Citizens’ Health Care Working Group
Public Meeting
United Food and Commercial Workers International Union
1775 K Street, NW, 11th Floor
Washington, DC
Wednesday, September 13 and Thursday, September 14, 2006
Meeting Minutes
Working Group Members Present
Pat Maryland, Chair (Monday)
Richard Frank, Vice Chair
Frank Baumeister
Dotty Bazos
Montye Conlan
Joseph Hansen (Thursday)
Therese Hughes
Randy Johnson (Wednesday; Thursday by phone)
Catherine McLaughlin (By phone)
Scot Nystrom (Representing the Secretary, HHS, Michael Leavitt)
Aaron Shirley
Deb Stehr
Christine Wright (Wednesday)
Working Group Members Not Present:
Brent James
Rosie Perez
Staff
George Grob, Executive Director
Jill Bernstein
Carolyn Dell
Margretta Kennedy
Andy Rock
Connie Smith
Caroline Taplin
Lora Wentzel
Other Attendees:
Don Cox, Office of the Assistant Secretary for Planning and Evaluation, DHHS
Mary Giffin, Government Accountability Office (GAO)
Jeff Jendel, Public Forum Institute (PFI)
Susanna Knouse, PFI
Elizabeth Magruder, PFI
Jonathan Ortmans, PFI
Mary Ella Payne, Ascension Health
Carol Reagan, United Food and Commercial Workers (UFCW)
Meeting Summary
Pat Maryland, the Chair, began the meeting at 8:42 a.m., Wednesday, September 13, 2006. Jonathan Ortmans, PFI, facilitated the meeting.
Pat Maryland and Richard Frank, Vice Chair, summarized a brief meeting with Senator Wyden and his staff the evening before. The Senator had provided some suggestions regarding effective presentation of the Working Group’s recommendations, including suggesting a final copy editing and observing that holding the final press conference on Monday, September 25th, might attract more media attention. The Chair and Vice Chair had also met with staff from Senator Hatch’s office and reported that it appeared that neither sponsoring Senator would be able to attend the press conference but that they had agreed to issue a joint press release.
The Members discussed the close out activities related to the project, including the fact that budgetary authority for the Working Group ended on September 30, 2006 and that no further funds could be expended (apart from very limited “close out” activities).
The Members also discussed various concerns about each specific recommendation, the relationships between and among the individual recommendations, and the need to convey that the recommendations formed a cohesive whole. Also discussed was the need for a uniform tone and “voice” in the documents,
The Chair and Vice Chair clarified that the comments that Senator Wyden had made did not address the substance of the recommendations; rather his comments were offered in the spirit of “food for thought” regarding the process of how to effectively communicate the sense and importance of the recommendations to the public, the President, and the Congress. Members also discussed the fact that partisans on both the political left as well as right appeared to have expressed various misgivings regarding the direction that the recommendations had taken. The Members concluded that they had probably reached appropriate compromises in seeking common ground where most of the public could support their final recommendations.
Members briefly discussed their expectations regarding the likelihood that the legislatively-mandated congressional hearings would probably be taking place after the new, 109th, Congress was convened in January. Because no further expenditure of funds is authorized after October, Working Group Members who testified would need to pay their own expenses.
The Members discussed some of the technical details regarding the press conference: who would speak, how material would be presented, and what staffing support was needed.
Initially, the Members thought that the final recommendations/report could be issued as late as December, consistent with the statute and voted to do so, as indicated in the Attachment below. Later in the meeting, however, after the Executive Director confirmed with the relevant Departmental officials that no further expenditures or provision of staff support could take place after September, the Working Group reached a tacit agreement to issue the final recommendations by the end of September, 2006, as previously planned.
The Working Group proceeded through the recommendations, briefly discussing, commenting and suggesting changes to each and then took votes on each one, to determine who supported each (see Attachment). The Members also discussed the content of the letter to the President. Decisions and conclusions reached are reflected in the final documents that are available on the Working Group web site: http://www.citizenshealthcare.gov.
The Members discussed the media message that best represented the concerns and priorities that the Working Group had heard from the American people. Members discussed whether the word “universal” was apt, in this context; most of the Members agreed that it captured the spirit of what the American people they heard from wanted. On the other hand, “universal” did not necessarily mean “single payer.” Members also agreed that one of the most significant aspects of the dialogue with Americans was the remarkable consistency in what people said across the entire country. Other messages that Members pointed out they had heard loud and clear, included: access to care, difficulty negotiating the health “non-system,” health care costs, and addressing disparities.
The Members explored further what should be said about financing their recommendations, including: reallocating current funds and using them more efficiently, fixing unfair subsidies, and raising new revenues.
