Why did we host the California Healthcare Summit?
Biomedical innovation is the combined product of a set of key questions and principles that the
human imagination, scientific discovery, and venture California Healthcare Institute can incorporate into
investment. Over the past generation, California— our policy agenda. These principles began with a core
rich in all three—has produced more such innovation belief in the value of medical innovation, for there is
than anywhere else in the world. This would be cause no other way to address the many diseases that today
for celebration, but widespread concern about have no cure. If one accepts that innovation must
increased spending for medical care (especially the continue because patients are waiting, this ineluctably
costs of advanced medical technologies) clouds the leads to certain additional principles: adequate govern-
industry’s future. ment funding for education and basic research;
This year’s California Healthcare Summit was protection of intellectual property; reasonable reim-
organized to explore the dynamics of biomedical bursement for innovative products; and in California, a
innovation from the perspectives of those who business climate supportive enough to allow biomed-
produce it: academic leaders, scientists and corporate ical enterprise to flourish.
executives. While each of these groups plays an essen- These are CHI’s common principles, and what
tial role in technological innovation, surprisingly, they follows is the rich conversation from which they grew.
seldom come together to share their perspectives. Yet
they confront many of the same questions: How can
we measure the value of new drugs and medical – David Gollaher
devices? How can we afford them? President and CEO, California Healthcare Institute
The long debate about expanding Medicare to
cover pharmaceuticals brought these issues into sharp
focus. Alas the Medicare bill recently passed by
Congress does little to resolve the structural problems
in the pharmaceutical and health care industries. For We were very pleased to participate in
instance, health care executives understand that CHI’s Inaugural California Healthcare Summit and feel it
because the government is buying more drugs, it will initiates a proactive means of having academic and industry
inevitably scrutinize products more closely in order to leaders come together to resolve the critical issues facing the life
restrain spending. sciences industry. We look forward to the continued work that
What form this scrutiny will take is unknown. CHI is doing to facilitate the growth and evolution of this
Government agencies and private sector payers are industry regionally, nationally and globally. –John Rhodes,
exploring different tools that might be used to enforce Global Life Sciences Leader, Deloitte.
the practice of evidence-based medicine. But the drugs
industry fears that government intervention in medi- The following paper summarizes some of the complex issues that
cine would fix prices, and that innovation would came to light during CHI’s Inaugural California Healthcare
inevitably suffer. Whether the private sector can Summit. An effective solution to these challenges will result from
organize itself to weigh the costs and benefits of new the collaborative effort between academic leaders, government
technologies remains to be seen. officials, scientists and corporate executives. Sustaining this
California has its own problems, all of which affect collaboration is key to the future of the life sciences industry and
health care: a record budget deficit, political tumult, CHI will play a major role in facilitating that continued
deteriorating infrastructure, and legal and regulatory exchange. –Lee Akay, Senior Life Sciences Partner, Deloitte.
burdens that hamper business expansion and job
creation. In a global market, where Singapore, Puerto
Rico, and Ireland aggressively compete with dozens of Since the time I became governor in January of ’75, there are
American states to attract new plant facilities, 25,000 new laws. Now if you really want to increase your profit
California is at risk. Unless the state recognizes the margins, reduce the hassle of dealing with traffic and weather and
importance of biomedical manufacturing, and adopts obstinate political considerations, if you are looking for land and
policies that encourage growth, our industry’s next good transportation and a good port that doesn’t have the conges-
wave of jobs may be created elsewhere. Once gone, tion of the Alameda Corridor I suggest you move your business to
they are unlikely ever to return. Oakland. We don’t have too many regulations.
