Updated: Feb 10
Speaker Jose Oliva's remarks as prepared for delivery on Jan. 14, 2020, the Opening Day of Regular Session, are available below. Video of the full speech is available here.
Governor, members of the cabinet, justices of the Supreme Court, Thank you for joining us today as we open our legislative session.
It is an honor to stand here, not just at the start of a new session but at the start of a new decade. The beginning of a decade which is vastly different than our leaders faced at the start of the last decade. As lawmakers came together to open session in 2010, they did so in the throes of the Great Recession. The financial and housing markets had collapsed and unemployment was at crippling levels. State leaders all across the country were faced with the difficult task of choosing a way forward.
States, like Florida, that made the difficult budget and regulatory decisions enjoyed a full recovery and many, like Florida enjoy an economy that is better and stronger than before the recession. Those states that chose to tax and spend their way out are still looking for answers. Some of them now struggle to stem a mass-exodus. SPENDING IS NOT CARING, SOLVING IS CARING. As we begin this new decade we must keep that example ever-present.
But our work here affects more than just our residents. Florida is a national leader in innovative policy and fiscal restraint. The work we do here is regularly cited by our fellow states and often adopted. If states are the laboratories of democracy, Florida is the leader in bi-partisan, effective and functional government.
Last year alone we passed transformational healthcare and education policy that is being discussed in legislatures around the country. One such piece of legislation stands out as an example of what is possible when we all work together. Frustrated by the unrelenting abuse of the pharmaceutical companies we chose to fight rather than pay their ransom. With the leadership of our Governor and with our partners in the Senate, we looked past our state line and even beyond our country’s borders and we passed a first-in-the-nation drug importation bill.
Since the conclusion of session our Governor has worked tirelessly with the President to force action. Against all odds, the FDA acted. Few issues have attracted the mass special interest opposition our drug-importation bill attracted. Big Pharma hired every firm in town it seemed and flooded the airwaves with false claims aimed at frightening our citizens. Still, we did not flinch.
It is true, we still have a long road ahead in achieving full importation but we moved and immovable object. Beyond that we did something far more significant. We proved that government of the people still lives!
So as we turn our attention forward we still face many challenges. Chief among them continues to be healthcare. We did not choose healthcare as our priority, challenging its many facets has been daunting. No, it chose us, it chose us through the sheer audacity of the defenders of the status quo.
Now, I am not given to hyperbole, I use these words with precision. The Healthcare Industrial Complex made up of Hospitals, medical device manufacturers and pharmaceutical companies are the Great Robber-Barons of our time. The term Robber-Baron is defined by government manipulation, monopolizing industry and price gouging. Check, check and check. The care-givers who work in these institutions are good and dedicated people. The collective actions of the institutions that employ them are unconscionable. These institutions interact with our citizens at their most powerless and exposed moments and they financially assault them.
If during a hurricane a supermarket or a hardware store or a gas station raised their prices even a small percentage, there would be outrage and rightfully so. But if, God forbid, you are involved in an accident on your way home today, you will be in the hands of good people who will work hard to save your life. The organizations they work for will gouge you on every good and service they deem appropriate. Common items like gauze, IV bags and needles will be charged to you at sometimes hundreds of times their original cost. And should you fail to pay you will find yourself among the millions of Americans who have been made bankrupt as a result of exorbitant medical bills. It is unquestionably the single greatest threat to our solvency.
And what do they propose as a solution? More money of course. More money leads to higher prices which leads to more money and so on. What is truly amazing to me is that their appetite is so insatiable that they would risk their own existence in pursuit of more. The drum beats of socialized medicine grow louder each day but so attached are they to their gravy train that they fall deaf to its warning.
Politically, they now have the advantage. Our citizens demand from us a solution. We provide reforms which the Healthcare complex opposes and we are left only with spending as proof of our concern. SPENDING ISNT CARING, SOLVING IS CARING! If spending was the answer we would already have solved it as we turn over nearly half our entire budget to them. They receive State dollars, federal dollars and private payer dollars. We also extend them all manner of local tax breaks and it is not enough! It will never be enough. Until we have the courage to empower the patient and loosen the regulations which have allowed their empire-building it will never be enough.
Each day they find new ways to attract patients and public dollars. The newest iteration is stand-alone ER’s. These facilities are primary care substitutes at emergency room prices. They are highly profitable because they can charge significantly higher rates. How do I know this? I have actually had hospital executives boast of their stand-alone ER’s and their effects on the bottom line. The audacity is such that they advertise them openly on billboards listing the wait times. Clearly this isn’t intended for anyone in an actual emergency as I can’t imagine one would have time to shop. This is done to lure us in to their facilities for far less emergent conditions. Moms and Dads take their children there for sore throats and earaches and fevers.
But if we are being honest, we share a good measure of the blame. We often allow and even provide the conditions necessary for this abuse. One very notable example of negligence on our part has been a great limiter of access. You see fewer and fewer medical students are studying to be primary care physicians. The cost of schooling is high and other specialties offer far more lucrative options. This together with an exploding population has created a large and growing demand for primary care which will soon reach crisis levels.
Florida’s archaic and backwards approach to scope of practice has contributed the problem. Florida is one of a handful of states that still prevent healthcare professionals from practicing what they are educated, trained and certified to do. In spite of truly overwhelming evidence, Florida resists. This kind of protectionism on behalf of special interest groups is not just wrong it is costly and it is dangerous.
