1 1 NATIONAL GOVERNORS ASSOCIATION 2 WINTER MEETING 3 Saturday, February 20, 2010 4 5 6 CHILDHOOD OBESITY 7 AND 8 TRANSFORMING HEALTH CARE DELIVERY 9 Grand Ballroom 10 JW Marriott Hotel 11 1331 Pennsylvania Avenue NW 12 Washington, DC 20004 13 14 15 16 17 18 19 20 21 22 2 1 PARTICIPANTS: 2 3 GOVERNOR JAMES H. DOUGLAS, VERMONT, CHAIR 4 GOVERNOR JOE MANCHIN III, WV, VICE CHAIR 5 6 GUEST: 7 MICHELLE OBAMA, FIRST LADY OF THE UNITED STATES 8 9 10 GUESTS: 11 Atul Gawande, M.D., M.P.H., Surgeon, 12 Department of General/GI Surgery, 13 Brigham and Women's Hospital, and 14 Associate Professor, 15 Harvard Medical and HSPH 16 17 Jack Cochran, M.D., Executive Director 18 The Permanente Federation 19 20 21 22 3 1 P R O C E E D I N G S 2 3 (11:03 a.m.) 4 CHAIRMAN DOUGLAS: Ladies and gentlemen, 5 let's begin the Winter Meeting of the National 6 Governors Association. Thank you all for being here. 7 We've got an exciting program not only today but 8 throughout the course of the next couple of days, and 9 I want to get right into our featured guest in just a 10 few moments. 11 First of all, I will entertain a motion to 12 adopt the Rules of Procedure for our Winter Meeting. 13 Could I have such a motion? 14 (Motion duly made.) 15 CHAIRMAN DOUGLAS: Thank you. Is there a 16 second? 17 (Motion duly seconded.) 18 CHAIRMAN DOUGLAS: Seconded. Any 19 discussion? 20 (No response.) 21 CHAIRMAN DOUGLAS: If not, all in favor of 22 adopting the Rules please signify by saying aye. 23 4 1 (Chorus of ayes.) 2 CHAIRMAN DOUGLAS: Opposed, no? 3 (No response.) 4 CHAIRMAN DOUGLAS: The ayes have it and 5 you have adopted the Rules, one of which is that any 6 governor who wants to submit a new policy or 7 resolution for adoption at the meeting will need a 8 three-fourths vote to suspend the rules, and any 9 such proposal should be submitted in writing to David 10 Qualm of our NGA staff by 5 p.m. tomorrow. 11 I want to take a moment to introduce our 12 new colleagues who have joined us since we last 13 gathered: The governor of the great state of New 14 Jersey, Chris Christie. Chris, welcome. 15 (Applause.) 16 CHAIRMAN DOUGLAS: The governor of Alaska, 17 Sean Parnell. Sean, thank you for being here. 18 (Applause.) 19 CHAIRMAN DOUGLAS: And the governor of 20 Utah, Governor Gary Herbert. Gary, welcome. 21 (Applause.) 22 CHAIRMAN DOUGLAS: I don't see Governor 23 5 1 [Robert] McDonnell here, but I expect that we'll see him at 2 some point during the meeting, from Virginia, and 3 we'll welcome him as well. 4 So congratulations to all the new 5 governors, and welcome to NGA, and we look forward to 6 working with you. We are a pretty good group, I 7 think you'll find, not only of governors but--well, 8 most of the time-- 9 (Laughter.) 10 CHAIRMAN DOUGLAS: --of not only 11 governors, but other state officials. We've got 12 former governors who attend our meetings, great first 13 spouses who are part of our NGA family; we have 14 corporate partners; foreign dignitaries; the media, 15 of course; a lot of folks at our meetings, and I want 16 to thank you for being here. 17 Speaking of foreign visitors, we are 18 joined by several whom I want to acknowledge and 19 thank for being with us. The Ambassador of Canada to 20 the United States, Ambassador Gary Doer is here. 21 (Applause.) 22 CHAIRMAN DOUGLAS: And he is our host for 23 6 1 the evening at the Canadian Embassy tonight. As many 2 of you know, Gary was a Provincial Premiere for a 3 decade, so he is well familiar with our 4 responsibilities, and we look forward to his 5 hospitality tonight and continued friendship. 6 We have a number of Canadian 7 parliamentarians with us, as well, and I would like 8 to welcome them to the NGA. There they are, with the 9 ambassador. 10 (Applause.) 11 CHAIRMAN DOUGLAS: As well as a delegation 12 from the Canada-United States Interparliamentary 13 Group. We welcome the members of that group who are 14 with us, as well. 15 And on the other side of the house we've 16 got 20 deputy and district governors from various 17 provinces in Turkey. We are honored to have them 18 with us today. 19 (Applause.) 