Ultimately the purpose of this Summit was to create –Mayor Jerry Brown, Welcome Reception Keynote Speaker
ADVERTORIAL CHI INAUGURAL CALIFORNIA HEALTHCARE SUMMIT 1
The Business Case for the Value of Medical Innovation
David Beier, Partner, Hogan & Hartson medicine, and international competition. And, in
closing, Beier posed what he considers the most
Alan Garber, M.D., Ph.D., Director, Center for Health profound issue for the industry: How do you reconcile
Policy/Center for Primary Care and Outcomes Research, what is essentially a free market pricing system in the
Stanford University School of Medicine United States with price controls elsewhere in the
world? How do you persuade the Europeans, the
Greg Simon, President, Center for Accelerating Japanese, the Australians, and others with high stan-
Medical Solutions dards of living to pay higher prices for drugs in order
to help fun some of the R&D expenses currently borne
David Beier acknowledges that there are a lot of chiefly by Americans?
reasons why government ends up influencing the David Beier’s comments were a perfect lead in to
outcome of product decisions in the private sector, not Alan Garber’s perspective on short term trends in the
the least of which is the sheer scale of government market for innovation. A market that, he claims, is
spending. A trillion and a half dollars is in play across increasingly price sensitive.
the entire healthcare system. The government now Garber asks that we look at what’s happened to
spends 27 billion dollars on NIH alone and further private health insurance premiums. Through 2003
encourages R&D activities through a variety of tax there have been three years of double-digit increases
mechanisms. In fact, the tax law is a big stimulus for in private health insurance premiums, and 2004 is
capital formation as it empowers venture capitalists to expected to increase again in the 12 to 15 percent
pick winners and losers instead of relying on govern- range. This is a sustained increase that far exceeds the
ment to fund life sciences investment as so many general rate of inflation and the rate of growth in
foreign countries must do. workers’ earnings.
When premiums increase at these rates,
more and more people become uninsured.
Garber explains, “You ratchet up premium
costs, the number of people with insurance
goes down just as you would expect.”
Can we count on new technologies to help
lower expenses in the future? Garber discour-
ages this line of thinking, explaining,
“Typically, new technologies in medical care
do not lower expenditures. They may be
worthwhile… but they don’t typically lower
expenditures. For one thing, demand is highly
subsidized because most of the consumption
of drugs and devices is by people who are
paying a fraction of the real cost; typically
between zero and twenty percent.” People
Another way government influences the market- tend to consume more when they’re paying less of the
place is its role in pre-market approval of products. cost. However, increased consumption also promotes
Increasingly, because government is a huge payer, innovation. It means that producers of technology can
federal agency decisions about whether or not to expect greater revenues than they could in the
approve a product, or whether to pay for a product absence of insurance. The market for innovation will
(and at what price), drive private sector decision- continue to evolve, but the focus will need to be upon
making. Beier pointed out that the government sets demonstrating value.
the rules and implements them with respect to intel- As President of a newly formed organization,
lectual property and trade, saying, “If you can’t Center for Accelerating Medical Solutions, Simon
protect your products against free riding, and you states his firm’s mission as nothing short of acceler-
can’t access foreign markets, you’re not going to be ating time. As he says, “It’s about bringing what’s going
able to make money.” to be in the future more quickly to the present.” And
Beier summarized six challenges that can’t be one of the most important issues is related to the
ignored: intellectual property, product approval, reim- economic benefit of accelerating a cure rather than
bursement, limits on sales and marketing, personalized extending a life for an additional six months. Simon
2 CHI INAUGURAL CALIFORNIA HEALTHCARE SUMMIT ADVERTORIAL
“All Your Issues are Big Issues” than their grandparents or even their own parents, the
Baby Boom generation. The economic cost of battling
–Greg Simon these diseases, and the lives lost to them, is enormous.
When you talk to the groundbreakers out there,
states that the U.S. spends a significant amount of they say that all of our focus right now should be on
money on pain management to extend the lives of early diagnostics. Our challenge will be to motivate
terminally ill patients in their last six months while the companies to continue to develop these early diagnos-
amount of money spent up front on prevention of the tics when past innovations have suffered from
illness is paltry by comparison. When we talk about decreasing levels of reimbursement and intense
accelerating a cure for cancer by one year, we’re not scrutiny by payers.
talking about saving a life by one year. We’re
talking about saving a life that will contribute
productively for another 15 years accruing an Leading Causes of Death in 1900 vs. 2000
enormous benefit to society.
