Exhibits - Paul O’Neill, Former Secretary of the Treasury

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207 of 995 DOCUMENTS

The White House Bulletin

January 30, 2001

O'Neill Sworn In As Treasury Secretary.

LENGTH: 331 words

In a ceremony at the White House today, Paul O'Neill was sworn in as

President Bush's Treasury Secretary. Before administering the oath of office,

Vice President Dick Cheney said O'Neill's confirmation by the Senate "is good

news for the American economy, because he brings to his assignment a deep

understanding of the world of business and commerce, and he also understands

thoroughly the work of government. He takes seriously our responsibility to the

American people, not just to build a healthy, growing economy, but to keep a

watchful eye as well on how their tax dollars are spent." Cheney added,

"Secretary O'Neill is a man of consistently sound judgment. He'll be a source of

wise counsel on many issues and greatly valued as a member of the team. Finally,

having Paul O'Neill at Treasury is good news for everyone who expects the best

in public service. He's a man of honor and decency, who will make all Americans

proud." After O'Neill took the oath, President Bush said, " With Paul over at

the Treasury, he is literally a next-door neighbor, and I'm going to see a lot

of him right here in this office. He'll be a valued adviser and a steady hand."

Bush noted that O'Neill "has served in this office before, at the Office of

Management and Budget. He understands the workings and responsibilities of the

executive branch. More than that, he understands the private sector, where he

and others like him have been driving our country's economic boom." Bush

continued, "Paul and I share a great goal: to make sure that all Americans canfind high-paying, high- quality jobs. And we share a vision of how to get there.

Our prosperity depends on free trade, less regulation, and America's strong

place in our global economy. More than ever, American jobs depend on America's

standing in the world. I value Paul's vast experience in the world economy. I

value his background in employing American workers. And I value his steadiness,

his conviction and his authority."

LOAD-DATE: January 30, 2001

LANGUAGE: ENGLISH

Copyright 2001 Bulletin Broadfaxing Network, Inc.

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FOCUS - 6 of 6 DOCUMENTS

Associated Press Online

December 18, 2002 Wednesday

O'Neill's Last Day Set for Dec. 31

SECTION: WASHINGTON DATELINE

LENGTH: 189 words

DATELINE: WASHINGTON

Treasury Secretary Paul O'Neill, the first Cabinet member to leave the Bush

administration, will serve until the end of the year, it was announced

Wednesday.

Treasury Department spokesman Rob Nichols said that O'Neill's last day on the

job will be Dec. 31. Starting on Jan. 1, Deputy Treasury Secretary Kenneth Dam,

the No. 2 official in the department, will become acting Treasury secretary.

Dam will serve in that position until the Senate acts on President Bush's

nomination of railroad executive John Snow, chairman of CSX Corp., to replace

O'Neill.

Bush on Dec. 6 shook up his economics team by firing O'Neill and Lawrence

Lindsey, the director of the president's National Economic Council, in an effort

to find more effective spokesmen for the administration's economic policies.

Informed of the president's decision by Vice President Dick Cheney, O'Neill

submitted a terse three-sentence resignation letter saying he would be leaving

the administration, but he did not give an exact departure date.

Since that time, O'Neill has remained out of public view, working in his

Treasury office to wrap up pending matters.

LOAD-DATE: December 19, 2002

LANGUAGE: ENGLISH

Copyright 2002 Associated Press

All Rights Reserved

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News and Observer (Raleigh, NC)

December 7, 2002 Saturday, FINAL EDITION

Bush's economic advisers quit

BYLINE: Lawrence M. O,',rourke, N&o Washington Bureau

SECTION: NEWS; Pg. A1

LENGTH: 1066 words

WASHINGTON -- President Bush shook up his top economic team

Friday, accepting the resignations of Treasury Secretary Paul

O'Neill and White House economic adviser Lawrence Lindsey.

O'Neill's resignation, apparently forced by the White House,

came as the government reported that the lagging economy suffered

another setback in November with a jump in the jobless rate to 6

percent, matching the highest in nearly nine years.

The White House said that O'Neill will be leaving the

government as Bush prepares an economic stimulus package that

will include new tax cuts, some of which were opposed by O'Neill.

O'Neill was the first of the original Bush Cabinet members to

resign. He joined the administration in 2001 with the backing ofVice President Dick Cheney.

Speculation about O'Neill's successor included Wall Street and

corporate executives, retiring GOP members of Congress, a few

Democrats, academic economists, and administration officials.

Among those mentioned from Wall Street were investment broker

Charles Schwab, Goldman Sachs investment banker Henry Paulson,

New York Stock Exchange President Richard Grasso, former Federal

Reserve Board member Wayne Angell, UBS Paine Webber head Joseph

J. Grano Jr., and former Goldman Sachs Chairman Stephen Friedman.

Two Texas Republicans retiring this month were also floated as

possibilities. They are Sen. Phil Gramm and House Majority LeaderRichard Armey, both advocates of an overhaul of the tax system,

lower taxes and spending, and reduced federal regulation of the

marketplace.

Some Treasury watchers speculated that Bush might reach across

party lines and put a Democratic senator, either John Breaux of

Louisiana or Zell Miller of Georgia, in the Cabinet's most

visible economic post.

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GOP sources said that Bush might ask an old friend and

political supporter, Don Evans, to resign as commerce secretary

and accept nomination as treasury secretary.

Also on various lists to replace either O'Neill or Lindsey

were R. Glenn Hubbard of the Council of Economic Advisers andHarvard professor Martin Feldstein.

O'Neill, 67, had gained a reputation as blunt-spoken corporate

executive while serving as head of Alcoa, the world's largest

aluminum maker, in Pittsburgh.

O'Neill has occasionally been on the outs with congressional

Republicans -- once for expressing skepticism about a major tax

cut plan by GOP leaders.

He also made some erratic comments on the stock market,

including a prediction six days after the Sept. 11 terrorist

attacks, when the markets reopened, that stocks would be

approaching all-time highs in 12 to 18 months.

But he has been working since the Nov. 5 midterm election as

if he were going to be spending the next two years fighting for

the economic recovery package Bush will submit next month.

The next treasury secretary is expected to have a critical

position in helping bring about an economic resurgence that will

appeal to potential voters in the 2004 White House election.

The terms and conditions under which O'Neill and Lindsey are

leaving the administration were murky. Administration officials

speaking on condition of anonymity suggested that O'Neill and

Lindsey had submitted their resignations at Bush's request.

"My economic team has worked with me to craft an economic

agenda and help lead the nation out of the recession and back

into a period of growth," Bush said in a statement issued by

press spokesman Ari Fleischer. "I appreciate Paul O'Neill and

Larry Lindsey's important contribution to making this happen."

O'Neill's office released the text of his terse letter of

resignation: "I hereby resign my position as secretary of the

Treasury. It has been a privilege to serve the nation during

these challenging times. I thank you for that opportunity. I wish

you every success as you provide leadership and inspiration for

America and the world."

Pressed on whether O'Neill and Lindsey has been fired,

Fleischer replied, "They have each resigned." The New York Times

reported that Vice President Cheney told O'Neill on Thursday

night that the president no longer needed his services.

On Capitol Hill, Senate Republican leader Trent Lott of

Mississippi declared that the departure of O'Neill and Lindsey

gives the White House "the opportunity to build a new team that

will focus on economic growth and creating American jobs."

Page 2Bush's economic advisers quit News and Observer (Raleigh, NC) December 7, 2002

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The outgoing House Democratic leader, Rep. Richard Gephardt of

Missouri, said the resignations could "spur the administration to

take responsibility for getting the economy back on track."

