Tom Vilsack on Health Care

Democratic IA Governor

Focus on curing incurable diseases that drive up health cost

[We can reduce healthcare costs by] curing incurable diseases. This is America. We can do great things. Letís pick out one or two diseases that are driving up health care costs and let us challenge ourselves as Americans in the next decade to eradicate those diseases. We did that when I was a kid with polio, and we saved more money in the health care system than the entire cost of the health care system.
Source: 2007 AFSCME Democratic primary debate in Carson City Nevada Feb 21, 2007

Focus on wellness to improve healthcare without tax increase

Q: Do you think that itís going to be necessary to raise taxes to pay for health care?

A: We absolutely do need universal coverage. 47 million Americans do not have health insurance coverage, which means that they donít stop getting sick; they donít stop getting health care; they actually get it in the most ineffective and expensive way: in an emergency room. We can stop that, and we can create a more efficient health care system.

But it is much more than universal coverage. It is actually incorporating wellness into the system, at every level -- from the moment a child is born. So there are ways to do this without necessarily raising the tax burden on folks and certainly on working folks. You know, when working folks hear about tax increases, their interpretation is they may be next. And I think our party can do a better job being innovative and creative. We can look inside the budget.

Source: 2007 AFSCME Democratic primary debate in Carson City Nevada Feb 21, 2007

Help Medicare by sharing data & providing long-term homecare

Q: What are your plans for insuring the finances of Medicare?

A: Medicareís a much more difficult issue than Social Security. First and foremost, we have to stop paying for services and we have to start paying for results. We know today because we have inadequate data about our health care system, that in some communities youíre more likely to get surgically worked on for a back injury than I might in some other community. [We should] take data and information about what works and what was the most efficient way of providing health care. Thatís one strategy.

Another strategy is to make sure that we have a long-term care system that encourages people to stay in their homes with greater dignity, provides assisted living as an alternative, and only puts folks in nursing homes when they want to be and when they need to be. You can do a substantial amount of work in that regard.

Source: 2007 AFSCME Democratic primary debate in Carson City Nevada Feb 21, 2007

Disapprove inefficient uses of tobacco prevention dollars

It is difficult to justify a sole source contract when there are other qualified organizations that would be denied any opportunity to bid on such a large contract. Furthermore, I expect this program to demonstrate its effectiveness through an independent evaluation. Certified mentoring programs in Iowa are required to meet standards of effective practice, and I expect the same of this program.
Source: Veto Message May 17, 2004

Supports changes to the new Medicare law

The administration supports changes to the new Medicare law to strengthen the drug benefit for seniors and to reverse or eliminate the significant shifting of costs to the states created by the new law. The administration wants to maintain the stateís ability to run its Medicaid program without losing financial flexibility. Additional federal relief for Medicaid is also needed.
Source: Press Release Jan 23, 2004

Establish "report cards" on HMO quality of care.

Vilsack signed the manifesto, "A New Agenda for the New Decade":

Promote Universal Access and Quality in Health Care
That more than 40 million Americans lack health insurance is one of our societyís most glaring inequities. Lack of insurance jeopardizes the health of disadvantaged Americans and also imposes high costs on everyone else when the uninsured lack preventive care and get treatment from emergency rooms. Washington provides a tax subsidy for insurance for Americans who get coverage from their employers but offers nothing to workers who donít have job-based coverage.

Markets alone cannot assure universal access to health coverage. Government should enable all low-income families to buy health insurance. Individuals must take responsibility for insuring themselves and their families whether or not they qualify for public assistance.

Finally, to help promote higher quality in health care for all Americans, we need reliable information on the quality of health care delivered by health plans and providers; a ďpatientís bill of rightsĒ that ensures access to medically necessary care; and a system in which private health plans compete on the basis of quality as well as cost.

Source: The Hyde Park Declaration 00-DLC5 on Aug 1, 2000

No federal pre-emption of employee health plan regulation.

