CQ Transcripts Wire
Thursday, January 8, 2009 2:34 PM
FORMER SENATOR TOM DASCHLE (D-S.D.): I thank you and I thank Senator Enzi for the opportunity to talk about an issue that we care so deeply about. And before I get into my statement, let me just thank my family especially for being here as they are and for all of the support and affection and encouragement that they've given me over these past few weeks and months. It has meant everything to me.
It also means a great deal that two very, very close and dear friends could be here to introduce me. Tim and I have known each other for well over 30 years in so many different stages in life. And I'm honored to call him one of my best friends and I am grateful for the extraordinary leadership and partnership that he has -- he has shown South Dakota these many, many years.
Bob Dole has gone the extra mile to show what it is to be friends with somebody on the other side of the aisle. He has reached out to me from the very beginning when I came to the Senate, when I became leader. When I left the Senate, he was the very first person to come to be to talk about post-Senate life and he has been my partner as he said for four years at the law firm. And I can't tell you how much I appreciate that friendship.
He mentioned this line we do we've kind of adopted -- when he's not around, I use his lines and I don't think he's ever had to use mine. But we talk about I was introduced once as a model politician and a model legislation and a model South Dakotan. Linda showed me the word model as it's defined in the dictionary and there it's defined as a small replica of the real thing. And... (LAUGHTER)
Well in the best sense of the word, Bob Dole is a model friend and somebody that I have admired and will continue to admire the rest of my life.
I want to thank all of my former colleagues and friends on the committee dais as well from keeping our food and medicine safe to tracking infectious diseases, to helping families in need, to researching the cures of tomorrow, to providing care to underserved populations. The Department of Health and Human Services has a significant role to play in keeping America healthy.
This Department will also be central to tackling one of the greatest challenges of our time, reforming the U.S. health care system. The flaws in our health system are pervasive and corrosive. They threaten our health and economic security and that is why the president-elect has crafted the new White House office of Health Reform and I'm honored to be chosen to serve in this role as well.
If confirmed, I will use these dual roles to marshal the talent and energy necessary to at last succeed in making health care affordable and accessible for all Americans. I'm grateful to the president-elect for putting his trust in me and I look forward to returning to public service at a pivotal moment in American history.
Let me begin by again reiterating my gratitude to our chair and ranking member by testifying on the subject of health care before Ted Kennedy feels a bit like talking about one's trumpet-playing skills in front of Louis Armstrong. And Senator Enzi, while he may not have been here the same number of years as Senator Kennedy, has been an effective voice in sounding the call for change through his leadership on the committee as well.
As I know it is for many of you, health care is personal to me. I ran for Congress 30 years ago to help places like rural South Dakota where people sometimes went without proper health care because the nearest doctor's office was too far away.
When I came to the Senate I had the privilege of serving with many of you and working on significant health care legislation including covering millions of children through the Children's Health Insurance Program, improving the ability to workers to keep their health insurance if they lost or changed a job and ensuring that advances in genetics didn't lead to health and employment discrimination.
When I left the Senate I was able to travel around the country talking to businesses and community groups, people I met about what was broken in our health care system and co-wrote a book called Critical about how I thought we might fix it.
While our investments in research and pioneering work by our scientists lead innovation, too often patients don't actually get our best. In 1994, we had 37 million Americans who were uninsured. Today that number is 46 million. In 1987, one dollar out of 15 went toward health care for the average family. Today, it's one out of six.
T. DASCHLE: President-Elect Obama recognizes that many of you have been working for many years on these issues and that any effort at reform will require very close cooperation with Congress.
He also realizes that change cannot be dictated from the White House or from Washington out, but must come from the grassroots of this country and involve as many Americans as possible in the process of reform.
In addition to being collaborative, it also needs to be an open, transparent process where people know their voices are being heard.
We've already begun to listen. During the transition we reached millions of Americans via our Web site change.gov to get their input on how best to change our health care system.
Tens of thousands of Americans shared their greatest concerns about health reform, and thousands more open their homes to host health care community discussions.