Another Democrat, Rep. David Price of Chapel Hill, criticized

O'Neill and Lindsey for the return of budget deficits. "SecretaryO'Neill and Mr. Lindsey have presided over a program that has

brought our country back to the dark days of deficit spending

with a total lack of fiscal discipline."

O'Neill and Lindsey have been at odds over the shape of an

economic stimulus package. Lindsey and Bush's political advisers

have proposed a broad package of tax cuts, contending it would

spur consumer consumption and boost the economy even if it had

the short-term effect of raising the federal budget deficit.

O'Neill made no secret of his opposition to broad-based cuts.

He said that the economy was recovering and would pick up the

pace if taxes were cut selectively for certain lagging

industries. He warned that deeper deficits could push up interestrates.

O'Neill perhaps got his most extensive press coverage when he

toured Africa with Bono, the leader of the Irish band U2. Bono

set out to persuade the treasury secretary to wipe out the debt

of developing nations.

###

###

POSSIBLE SUCCESSORS

WAYNE ANGELL, a former member of the Federal Reserve

BILL ARCHER, retired House Ways and Means Committee chairman

JOHN BREAUX, Democratic senator from Louisiana

DON EVANS, Secretary of Commerce

MARTIN FELDSTEIN, Harvard economist

PHIL GRAMM, former Texas senator

RICHARD GRASSO, NYSE president

RUDOLPH GIULIANI, former mayor of New York

CHARLES SCHWAB, investment counselor

ROBERT ZOELLICK, U.S. trade representative

LOAD-DATE: December 7, 2002

LANGUAGE: ENGLISH


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GRAPHIC: Treasury Secretary Paul O'Neill is the first member of Bush's Cabinet

to step down.

Copyright 2002 The News and Observer


Saturday,


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Saint Paul Pioneer Press (Minnesota)

September 27, 1999 Monday

SERIOUS MISTAKES COMMON ACROSS U.S., DOCTORS SAY;

HOSPITALS: IMPROVEMENTS NEEDED

BYLINE: ANDREA GERLIN, Knight Ridder News Service

SECTION: MAIN; Pg. 1A

LENGTH: 1458 words

As most Americans would, more than 30,000 patients who were admitted to 51 ofthe hospitals in New York state in a single year expected that the finest health

care system in the world would provide them every chance of recovery.

For some, the reality was otherwise: 1,130 of the patients suffered injuries

caused by medical errors - not their underlying medical conditions. Of those,

154 died from the injuries.

Put another way, one of every 200 of the patients admitted to a hospital

ended up dead because of a hospital mistake.

Those were among the key findings of the "Harvard Medical Practice Study,"

published in 1991 in the New England Journal of Medicine. It remains the most

comprehensive and rigorous examination of hospital errors ever, while data

supporting the findings throughout the country continue to mount.

"The facts are, we commit thousands of errors every week nationally," said

David Nash, associate dean and director of the Office of Health Policy and

Clinical Outcomes at Thomas Jefferson University in Philadelphia.

"People get killed every day in hospitals," said Bertrand Bell, a professor

at Albert Einstein College of Medicine in New York. "This goes on in every

hospital in the United States. The public doesn't see it at all."

In interviews, top doctors at the University of Pennsylvania, Harvard Medical

School, Stanford University School of Medicine, the University of California at

Los Angeles, and Albert Einstein College of Medicine in New York, said medical

errors are a serious and common problem at hospitals across the country. One

reason, they say, is that the culture of medicine is founded on unattainable

standards of perfection, and those ideals are reinforced by public expectations.

"The country spends an awful lot of money making sure cars and airplanes are

safe," said David Gaba, a physician and professor at Stanford University. "But

this is an issue that's been somewhat hidden because when there's a problem,

it's not 100, it's one or two."

Lucian Leape, a pediatric surgeon and adjunct professor of health policy at

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the Harvard School of Public Health, who led the 1991 study, said those

seemingly small numbers add up to one million people being injured by errors in

hospital treatment every year - and 120,000 people dying as a result of those

injuries.

"Health care is a huge industry, and injury is its number one problem," Leapesaid. "There's an incredibly long way to go."

When the Harvard study was published, it received little public attention.

But organized medicine went on the defensive. The American Hospital Association

disputed the conclusions. The American Medical Association attacked the

researchers' methods and findings.

But as the decade has progressed, and the public has shown declining

confidence in the health care system, the associations have changed course, and

now frequently cite the work of Leape and his colleagues. The American Hospital

Association even made medical error reduction one of its top two quality

initiatives for 1999.

"Most hospitals have systems in place, particularly in terms of medication,to make sure errors do not occur," said Jack Lord, chief operating officer of

the AHA and a forensic pathologist. "There are clearly initiatives under way. Is

there better coordination that could be done? Yes."

Nancy Dickey, a family physician who completed her term as president of the

AMA in June, said: "We still believe that health care is extremely safe in this

country when you consider the millions of interactions every year. However, it

could be better. It could have better controls to prevent mistakes."

Medication mistakes represent a leading category of hospital errors,

accounting for 19.4 percent of the adverse events in the Harvard study. Among

the drugs most frequently at the center of medication errors are insulin, blood

thinners and chemotherapy drugs. They are commonly prescribed in chronic

conditions that can lead to hospitalization, and have lethal potential.

The largest number of errors - 48 percent - resulted from surgical treatment.

By its very nature, surgery carries risks, some unforeseen and others

preventable. Technical mistakes during surgery and wound infections afterward

each accounted for roughly 13 percent of the adverse events identified in the

study.

The Harvard study found that, on average, there was a 3.7 percent medical

error rate at the hospitals in its sample. Other studies have found that only 5

percent to 10 percent of all medical errors are reported to hospital

administrators; the remaining 90 percent to 95 percent go unreported.

Doctors interviewed at leading medical centers agreed that hospital error

rates could be reduced significantly. The steps would not be easy, they say. The

change would have to be broad-based, requiring the medical profession to

overhaul its culture and encourage openness about its limits. In addition,

hospitals and the medical profession would have to use new technology and

systems that have made improvement possible in other industries. And hospitals

and doctors would have to develop more effective means of policing medical

errors.

Paul O'Neill, chairman of aluminum producer Alcoa and chairman of Rand Corp.,

Page 2SERIOUS MISTAKES COMMON ACROSS U.S., DOCTORS SAY;HOSPITALS: IMPROVEMENTS NEEDED

Saint Paul Pioneer Press (Minnesota) September 27, 1999 Monday


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a California think tank, spent 10 years in the White House developing health

care policy during the Johnson, Nixon and Ford administrations. O'Neill said in

an interview that the error rate in hospitals could be reduced substantially.

"If we decided as a nation that we were going to have a 90 percent or 95

percent improvement in outcomes as far as patient errors were concerned, wecould," O'Neill said.

Michael Cohen spent 14 years as a pharmacist at Temple University Hospital

and Quakertown Hospital. Today he is the full-time president of the Institute

for Safe Medication Practices, a small nonprofit organization based in

Huntingdon Valley, Pa. His group collects 50 to 60 confidential reports of drug

errors each month and sends weekly alerts to 5,800 hospital pharmacies around

the country.

Cohen got started in the field after a dire episode while he was at Temple in

1975. "A patient was killed by an insulin order," he said. In that case, Cohen

said, the doctor wrote a prescription for 6 units of insulin, abbreviating

"units" to the letter "u." The letter was read as a zero in the pharmacy and the

patient received 60 units of insulin, or 10 times the proper dose.

