Thursday, January 22, 2009
Hearing on the States’ Role in Keeping Americans Healthy
Health, Education, Labor, and Pensions Committee
“Good morning. I would like to thank everyone for coming, this morning, to discuss some of the creative ways that states are taking the initiative in promoting disease prevention and a broader culture of wellness.
“I am very glad to learn that our committee chair, Senator Kennedy, is out of the hospital and doing well. We wish him a speedy return to the Senate.
“In December, looking ahead to the task of drafting historic health care reform legislation, Senator Kennedy asked me to chair the Prevention and Public Health working group.
“This is going to be an extraordinarily important component of any reform legislation, because we will never get health care costs under control unless we place a major new emphasis on public health and prevention, while strengthening America’s public health system.
“It’s not enough to talk about how to extend insurance coverage and how to pay for health care – as important as those things are. If all we are going to do is figure out a better way to pay the bills for the currently broken, unsustainable system, then we are sunk.
“Indeed, I have laid down a market here in the early days of America’s great debate about national health care reform: If we pass a bill that greatly extends health insurance coverage but does nothing to create a dramatically stronger prevention and public health infrastructure and agenda, then we will have failed.
“It simply makes no sense to legislate broader access to a health care system that costs too much and delivers too little, largely because it neglects prevention and public health.
“A robust emphasis on wellness is about saving lives, saving trips to the hospital, and saving money – and it’s the only way we are going to get a grip on skyrocketing health care costs.
“To that end I look forward to hearing from our witnesses about the exciting, innovative things that states are doing in the field of public health and prevention.
“I have never been one to believe that all wisdom radiates from Washington. The fact is, the states often are more nimble and creative when it comes to reform and public policy innovation. We look to the states as incubators and testing grounds for new ideas. And this is certainly true with respect to wellness, disease prevention, and public health.
“As we draft health reform legislation at the federal level, it is important that we capture the excellent ideas and practices that are being pioneered by the states and coordinate our initiatives. And that is exactly the purpose of this hearing.
“We have five distinguished witnesses, this morning.
“I welcome my good friend, Iowa State Senator Jack Hatch, who played a leading role, last year, in passing Iowa’s Comprehensive Health Care Reform Act. This legislation places a major emphasis on wellness. It ties preventive care to increased reimbursements. And it creates new incentives to encourage primary care providers to offer preventive care and wellness treatments.
“I also welcome Dr. Jonathan Fielding, Director of Los Angeles County Public Health, a professor at UCLA, and one of America’s foremost experts on public health. His testimony will focus on strategies for reducing tobacco use and obesity, especially among our young people. I especially appreciate Dr. Fielding’s emphasis on the role that schools and communities can and must play in combating childhood obesity and preventing youth smoking.
“I welcome Bill Emmet, Director of the Campaign for Mental Health Reform. As Mr. Emmet knows very well, mental health is too often the neglected stepchild – or, at worst, the orphan – in our health reform agenda, which is extremely misguided. It should be obvious that mental health is integral to physical health. In so many cases, you can’t have the latter without the former – and legislation drafted by this committee needs to reflect that reality.
“ Welcome to Dr. Allen Dobson, Assistant Secretary for Health Policy and Medical Assistance at the North Carolina Department of Health and Human Services. Dr. Dobson will discuss another aspect of health care reform that is very close to my heart: the importance of getting entire communities involved in promoting wellness and prevention – something you have done in North Carolina by emphasizing primary care and the “medical home” concept.
“Finally, I welcome Dr. JudyAnn Bigby, Secretary of Health and Human Services for the Commonwealth of Massachusetts. Three years ago, Massachusetts enacted health care reform legislation designed to move the state to near-universal health insurance coverage. But, from the outset, leaders in Massachusetts insisted that health care reform is about much more than just health insurance. The 2006 bill promotes wellness and prevention in myriad ways. And we have a lot to learn from the Massachusetts example.
“As I have said many times, prevention and public health have been the missing pieces in the national conversation about health care reform. It’s time to make them the centerpiece of that conversation. Not an asterisk. Not a footnote. But the centerpiece of health care reform.
“With that in mind, I again welcome all of you to the committee. Your testimony will be very valuable as we move forward with health care reform at the federal level. And I look forward to your ideas and insights.”