These days, we don’t die the same way we As precent of all deaths in the United States
used to. At the beginning of the 20th century;
pneumonia was the number one cause of 1900 2000
death. Tuberculosis came next, and diarrhea PHEUMONIA 12% HEART DISEASE 30%
was third in line. Now, in the 21st century, TUBERCULOSIS 11% CANCER 23%
heart disease, cancer, and stroke top the list. DIARRHEA 8% STROKE 7%
Furthermore, in that same space of time, we HEART DISEASE 6% RESPIRATORY DISEASE 5%
have increased our life expectancy from the LIVER DISEASE 5% ACCIDENTS 4%
age of about 50 to 75 or so. And yet, today’s
children are much more likely to get cancer SOURCE: MILKEN INSTITUTE
Forging the New Industry-Academic Partnership
Edward Penhoet, Ph.D., Chief Program Officer, Science comparatively new players in the interaction with the
and Higher Education, Gordon & Betty Moore Foundation academic world, and this brings new life and perspec-
tives to the exchange.
M. R. C. Greenwood, Ph.D., Chancellor, University of Penhoet posed several key questions for considera-
California, Santa Cruz tion: How well is technology transfer working?
Should the National Institutes of Health focus exclu-
Christina Waters, Ph.D., Director of Scientific sively on basic research, or should it assume a more
Development, Genomics Institute of the Novartis Research translational approach to its mission and move toward
Foundation actually developing products? If it’s the latter, is this
going to change the way universities think about their
Fittingly, for a discussion centered on ways in own role in translational research going forward? And
which industry and academic collaboration can move what role will universities play in commercializing
scientific discovery forward, this panel chose a collab- pharmaceuticals and other health care products for
orative approach featuring an interactive exchange the Third World?
with the audience. With that, Penhoet handed the microphone to
While microphones were being positioned M.R.C. Greenwood, who commented, “When a $30
throughout the audience, Ed Penhoet began by billion agency at the federal level begins to change its
acknowledging that the topic of the relationship policies, that always has an impact on the university,
between industry and academia is a tired one but one because our university researchers, especially those in
worth looking at because there are new factors at play. the life sciences, are very sensitive to directional
For example, Penhoet noted that virtually all the large changes.…When it looks like somebody’s going to tell
pharmaceutical companies in the world have become them how to do their business and how to do more of
biotech companies. One by one, they are moving to the translational side of research than the basic
the clusters where biotech thrives—the Bay Area, San research, then it usually results in great anxiety and
Diego, Cambridge—places centered around leading push-back. And that’s sort of the state that we’re in
academic institutions. Pharmaceutical companies are continued on page 4
ADVERTORIAL CHI INAUGURAL CALIFORNIA HEALTHCARE SUMMIT 3
continued from page 3
right now with the so-called NIH road map. We don’t
understand it very well. There’s a lot of anxiety.”
Christina Waters described an innovative business
model that is working well for Novartis. GNF, the
Genomics Institute of the Novartis Research
Foundation, is a 260,000-square-foot laboratory for
400 scientists located in the heart of San Diego’s
biotechnology cluster. The Scripps Research Institute
is across the street, the Salk Institute and University of
California, San Diego, are down the road, and dozens
of local biotech companies create a vibrant and entre- Panelists from left: Christina Waters, M.R.C. Greenwood,
preneurial community to draw from. GNF scientists Edward Penhoet.
hail from chemistry, genomics, proteomics, structural into the Novartis pipeline. Bringing everything
biology, computational biology, and engineering, and together under one roof has proved to be a very
there is a strong emphasis on informatics across all the powerful way to move science forward. In fact, Waters
disciplines. There are two interdisciplinary discovery reported that GNF has moved forward with three
teams focused on discovery research and an infrastruc- startup companies to date, a remarkable success rate
ture that supports translational medicine that flows for a company that was started only four years ago.