The reasons that mistakes occur are multiple and complex. Errors were a

problem long before managed-care pressures led to cutbacks at hospitals in the

last decade.

Many doctors point out that given the number of opportunities they have to

err, it is remarkable that more mistakes do not occur. A study presented at a

1989 conference in Denver found that 178 "activities" were performed each day on

the average patient in an intensive-care unit, with 1.7 errors occurring, or a 1

percent daily rate.

Many mistakes have what in retrospect seem to be simple origins in poorly

designed systems, experts say. Patient care becomes fragmented as doctors and

nurses change shifts or more consultants join the treatment team, multiplying

the risk of communication breakdowns. Different medications may come in similar

packages or have similar names. Handwritten prescriptions and medical charts are

frequently illegible.

"People die of penmanship errors," said Arthur Caplan, director of the Center

for Bioethics at the University of Pennsylvania Health System. "Anybody who

thinks that a system that keeps paper records in script is ready to deal with

error is dreaming. You've got a 19th-century Charles Dickens system in an era of

high technology."

Almost uniformly, doctors and researchers cite an unrealistic and less than

honest culture among medical professionals as the single most important factor

that contributes to errors.

Beginning in medical school, the culture of medicine discourages

acknowledging mistakes, asking for assistance, exhibiting any weakness, or

challenging a supervisor. In medicine's carefully ordered hierarchy, admitting

or pointing out a mistake is frowned upon.

The pressure under which doctors and nurses work, deprived of sleep and

motivated by fear of making mistakes, can actually increase the chances that

they will make errors. "It's well-known that people are more likely to make




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mistakes when they're tired, overworked, hungry, bored, anxious, frightened, in

a hurry, and under pressure from above," Leape said.

In addition, there is little incentive for hospitals to acknowledge and deal

with the problem of medical errors.

Hospital executives, for example, face business pressures to deny the

occurrence of medical errors, lest they be sued and have to pay for them.

LOAD-DATE: October 23, 2002

LANGUAGE: ENGLISH

SERIES: Medical Mistakes: A Special Report

Copyright 1999 Saint Paul Pioneer Press

All Rights Reserved




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Pittsburgh Post-Gazette (Pennsylvania)

November 28, 1999, Sunday, FIVE STAR EDITION

ROUNDTABLE DISCUSSION;

FIVE HEALTH CARE EXPERTS DEBATE HOW TO IMPROVE THE

SYSTEM IN PITTSBURGH

BYLINE: DOUGLAS HEUCK, POST-GAZETTE BUSINESS EDITOR

SECTION: TABS, Pg. H-3

LENGTH: 733 words

Following are the introductory remarks of Paul O' Neill, chairman of Alcoa.

My engagement in the health and medical care activity in Pittsburgh is

related to the view I have of this community, which is broader than health and

medical care.I believe Pittsburgh is a good place with a potential to be a great

place, but I don't think it is a great place yet. In order for us to be a great

place, we need to select the areas where we have a prospect of being great

because we have a good foundation to work from.

In education, I think we have the makings of a great system. At the higher

education level, we have real distinction at Carnegie Mellon, UPMC and the

University of Pittsburgh. Many of the programs are really first rate. I think weare not as great at the elementary levels.

In the health and medical area, we have many elements of greatness but we are

not truly great. I believe it is possible for us to do some things that would be

good for the whole community and that would demonstrate to the whole nation that

there is a different way to think about the problems in health and medical care

- ing on being a place of best practices.According to the best national studies,

there are 185,000 human beings in the United States killed every year by medical

mistakes. To put that in context, that's two Egyptian airliners every day going

down. Because it only happens to one individual at a time, we don't pay a lot of

attention to it, and we don't really see it. But that study said 185,000 -

that's a lot.

The error rate in the best studies is one in 2,000. Think about that. Some ofyou would know about the idea of six sigma. There are a lot of industries that

say, "We are in a six sigma industry." That means you are only permitted to make

3.4 errors per million exposures. One in 2,000 is 500 per million. It's no

sigma.

I think in Pittsburgh we can create a community resolve to be a learning

laboratory for the nation. And we pose to say that we are going to demonstrate

that we can eliminate medication errors in all of southwestern Pennsylvania. And

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we can eliminate staph infections. Those infections are a serious cause of

extended and more costly hospital stays for patients who contract an infection

through no fault of their own, but because of the way medicine is practiced.

Maybe we can add to that that we are going to eliminate accidents that happen

to medical staff. One of the routine ones is for people to stick themselves witha hypodermic needle and get an infection.

We can do this, and it will require a very substantial change in the system

of delivery of medical care. It will require using electronic technology to the

level that we already use it in banks. Believe it or not, we could use it in

medical care. So that you could capture data about a patient's radiology and

admission and all the rest just by effectively using your plastic card to

download data to any doctor you want to.

We already have the capability to do all of these things. My notion is that

we can get the community leaders, in a very broad-based sense, to agree that we

will be a learning laboratory and that we can be on our way to achieving what I

think is possible for the country - an improvement in the value equation of

heath and medical care of something between 35 and 50 percent. That means eithertwice as much care available or half the current costs.

Those are doable things, and if we together don't do something in that

direction, we are going to continue to be the victim of well-intentioned,

fiddling-with-reimbursement formulas that don't accomplish anything except drive

the provider community crazy and interfere in decisions that ought to be made by

people with professional training.

We're not too far away from having an agreement that we are going to try to

do this. That we can do something in Pittsburgh that will show the rest of the

nation how we can do a job that is worthy of an intelligent society, instead of

continually arguing and debating issues that go nowhere.

All of the arguments in the current debate on medical and health care are so

well-learned. Most of the participants can recite their part of the argument in

their sleep. And it's not only boring, it's counterproductive as hell. There is

a better way, and we here in Pittsburgh have a chance to show the whole nation

how to do it better.

PG BENCHMARKS

LOAD-DATE: July 20, 2000

LANGUAGE: ENGLISH

GRAPHIC: PHOTO, PHOTO: Lake Fong/Post-Gazette: Paul O'Neill

Copyright 1999 P.G. Publishing Co.

Page 2ROUNDTABLE DISCUSSION;FIVE HEALTH CARE EXPERTS DEBATE HOW TO IMPROVE THE SYSTEM

IN PITTSBURGH Pittsburgh Post-Gazette (Pennsylvania) November 28, 1999, Sunday,


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ist Health Reform - Los Angeles Times http://articles.latimes.com/2000/dec/20/local

12/2/2008 1

You are here: LAT Home > Articles > 2000 > December > 20 > California | Local

Archive for Wednesday, December 20, 2000

Centrist Health Reform

December 20, 2000 in print edition B-8

As governor of Texas, George W. Bush essentially dodged health care issues, allowing a patients bill of rights to

become law without his signature, for instance. He also proposed limits on the expansion of publicly funded health

insurance for children that were far stricter than in most other states.

However, in his campaign and now as president-elect, Bush has been guided by health advisors who back bold and

often sensible reforms. Bush health policy aide Sally Canfield formulated reforms for her previous boss, Rep. Jim

McCrery (R-La.), that were at the heart of some of The Times editorial recommendations during the campaign, such

as pushing insurers to offer affordable basic policies that do not discriminate by age, gender or health condition.