Vilsack adopted the National Governors Association position paper:

The Issue

In 1999, 42.6 million Americans did not have health insurance. All states have been fervently working to reduce the number of uninsured Americans, to make health insurance more affordable and secure, and to provide quality health care at a reasonable cost to the uninsured. However, the federal government has also expressed an interest in this issue. Any action taken at the federal level could have serious implications for traditional state authority to regulate the health insurance industry and protect consumers.

NGAís Position

Although the Governors are extremely sensitive to the concerns of large multi-state employers, the fact remains that the complete federal preemption of state laws relating to employee health plans in the Employment Retirement Income Security Act (ERISA) is the greatest single barrier to many state reform and patient protection initiatives.

The Governors support efforts designed to enable small employers to join together to participate more effectively in the health insurance market. In fact, Governors have taken the lead in facilitating the development of such partnerships and alliances. However, these partnerships must be carefully structured and regulated by state agencies in order to protect consumers and small businesses from fraud and abuse and underinsurance. NGA opposes attempts to expand federal authority under ERISA. The Governors have identified the prevention of such federal legislation in the 107th Congress as a top legislative priority.

States have the primary responsibility for health insurance regulation. Across the nation, Governors are working to protect consumers and patients and to properly regulate the complicated health insurance industry.

Source: National Governors Association "Issues / Positions" 01-NGA13 on Oct 5, 2001

Maintain Medicare funding of HMO benefits.

Vilsack signed the Midwestern Governors' Conference resolution:

Source: Resolution of Midwestern Governors' Conf. on Medicare Equity 99-MGC2 on Oct 14, 1999

Protect state tobacco settlement funds from federal seizure.

Vilsack adopted a letter to Congressional leaders from 53 Governors:

As you know, preserving and protecting the state tobacco settlement funds is the nationís Governorsí highest priority. We strongly urge you to reach final agreement and pass the conference report on the emergency supplemental appropriations bill soon, and to retain the Senate provision that protects our settlement funds from federal seizure.

Many of our state legislatures are currently in session, and some have already completed work on their budgets. Therefore, it is critical that conferees reach agreement quickly on this issue. Governors are unified in their commitment to ensuring that the funds remain in the states and that there be no restrictions on statesí ability to tailor spending to meet the needs of their citizens.

We offer our strongest support for conferees to recede to the Senate version of the bill containing the Hutchison/Graham bipartisan tobacco recoupment protection legislation.

Source: National Governor's Association letter to Congress 99-NGA31 on Apr 14, 1999

Other governors on Health Care: Tom Vilsack on other issues:
IA Gubernatorial:
Terry Branstad
IA Senatorial:
Chuck Grassley
Tom Harkin

Newly seated 2010:
NJ Chris Christie
VA Bob McDonnell

Term-limited as of Jan. 2011:
AL Bob Riley
CA Arnold Schwarzenegger
GA Sonny Perdue
HI Linda Lingle
ME John Baldacci
MI Jennifer Granholm
NM Bill Richardson
OK Brad Henry
OR Ted Kulongoski
PA Ed Rendell
RI Donald Carcieri
SC Mark Sanford
SD Mike Rounds
TN Phil Bredesen
WY Dave Freudenthal
Newly Elected Nov. 2010:
AL: Robert Bentley (R)
CA: Jerry Brown (D)
CO: John Hickenlooper (D)
CT: Dan Malloy (R)
FL: Rick Scott (R)
GA: Nathan Deal (R)
HI: Neil Abercrombie (D)
IA: Terry Branstad (R)
KS: Sam Brownback (R)
ME: Paul LePage (R)
MI: Rick Snyder (R)
MN: Mark Dayton (D)
ND: Jack Dalrymple (R)
NM: Susana Martinez (R)
NV: Brian Sandoval (R)
NY: Andrew Cuomo (D)
OH: John Kasich (R)
OK: Mary Fallin (R)
PA: Tom Corbett (R)
RI: Lincoln Chafee (I)
SC: Nikki Haley (R)
SD: Dennis Daugaard (R)
TN: Bill Haslam (R)
VT: Peter Shumlin (D)
WI: Scott Walker (R)
WY: Matt Mead (R)
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Page last updated: Aug 15, 2011