Luncheon Speech

I appreciate very much the invitation to speak with you and the opportunity of bringing you messages from both the Secretary of the Department of Health and Human Services and the Assistant Secretary for Health/Acting Surgeon General of the U.S. Public Health Service. I would like to take this opportunity to congratulate you (the organizers of this Conference) on identifying the critical issues in the field and assembling such a broad array of experts to address them. I would like to present a brief view of the emerging framework for health that puts into perspective some of the aspirations of the Administration and to highlight several points with regard to prevention and occupational health. The goals are: 1. To improve the overall health status of our people. (This has been and will remain the National policy regarding health.); 2. To engage the Nation in the important effort of enhancing public health. (This is not reserved exclusively for the activity of the Federal Government or for State Governments. Public health has to be a cooperative effort that brings together all of the people engaged in the process of serving the people.); and 3. To pledge that health care will not be priced out of anyone's reach because of inflation. (It is clear that there are major tasks of bringing about economic recovery in our country. One aspect of this effort is to guard against the cost of health care not being allowed to rise beyond the reach of persons who need that care.) "How will these goals be achieved and what must change in the delivery of health and medical care in our society?" There are a number of real issues as well as perceptions that adversely affect the attainment of these goals: First, The cost of medical care is soaring and the public, industry unions and other elements of our society are becoming concerned. (They recognize the problem and are demanding a solution.); Second, There is a growing concern about the priorities that have been set. (For example, the evidence that preventive interventions are the most effective approach is overwhelming, yet medicine has not yet given that a high priority.); and Third, There is the perception that physicians do too much to too many people at too great a cost and that too much and too costly technologies are used. In view of the perceptions, we all must accept some changes and the challenges that needed changes will bring. A month before the new budget went to Congress, President Reagan went on nationwide television and told the American people that, "It is time to recognize that we have come to a turning point and we are threatened with an economic calamity of tremendous proportion and the [old business as usual treatment can't save us. Together we must chart a new course]." Now eight months down the road from this and a long Spring and Summer of discussion both within the Executive Branch and in the Congress, many plans and programs and concepts have emerged. The new course has been charted and the turning point has been made. Business as usual has been put aside and the Administration's leadership has been stretched and tested in putting forth a better approach with the reality that money is tight and that old habits of delivering care are difficult to change. The Congress has now given us a look at a new health budget that takes into account some of the harsh economic realities and that does make allowances for the persistence of familiar behavior. Against this background, it is now possible to begin addressing ways to provide health services to people at a price the Nation can afford to pay. There are without question difficult decisions involved but the Administration is committed to supporting and improving health care in America. It has been the President's contention that one of the principal causes of the inflationary spiral in the country was the steady and indefensible growth of the Federal budget. The problem stems from the fact that we have been living well, but beyond our means for nearly 30 years. Now we are discovering that there is a bottom to the barrel after all. It is possible for our society to run out of things like energy (oil), water or money. The health bills must be paid -- by Government, by insurance, by parents or by someone. Each year with a bigger shopping list and more money to spend the Federal Government went into the marketplace to buy. This action altered the