Some Democrats in Congress are vowing that their top priority next month will be one of the most controversial

health reformslegislation to expand consumers right to sue HMOs. First they should seek common ground on other

moderate and urgently needed reforms. Three stand out:

* Disabled childrens insurance. Revive a bill by Sens. CharlesE.

Grassley (R-Iowa) and EdwardM.

Kennedy(D-Mass.) that would allow the families of children with disabilities to be covered by Medicaid. The bill, SB2274, which

had 77 co-sponsors in the Senate, would end the current, perverse system wherein parents of disabled children

who leave welfare for work lose their childrens Medicaid health insurance even though no private insurer will take

them on at an affordable price. The bill is pro-work, pro-family and pro-taxpayer, but Senate leaders unconscionably

killed it earlier this month.

* Health care quality. Health policy experts say that improving quality assurance systems in health care is key to

protecting patients and containing health care costs. One model for reform comes from an unlikely source, Bushs

reputed first choice for Treasury secretary, retired Alcoa Chairman Paul H. ONeill. He is highly respected in health

policy circles for spearheading public-private reforms in Pennsylvania that have improved quality by, for example,

directing public money only to hospitals that allow detailed scrutiny of their safety records and pioneering robotic toolsthat help pharmacists avoid medication errors.

* Prescription drug reform. Bush transition staffers have been talking with congressional leaders about his campaign

promise to provide full catastrophic prescription drug coverage for seniors who have already spent $6,000 out of

pocket. Controversy is swirling over whether states should be free to use new federal drug funding to leverage

down drug costs for all consumers, but leaders should not let that separate controversy derail catastrophic coverage,

which both Bush and Al Gore supported.

With Texas having the highest percentage of uninsured people in the nation, Bush certainly has yet to prove himself

California | Local


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ist Health Reform - Los Angeles Times http://articles.latimes.com/2000/dec/20/local

12/2/2008 1

as a health care leader. Nevertheless, he deserves every chance to succeed, and there is plenty of common ground

on which to build solid reform.

More articles from the California | Local section

California and the world. Get the Times from $1.35 a week

Copyright 2008 Los Angeles Times


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hanges bubbling in effort to rein in health costs http://www.post-gazette.com/businessnews/20000409healt

12/2/2008 1

Anita Dufalla - Post-Gazette

Big changes bubbling in effort to rein in

health costs

Sunday, April 09, 2000

By Pamela Gaynor, Post-Gazette Staff Writer

Steep cost increases are again forcing many in the region's business

community to re-evaluate their health benefits programs.

Benefits consultants say many large employers saw increases in

premiums or administrative outlays for health care approach double

digits in 1999 and can expect more of the same this year.

Smaller companies, on which the

region's economy increasingly

depends, could face even bigger

increases, particularly if their

workers are older.

The runaway costs are stirring a

kind of activism unseen since the

early 1990s, when corporations

began pushing the region's largesthealth insurer to roll out more

managed care plans in hopes that

the plans would tame costs.

Some companies are even

beginning to think about an option that once seemed unthinkable to

them: Capping the contributions they make to employees' health benefits

and letting their workers choose their own health plans.

Other avenues that companies are exploring for relief range from joining

purchasing coalitions as a way of leveraging their market clout todropping exclusive arrangements with single insurers.

Whatever the measures, the business community's frustrations could

translate into higher costs for employees; health plans that afford fewer

choices of physicians and hospitals; and escalating demands for

hospitals to curb spending and prove they provide high-quality,

cost-effective care.

"Employers are asking fairly fundamental questions about the way they

offer health-care benefits to their employees," said David Lagnese, a


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12/2/2008 1

consultant in Towers Perrin's Downtown office. "In the eight years I've

been here, I've never seen employers so profoundly question where

they're going."

The renewed soul-searching among corporate benefits purchasers

follows a brief respite in the mid-1990s, when the introduction of

managed care temporarily reined in runaway medical costs. But

managed care, perhaps more so in this region than elsewhere, fell far

short of its promotions.

At the extreme, Lagnese said, he's fielded a handful of inquiries from

companies about the possibility of shifting to so-called "defined

contribution" benefit plans. Those arrangements set aside fixed sums for

employees to purchase health benefits.

No one knows if or how fast the approach will take hold because it

raises problems even as it appears to provide a solution for employers

tired of being in the business of health care.

For example, the employers would still have to decide whether tonegotiate with insurers because there are few individual options for

purchasing health insurance, particularly for older workers. In addition,

employers have to determine whether lump-sum payments to employees

create inequities, favoring younger employees who can choose cheaper

plans and sock away savings while older workers with families must

spend their entire allotments on health care.

There also are tax laws to consider, because employers want to preserve

the tax breaks they get for providing health-care benefits and keep those

benefits tax-free to employees.

"There's an interest [in defined contribution plans], particularly at the

CEO level, because it sounds simple," said Jere Cowden, a consultant

with MMC&P Spectrum Benefit Options. "It's such a good sound bite.

But you have to make sure you don't make benefits unaffordable for a

large percentage of your work force.

"I tell people we're moving toward defined contributions, just as we did

in pensions." It won't be a rush, in his view, but, "There will be some

companies rolling it out in the next few years."

Highmark Blue Cross Blue Shield expects the move to happen quickly,

said Dr. Kenneth Melani, executive vice president of strategic businessdevelopments.

"Most major consulting firms and our own research indicate that in the

next three to five years, over 60 percent of companies will be in defined

contributions," Melani said.

The region's largest insurer is so convinced of this that in July, it's

rolling out an Internet-based system that caters to defined contribution

plans.


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12/2/2008 1

Using the system, employees could construct any of 16 different health

plans for themselves by choosing among an a la carte menu of options,

each of which would either add to or subtract from their costs. By

January, Highmark expects to provide enough options that some 32

plans could be created.

Many experts believe either of two events could trigger a cataclysmic

shift to defined contribution plans: an economic downturn or any actionin Congress to open managed care plans -- and possibly employers who

run them -- to patient lawsuits.

At the moment, employers find standard health-benefit plans to be an

essential recruiting tool in a tight labor market. And it remains unclear

whether Congress will ultimately enact a "Patient Bill of Rights," or, if it

does, whether it will make health plans or employers liable for unsound

medical decisions.

To be sure, not everyone buys the philosophy that business can

significantly diminish its role in health care or the idea that insurersshould be immune from medical suits.

U.S. Bank President Orlando Hanselman dismisses both.

Still, he's trying to rein in costs. Hanselman is spearheading formation of

a nonprofit purchasing cooperative for companies in Cambria and

Somerset counties, where his Johnstown-based bank does much of its

business.

Although small companies in Western Pennsylvania have long used

trade and business associations such as the Chamber of Commerce to get

group rates from Highmark, the co-op or coalition movement, which

traditionally tries to force competition between insurers, has been

relatively weak here.

Nor have any of the city's big corporations been in the forefront, as they

were in Minneapolis and some other cities. Coalitions formed among

businesses in this region have been largely among smaller firms in

outlying counties.

And the biggest such organization formed here so far, the Public

Employees Purchasing Coalition, brought together municipalities,

school districts and their unions -- not companies.

"The philosophy behind this is that, right now, the most cost-effective

way to procure health care is through groups," said Hanselman. With

500 employees, his bank is among the biggest employers in Cambria and

Somerset counties, yet even it doesn't feel it has enough buying clout on

its own.

Seminars explaining the new Cambria-Somerset cooperative, called

E.Map, for Employer Medical Access Partnership, have drawn more

than 200 employers. And seven insurers attended the co-op's bidding


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12/2/2008 1

conference, presumably with the idea of challenging Highmark, which is

thought to control as much as 90 percent of the health insurance

business in the two counties.

