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Secretary Kim Belshe, CA HHS

“Incremental reform can not work…much of the coalition built today in DC reflects the past efforts here in CA with such a diverse group of stakeholders that believe this.”

“Where should we focus our efforts? States will continue to play a central role, and some issues need attention now regardless of federal efforts. We need to do a better job in program eligibility determination and how to improve the value of state dollars.”

“Coverage tugs at our hearts, but cost-containment tugs at our wallets. A recent CMS report shows public health care expenditure will surpass private spending for th first time ever next year. This cost growth is not matched by revenue growth. People are concerned that reform is a government takeover of health care, but I am worried that without reform health care will take over government.”

“With the waiver, we need to begin again with high cost seniors and the disabled in order to make the case to Washington that we can maximize the investment, agressively but responsibly. The coverage initiatives must build on that, too.”

“If issues can be resolved in the market or elsewhere they will be, but the hardest issue like health care can only be done in policy. Change is impossible, but necessary.”

“We need to connect the dots between the budget, the waiver, and state/federal reform. Governance is an essential part of that discussion.”