We are currently compiling their reports to share with each of you and the President-elect and everyone else. But one thing was crystal clear. America cannot afford more of the same when it comes to health care in this country, and I hope on this we can all agree.
It is unacceptable that in a nation of approximately 300 million people, nearly one in six Americans don't have health insurance. As we face a harsh and deep recession, the problem of the uninsured is likely to grow.
But the number of uninsured only describes part of the problem. Even Americans who do -- do have health insurance don't always get the care they need, especially high-value preventative care.
In some cases this is due to a shortage of providers, especially primary care providers in rural areas that we must work to address.
In other cases it is simply because our health care system is not oriented towards prevention and therefore fails to incentivize the screenings and lifestyle changes that can do so much to improve health.
Any health care reform plan must make sure that every American has preventative care that prevents disease and disability. Coverage after you get sick should be a second line of defense. Today it's often the first line. In addition to being sound medicine, this is sound fiscal policy. Studies have shown that for every dollar spent on prevention could actually net a return of $5.60 in health care costs, totaling upwards of $16 billion annually within five years.
But it's not enough to give every American care. It needs to be high-quality care. By some measures nearly one-third of the care of Americans receive is at best inadequate and at worst harmful.
Disparities in access and quality produce disparities in outcomes. On the Pine Ridge Reservation in South Dakota, one-half of the people over 40 have diabetes, and the life expectancy today is just 47 years, what life expectancy was for the rest of the country in 1900.
This, too, is unacceptable. We need to make sure that every American gets high-quality care, and if you see fit to support my nomination, I'll make sure this goal includes the Indian Health Service.
But even if every American had good insurance and great care, we'd still have an overwhelming problem related to health costs.
Over the past nine years, health insurance premiums rose three times faster than inflation. The fact that health care premiums have doubled in the last eight years piece for some families to make the awful choice between health insurance and rent or heat and food.
And these cost increases are as unsustainable for our national budget as they are for our families' budget.
By 2025 the Congressional Budget Office projects that health care will account for 25 percent of our GDP. By comparison the entire federal budget today is about 20 percent of GDP.
Any health care reform plan must achieve three goals of increasing access and quality while containing costs. But helping to develop a successful plan is only part of what the next secretary of Health and Human Services must do.
I believe the agencies of the Department of Health and Human Services can do a great deal to promote a system of wellness rather than a system of acute care, from the laboratory bench to the bedside.
Take the example of heart disease. Research funded by the NIH led to drugs approved by the FDA, which together with the prevention promoted by CDC have helped cut deaths from heart disease in this country by half.
Now, we must do the same for other chronic and preventable conditions, and I want to assure that Congress and the American people that as we make determination about what is safe and what is not, what is effective and what is not, we will be guided by evidence and effectiveness, not by ideology.
Finally, let me say that the department will remain dedicated to performing all of its vital services, ensuring our medical systems are prepared to respond to natural disasters, strengthening our public health system, working to improve the healthy development of our children to Head Start, confronting the challenge of long-term care for the elderly, working with states on child support enforcement and providing assistance to people with disabilities.
Especially in these difficult economic times, the human services function of Health and Human Services will continue to be a lifeline for many Americans.
So that equals or I began, with the need to reform our system. When health care reform collapsed in 1994, I remember all the criticism people had after the fact.
They said that it took too long. They said the process was too opaque. They said the plan was too hard to understand, and they said the changes felt too dramatic.
These are good arguments for undertaking reform in a way that is aggressive, open and responsive to American concerns, but they're not good arguments for ignoring the problem.
One of my favorite quotes is from Nelson Mandela. Referring to an end to apartheid, he once said, "Some things seem impossible until they are done."
He could have been talking about health care reform, because for generations now it has seemed an impossible goal. But this time the cost of failure is simply too high. This time working together, Democrats and Republicans can show it no longer has to be impossible. This time it can be done.
Thank you, Mr. Chairman, and members of the committee. I'd be happy to take your questions.