Even without a push from coalitions, benefits consultants expect

competition between insurers to escalate.

Last year, some high-profile organizations such as H.J. Heinz Co.,

which had long put its benefits business exclusively in Highmark'shands, opened their doors to insurance competition for the first time in

memory. So did the Manufacturer's Association of Northwest

Pennsylvania, which now offers Aetna U.S. Healthcare and UPMC

Health Plan alongside Highmark. Other trade and business associations,

long exclusive Highmark clients, are considering similar moves.

As a result of renewed competition, Highmark's enrollment in Western

Pennsylvania fell by 50,000 in 1999.

"I think this year is going to be an extremely interesting year for health

care in this market," said Tom Tomczyk, a benefits consultant inWilliam Mercer & Co.'s Downtown office. "I think what you're seeing is

the heat being turned up a bit by UPMC [Health Plan]." UPMC Health

System formed the fledgling insurance subsidiary a little more than two

years ago to compete with Highmark.

"I think we could see a resurgence of HealthAmerica, too. I think they've

turned the corner," he said.

Competition from HealthAmerica helped push Highmark into the

managed care business in the mid-1990s. But financial problems,

management turmoil and the collapse of the Allegheny Health,

Education and Research Foundation, which had performed medical

management services under a contract with HealthAmerica, diminished

its regional standing in recent years.

Tomczyk and other experts maintain that to realize more cost savings

from managed care, employers here will have to be willing to embrace

more of the limitations that have come with it in other regions, including

so-called narrow-network health plans such as HealthAmerica's.

Narrow-network health plans, which restrict members' choice of

physicians and hospitals, have had a rough time competing ever since

Highmark introduced managed care plans that include most of theregion's doctors and virtually all of its hospitals.

But renewed cost pressures may change that.

"Limited network plans have brought down costs in every instance I

know of," said Cliff Shannon, executive director of SMC Business

Councils, a trade organization that helps its 8,000 member-companies

obtain group health insurance rates. "They've been a proven cost saver in

other markets."


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12/2/2008 1

Ironically, Highmark's own enrollment patterns last year provided an

indication that employers here are bending to that philosophy as another

way of curbing costs. While the insurer lost enrollment in its big

network plans, its own lower-priced narrow-network option, Community

Blue, increased its enrollment fivefold, to more than 51,000.

Of course, any significant shift to narrow networks has implications for

hospitals as well as patients. The more successful any narrow-networkplan is, the more business its affiliated hospitals and doctors can expect.

Nor is movement among health plans likely to be the only way the

business community's frustrations over health costs spill over to

hospitals and physicians.

In addition to shifting their approaches to buying health benefits, some

of the region's big corporations also are throwing their weight behind a

movement to stem some underlying causes of runaway medical costs.

Some of the region's largest employers, including PNC Financial,Mellon Financial, Giant Eagle and Heinz, have joined an initiative to get

doctors and hospitals to reduce medical errors and improve outcomes for

patients undergoing five of the most frequently performed, highest-cost

medical treatments.

Led by Alcoa Chairman Paul O'Neill and the Pittsburgh Regional Health

Care Initiative, their hope is to bring some of the same kinds of process

engineering techniques to medicine that were used to revitalize

smokestack industries.

In addition, the organization, formerly known as the Working Together

Consortium Health Care Initiative, hopes to restrain hospital spending

on services or facilities that are already at a surplus in the region. The

group has already taken aim at the number of emergency medical

helicopters in the region and the number of open-heart surgery centers.

"I think we'll get some more pressure from the purchasing community to

stop the insanity," said SMC's Shannon.

Takemeto...Takemeto...

Copyright 1997-2008 PG Publishing. All rights reserved.Terms of Use Privacy Policy


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77 of 77 DOCUMENTS


January 28, 2003 Tuesday SOONER EDITION

SECTION: BUSINESS, Pg.E-1

LENGTH: 550 words

Magee closing Passavant unit

Citing $800,000 in fiscal 2002 losses from its maternity department at UPMC

Passavant Hospital, Magee-Women's Hospital said it would close the unit March

28. Magee, which has run the service at UPMC Passavant since 1996, said births

there had declined, from 571 in 1999 to 533 last year, while costs had

increased. The parent of both institutions, UPMC Health System, is in the midst

of a cost-cutting campaign. UPMC McKeesport Hospital closed its maternity unit

about two years ago.

O'Neill rejoining RAND board

The research institution RAND announced yesterday that Paul O'Neill had been

elected to its board of trustees. The former Treasury secretary and Alcoa

chairman was elected to the RAND board in 1988 and became board chairman in

1997. He resigned from the RAND board in January 2001 after he was confirmed to

the Bush Cabinet post.

Code-sharing service arrives

US Airways and United Airlines were scheduled to inaugurate their

code-sharing service for Pittsburgh this morning at Pittsburgh International

Airport. Under the marketing alliance that began Jan. 7, the airlines share

codes for each other's flights for ticketing purposes. Last week, the carriers

expanded the alliance, allowing US Airways to travel on more United flights in

the West, and letting United customers travel on more US Airways flights in the

East.

Altria emerges from the smoke

Philip Morris Cos. officially became Altria Group Inc. yesterday, more thana year after proposing the name switch to distinguish itself from its cigarette

businesses. Philip Morris USA, Philip Morris International and Kraft Foods Inc.

will keep their names. Altria, derived from the Latin word "altus" and

reflecting a desire to "reach higher," will keep the ticker symbol MO.

Pilot named to US Airways board

Capt. William D. Pollock, an officer with the Air Line Pilots Association,

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has been appointed to the board of directors of US Airways. Pollock, newly

elected chairman of ALPA's Master Executive Council at US Airways, replaces

former MEC chairman Chris Beebe as a director. Beebe left the MEC chairmanship

to become ALPA International's vice president-finance/treasurer. Pollock, 46, is

one of four representatives of labor groups given seats on the 15-member board

during concession negotiations.

Go to airport, check in yourself

American Airlines said yesterday that it had installed four self-service

check-in machines at Pittsburgh International Airport. Customers with electronic

tickets can use the machines to check in for their flights, select seats, obtain

boarding passes and check luggage. The machines also can be used to request

ticket upgrades.

Also in business ...

TissueInformatics and Windber Research Institute in Somerset County saidthey were collaborating on producing software that could lead to faster and more

accurate diagnoses for breast cancer. The software would digitize images of

breast tissue and analyze them using machine vision. Currently, diagnoses depend

on human interpretation of tissue slides ... Consol Energy Inc. said it would

supply 76.5 million tons of coal to FirstEnergy Generation Corp., a unit of

FirstEnergy Corp., under the terms of a 17-year contract. The sales price was

not disclosed.


LANGUAGE: ENGLISH

NOTES:

This column contains information from local and wire dispatches, including

Associated Press and Bloomberg News


Page 2Pittsburgh Post-Gazette (Pennsylvania) January 28, 2003 Tuesday


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Agricultural Research Service

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Department of Defense

Counterdrug Technology DevelopmentProgram

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France

Cour des comptes

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Defence Research & DevelopmentOrganisation

Italian Ministry of DefenseMexico

Secretary of Public Education

United Kingdom

Buckingham County Council

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Crown Agents

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National Health Authority

Kahramaa (Qatar General Electricity andWater Corporation)

Qatar Petroleum

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Supreme Council for Family Affairs

Supreme Education Council

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International Organizations

Andrew T. Huang Medical EducationPromotion Fund

China Foundation for International andStrategic Studies

Korean Institute of Science and TechnologyEvaluation and Planning (KISTEP)

Mott MacDonald Group

SIKA Swedish Institute for Trans ort and




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University of Medicine and Dentistry of NewJersey

University of Michigan

Institute for Social Research

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University of New Jersey

University of Pittsburgh

University of Southern CaliforniaUniversity of Washington

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Arthritis Research Campaign

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Microsoft

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Papworth Trust

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Qatar Foundation

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Siemens

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Industry

ABT Associates, Inc.

