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REMARKS BY:

TOMMY G. THOMPSON, SECRETARY OF HEALTH AND HUMAN SERVICES

PLACE:

World Health Care Congress, Washington, D.C.

DATE:

January 27, 2004

Address to the World Health Care Congress

Thank you. It is good to see all of you.

Ladies and gentlemen, the greatest health care system the world has ever known operates right here in the United States, and many of the people in this room have played a role in making it great. But as great as our system is, we all know it can be even better. Our current system is stretched and it is stressed.

My goal as Secretary is to do everything I possibly can to ensure Americans are strong, healthy, and independent. I know that better use of technology - such as my command center - can improve health care, and my Department is fully on the side of health care information that is accurate, timely, and convenient to patients, providers, and researchers.

Hank represents the largest pharmaceutical company in the world - Pfizer - and I represent the largest health insurance company in the world - Medicare.

In fact, private investors spend $32 billion every year on health care research, and taxpayers spend another $32 billion. Their research yields new and better drugs that are more effective and more precise than older treatments. They also produce better screenings and more advanced preventive care.

Naturally, private health insurance plans have competed to cover recent advances in medicine. But until recently, Medicare did not. Medicare really has not been changed in thirty-seven years. Seniors who saw others taking advantage of modern medicine naturally wanted it, too. That's why President Bush recently signed into law the most significant improvements to Medicare since it was created in 1965. Medicare will be able to save seniors money on prescription drugs, make more preventive benefits available, and improve access to care in rural areas.

Improving Medicare is an example of the historic progress we're making in health care.

But we face another problem that is more surprising and harder to explain and why this session on private and public health collaborations is so important.

The problem is that twenty-first century treatments and an explosion of new medical knowledge are coordinated with pre-industrial technology-paper and pencils, manila folders, and loose slips of paper.

Why is it that when you go into a grocery store, a high school freshman can check out all of your groceries without making a single mistake? But doctors still haven't learned how to write. Doctors have terrible handwriting, and they scribble prescriptions that nurses and pharmacists misread or mistranscribe. If a nurse reads a script "UG" as an "MG" she could administer a thousand doses instead of one-milligrams instead of micrograms. Other Latin abbreviations that could be misread include t.i.d. for q.i.d. Some drugs have names that look very similar but have completely different results.

The Institute of Medicine estimates that up to 98,000 Americans die each year because of medical errors. Even more Americans are disabled.

NIH says it takes from 10 to 17 years for new discoveries to be routinely used. That time is shocking and unacceptable.

One of the keys to changing the health system-and improving care, reducing errors and, over the long term, saving money-is to incorporate information technology fully into the health care delivery system.

A good information system could save at least $100 billion a year - and probably more. It definitely could reduce deaths and disabilities.

Health care markets are developing and adopting more advanced information technology. And I'm very happy that my Department is leading the way.

Patients these days often see many doctors, as you know. We're going to develop a uniform medical record so everyone who treats a patient can use the best and latest information. Can you believe that every clinic you go into has its own paper record system, and that they all have very little interoperability?

The FDA proposed a new rule for bar coding medications. This will improve patient safety by allowing information systems to reduce a lot of preventable medication errors. A doctor can enter a prescription directly into the system-without ever using handwriting-and it will stay in the system until it is fulfilled.

And in the federal government, we have adopted five key health information standards. We are close to adopting six more standards. We have the private sector advising us as well.

To improve our understanding of the limitations of new drugs, we proposed standardizing reporting formats and standards for adverse events resulting from the use of approved drug and biological products. This will allow manufacturers and regulators to take corrective actions more quickly and help consumers make more informed decisions about treatments.

We made a common medical language available without charge to all members of the health care community. This uniform lexicon of treatments and diseases, called SNOMED, will be able to improve quality of care for Americans by enabling providers and every member of the health care community to communicate electronically with each other.

SNOMED and the other standards will allow for easy transmission, exchange, collation, and aggregation of electronic records from multiple sources. This will also make it easier for public health officials to detect outbreaks and possible bioterrorism attacks.

HHS will continue to encourage the free market development of standards necessary for the exchange of electronic health information.

My Department has requested and President Bush has proposed to spend $100 million next year on projects that use promising health information technology. This is going to improve care, and help prevent dangerous medical errors, saving both lives and money.

As we do these things, we will ensure that the privacy and security of medical information is protected in accordance with existing Federal and other laws and regulations. Just as banks have done with online financial transactions, we have the technology to insure the integrity and protection of electronic information.

We are also using technology to track the spread of infectious diseases such as SARS, monkeypox, West Nile virus, and avian flu. In each case, we react quickly, decisively, and effectively to protect Americans. Our public health infrastructure-from a county health department to CDC in Atlanta to the 24-hour command center next to my office-is better than ever, and is able to identify and track outbreaks quickly and put us and our resources in quick contact with those who need them.