In 1967 a report was provided to then President Johnson which explained that more Americans had died in accidents that year than had died in the entire Korean War. The main problem was lack of critical on-site care. At the time ambulance drivers were expected to do nothing more than throw you onto a gurney and speed you to the nearest hospital. Patients were dying in droves along the way. A few courageous and visionary doctors in CA, PA and here in Florida argued that training the ambulance attendants to administer on-site care would drastically reduce fatalities. Needless to say the physician community at large was outraged. The idea that a non-doctor would provide care to an accident victim on the side of the road, in the chaos of an accident scene was preposterous. Fortunately for all of us, these visionaries weren’t deterred. They pressed forward and the millions upon millions of lives that have been saved are their greatest legacy.
How telling of the power of an interest group that I stand here today, over half-a-century later trying to convince lawmakers; Not, to allow people with a two year degrees and 400 hours of training to administer care on a blood stained pavement in a chaotic setting, no, I am standing here saying that an Advanced Nurse Practitioner who has at least a four year degree in nursing, a graduate degree, in many cases, a doctorate in nursing and 2000 hours of clinical, supervised residency to be allowed to practice what they studied! Allowing Advanced Nurse Practitioners to practice independently will have an immediate positive effect on access and affordability.
It is a stain upon a state that prides itself on leading to even humor talk of patient safety coming from interest groups when we now know beyond a shadow of a doubt of its safety and efficacy. Or worse, to use phrases like, “if you want to be a doctor, study to be a doctor”. 30 states have out- grown this backwards policy, 30! It is high-time we allow healthcare professionals to practice to the extent of their training!
Another area where proliferation and spending threaten its own sustainability is our higher education system. We all proudly boast of having the best public University system. But as Thomas Sowell likes to ask, “Compared to what?” Our shared desire to see everyone reach the highest level of education they can achieve has allowed for excesses and created a student debt crisis. Colleges seek to be universities when they would far better serve in their original role. Universities seek extravagance in buildings and sports programs which adversely affect their costs and private colleges seek all takers. As law makers and custodians of the public purse we are relentlessly urged for more. An expenditure for a university is seen as a measure of caring, regardless of the future implications of such expenditures. SPENDING IS NOT CARING, SOLVING IS CARING. Our focus must be in ensuring these institutions will have the sustainability to exist in perpetuity. Public universities and colleges need to be leading the way in finding efficient and sustainable education.
Our scholarship programs are also a crucial component of providing access to higher education. Ensuring they are being judiciously administered is our responsibility. We will be looking closely at these programs, their requirements and most importantly, their outcomes.
Then there are areas where more resources are in order. Our Governor has made the environment a major priority and we will continue to offer our support to his efforts. He has also tasked us with finding ways to increase teacher pay. This house pledges to work towards a significant, equitable and sustainable proposal that can also accommodate wage increases in other critical areas.
One area in particular will be that of our childcare workers. New leadership brings us the opportunity for transformational change. Our budget will include wage increases for Child Protective Investigators and their Supervisors as well as additional dollars for support staff. These fine folks work day in and day out in some of the most stressing environments and have to make decisions that are critical to children’s safety and parents rights. We must support their efforts and provide them with the tools needed to succeed. But understanding that SPENDING IS NOT CARING, SOLVING IS CARING, we are embarking on an ambitious and collaborative effort of reform.
Together with our partners in the senate, the Governor and Sec. Poppell and with the tireless advocacy of our first lady, we will begin the work of reshaping child welfare in Florida. That includes updating infrastructure and reorganizing workflow but it also includes gathering data and using it to achieve the best outcomes for the unfortunate families who find themselves in these situations. It means being the best we can be at deciding whether to separate a family or to help them remain together.
To these ends we have partnered with Florida State University and with the commitment of President Thrasher we will become national leaders in gathering, studying and developing best practices for our child welfare system. We will fully fund the Florida Institute for Child Welfare at FSU to develop and constantly advance their curriculum at the FSU School of Social Work. But as excited as we are about these efforts, we know not all solutions are governmental, that is why we will work with organizations like Better Together to ensure that avoidable family separations and the tremendous bureaucracy that comes with family reunification can be minimized when justifiable.
And finally, the issue we all like to say is our only constitutional obligation, the budget. Chairman Cummings and his sub-chairs have worked diligently on a reprioritization project in all budget silos. The result of their work will allow us to meet new spending requests with existing dollars. I thank you Chairman and all of the sub-chairs for this effort. I look forward to working together with all of the members of this House to once again pass a budget with a reduced per-capita spending, a robust tax break and a stronger commitment to our reserve balances. I hope this decade does not bring the kind of economic turmoil the last one did but our actions today will determine how quickly our state and our leaders will be able to stabilize and recover.
Leader McGhee I look forward to building together on the great work of last session. To President Galvano and our partners in the senate, we reaffirm our commitment to work as we did last session, collaboratively and for the benefit of all.
And members, I thank you all for the trust and confidence you have placed in me. I reaffirm my commitment to you to conduct the business of this House with decorum and integrity and with equal respect for all. May God bless this House and this greatest of states in the greatest of countries, thank you.