AetnaAFEAS Consortium

Alaris Medical Systems, Inc.

Amgen

Amtrak

Atkins

Berkeley Policy Associates

Blue Cross & Blue Shield of Rhode Island

British Telecom

Cerner Cor oration




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CorSolutions

DMJMH+N

Edison Schools, Inc.

Ferring, Inc.

Furness Enterprise Limited

Galaxy Scientific Corporation

Genentech, Inc.

General Electric CompanyGlaxoSmithKline

Halcrow Group Ltd.

Health Services Advisory Group

Hewlett-Packard Development Company

Johnson & Johnson

Ethicon Endo-Surgery, Inc.

KRA Corporation

Eli Lilly and Company

National Pharmaceutical Council

Native American Industrial Distributors

PAFT ConsortiumPfizer Inc

PNC Financial Services Group

Risk Management Solutions

Save the World Air, Inc.

Technology & Management Services, Inc.

Telomer Consortium

U MAP Consortium

Wellpoint Health Networks, Inc.

WSP Group plc

Xerox Corporation

Zenith Insurance

Professional Associations

American Medical Association

Blue Cross and Blue Shield Association

Gas Technology Institute

Other Nonprofit Organizations

AED National Institute for Work andLearning

American Institutes for Research

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Council for Aid to Education

District of Columbia Primary CareAssociation

Energy Future Coalition

Geriatric Education Center Consortium

Healthy Home Resources, Inc.

Institute for Health Policy Solutions

Kaiser Permanente

Memorial Sloan-Kettering Cancer Center

Merck Childhood Asthma Network, Inc.

National Bureau of Economic Research




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77 of 979 DOCUMENTS

Pittsburgh Tribune Review

May 26, 2006 Friday

O'Neill targets medication errors, hospital

infections

BYLINE: Rick Stouffer

LENGTH: 619 words

America's health care system wants to heal patients, but spends half its time

skirting problems that never go away and waste time and money, Paul O'Neillbelieves.

O'Neill, former U.S. secretary of the treasury and former chairman and CEO of

Alcoa Inc., has become a health care reform crusader, telling audiences

including U.S. Senate committees and hospital symposiums nationwide that real

change is needed in how this country takes care of people. If health care

providers push for things like zero prescription errors and zero infections, it

is possible, he said Thursday in an interview.

Many of O'Neill's principles are supported by the Rand Corp.'s recent

"National Report Card on Quality of Health Care in America," which found, among

many startling results, that only half of all adults receive recommended levels

of care -- regardless of where they live, from whom they seek care, or what

their race, gender or financial status is.

Unfortunately, O'Neill's push to eliminate problems, medication errors and

in-hospital infections hasn't gone over as well locally as it has in other

areas. That is one reason O'Neill resigned in 2004 as a board member of the

University of Pittsburgh Medical Center and as a member of the Pittsburgh

Regional Health Initiative.

Others are paying attention. The O'Neill mantra of zero infections, zero

prescription errors is the center of a Floridawide media campaign. The Florida

Health Care Coalition is encouraging patients not to accept illegibly written

prescriptions. The program is known as "POP," the Paul O'Neill Pledge. The

pledge is, "I won't accept a prescription if I can't read the writing."

Today, the senior O'Neill is nonexecutive chairman and his son Paul Jr. is

managing director of Value Capture, a consulting firm Paul Sr. formed in early

2005 when he became frustrated at the pace of change at local hospitals.

"It's hard to find malevolent actions with intent in the health care

community, but there is so much chaos in the system that until people make time

to take a look at the situation, nothing will change," O'Neill said.

An early proponent of the O'Neill drive for quality is Richard Salluzzo,

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former head of the Conemaugh Health System in Johnstown, Cambria County, and now

chief executive of the five-hospital Wellmont Health System in Northeast

Tennessee-Southwest Virginia.

"It's no mystery that if a patient spends five days in a hospital, between

200 and 300 processes are performed and not all work well," Salluzzo said.

There are 319 measures of quality issued by a number of health-related

organizations, he said. "If you did all 319, there is no guarantee that you

would have a safe hospital," he said. "No one has ever defined what a 'safe'

hospital is. We are doing that here."

Salluzzo's plan, with the help of O'Neill's Value Capture consulting team, is

to look at every procedure, every minute a patient is in a hospital, examine how

care is provided and how procedures are administered -- even displaying on the

hospital system's Intranet what problems and mistakes occur and what measures

are taken to correct them.

"Health care falls in love with nostalgia and bureaucracy," Salluzzo said.

"We're fixing things, making them cost-efficient, with patient safety the toppriority."

O'Neill believes 50 percent of a hospital's staff time is spent doing the

tasks a hospital is supposed to perform. However, the other 50 percent of the

time, employees are busy working around problems that occur and recur every day.

"There is real evidence today that it is possible to achieve zero infection

and prescription mistakes, but it's not easy," the elder O'Neill said. "But if

you don't set out for zero mistakes, you won't reach zero."

LOAD-DATE: May 26, 2006

LANGUAGE: ENGLISH

PUBLICATION-TYPE: Newspaper

Copyright 2006 Tribune Review Publishing Company

All Rights Reserved

Page 2O'Neill targets medication errors, hospital infections Pittsburgh Tribune Review

May 26, 2006 Friday


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EXHIBIT 11


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Registrant Client Name

LOBBYING ACTIVITY. Select as many codes as necessary to reflect the general issue areas in which the registrant

engaged in lobbying on behalf of the client during the reporting period. Using a separate page for each code, provide

information as requested. Add additional page(s) as needed.

15. General issue area code (one per page)16. Specific lobbying issues

17. House(s) of Congress and Federal agencies Check if None

18. Name of each individual who acted as a lobbyist in this issue area

Covered Off icial Posit ion ( if applicable) NewFirst Name Last Name Suffix

19. Interest of each foreign entity in the specific issues listed on line 16 above Check if None

Printed Name and Title

v6.0.1f

Page ______ of ______2 2


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EXHIBIT 12


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y the Lobbying Disclosure Act Database http://soprw

Query the Lobbying Disclosure Act Database

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To view the filing details, please click on a row in the search results. The filing details will open in a new browser w

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Disclosure Home


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35 of 43 DOCUMENTS

AScribe Newswire

April 24, 2003 Thursday

Former U.S. Secretary of the Treasury Paul O'Neill

Will

Deliver University of Pittsburgh's 2003

Commencement Address

April 27

LENGTH: 378 words

PITTSBURGH, April 24 [AScribe Newswire] -- Former U.S. Secretary of the

Treasury Paul O'Neill will deliver the University of Pittsburgh 2003

commencement address.

His address is titled "New Directions: The Opportunity Ahead." Pitt's

commencement ceremony will take place at 1 p.m. April 27 in the Petersen Events

Center, located on Terrace Street in Oakland, for the very first time.