Also, in order to stop the current strain of avian flu from spreading or developing, we have sent teams over to Vietnam and Thailand. We are also working hard to develop a seed virus to be used in vaccines should they ever be needed.

This outbreak of avian flu is a threat, but it is a contained threat for now. We don't believe it has spread via human to human contact, only avian to human, and we are working to make sure that it does not become any more serious than it currently is.

Of course, if you think we're concerned about epidemics in the United States, you should visit Africa. I believe that the spread of AIDS can be reversed, not just in America, but around the world. That's why we hope to spend more than $18 billion next year to fight AIDS at home and overseas. That's why President Bush dedicated $15 billion over five years to fighting AIDS and caring for the afflicted in 14 focus countries in Africa and the Caribbean and more than 60 others in which we have prevention, treatment, and research programs.

Two years ago, I visited Botswana, Mozambique, South Africa, and the Ivory Coast and saw the damage with my own eyes. I held babies - orphans - who had contracted the virus from their mothers during birth. When I came home, I asked my Department to come up with a program to help HIV mothers have healthy babies and live to raise them. This initiative to prevent the transmission of HIV from mothers to children became the core of the President's Emergency Plan for AIDS Relief.

Many of you are helping in Africa as well. Hank's company, Pfizer, provides an antifungal drug, Diflucan free of charge to treat Africans with AIDS. Diflucan treats candida and cryptococcal infections, which frequently attack people with AIDS.

Two months ago, I returned to Africa as Chairman of the Global Fund to Fight AIDS, Malaria, and TB, along with the largest public-private delegation ever to visit that continent. Again I saw the devastation, but this time I also saw treatment and prevention programs we're supporting that are starting to work and show results.

Many Ugandans with AIDS live in villages so remote only rutted dirt roads reach them. So my department delivers medications such as Diflucan on Suzuki motorcycles. I went along on one delivery and met a woman named Rosemary. Her husband and brother both died of AIDS, leaving her to care for seven children and her elderly mother, who live in mud huts. She feeds them with the crops she grows on 2 acres of her brother-in-law's land, which bring in about $70 a year.

And she has AIDS.

You might expect Rosemary to be bitter. And not that long ago she was close to dying from AIDS. But when she started taking anti-retroviral drugs, her health improved, and she's back to feeding her family. And she's one of the most optimistic people I've ever met.

I also met a carpenter named Samson. AIDS killed his wife, and he has it, too. He goes down to the swamp every day to gather wood. After the wood dries, he makes tables and chairs, which he sells for $1.50 each. He supports three children on $5-7 a week. And his wife's grave is right there in the yard, a constant reminder that he uses to warn his children to avoid risky behaviors so they never get the virus.

Samson is also an optimist. And when he met me, he eagerly asked me to thank America and President Bush for sending the antiretroviral medicines that keep him healthy. Meeting Rosemary and Samson made me proud to be an American, and proud to do my part to help make Africa and the world better.

The health ministers who had been lamenting the devastation on my first trip were transformed by hope.

And so was I. And I continue to work to bring this hope to everyone I can. Many people live in parts of the world with few doctors, and few people who can read. So we developed an idea to bring basic medical information to them directly. Soon we hope to provide it to communities in Africa and even the United States, but the first place to receive it will be Afghanistan.

For every 1,000 Afghan babies that survive birth, another 145 die at birth or soon after. And mothers die in childbirth at a rate of 1600 mothers per 100,000 live births. If the mother dies, the baby has only 1 in 4 chance of reaching his first birthday. But even if the mother lives, 1 out of 4 children won't make it to age 5.

90% of maternal deaths could have been prevented with basic health care and basic health information. And we are starting to provide basic health care and information.

We are hoping to provide 20,000 interactive talking books to women in Afghanistan over the next year to promote health and disease prevention. These talking books can help women regardless of whether they can read or write. They provide good basic information in both Dari and Pashto - their native languages - on nutrition, sanitation, preventive health, childbirth, and immunizations. We field tested demonstration models in Afghanistan and they have been a big success. The women said they felt empowered.

We built a maternity clinic in Afghanistan and are hoping to build four more. We will distribute the talking books through these clinics.

Someone in this room may know an investor or a philanthropist who wants to distribute a book like this in Africa, or the Caribbean, or to other areas where literacy and basic medical knowledge are in short supply.

That is why this session is so important, because if we can stimulate partnerships between the free market and the public sector, we can bring hope all across the world. I want to encourage every one of you: let's use the technology that we have to help not only Americans, but people around the world.

We must continue to work to bring patient data and medical information to the families, hospitals, and doctors who need it as swiftly as possible. When it comes to life-saving information, there's no time to waste.

The time is now. We're moving, and with your help from the private sector, we can improve the health of men, women, and children not only in America, but around the world.

Thank you.

Last Revised: January 30, 2004

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