Plenary Session Transcripts

Governors Attending:

Guests:

Discussion Subjects:

• Economic Development and Commerce (EDC) – telecommunications vision statement; North American Free Trade Agreement (NAFTA); General Agreement on Trade and Tariffs (GATT); and announcement of business incentives report
• Executive Committee and Standing Committee Chairs – update on legislative priorities
• Human Resources (HR) – status of welfare reform initiatives; and overview of federal family and children initiatives
• Natural Resources (NR) – risk assessment and environmental mandates
• Plenary Session Discussion Subjects - Adoption assistance; national education goals; children and violence; German-American relations; and health and welfare reform

Points of Interest:

Dave Thomas, founder of the Wendy’s hamburger franchise, shared his personal story of having been adopted and told Governors of his advocacy of child adoption. He urged them to support guaranteeing the same employment benefits to adopting parents—including paid leave—that were given to birth parents.

A report was presented to Governors on the Goals 2000 Educate America Act that was pending in Congress. The legislation’s purposes were: first, to enlarge the National Education Goals Panel (NEGP) to add four state legislators to the eight Governors, four members of Congress, and the U.S. Secretary of Education who were already serving; and second, to add to NEGP’s mandate the jobs of certifying content and performance standards and showcasing promising state strategies.

During a panel discussion of school violence, social work professor Mark Singer pointed out that the experiences of today’s youth were different from those of previous generations. There had been a more than 300-percent increase in homicide rates among 15- to 24-year-olds in the United States between 1950 and 1990. Nine out of ten murders of young people in the industrialized world occurred in the United States. Gunshot wounds were the leading cause of death of both black and white teenage boys in this country. A recent Harris poll of more than 2,500 students in the sixth through ninth grades revealed that nearly 40 percent knew someone who had been killed or injured by a gun, and 15 percent admitted to having carried a gun within 30 days of the survey.

Dr. Singer said that children were being robbed of the sense of security that was a prerequisite for healthy development. Seeing the world as hostile, they felt the need to be prepared to defend themselves. They also tended to misinterpret behaviors as threatening, in turn acting violently toward others. More than half of the boys in a survey conducted by Singer said they had hit someone before they could be hit.

Singer argued that violence, which crossed socioeconomic and geographic lines, was learned via movies, television, music, and the like. He introduced a number of students who advocated teaching conflict resolution and using programs that were designed to keep young people occupied and help them develop self-respect.

German Chancellor Helmut Kohl, who had himself been a Governor, spoke at length about the long-standing relationship between the U.S. and Germany, expressing gratitude for our continued military commitments to his nation. He said that in the past, the notion of a bridge over the Atlantic had referred primarily to security and economic issues, but that it needed now to be widened to include cultural and scientific exchange.

Kohl also identified two dilemmas that the U.S. and Germany had in common: the need to improve our competitive standing in the global economy, and the social and economic burdens associated with aging populations. Among the questions that Governors asked of the Chancellor was to explain how his nation had maintained a successful universal health care system. Kohl conceded that an aging population was beginning to translate to higher costs. However, because premiums—paid half by the employer and half by the employee—were linked to wages, the cost to workers had not risen out of control.

Governors went on to discuss prospects for networking so as to integrate Medicaid patients into managed care systems. Several managed care advocates talked about successful state and local efforts, including one in which the state had contracted with a health maintenance organization to provide service to Medicaid patients. George Halvorson of HealthPartners spoke at length about the high cost of fee-for-service care in this country. He told the astonishing story of the discovery during a graduate student study that every single one of 185 consecutive heart attack patients arriving unconscious at one hospital had died. Yet that fact was not among the statistics maintained by the hospital or by government authorities, because health care providers were paid not according to outcome but rather by unit of care. Halvorson went on to say that the rates of certain surgical procedures in the United States—including caesarean sections and hysterectomies—far exceeded rates in other nations because doctors in the U.S. were paid more to perform those procedures. And Halvorson concluded by telling Governors that with 80 to 85 percent of patients in major metropolitan areas in Minnesota now receiving managed care, the state had brought down the cost of care to below the national average.

Dr. Charles DeShazer of Southeast Permanente Medical Group cautioned that shifting Medicaid beneficiaries to managed care needed to be an incremental process, both because their health care needs were often different from those of higher-income patients (e.g., treatment for substance abuse and the effects of crime), but also because managed care facilities that sought to participate in the inner city threatened the financial base of traditional providers such as clinics and public hospitals.

Dr. Stephen Cohen of “Doctors Who Care” disagreed with fellow panelists about managed care as an option, arguing that managed care physicians could not be patient advocates. Among his recommendations were that states use health care IRAs, under which Medicaid patients who remained within a specified annual deductible would be rewarded for the savings that resulted. Halvorson responded that there were several problems with this idea, among them: (1) it would be administratively expensive to determine when the deductible had been met; (2) there was risk to ensuring full health care for low-income people; and (3) those who had no health care needs during the year in question would be financially rewarded, costing the government more.

Opening a session on welfare reform, U.S. Senator Daniel Patrick Moynihan emphasized that there was a new generation of single mothers that accounted for more than 70 percent of families receiving Aid to Families with Dependent Children (AFDC). He told Governors that it was up to them to successfully transition these families from dependence to independence.