A Vision for Transformation: Medicare in the 21st Century
Mr. Gingrich thinks big. care available to all patients, from rural to urban
His vision for the locales. Managing such a system would require the
future of healthcare creation of a new position, Undersecretary of
centers on the need for Commerce for Health.
transformation not Gingrich was a strong proponent of the recent
reform. Reform, he change in tax law for health reimbursement
explained to the accounts which allows them to carry over from
Summit delegates over year to year rather than expire in December.
luncheon, is a losing Similarly, he sees enormous potential in flexible
battle. A system that doesn’t prioritize patient spending accounts which would carry forward
safety as its key driver, that doesn’t capitalize on balances from year to year earning interest tax
information and communication technology, that free. As the accounts build up over time, the indi-
doesn’t create a means to promote the culture of vidual has a large reserve available to support high
quality service with measurements, and that is not deductible plans. In addition, with flexible spending
centered around consumer responsibility, knowledge plans coupled with high deductibles there is a
and power to choose healthcare solutions, will not strong incentive to manage personal preventative
be successful in the 21st century. Gingrich argues healthcare. As Gingrich puts it, “When you have to
that we need to address these key drivers as priori- pay for our own oil change, people don’t let their
ties by redesigning the entire Medicare program engines freeze up.” On the other hand, he says, “Co-
from the ground up, not by marginally improving the pays actually maximize the cost of the drugs
current system. Such a redesign would reflect reali- chosen in a given class because if I’m going to put
ties in both costs and in drug usage in terms of up ten dollars in advance, or twenty or thirty, and
price controls and would provide incentives for my choice is a drug that costs fifty, seventy or
health management, co-morbidity management and ninety [dollars]…I get a higher return on my dollar
specialized care, in addition to the use of informa- if I pick the most expensive drug.”
tion technologies and continuing medical education. One central theme that emerged throughout
His vision of the end goal for this system would be Gingrich’s presentation was his conviction that
to allow every doctor in the country to adopt best health is a moral issue. He states, “You have to start
practices within a year of their introduction and with saving lives and then you can get permission to
consequently provide the highest quality of health- save money—you can never do it in reverse.”
4 CHI INAUGURAL CALIFORNIA HEALTHCARE SUMMIT ADVERTORIAL
How Government Price Controls Affect Innovation
G. Steven Burrill, CEO, Burrill & Company commercial products have been introduced only in
the past few years. What’s crucial, he said, is that the
John Martin, Ph.D., President & CEO, Gilead Sciences capital markets supported the company’s early years
of R&D, and that ultimately these products have
Peter Barton Hutt, Partner, Covington & Burling come to market to address important, unmet medical
needs. The key to Gilead’s success was that from the
Three distinguished CHI board members offered beginning, stakeholders understood the product inno-
different perspectives on the relationship between vations and believed that if Gilead’s products worked,
pricing and medical innovation during this late-after- they could command premium prices.
noon session. Their various backgrounds in venture While Gilead commercializes some drugs world-
capital, drug discovery, government, and law wide, its AIDS products are available in every
informed their views and gave the discussion remark- country in the world. In resource-poor countries,
able range and depth. AIDS drug prices can be as low as 10% of the U.S.
The venture capitalist perspective came first as price. Martin believes that the U.S. public under-
Steve Burrill opened the session, saying, “We started stands why subsidizing AIDS drugs in poor countries
this industry some 35 years ago, and for 35 years we is necessary. Still, he reflected on the challenge of
have had one single umbilical cord and that is the how to serve global markets without jeopardizing
capital markets.” Burrill went on to explain that the business principles, innovation, and the ability to
relationship between government policy and the develop future drugs.