20 CHAIRMAN DOUGLAS: They are here courtesy 21 of the Turkish Minister of the Interior for a 22 Professional Development Program in Public Policy and 23 7 1 Public Administration at Virginia Commonwealth 2 University in Richmond, and we are honored to have 3 them with us. 4 CHAIRMAN DOUGLAS: Well, over the next few 5 days we are going to be talking about some critical 6 issues that are affecting states, especially the dire 7 economic situation that we're facing. We are going 8 to be talking about the ever-rising cost of health 9 care. 10 And because of the critical issues in our 11 health care system, I have decided, as you know, to 12 focus my efforts this year as your chair on reforming 13 our health care system. My “Rx for Health Reform” 14 initiative is taking a look at ways that we can 15 deliver high quality, more efficient care to control 16 health care spending and improve health outcomes. I 17 look forward to a lively discussion over the next 18 couple of days on these issues. 19 As a kickoff to our agenda this weekend, 20 it is a distinct pleasure and honor to introduce our 21 opening speaker. First Lady Michelle Obama has been 22 working tirelessly on behalf of communities across 23 8 1 the country for many years. 2 Recently she announced a major new 3 initiative in childhood obesity, which has become a 4 serious epidemic in our country. Mrs. Obama's 5 efforts will tackle the health challenges our 6 children face in our homes, communities, and schools. 7 Our efforts must indeed focus on providing children 8 every opportunity to be healthy, productive citizens. 9 So, governors and guests, please join me 10 in welcoming the First Lady of the United States, 11 Michelle Obama. 12 (Applause and audience stands.) 13 MRS. OBAMA: Thank you. 14 (Continuing applause.) 15 MRS. OBAMA: Thank you all, so much. 16 Thank you. It is a pleasure for me to be here with 17 all of you today and to welcome you all to 18 Washington. 19 Thank you, Governor Douglas, for that very 20 kind introduction. And thanks to you and Governor 21 Manchin for your leadership in Vermont, as well as 22 [West] Virginia, and as the Chair and Vice Chair of the NGA. 23 9 1 I also want to recognize all of the governors who are 2 here today, and to thank you for your outstanding 3 leadership and the dedicated service that you provide 4 to states all across this country. We are grateful 5 to you. 6 Now I would be remiss if I didn't thank 7 all the spouses who are here for all the things you 8 have to put up with. 9 (Laughter and applause.) 10 MRS. OBAMA: Absolutely. You all are 11 making the same kind of sacrifices, putting up with 12 long hours and late-night crises, and all I can say 13 is "been there, done that." 14 (Laughter.) 15 MRS. OBAMA: I know how you feel, and we 16 are just grateful to have you all. And again, we 17 will give them another round of applause. 18 (Applause.) 19 MRS. OBAMA: Now I know that the focus of 20 this year's meeting is the issue of health care. 21 Over the next few days you are going to be talking 22 about spiraling costs that are straining your budgets 23 10 1 and running up all of our deficits. Costs like the 2 nearly $150 billion a year that we spend on obesity- 3 related conditions like diabetes, heart disease, and 4 high blood pressure. 5 You are going to talk about the staggering 6 Medicaid burdens and how premiums have risen three 7 times faster than wages, often bankrupting families 8 in your states, sinking businesses in states all 9 across this country. 10 But we all know that there is another set 11 of statistics that have to be a part of this 12 discussion. Like how nearly one in three of our 13 children in this country is now overweight or obese; 14 like how one in three kids today will eventually 15 develop diabetes; and in the African American and 16 Hispanic communities, the number is nearly half. 17 Because if we think our health care costs 18 are high now, just wait until 10 years from now. 19 Think about the many billions we are going to be 20 spending then. Think about how high those premiums 21 are going to be when our kids are old enough to have 22 families of their own and businesses of their own. 23 11 1 We all know that we cannot solve our 2 health care problems unless we address our childhood 3 obesity problem, too--and that is really why I am 4 here today, to talk about the issue of childhood 5 obesity that is so important to me, and what our 6 states and our nation can do to solve it.