"We are delighted to welcome Paul O'Neill to campus and to honor him at this

year's commencement-our first commencement at the Petersen Events Center," said

Pitt Chancellor Mark A. Nordenberg. "Paul's professional and personal

accomplishments are testimonies to his perseverance, integrity, and strong

spirit of inquiry. Having stood at the helm of two great international companies

[Alcoa and International Paper] and served as secretary of the Treasury, heknows the critical importance of courageous leadership-in business, in politics,

and in life."

A special advisor since March to The Blackstone Group, a private investment

bank with offices in New York and London, O'Neill was a member of the Pitt Board

of Trustees from March 1988 to June 1991, serving on the Academic

Affairs/Libraries Committee and as chair of the Graduate School of Public and

International Affairs' Board of Visitors. In February, O'Neill was appointed a

University director of the University of Pittsburgh Medical Center [UPMC] Board

of Directors and a member of the Executive Committee of the UPMC Board.

O'Neill was secretary of the U.S. Treasury from January 2001 to December

2002. Prior to serving the Bush administration, he was chief executive officer

of Alcoa from June 1987 to May 1999 and chair of its board from 1987 until his

retirement from that position in January 2001. Before joining Alcoa, O'Neill was

president of International Paper Company from 1985 to 1987; he was vice

president of that company from 1977 to 1985.

O'Neill earned the Bachelor of Arts degree in economics at Fresno State

College and the Master of Public Administration degree at Indiana University.

O'Neill and his wife, Nancy, have four children and 12 grandchildren. He and his

wife live in Pittsburgh.

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CONTACT:

Robert Hill, University of Pittsburgh, 412-624-8891;

[email protected]

LOAD-DATE: April 25, 2003

LANGUAGE: ENGLISH

Copyright 2003 AScribe Inc.

Page 2Former U.S. Secretary of the Treasury Paul O'Neill WillDeliver University of

Pittsburgh's 2003 Commencement AddressApril 27 AScribe Newswire April 24, 2003Thursday


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December 9, 2004 Thursday

SOONER EDITION

O'NEILL CRITICIZES UPMC AS HE QUITS ITS BOARD

BYLINE: PAMELA GAYNOR, PITTSBURGH POST-GAZETTE

SECTION: BUSINESS; Pg. A-1

LENGTH: 896 words

Former U.S. Treasury Secretary Paul O'Neill has quit the board of the

University of Pittsburgh Medical Center, saying he did so because he was

frustrated that the region's largest health care provider would not embrace a

regional plan for eliminating medication errors.

Without UPMC's full participation in projects to improve the quality of

medical care, O'Neill said, he questioned the future of the Pittsburgh Regional

Healthcare Initiative.

O'Neill helped launch the regional initiative, one of the first of its kind

in the country,shortly before the federal Institute of Medicine, in a landmark

study five years ago, estimated medical errors kill 98,000 people annually. He

remains on its board.

"The fact that the leading academic medical center in this part of the world

wouldn't make a public declaration that it was going to identify medication

errors ... makes it difficult to say that the Pittsburgh Regional Healthcare

Initiative is really regional," said O'Neill, who began the initiative while he

was chairman of Alcoa and rejoined it after leaving his job as President Bush's

Treasury secretary at the end of 2002.

O'Neill, who was appointed as a UPMC trustee and member of the board's

executive committee in 2003, resigned from the board in mid-September.

UPMC, as a matter of policy, does not disclose who serves on its board,

though the health system's president, Jeffrey Romoff, said at the time of

O'Neill's appointment that he welcomed O'Neill because of his widely recognized

knowledge about health care.

O'Neill and Romoff, however, are said to have clashed on numerous matters,

including the VA Pittsburgh Healthcare System's liver transplant program, which

last year broke away from UPMC.

One board member, who asked not to be identified, said that while UPMC's

refusal to embrace the medication-error reporting project might have been a

tipping point, O'Neill was also dissatisfied with the amount of information

executive committee members received before voting on important decisions.

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"If it wasn't this [stance on the medication error project] it would have

been something else," the board member said.

UPMC Board Chairman G. Nicholas Beckwith III dismissed speculation that

O'Neill had resigned over any quarrel about how much information the health

system's leadership shared with its executive committee.

He also said that "UPMC has been an active participant" in numerous quality

improvement projects sponsored by the regional health care initiative, but

"because of the press of business and the press of time, we haven't been able to

participate in all of the projects."

"As far as why Mr. O'Neill chose to resign, I think only he can respond,"

Beckwith said.

O'Neill would not comment on any dispute he might have had with Romoff

concerning the VA Pittsburgh Health System's organ transplantation program, but

he did not disagree that he "had a few set-tos" with top UPMC management over

what he saw as the insufficiency of information shared on some important

decisions. O'Neill said that in instances where he challenged the adequacy ofinformation, he had been given what he wanted.

O'Neill maintained that his main reason for leaving UPMC's board was the

health system's refusal earlier this year to participate in a proposed PRHI

undertaking in which participating hospitals would have committed to eliminating

all medication errors.

The campaign, which was never launched, would have begun with identifying

errors that occurred because of the illegibility of handwriting on

prescriptions.

"The reason to start there is it engages the first people in the process ...

namely the doctors," he said.

O'Neill said UPMC's unwillingness to participate in the project made him

question the system's desire to be held to measurable standards of quality.

"I don't understand the leadership there," he said.

O'Neill said he "found that being an insider at UPMC didn't make any

difference" in his ability to push the health system to fully embrace the kinds

of quality projects the regional health initiative was spearheading.

The projects were modeled after practices borrowed from industrial titans

such as Alcoa and Toyota. Those companies improved performance on an array of

issues, ranging from production to safety by examining each step in a process to

determine where things go wrong.

O'Neill's use of such practices in overhauling Alcoa -- including ones that

dramatically reduced occupational injuries -- has become the stuff of legend in

major academic business reviews as well as in the news media.

O'Neill has said he is convinced that eliminating medical errors is the key

not just to improving quality but to lowering runaway health care costs,

possibly by as much as half.

Page 2O'NEILL CRITICIZES UPMC AS HE QUITS ITS BOARD Pittsburgh Post-Gazette

(Pennsylvania) December 9, 2004 Thursday


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Others said UPMC wasn't the only player in the region's health-care landscape

to refuse participation in the medication error project or to be reluctant to

pursue some other quality improvement initiatives.

"I wouldn't say it was just UPMC," said Karen Feinstein, who chairs the

Pittsburgh Regional Health Initiative. "We have varying degrees [of acceptance]from a number of systems."

She and O'Neill both said the organization is rethinking its mission and

structure.

O'Neill's outspokenness about his quarrels with UPMC is not unusual for him.

He also bared his quarrels with the Bush administration in former Wall Street

Journal reporter Ron Suskind's book, "The Price of Loyalty."


LANGUAGE: ENGLISH

GRAPHIC: PHOTO: Paul O'Neill: Chides UPMC for not joining plan to eliminate

medication errors.

PUBLICATION-TYPE: Newspaper


Page 3O'NEILL CRITICIZES UPMC AS HE QUITS ITS BOARD Pittsburgh Post-Gazette

(Pennsylvania) December 9, 2004 Thursday


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Tuesday, October 28, 2003

Pittsburgh Business Times

The Pittsburgh Regional Healthcare Initiative on Tuesday named Paul O'Neill, the

former Bush administration official and leader of Alcoa, as its chief executive officer.

Mr. O'Neill was a founding co-chair with Karen Wolk Feinstein of the Initiative in December

1997. He is a member of its board of directors and chairs the leadership obligation group.

"We are very fortunate that he will take the reigns directly," Ms. Feinstein said.