capital markets directly affects investors’ returns. He Martin went on to share the experience of intro-
recalled the market’s negative response in the early ducing the antiviral drug Viread in Canada, where
’90s to the Clinton administration’s proposed health Gilead has captured 10% of market share. The
care reforms. There was an immediate reaction on trouble is, this share doesn’t come from sales; Viread
Wall Street as initial public offerings dried up is given away free as part of an extended clinical
overnight and pharmaceutical companies’ stock prices trial. The company has delayed launching the
plunged in anticipation of government price controls product because the price review board in Canada
on drugs. Burrill more recent example was President would simply mandate a price, undoubtedly 40%
George W. Bush’s announcement that the government lower than the U.S. market pays, with no regard for
would spend over $6 billion on bioterrorism, which how this would affect future innovation. The price
sent stock prices soaring for biotech companies with differential would inevitably aggravate the current
potential solutions. problem of reimportation between Canada and the
Next Burrill talked about a regulatory burden that United States.
directly affects investor returns: the complexity and Peter Hutt expanded on the theme of importation.
duration of the path to U.S. Food and Drug When consumers are so frustrated by high drug
Administration approval. Burrill welcomes the prices that they take buses to Mexico and Canada,
approach of new FDA Commissioner Mark politicians capitalize on their dissatisfaction. Hutt
McClellan, characterizing McClellan as fundamen- said the situation creates border state politicians who
tally an economist, notwithstanding his medical condone the practice of importation for the sake of
credentials. Regarding FDA policy changes to come, political survival. He was indignant that the FDA has
Burrill predicted we’re going to see more conditional been attacked for insisting that U.S. drug law, which
approvals at the end of Phase III trials. And then, he prohibits importation, be enforced. Hutt reminded
says, we’re likely to see a lot of label restrictions later the audience that the U.S. subsidizes the research
on. He summed it up by saying, “The problem we that produces most medical breakthroughs, and noted
have in this biomedical innovation business is you’re that Commissioner McClellan has argued that the
talking about things that have roughly 20-year international pricing problem will not be solved until
patent lives, and we take 15 years to get them the rest of the world pays its fair share for drug
approved. We don’t have a whole lot of time left to research. And this led Hutt to express another
recover their value.” concern: are we going to have to rely on philan-
John Martin’s story confirms Burrill’s thesis. His thropic organizations such as the Gates Foundation
company, Gilead Sciences, in business since 1988 to finance drugs that combat malaria and other
with $1.6 billion spent on R&D since its inception, diseases for which there is no market in the United
experienced its first year of profitability in 2002. States? How can the U.S. free-market system co-exist
Martin explained that Gilead’s most significant with price-controlled systems around the world?
ADVERTORIAL CHI INAUGURAL CALIFORNIA HEALTHCARE SUMMIT 5
Spotlight on California
expenses, but those areas are becoming increasingly
Can Medical Innovators cost-prohibitive. Taxes in California are high across
the board, added Woodgrift, and he is worried about
Continue Manufacturing a referendum under discussion which would poten-
tially increase commercial property tax value by
in California? 55%. “This is a problem because when you have
jobs, you have to have infrastructure for those jobs,”
Tracy Lefteroff, Global Managing Partner, Lifesciences, Woodgrift concluded.
PricewaterhouseCoopers Robert DiTullio offered another perspective which
focused on workforce quality. His company,
Robert DiTullio, Vice President, Regulatory Affairs & Diagnostic Products Corporation, has doubled its
Quality Systems, Diagnostic Products Corporation headcount in California over the past ten years while
at the same time enjoying a three-fold increase in
Todd Kaufman, Director, State Government Affairs, sales. During that time, he’s become convinced that
Genentech firms need workers who have technical training and
experience. Through internships and more focused
Dana Mead, Jr., President, Guidant Vascular Intervention coursework, new hires can now enter the workplace
with the skill sets necessary to become productive as
Randy Woodgrift, Corporate Vice President of soon as they join the company. One of the tremen-
Manufacturing Operations, Edwards Lifesciences dous advantages to being in California, DiTullio
remarked, is access to the University of California
As moderator of this afternoon session, Tracy system with its high-quality programs that prepare
Lefteroff led off the discussion by sharing early students for careers in biomedical manufacturing and
trend data from a manufacturing survey recently the life sciences. This access to skilled workers,
conducted by CHI and PricewaterhouseCoopers. A combined with the diversity of the workforce popula-
majority of California companies surveyed reported tion, is one reason Diagnostic Products continues to
that they expect to expand manufacturing in maintain a strong presence in California.
