Agenda Item: Welcome and Introduction

SECRETARY SHALALA: Thank you very much, David. I am sorry I can't spend more time with you today. As you know, Congress is in session. All of you will appreciate the fact that I am beginning to feel about Congress the way I used to feel about the students in May. They were starting to get on my nerves and I wanted them all to go home. [Laughter.]

Let me first begin by thanking our wonderful Surgeon General, by thanking everyone in this room for getting us a Surgeon General. I think David Satcher has clearly already started out in a very strong way and is going to make an extraordinary contribution, as he has throughout his career.

I also want to acknowledge the former Assistant Secretaries for Health. Julie Richmond, is here, I noted. His 1979 Surgeon General's report called Healthy People started this initiative. Ed Brandt, whom I am going to swear in, in a moment, carried forward those national health promotion targets in the Reagan Administration, because they are good public health and good public management. Bob Windom initiated the mid-decade report to inform everyone in this country of our successes and the challenges in reducing health risks. Monty DuVal chaired the Institute of Medicine panel that created the Healthy People 2000 consortium. I am sorry that Phil Lee couldn't be with us. He had a conflict in his schedule. I think Phil Lee has become even busier since he left all of us.

I want to acknowledge the Assistant Secretaries and the other senior members of the department who are here. We really have an all-star line-up.

You have a number of issues to contend with. I heard David the other day talk about this process. One of the things he said reminded me of something that I need to say to all of you. I hope that as we lay this out, we will find some simple way so that everyone will remember what the goals are. It is a complex process to get here, but at the end of the day we need these goals to be goals that people on the street can remember, that they identify with.

To do that, and to be responsible and comprehensive and not simplistic, will be complicated, but I think you can achieve that. I see not only the process of putting the goals together because they will set the tone for the country, but remember that these are also going to guide the health care system. We need a national consensus about them. A process of lots of different participants who care deeply about health care is important, but at the end of the day there is another consensus that needs to be built around them. To do that, we need to have goals that are explainable and understandable to the American public and easy ways of pointing them out to people.

I look forward to the outcome of the deliberations. I want to remind everybody that there are 610 days before the end of the century and we need to get these out. The book actually comes out in 2000. We of course are going to get public comments on these this year, because this agenda does need to be released at the beginning of the new millennium.

There are numerous issues that are going on, from tobacco to the changes in Medicare, to our own commitments to eliminate health disparities, to remove separate targets in a whole set of areas, to the children's environmental health issues. I chaired a panel with Carol Browner which is a very unique interagency task force that is going to lead to a set of major interagency initiatives on issues like children's asthma and unintentional injuries and cancers and developmental disorders.

We are making a series of research investments. Hopefully, when we get this comprehensive tobacco legislation, we will have the resources for a major expansion in the National Institutes of Health and new research funds in CDC and AHCPR.

All these initiatives are encompassed in the draft Healthy People objectives that you are going to look at today. I see this as an extraordinary opportunity to set national objectives. But these national objectives ought to reflect the new reality of the health care system, a movement by us to quality as a way of looking and reviewing and paying in the health care system. Obviously, we want it to reflect this nation's new commitments related to tobacco and, particularly, tobacco related to kids.

Of course, the health care system is changing dramatically, particularly in relationship to youngsters. We should, by the end of this century, have this country's commitment to make sure that every kid has a comprehensive health care package. That ought to make a difference in terms of where we are going.

So, welcome to the second meeting of the council. I look forward to seeing the results of your work. Remember that, taking Healthy People 2000 into the new millennium, this time around we want a way in which these objectives and this process actually are well known and not just to adults, but also to school kids, so that there really is a national consensus. Building that national consensus ought to be part of the process that we commit ourselves to both during and after you have completed your work.

So, thank you very much, and let's get Ed sworn in. Raise your right hand. I solemnly swear that I will support and defend the Constitution of the United States against all enemies foreign and domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely without any mental reservation or purpose of evasion; and that I will well and faithfully discharge the duties of the office which I am about to enter, so help me, God. Thank you.

[Applause.]

SECRETARY SHALALA: Again, I am sorry that I have to leave you. I am going off to announce a new drop in teenage pregnancy rates in the country, a major announcement by us.

[Applause.]

SECRETARY SHALALA: Teenage pregnancy is an example of an issue that large numbers of people worked on -- churches, communities, a huge national effort by the Federal Government to take on these responsibilities.

It really did make a difference, but it tells you what happens when you have a comprehensive effort, I think, David, coming at the issue from many different directions with multiple strategies, without a single fix. The fact that those rates are coming down now, I think, is a sign that when you take on an issue in a comprehensive way, without assuming that there is a silver bullet, that actually we can make a difference.

I think that, in a whole set of areas that you are going to be reviewing, that is exactly what we are talking about, and it certainly is what we are talking about in terms of the tobacco industry and the targeting of kids. What we need is something comprehensive, because we know of no one thing that can change teenage smoking or change teenage behavior in this country.

DR. SATCHER: We are going to have Dr. Hamburg, Peggy Hamburg, the Assistant Secretary for Planning and Evaluation, talk a little bit more on the elimination of racial disparities. She got a little bit confused about the schedule. So, we are going to allow her to say a little bit about the initiative, which is such an important initiative, which we are co-leading.

After that, Earl Fox is going to take over the chair, because I have to leave and go over to the Hill.

Let me just say, in addition to reporting on what has happened in terms of the framework, Earl is a real leader in this area. We are real fortunate to have him. He was Director of the Office of Disease Prevention and Health Promotion until we asked him to go over and take over HRSA after Dr. Sumaya left. He has done an outstanding job at HRSA. I am really delighted that today he will both chair part of this meeting and lead the discussion. I am going to step out to go over to the Hill, and I will see you later.

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