Plenary Session Transcripts

• Economic Development and Commerce Committee (EDC) – Global Competitiveness and Innovation Strategies for States
• Education, Early Childhood and Workforce Committee (ECW) – International Education: Preparing Students for the Global Economy; and Global Competitiveness and Critical Language Initiatives
• Health and Human Services Committee (HHS) – Opportunities for States in New Federal Medicaid Reforms
• Natural Resources Committee (NR) – The Potential Impact of Emerging Energy Technologies on U.S. Energy Policy
• Other Sessions: "Creating Healthy States" breakout sessions on "Where we Learn: Wellness in Our classrooms and Lunchrooms," "Where We Work: Wellness in Our Offices and for Our Employees," and "Where We Live: Wellness in Our Homes and Communities;" and special session on "Challenges and Opportunities in Building a National Health Information Network"
• Plenary Session Discussion Subjects - creating healthy states; a culture of wellness; update on achievements in education; and the health care crisis

Dr. David Katz of the Yale School of Public Health cited statistics that reveal a tripling in the rate of obesity in children and adolescents over the span of just a few decades. But he argued that he believed those statistics were in fact underestimates, due to our society’s tendency to avoid labeling someone "overweight." He added that some 65 to 80 percent of American adults are overweight or obese, and he noted an explosion of Type II diabetes that threatens to arrest progress made in reducing cardiovascular mortality among adults in the United States. He also noted the occurrence of insulin resistance among children. Most troubling, Dr. Katz said, is that humans have no natural defenses against caloric excess. We are designed for physical activity, and the reduction in that activity brought on by relatively recent changes in technology (i.e., the proliferation of automobiles) and lifestyle is something that the human body was not designed to withstand. And eating foods spiked with hidden flavor enhancers—i.e., sale and sugar—stimulates the appetite, so we take in more calories in order to feel full.

Olympian Joan Benoit Samuelson, Gold medalist in the marathon, told governors of her work co-chairing the Maine governor’s council for physical activity, composed of 24 health and fitness professionals with a mission to promote wellness for Maine citizens through physical activity and other healthy practices. She noted that the council’s most successful initiative had been its work with schools, businesses, and senior populations to promote fitness through walking. And she referred to a program called Health Maine Partnerships under which an infrastructure had been created for implementing physical activity and nutrition initiatives in schools, communities, health care settings, and work sites. She noted that Maine has continued to dedicate 100 percent of its tobacco settlement funds to health care and health promotion. And she urged governors to consider seven additional initiatives to improve the health of their citizens: (1) Enable greater accessibility of state resources such as parks; (2) challenge state transportation departments to implement smart growth objectives and make more communities walkable; (3) improve the use of federal and state funded programs such as Food Stamps for the purpose of purchasing healthier food choices; (4) implement initiatives for youth that would support healthy lifestyles; (5) give children physical education credits for walking, biking, or running to school; (6) promote private, corporate, and school partnerships that build fitness facilities in schools or other public spaces for use by communities; and (7) increase winter activities such as skiing, where feasible.

Mike Leavitt, Secretary of the U.S. Department of Health and Human Services, spoke to governors about a variety of health-related issues, including progress being made with respect to Medicaid reform and Medicare’s Part D prescription drug benefit.

At the plenary session on encouraging a culture of wellness, Lee Scott, CEO of Wal-Mart, talked about his company’s initiatives in support of employee wellness. With 3,800 stores in 50 states and Puerto Rico and staff totaling 1.3 million, Wal-Mart is the largest employer in the nation. Scott discussed Wal-Mart’s creation of jobs in economically depressed neighborhoods, as well as the commitment it has made to environmental integrity and energy conservation through the use of environmentally safe materials and an increase in fuel efficiency in its fleet of trucks. The focus of Scott’s address, however, was the health care benefits that Wal-Mart provides its employees, whether they be full-time or part-time. He noted that 30 percent of staff who have health care coverage were uninsured before they starting working at the company, which insures a total of one million people. It is the company’s policy to gear its coverage to the kinds of care most families need. Recognizing that many families experience the need for occasional medical treatment for common illnesses , its "value plan," for example, permits beneficiaries three doctors visits and three generic prescriptions before any deductible is applied. And Scott went on to say that Wal-Mart is in the process now of making additional improvements to its benefits, including reducing the coverage waiting period, extending the availability of the "value plan" for a slightly higher premium, and ensuring immediate coverage for the children of part-time employees who become eligible for health care insurance. In addition, under contract with private care providers, the company is experimenting with health clinics in some of its stores, which serve as an alternative to expensive emergency room care in many cases.

By the same token, Scott expressed concern about the rising cost of health care, noting that Wal-Mart’s own employee health care costs had risen 19 percent in each of the previous three year. And he expressed opposition to legislation mandating employer coverage. He recommended instead that public-private partnerships be encouraged to find creative ways to make health care more affordable and accessible.

A world-class body builder in his youth, California Governor Arnold Schwarzenegger spoke to his colleagues about health and fitness, and about the importance in particular of instilling the value of healthy living in our youth—something that he said helped him reach and maintain his fitness level. He noted that in California alone, the average body weight of a 12-year-old had risen 10 pounds since the 1970s, a sign that action was urgently needed to reverse the trend toward obesity and poor health.