California in the next two years; significantly,
though, during the same period many also plan to
expand outside California. Decisions about where “You can build a building
to locate facilities are driven by several factors,
including proximity to R&D, workman’s compensa- anywhere, and that’s a cost, but if
tion costs, state tax policy (including manufacturers’
tax credits), along with infrastructure, housing and you don’t have the right talent…”
overall cost of living.
The survey data reflects trends Randy Woodgrift –Randy Woodgrift
sees at Edwards Lifesciences. Edwards represents
3,000 manufacturing jobs producing an array of The CHI/PWC survey revealed tax credits as a key
cardiovascular technologies —tissue, heart valves driver of decisions about plant expansion. As Dana
and walls. Woodgrift observed that while his Mead shared statistics from Guidant’s worldwide oper-
company is growing in California, it is growing ating units, it became apparent just how significant
even faster in other locations. those credits can be. Since 1994 when Guidant was
Woodgrift touched upon several areas that make spun off from Eli Lilly, the company has added 2,000
doing business in California more difficult than it jobs--almost all internationally. As a result of this shift,
should be. One is the abundance of regulations. Guidant’s overall tax rate has dropped from 34% to
County, state and federal agencies have different, 24%, savings that have enabled investment in other
and sometimes conflicting, regulations making parts of the business. Mead pointed to the corporate
corporate administration excessively burdensome. tax burden in California, which is 40% higher than
Another concern is the high cost of living in the national average, and to the manufacturer’s tax
California. In the past, companies could relocate credit which the legislature allowed to expire, as two
to non-urban areas of the state to reduce living areas that need to be addressed. He told the audience
6 CHI INAUGURAL CALIFORNIA HEALTHCARE SUMMIT ADVERTORIAL
that in Guidant’s operations in Puerto Rico, taxes were research,” said Ortiz, referring to a new law she
2-5% per year, while in Ireland they were still attrac- authored. “California has managed to lure at least
tive at 10-12% per year. 35 of Harvard’s best and brightest researchers as a
Genentech’s Todd Kaufman brought up the issue of result of that legislation.”
state tax apportionment formulas, contrasting Ortiz emphasized that California is a global
California’s formula which is based upon sales, payroll leader in biomedical research, biotechnology,
and property with that used by other states where medical device production, and medical diagnos-
property and payroll are excluded. “If a company like tics. She listed the positives of California—that the
Genentech were to locate a new plant in another state, state topped Fortune’s 2002 list of best states for
we would not increase our tax burden for corporate business, and that more than 650,000 jobs were
income in the state we moved to, and we would reduce added in California between 1999 and 2003.
our tax burden, because we would be reducing our But she acknowledged that the Golden State still
apportionment in California,” reasoned Kaufman. must battle serious challenges.
“We’re talking about an annual benefit…of maybe $30- “We’re facing this ongoing budget deficit of at
$35 million. And rising as sales grow. That’s enormous.” least $8 billion, and that will undoubtedly
Kaufman went on to explain that in biopharmaceu- constrain our ability to fund a number of important
tical manufacturing, facilities need not be continued on page 8
located near R&D. Because facility invest-
ments are made in advance of FDA
product approvals, and are consequently The Road from Recall to Reform
high risk ventures, companies are going
to look for opportunities in states where Republican Assemblyman Kevin
there are favorable tax incentives and McCarthy – the first freshman
other up-front financial incentives that ever elected leader of the GOP
reduce their net costs over time. caucus – exudes enthusiasm and
California needs to take these issues seri- energy.That enthusiasm was
ously if it wants to protect its contagious at the Summit Dinner
manufacturing base. as he shared an insider’s perspec-
tive on Governor
Schwarzenegger’s agenda. In
contrasting Schwarzenegger with Gray Davis he pointed out
California’s Health that above all else, Schwarzenegger is the consummate leader;
he takes a position and actively champions it. He is an effective
Care Agenda in 2004 champion because he has a gift for reaching out to people and
building coalitions. He doesn’t get things done by sitting in his
California office; he is out and about sharing his ideas and philosophies
Senator with legislators, the press, and the voting public.