Governors then went on to talk about the welfare reform task force that President Clinton had asked them to lead, and to exchange information on reform efforts that were ongoing at the state level. Among these were:

• The Strength of Michigan Families Agenda, under which those on public assistance for more than 90 days were asked to work, participate in job training, or be involved in community service for 20 hours a week. Two-thirds of AFDC parents in Michigan were now working as a result of the program, which had entailed securing several waivers of federal regulations, including a limit on the number of working hours that were permitted in two-parent families receiving welfare benefits.
• Massachussetts’ “Ten Most Wanted” poster program, under which the names of the ten residents owing the most in child support were displayed in post offices across the state. The state had also made willful nonpayment of child support a felony, hospitals were now required to undertake efforts to establish paternity at birth, and the state revenue department was empowered to pull the professional and driver’s licenses from those who were guilty of non-payment.
• In Wisconsin, which led the nation in transitioning people off of welfare, cash benefits were limited to two years. The state’s Learn-Fare program required that children stay in school in order for their families to continue receiving welfare benefits. And under a program called Children First, non-custodial parents were required to work or be subject to incarceration.

Senator Bob Dole told Governors that no health care reform legislation could be enacted without broad, bipartisan support. The Senator also talked about anti-crime legislation, stating that he had concerns about the three-strikes-you’re-out proposal, which he felt would not stop violent crime. He also said that he was about to introduce legislation to establish a gun buy-back program, under which the federal government would match state buy-back efforts dollar for dollar.

In his address, which focused on health care and welfare reform, President Bill Clinton said that small businesses paid health insurance premiums that were on average 35 percent higher than those for large businesses and government. The most conservative estimate of uncompensated care burdens on hospitals was $25 billion annually. A total of 58 million Americans were without health coverage at some time during the year. And 81 million Americans had preexisting conditions that either raised their premiums or limited their health coverage. Clinton also noted the connection between health care and welfare, emphasizing that many people simply could not afford to work because of the high cost of employer-based health insurance.

Memorable Quotes:

German Chancellor Helmut Kohl said: "…the fact that I am here today as Chancellor of a free Germany has a lot to do with what American friends did over these past nearly 50 years. Throughout these decades the United States [has] borne the most important responsibility globally and…always tried to give their best…Which other nation on earth would have so quickly helped its newly vanquished war enemies…we have not forgotten that over these 48 years, about 15 million Americans…have lived in our country, have served their country as soldiers in Germany together with their dependents. Far away from home they defended our freedom, our common freedom…Their steadfastness was a decisive factor in the collapse of Communist dictatorship and the freeing of Central and Southeast Europe and Germany's reunification in peace and freedom…The close partnership and friendship between our two countries has stood the test of time…This is why it is as important as it was then…that only a strong America will be in a position to assume its world responsibilities…your country is the only remaining superpower. The world continues to pin even more hopes and expectations upon you."

At the same time, Chancellor Kohl noted: "[W]e Europeans want to continue to develop a trans-Atlantic partnership…America needs Europe in the future, too…Our efforts to create a genuinely independent European security policy and defense policy are designed to complement and strengthen the Atlantic alliance. And what we also need…is to try to see to it that less of a burden falls on the United States…"

Governor Carroll Campbell of South Carolina said this about the need for welfare reform: "…even though our economy appears to be in a significant upswing, there is not a corresponding reduction in public dependency. Today the impact of the economy has been overwhelmed by the impact of social trends reflecting family breakdown and a change in values and responsibilities…The very fabric of our society is under siege and unless we take some steps now to begin the long task of changing these trends, the society that we bequeath our grandchildren will be far different from the one on which our achievements have been built…We, in government at all levels, should refocus. We should bolster family financing, help educate children, and improve public safety and support those in need so they won't always need support. Pocketbook pressure is the major stress on families. The government doesn't help matters with big programs and bureaucracies. We need to look for financial relief to strengthen families."

Senator Bob Dole said about crime control legislation: "I know the item of the day, the hot ticket is the three strikes and you're out. Or, as I said, three strikes and you're in forever. I guess at the federal level if that is finally adopted it may take care of about 250 to 300 prisoners a year…But as far as ending violent crime, it's not going to do it…Let me say right up front that…most of us don't believe that just locking people up and throwing away the key will solve the crime problem by itself…And there is a strong bipartisan feeling about [truth in sentencing] on the Senate side. We know we have to start early. We have to work with young people. We have to make sure they understand that there is a right and wrong…[But] [w]e've seen far too many stories about violent felons committing horrible crimes soon after they're released from jail…and that's why we make incarceration a top priority."

Selected Policy Positions Adopted:
(1) Calling on Congress and the Administration to recognize the federal government's sole responsibility in immigration policy by repealing federal mandates requiring state, territorial, and local governments to fund health care and other public services to undocumented individuals; (2) expressing the need for comprehensive programs to facilitate safe and efficient motor carrier transportation; (3) calling on the federal government to return the Supplemental Security Income program to its original framework, in which states had flexibility in administering their state supplemental payments; and (4) supporting federal "three-strikes-you're-out" legislation that would require a sentence of life imprisonment without parole or probation for any individual convicted of a federal felony who had two prior convictions for violent offenses.

Presidential Addresses: