies that give out free generic drugs for chronic conditions and provide special care centers for workers and family members who have high cost and complex chronic conditions.
Johnson & Johnson (Bill Weldon, Chairman of the Board and CEO): Johnson & Johnson has one of the longest-running workplace health programs in the United States. The company has a sophisticated set of disease management and prevention interventions, risk-based incentives, pedometers/exercise goals, treadmills available for offices, and other health related programs. According to its recent employee health scorecard for United States employees, at the end of 2007, Johnson & Johnson continued to make health improvement progress and its health initiatives avoided an estimated $15.9 million in health care costs in 2007. As well, from the late 1990s to 2006 in the United States, smoking declined from 12 percent of its workforce to four percent, high blood pressure dropped from 14 percent to six percent, and high cholesterol went from 19 percent to six percent. A 2002 Rand study found that Johnson & Johnson’s initiatives had improved employee health and employees had saved an average of $225 per year because of a reduced need for doctor visits.
Microsoft (Cecily Hall, Director of US Benefits): Microsoft creates personalized health goals and has a staff of doctors that makes house calls to avoid emergency room visits. Its obesity program assigns employees to a primary care doctor, behavior health specialist, and nutritionist, and Microsoft provides free meals consistent with diet recommendations to eat on site or to take home. The result of its initiatives has been very low premium growth and a healthier workforce than other companies with workers of similar age. Microsoft has been continually recognized as one of Fortune’s 100 Best Places to Work.
Ohio Department of Health (Dr. Alvin Jackson, Director of Ohio Department of Health): The State of Ohio created a "Take Charge! Live Well!" program to reduce health risk factors for state workers, with more than 50 percent of eligible workers participating. Until 2005, health care programs for state employees in Ohio focused on disease management and improving the health of high-risk groups. After reviewing data, the state discovered that while 27 percent of total health care costs were related to high-risk employees, 44 percent of costs were associated with preventable conditions. Ohio’s "Take Charge! Live Well!" comprehensive health management program includes online and telephone health assessments, health coaching, online health improvement program, on-site employee health screenings (offered at about 40 locations), preventive care, chronic condition management, and monetary incentives of up to $100 in incentive payments, or $200 when spouses are enrolled, if employees complete a health assessment and participate in a health improvement program.
Pitney Bowes (Murray Martin, Chairman of the Board, President, and CEO): Pitney Bowes offers onsite comprehensive health clinics and fitness centers, redesigned food merchandizing and prices in their cafeterias, incentives management for the health of their employees, and low cost drugs for chronic diseases. The company has also adopted infection control practices and offers low-cost or no-cost preventive screenings and immunizations on-site and off-site. The company’s initiatives and its commitment to increase employee participation in managing their own health have resulted in $40 million in savings over the last nine years.
REI (Sally Jewell, President and CEO): REI offers health benefits to all of its full and part-time workers and has been continually recognized as one of Fortune’s 100 Best Places to Work. The company offers employees support for outdoor activities ranging from outdoor gear and apparel discounts, free rentals, and outdoor challenge grants. REI employees can earn extra healthy lifestyle dollars to put toward the cost of coverage by engaging in specific "good behaviors," such as getting regular aerobic exercise. REI also supports personal health goals and provides equipment support, discounts, and time off so employees can achieve their goals.
Safeway (Steve Burd, President and CEO): Safeway has innovated in benefit design to reward employees’ healthy behaviors and improve adherence to recommended treatments for chronic diseases. Over 74 percent of Safeway’s 30,000 nonunion workers have signed up for its "Healthy Measures" program. Under this program, participants undergo screening tests (including cholesterol, blood pressure, and weight control), and employees who score well pay lower health premiums. Safeway has saved millions by making employees accountable for their weight, smoking, cholesterol, and blood pressure. The company also has a free fitness center at its headquarters, offers gym membership discounts, and provides a 24-hour nurse health hotline. In 2006, Safeway’s efforts reduced their total health care spending by 13 percent, and employees who signed up have saved more than 20 percent on their premiums.