Governor Schwarzenegger also commented on his shock—while serving as Chair of the President’s Council on Physical Fitness and Sports—on discovering that different federal departments with responsibility for health-related issues did not coordinate their efforts. For example, the Department of Health and Human Services, whose job it was to promote health and fitness, did not work with the Department of Education to ensure that schools maintained quality physical fitness programs and with the Department of Agriculture to ensure that it provided healthy foods through its school lunch program.

Governor Huckabee welcomed "Elmo" and "Rosita"—two of public television’s Sesame Street characters—toopen a panel discussion, moderated by Dr. Sanjay Gupta of CNN News, about the role of messaging and the media in promoting healthy habits among our nation’s youth. Participating in the discussion were executives from public television, Nickelodeon TV, and Channel One.

Governor Huckabee closed the session by encouraging governors to participate in NGA’s Healthy States initiative and informing his colleagues that "healthy states grants"—funded with the assistance of corporate sponsors—would be announced soon as an incentive for governors to undertake projects and innovations designed to encourage health and wellness in their states.

The closing plenary session began with an update on achievements in the education arena, and it was noted that since the national Education Summit held one year earlier, all fifty states had signed NGA’s Graduation Rate Compact and had agreed to collect and publicly report comparable four-year high school graduation rates and related data. A number of governors also shared information about initiatives being undertaken in their states as part of the "Honor State Grant" network in which twenty-nine states were now participating.

Former Arkansas Governor and U.S. President Bill Clinton then addressed the meeting. Clinton’s speech focused on the health care crisis, which he noted was both a federal deficit problem and a significant factor in the ability of the United States to compete on the world economic stage. He noted, for example, that $1,580 of the cost of an automobile manufactured by General Motors went toward the company’s employee health care costs. And he emphasized that reducing the percentage of Gross Domestic Product spent on health care from its current 16 percent down to 11 percent would translate to a savings of $700 billion, which could be spent on other critical needs including investment in alternative energy production. He also noted that certain aspects of health care spending should be targeted for greater scrutiny, including the costs of administration and prescription drugs. And he echoed the sentiments of speakers at the opening plenary session concerning the epidemic of obesity and other lifestyle choices that were contributing to the crisis in health care and health care costs. He referred to the findings of an Emory University study that rising obesity rates accounted for 27 percent of the growth in health care spending between 1987 and 2001. And he noted that three decades earlier, the average American family spent 70 cents of every food dollar on food prepared in the home, compared with 53 cents now. He said that the Clinton Foundation and the American Heart Association (AHA) were engaged in a joint effort to address the problem of childhood obesity—an effort that he said began after he underwent heart surgery himself, which resulted in publicity about cardiovascular health that AHA felt the President could help to expand. And he thanked Governor Mike Huckabee for joining in the Clinton Foundation/AHA alliance, whose goal is to halt the rise in child obesity by the year 2010 and reverse it by the year 2015. He said that the alliance was working with the media to reach out to children and families, with the food and restaurant industry in improving the nutritional value of their products, and with schools to highlight best practices in nutrition and health education.

California Governor Arnold Schwarzenegger said: "…in California alone I can tell you the average body weight of a 12-year-old has increased by 10 pounds since the ‘70s. In California in the last ten years, we gained 360 million pounds of body weight…What does that do? What does that lack of exercise and bad nutrition do to our kids? It has a tremendous health effect. Our kids suffer from depression, heart diseases, sleep disorders, all kinds of things come along with that. Which of course costs a lot of money and puts an extra burden on our health care system."

Selected Policy Positions:
(1) expressing support for the tenets of the "No Child Left Behind Act" (NCLB), while emphasizing a stronger role for governors in its implementation; (2) emphasizing the need for a continued federal commitment to early literacy programs and to students with the greatest needs, as well as to better coordinate early childhood education services; (3) expressing support for public health policies including chronic disease prevention, sufficient public health infrastructure, adequate immunization and vaccine supply, and responding to public health threats including bioterrorism, catastrophic natural disasters, and emerging infectious diseases; (4) strengthening the governors’ commitment to the improvement of Food Stamp program benefits for the elderly and the disabled; (5)recommending that public emergency management assistance be administered through a partnership as defined by state and federal coordinating officers; (6) calling for full funding of the Low-Income Energy Assistance Program (LIHEAP) at its most recently authorized level; (7) seeking strengthened language with respect to state flexibility in the enactment and enforcement of policies designed to reduce youth access to tobacco; (8) urging Congress to exempt federal grants and state matching funds to the Clean Water Revolving Loan Fund and the Safe Drinking Water Revolving Loan Fund from arbitrage rebate requirements, and expressing support for amending the Wetland Loan Act to enable the further conservation of high priority wetlands and grasslands; and (9) clarifying gubernatorial support for providing the U.S. Secretary of Interior with the flexibility to delist or ownlist species protected under the Endangered Species Act (ESA).