News
January 27, 2009
statement by senator tom harkin: on access to prevention and public health for high risk populations
Good morning. I would like to thank everyone for coming, this morning. This committee is holding a series of hearings as we gather testimony to help us in crafting comprehensive health care reform legislation. This morning, we will be hearing from a distinguished panel of witnesses about ways that we can improve access to preventive services and public health for vulnerable populations – groups that have been traditionally neglected and underserved, including people with disabilities, people who live in rural areas, senior citizens and children, especially those who live in poverty.
“I thank our committee chair, Senator Kennedy, for giving the go-ahead for this hearing. Looking forward to seeing him back in this chair soon.
“Last month, looking ahead to the historic task of drafting comprehensive health care reform legislation, Senator Kennedy asked me to chair the Prevention and Public Health working group.
“I am convinced that this has got to be the central focus of any reform legislation, because we will never get health care costs under control unless we place a major new emphasis on wellness and disease prevention, while strengthening America’s public health system.
“We are in the early weeks of America’s great debate about National health care reform. On several occasions, I have laid down a public marker, saying that 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 the American people.
“Well, this morning, I want to lay down a second marker: If we fail to seize this unique opportunity to expand access to preventive services and public health for vulnerable, high-risk populations, then that, too, would be a terrible failure.
“We simply must seize this unique moment to rectify some of the most outrageous inequities and pockets of neglect in our health care system!
“This is a matter of justice. It’s also a matter of basic economics. Because when citizens from these vulnerable, high-risk populations show up the emergency room with late-stage illnesses because of chronic neglect and lack of preventive care, then we all pay.
“So I look forward to hearing from our witnesses, and getting their best thinking about expanding access to prevention and public health.
“We have six highly respected witnesses, this morning.
“Dr. Risa Lavizzo-Mourey is president and CEO of the Robert Wood Johnson Foundation, a private philanthropic organization whose goal is to improve the health and health care of all Americans.
“Under Dr. Lavizzo-Mourey’s leadership, The Robert Wood Johnson Foundation has targeted a set of high-impact priorities, including improving patient care, strengthening state and local public health systems, and halting the rise in childhood obesity by 2015.
“Dr. Lavizzo-Mourey received her medical degree from Harvard Medical School, and an M.B.A. from the University of Pennsylvania's Wharton School. She is a member of the Institute of Medicine of The National Academies, and she previously served as deputy administrator of what is now the Agency for Health Care Research and Quality. I was also pleased to learn that Dr. Lavizzo-Mourey still practices at a federally qualified community health center, the Chandler Clinic, in New Brunswick, N.J.
“I would like to welcome Dr. Lavizzo-Mourey and thank her for her tremendous efforts to improve our health care system. I look forward to hearing her testimony about health care access for vulnerable populations.
“Dr. David Stevens is the Director of the Quality Center and Associate Medical Director of the National Association of Community Health Centers. He is also Research Professor in the Department of Health Policy at the George Washington University School of Public Health and Health Services.
“Previously, Dr. Stevens worked at the Agency for Healthcare Research and Quality (AHRQ), where he participated in initiatives to reduce health disparities, to improve care management, and to prevent type 2 diabetes.
“Prior to that, he worked at the Health Resources and Services Administration (HRSA). Dr. Stevens is also a member of the commissioned corps of the US Public Health Service, and he continues to provide clinical care at a federally qualified health center which serves Prince Georges County and Southern Maryland.
“I look forward to hearing from Dr. Stevens about the vital role of Community Health Centers in providing health care access to vulnerable populations.
“Mr. Michael Meit serves as Principal Research Scientist for NORC, the National Opinion Research Center, at the University of Chicago. At NORC, he is also Deputy Director of the NORC Walsh Center for Rural Health Analysis, where he is responsible for NORC projects in the areas of rural health, public health, and preparedness.
“Mr. Meit has experience working at both the state and national levels, first with the Department of Health in Pennsylvania and then with the National Association of County and City Health Officials (NACCHO). Mr. Meit recently finished a term on the National “Advisory Committee for Rural Health and Human Services, and he currently chairs the National Rural Health Association’s Rural Public Health Interest Group.
“Mr. Meit received his master’s degree in clinical psychology from Indiana University of Pennsylvania and his master of public health degree from the University of Pittsburgh.
“As Co-chair of Senate Rural Health Caucus, I am particularly interested to hear Mr. Meit’s testimony about the state of health care in rural communities. Thank you for coming to speak today about this important issue.
“Dr. Lisa Iezzoni is Professor of Medicine at Harvard Medical School and Associate Director of the Institute for Health Policy at the Massachusetts General Hospital in Boston.
“Dr. Iezzoni studies health care quality, delivery system, and policy issues relating to persons with disabilities. In 2006, she co-authored More Than Ramps: A Guide to Improving Health Care Quality and Access for People with Disabilities.
“Dr. Iezzoni received her medical degree from Harvard Medical School and her master’s degree in health policy from the Harvard School of Public Health. She is also a member of the Institute of Medicine in the National Academy of Sciences.
“Welcome, Dr. Iezzoni. I look forward to hearing your perspective on access to health care for individuals with disabilities, an issue that is close to my heart.
“Dr. Robert Butler is President and Chief Executive Officer of the International Longevity Center - USA, and professor of geriatrics at the Brookdale Department of Geriatrics and Adult Development at the Mount Sinai Medical Center in New York City.
“Dr. Butler has had a long and distinguished career in research on aging. He was the founding director of the National Institute on Aging at the National Institutes of Health. He has also written extensively on the subject of aging, and his book Why Survive? Being Old in America won the Pulitzer Prize in 1976. His research and writings are helping to establish a new vision of old age.
“I welcome Dr. Butler and thank him for his testimony. His expertise on the subject of aging will contribute greatly to our discussion of how to improve access to health care for our elderly citizens.
“Finally, Dr. Joseph Hagan is Clinical Professor of Pediatrics at the University of Vermont College of Medicine.
“Dr. Hagan has received numerous awards for teaching and for clinical medicine. He has also served as an advisor to the Vermont Department for Children and Families. He is a fellow of the American Academy of Pediatrics and serves on a number of committees and as Liaison to the CDC Task Force on Community Preventive Services for the academy.
“Dr. Hagan received his medical degree from the Georgetown University School of Medicine and completed his residency in pediatrics at the Medical Center Hospital of Vermont.
“Thank you, Dr. Hagan, for coming to speak to us and share your expertise in pediatric medicine with the committee. Dr. Hagan will speak about the unique challenges of access to health care for children.
“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. And we need to guarantee that our must vulnerable, high-risk populations have equal access to prevention services and public health.
“So this is an extraordinarily important hearing. And I appreciate our witnesses for appearing here today. We look forward to your ideas and insights.”