The Working Group then discussed the issue of individual Member or dissenting views and tacitly agreed that the full text of any such comments would be included in the full report.
It was agreed that, for the purposes of the September 25th press conference, the Executive Summary, at a minimum, would be made available to the press; however, if possible, the revised and corrected text of the Recommendations would also be made available. All would depend on how quickly these documents could be pulled together.
There was a brief discussion of the budget; the Executive Director reported
that almost all the available funds were spent or committed at this
point. There was only enough to provide for assistance with reviewing
the final documents and for essential “close out” and archiving
activities obligatory for the Working Group and its staff that would
be under way during the latter part of September and through the end
of October. The office administrative officer, Margretta Kennedy indicated
that she needed all final travel vouchers/invoices from the Members
immediately so that they could be paid.
The Members briefly discussed what strategies to pursue to keep the message alive until the hearings were held.
Pat adjourned the meeting at 11:35 a.m., Thursday, September 14, 2006.
ATTACHMENT
Working Group Meeting Decisions
September 13-14, 2006
Below are the specific votes taken by the Working Group during its September meeting, indicating those voting and the tally of the voting. Because the wireless key pads, used during so many of the community meetings, were employed, the voting was anonymous. Although present during the meeting and engaging in the discussions of the Working Group, Scott Nystrom, representing Secretary Leavitt, did not participate in the voting.
++++++++++++++++++++++++
Do you support the strategy of focusing on the press conference materials
and printing the report later, but not later than December 28th? (Voting
included: Dotty Bazos, Montye Conlan, Richard Frank, Therese Hughes,
Randy Johnson, Pat Maryland, Catherine McLaughlin on the phone, Deb
Stehr, and Chris Wright)
Yes: 6
No: 3
Not Present: Frank Baumeister, Joe Hansen, Brent James, Rosie Perez,
Aaron Shirley
The Working Group stated the basic recommendation, and then took a vote to see whether there was a clear majority support for each. Individuals not present for a vote can not be assumed to agree or disagree with the recommendation although most Members not present have expressed their active support the recommendations at earlier meetings and subsequently, informally.
Recommendation 1 – Establish public policy that all Americans
have affordable health care. (Voting included: Catherine McLaughlin
on the phone, Dotty Bazos, Frank Baumeister, Montye Conlan, Richard
Frank, Therese Hughes, Randy Johnson, Pat Maryland, Deb Stehr, and Chris
Wright)
Yes: 9
No: 0
Not Present: Joe Hansen, Brent James, Rosie Perez, Aaron Shirley
Recommendation 2 – Guarantee financial protection against very
high health care costs. (Voting included: Frank Baumeister, Dotty Bazos,
Montye Conlan, Richard Frank, Joe Hansen, Therese Hughes, Randy Johnson,
Pat Maryland, Catherine McLaughlin on the phone, Deb Stehr, and Chris
Wright)
Yes: 8
No: 2
Not Present: Joe Hansen, Brent James, Rosie Perez, Aaron Shirley
Recommendation 4 – Promote efforts to improve quality of care
and efficiency. (Voting included: Frank Baumeister, Dotty Bazos, Montye
Conlan, Richard Frank, Therese Hughes, Randy Johnson, Pat Maryland,
Catherine McLaughlin on the phone, Deb Stehr, and Chris Wright)
Yes: 10
No: 0
Not Present: Joe Hansen, Brent James, Rosie Perez, Aaron Shirley
Recommendation 5 – Fundamentally restructure the way end-of-life
services are financed and provided. (Voting included: Frank Baumeister,
Dotty Bazos, Montye Conlan, Richard Frank, Therese Hughes, Randy Johnson,
Pat Maryland, Catherine McLaughlin on the phone, Deb Stehr, and Chris
Wright)
Yes: 10
No: 0
Not Present: Joe Hansen, Brent James, Rosie Perez, Aaron Shirley
Recommendation 3 – Foster innovative integrated community health
networks. (Voting included: Frank Baumeister, Dotty Bazos, Montye Conlan,
Richard Frank, Therese Hughes, Randy Johnson, Pat Maryland, Catherine
McLaughlin on the phone, Aaron Shirley, Deb Stehr, and Chris Wright
by proxy)
Yes: 10
No: 1
Not Present: Joe Hansen, Brent James, Rosie Perez
Recommendation 6 – Define a core benefit package for all Americans.
(Voting included: Frank Baumeister, Dotty Bazos, Montye Conlan, Richard
Frank, Therese Hughes, Randy Johnson, Pat Maryland, Catherine McLaughlin
on the phone, Aaron Shirley, Deb Stehr)
Yes: 8
No: 2
Not Present: Joe Hansen, Brent James, Rosie Perez, Chris Wright