Deborah Schwarzenegger’s single biggest challenge is solving the
Ortiz (D: budget crisis, and he will pursue this with a single-minded
Sacramento) focus. As McCarthy says, “His mind is on solving the budget
is deeply and solving the economy, and he will drive and drive until he
committed brings it back.” One of Schwarzenegger’s first initiatives upon
to taking office was to audit the state budget. McCarthy reported
promoting that the transition team is also taking a close look at pension
medical research for human health. Chair and worker’s comp issues.
of the State Senate Health Committee, In closing, McCarthy acknowledged that Schwarzenegger
Ortiz addressed the summit during an intends to reform Sacramento by changing the structure of the
afternoon session and spoke positively way things are done. Effectively, the message from the people
about California’s role in scientific devel- in the recall campaign was, “We want change.” And
opment. Schwarzenegger’s message to the people is, “Change is going
“I felt passionately about stem-cell to come.”
ADVERTORIAL CHI INAUGURAL CALIFORNIA HEALTHCARE SUMMIT 7
Spotlight on California
continued from page 7 economic recession, growing competition from other
priorities,” said Ortiz, who also sits on the state’s states and countries, rising health care costs, and
Senate Budget Committee. In addition, she pointed soaring workers’ compensation premiums. Ortiz
out that about 33% of California’s budget currently pointed out that low-income seniors are “having to
goes toward health and human services, which she make very difficult choices of whether to buy medi-
called “our most expensive and our most vulnerable cine or food.” Despite these difficulties, she remains
area in the state budget.” hopeful about reaching political consensus to solve
California’s budget crisis comes during a period of California’s problems.
Total Recall
Daniel Weintraub loves who is surprised by the new California governor’s
his job. He has covered reception. “Sacramento has been called
California government ‘Hollywood for ugly people,’ but apparently that’s
and politics since about to change as now it’s just going to be
1987 and is presently Hollywood, period.”
a political columnist Beyond the media frenzy, people in Sacramento
for the Sacramento and throughout the state expect new leadership
Bee. He boasts that he will translate into significant changes for
has the best job in California.
journalism. Still trying to grasp the meaning and So now all eyes are on the state capital.
implications of the California recall election, the Weintraub describes Schwarzenegger as generally
veteran reporter explored the state’s changing of nonpartisan, and expresses optimism that his lead-
the guard during the summit’s closing session. ership could bring innovation and transformation.
“Gray Davis got into his predicament because Weintraub concedes that Medi-Cal will probably
of his unwillingness to make tough decisions,” said suffer in the “budget mess” in the months ahead
Weintraub. He had observed Governor Davis’s and notes that Schwarzenegger opposed legislation
impressive climb and had witnessed firsthand his mandating employers to provide health coverage to
political collapse—his loss of recall votes even in workers. But he remains cautiously enthusiastic
parts of the state where he had won the majority. about progress.
Weintraub thinks the energy crisis and Davis’s “You’re not going to be able to pigeonhole him.
shortsightedness contributed to his political down- He’ll be on the left on one issue and on the right
fall. And now Arnold Schwarzenegger, who he says on another,” said Weintraub. He describes the new
“was in the right place at the right time,” has governor’s approach as “more hopeful, more
taken office. forward looking, more thinking about the future,
“Schwarzenegger walks through a lobby and less fear of making mistakes. Taking risks and
people just burst into applause,” said Weintraub, trying new things.”
FOUNDING SPONSOR SUMMIT SPONSORS
8 CHI INAUGURAL CALIFORNIA HEALTHCARE SUMMIT ADVERTORIAL