Ken Segel has directed the Initiative since 1999. He will stay with the organization to lead

public policy operations and serve as a special assistant to Mr. O'Neill.

Mr. O'Neill was the chief executive of Pittsburgh-based Alcoa Inc. from 1987 to 1999, and

served as chairman until 2000. He left the world's largest aluminum producer to serve as

Secretary of the Treasury until he resigned the post last December.

The Pittsburgh Regional Healthcare Initiative works to solve problems of quality, safety and

cost in healthcare.

Pittsburgh Business Times - October 28, 2003

http:/ / pittsburgh.bizjournals.com/ pittsburgh/stories/ 2003/ 10/ 27/ daily29.html

O'Neill to lead Healthcare Initiative

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Page 1 of 1O'Neill to lead Healthcare Initiative - Pittsburgh Business Times:

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The Pittsburgh Regional HealthInitiative, or PRHI, is an independentcatalyst for improving healthcare safetyand quality in SouthwesternPennsylvania. It operates on thepremise that dramatic quality

improvement is the best cost-containment strategy for health care.

PRHI was the first regional consortium ofmedical, business and civic leaders toaddress healthcare safety and qualityimprovement as a social and businessimperative. Turning its own community intoa demonstration lab, PRHI strives toaccelerate improvement and set the pacefor the nation. Its experiment reflects threeprinciples:

1. Health care is local. Federal policychanges alone cannot achieveneeded reform.

2. Those who work at the point of care

develop quality and safetyimprovements that work and last.

3. Continuous improvement in qualityand safety requires the highestpossible standard, namely perfection.To settle for less limits achievement.

PRHI offers healthcare leaders thenecessary tools, expertise, education,models and networks to perfect patientcare and safety in their organizations.Using the Toyota Production System as amodel, PRHI developed a quality

improvement method for clinical settings known as Perfecting Patient Caresm

. PRHI teaches this method

through a four-day curriculum called Perfecting Patient Caresm University, as well as in advanced andindividualized courses and on-site coaching.

Thousands across the nation have already learned how Perfecting Patient Caresm can transform health care.Together, they demonstrate the value of quality engineering in any healthcare settingfrom neighborhoodclinics, to hospitals and nursing homes.

PRHI is a nonprofit operating arm of the Jewish Healthcare Foundation with funding from local corporations,foundations, health plans and government contracts and grants.

650 Smithfield Street Centre City Tower Suite 2400 Pittsburgh, PA 15222 Phone: 412-586-6700 Email:[email protected] Pittsburgh Regional Health Initiative Terms of Use

Page 1 of 1Pittsburgh Regional Health Initiative

6/25/2008http://www.prhi.org/about_mission.php


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Client Name: University of Pittsburgh Medical Government Entity Contacted: Treasury, Dept of

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February 24, 2005 Thursday SOONER EDITION

O'NEILL PLANS HOSPITAL CONSULTING VENTURE;

FORMER TREASURY SECRETARY'S DECISION GROWS OUT OF

FRUSTRATION WITH UPMC'S SUPPORT FOR LOCAL

INITIATIVE

BYLINE: Christopher Snowbeck, Pittsburgh Post-Gazette

SECTION: BUSINESS, Pg.C-10

LENGTH: 785 words

Frustrated by the pace of change at local hospitals, former U.S. Treasury

secretary Paul O'Neill is striking out on his own to create a for-profit venture

that will consult with hospitals on how to improve patient care.

The yet-to-be-named company already has a contract to work with a group of

five hospitals based in northeast Tennessee, and could work with three or four

hospitals in Pittsburgh, O'Neill said in an interview yesterday at the

Post-Gazette.

The firm will push the same quality improvement concepts that O'Neill hoped

the region's medical community would embrace through the Pittsburgh Regional

Healthcare Initiative, a Downtown nonprofit group that the former Alcoa CEO

helped form in 1997. The initiative sought to boost patient safety in hospitals

by training health-care workers in manufacturing principles that worked at

Toyota, Alcoa and other industry leaders.

At one time, O'Neill believed that quality innovations in health care could

showcase the region and serve as a growth industry. But he said the effort was

frustrated by both a lack of support from business leaders as well as resistance

from hospitals, including the University of Pittsburgh Medical Center.

O'Neill resigned in September from UPMC's board, in part because of what he

viewed as the health system's reluctance to embrace the regional quality

improvement effort.

"It's partly because UPMC doesn't really want to have much of an affiliation

with the other places in the community," O'Neill said. "They have an instinct

toward dominance as opposed to collaboration. I think it's a really unfortunate

idea in this area of human health and well-being."

UPMC officials have bristled at the suggestion they don't support quality

programs, and a spokeswoman reiterated yesterday that many UPMC doctors and

clinicians have been leaders in the initiative.

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"We find it ironic that Mr. O'Neill, who was the CEO of an exceptionally

competitive, acquisitive and successful international aluminum company, would

criticize UPMC for its competitiveness," said spokeswoman Jane Duffield.

"Whether we like it or not, the reality is that health care has become an

extremely competitive industry during the last several years," she said. "Itremains national policy to encourage competitiveness modeled on our major

corporations, which Mr. O'Neill also uses as his basis for safety and quality

measures."

The regional initiative will continue and O'Neill will play a part, he said.

But its work will focus on what he called "community-based" projects such as an

ongoing registry of information about heart surgery patients.

The initiative has worked extensively with hospitals on improving the

systems in which they provide care. Some of that work will be split off into the

new for-profit company, O'Neill said.

One of the reasons for the new venture is the ability to charge for services

and raise money, he said. Maintaining a staff that can consult with hospitals isexpensive, O'Neill said, noting that at one point the initiative was collecting

$2.5 million per year from the community to maintain its operations.

But there are other reasons to charge for the service, he said. "Giving

people the kind of information that we've been giving them as a charity is not a

good idea, because, if people think it's free, that's what they think it's

worth," he said. "My notion is if people pay for it, they'll act on it."

O'Neill would like to call the new business Value Capture and is checking to

make sure the name is not already being used. The company has a client in

Tennessee because that health system's CEO, Dr. Richard Salluzzo, once worked

with the regional initiative.

Salluzzo ran the Conemaugh Health System in Johnstown until November, whenhe became the president of Wellmont Health System, based in Kingsport, Tenn.

O'Neill said he was proud of several accomplishments realized by the

initiative, but the pace of change was too slow.

A program to collect information about medication errors, for example, was

making great strides by the standards of health care, O'Neill said. But the

effort was capturing only a fraction of the mistakes that were likely occurring

in the region, he said.

O'Neill decided he needed to challenge hospitals to go further with reforms,

and proposed a new model for reporting mistakes that many hospitals opposed.

He noted, for example, that some CEOs were reluctant to tackle doctors'sloppy handwriting, a critical factor in many medication errors.

"They didn't want to say to doctors, 'You're creating the potential for

serious harm with the first step of what you do, which is write prescriptions,'

" O'Neill said.

LOAD-DATE: February 24, 2005

Page 2O'NEILL PLANS HOSPITAL CONSULTING VENTURE;FORMER TREASURY SECRETARY'S DECISION

GROWS OUT OF FRUSTRATION WITH UPMC'S SUPPORT FOR LOCAL INITIATIVE Pit

Exhibits - Paul O’Neill, Former Secretary of the Treasury

Documents

Transcript of Exhibits - Paul O’Neill, Former Secretary of the Treasury