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	U.S. Department of Health and Human Services

REMARKS BY:	TOMMY G. THOMPSON, SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE:	U.S. Conference of Mayors (USCM), Madison, Wisconsin
DATE:	June 15, 2002

Tom (Cochran, USCM executive director), thank you for your tremendous leadership of the Mayor's Conference. You succeed in bringing people together around a common agenda. Thank you for your fine work.

It's wonderful to be here with all of you. Welcome to Wisconsin! As governor of Wisconsin, Madison is where I lived for 14 years.

My wife Sue Ann works here in Madison as head of the Wisconsin Women's Health Forum, and we bought a house here just last year. So, in a real way, this is my home.

Isn't this a beautiful convention center? When I worked with Mayor Soglin and other Madison leaders to get this beautiful Frank Lloyd Wright facility built, we envisioned it attracting grand conventions such as this one with our nation's mayors.

And it's a symbol of a state, a city and its leaders coming together to do the right thing and make the community and the state stronger as a result.

So we hope you all enjoy not just this beautiful facility, but all the other treasures and fun that Madison and Wisconsin have to offer. And, of course, while you're here, don't forget to spend lots of money.

And let me recognize the mayor of this beautiful city, my friend Susan Bauman, an active, engaged leader … and greet Wisconsin mayors Jeff Speaker, Paul Jadin, Tim Seider, John Antaramian, Telesfore Wysocki and Theresa Estness. These outstanding public servants are wonderful representatives of our great state here at this conference.

Mayors have a tough time. You have to endure everything from angry constituents to the demands of difficult budgets. But you stay with it and get the job done.

I want you to know that the President and I and my other Cabinet colleagues you're hearing from this weekend are your partners. We don't believe that Washington has all the answers. We want to listen to you, learn from you and join with you as we find solutions to our country's problems.

There are a number of issues I want to discuss with you today. Let me begin with one that is foremost on many of our minds these days, bioterrorism.

Mayors are on the frontlines of our war against bioterror. In case of an attack, it's your police who have to protect and keep order … your medics who have to transport the sick and the injured … and your E-R personnel who have to treat the wounded.

I know this is a great concern to all of you. In the survey you released on Thursday, two-thirds of your said you are unsatisfied with your communities' ability to determine whether or not there's a threat … equip emergency personnel … or communicate with your constituents in the case of an emergency.

And I agree with you. We haven't invested as we should have in years past. But one of the positive results of 9/11 is that we are now building the best public health system in the world. And we're doing it in partnership with you.

Help is on the way. We've provided $1.1 billion to strengthen state and local public health infrastructure. That, my friends, is the largest one-time investment in our nation's public health system. Ever.

The first installment of $200 million went out earlier this year. And last week, we followed up with the release of more of that funding to help meet the specific needs of states and cities.

This is the first time that federal, state and local governments have come together on a unified plan to strengthen our public health system and better prepare to respond to a terrorist attack.

I can't overstate the importance of this fact. For the first time, we're working together and are on the same page. Now that we have plans, we need to get on with building. The grant money will allow that to take place.

And we got more help just a couple of days ago, when I was privileged to stand with the President at a White House ceremony when he signed the Public Health Security and Bioterrorism bill, which was drafted by my department.

This bill provides $4.3 billion for bioterrorism preparedness in the next fiscal year. That's a 45 percent increase over the current fiscal year - the biggest one-time investment in bioterrorism preparedness ever.

Of the money in this bill, there is $1.5 billion to fund state and local preparedness activities, such as improving laboratory capacity, enhancing epidemiological and surveillance capacity, and strengthening communications systems.

And $518 million will be used to build hospital preparedness to upgrade treatment and infection control areas, expand medical surge capacity and purchase decontamination equipment

The ability of first-responders to treat public health threats will depend in large part on their knowledge of what to look for.

That knowledge, and its use in treatment, are the hinges on which the public health of whole regions of our country might turn.

And you should know we're monitoring the funding allocations Congress passes along to make sure that the cities are getting their full fair share as you build the public health infrastructure.

So, while there's much more to do, we're getting stronger every day. And we're doing so together.

We're also gaining strength in the effort to continue to transform welfare.

It was here in Wisconsin that we took the first significant steps to end a system that was destroying families, destroying hope and opportunity.

When we began our efforts, there were 100,000 families on welfare in this state. When I left office last year, there were 6,700.

Our success laid the groundwork for our national effort. When welfare reform began nationwide, 12.2 million Americans were on the rolls. Now, that number is a bit less than 5.3 million.

Child poverty rates are at their lowest level since 1978, with child poverty rates for African Americans and female-headed households at their lowest levels ever.

And those people are not just off welfare - they are better off and are creating a new cycle of hope, dignity and self-reliance for their families.

But we have to finish the job. Having more than five million people still on welfare is not acceptable in a country as prosperous and as compassionate as ours.

More importantly, we have to help those off the rolls to climb the job ladder, escape poverty altogether and truly become self-sufficient.

We've proposed a bold plan to continue to reform welfare. First, although the number of welfare recipients has gone down by well over 50 percent, we're keeping funding constant - $16.5 billion.

We've also requested an additional $4.8 billion for childcare, including funding for day care and other childcare services. The House has increased this amount by $2 billion, and the Senate is likely to add even more. So, I'm fairly confident that we will be able to do even more than you requested.

I might add, that's what the Mayor's Conference requested in your resolution on TANF Reauthorization. We've heard you, and are acting to provide the funding necessary.

Second, the heart of our program is work - long-term, sustainable and well-paying. My friends, there can't be too many things either more compassionate or more common sense-oriented than that.

I know you are all deeply concerned with the future of the workforce. A skilled, capable workforce is essential to the future of America's cities. So, our plan raises the bar by requiring a 40-hour workweek of everyone who accepts welfare assistance.

As we all know, many remaining TANF recipients live in urban areas. That's a sad reality.

For that reason, we are launching a new initiative called the "Urban Partnerships for Welfare Reform" technical assistance program. This new endeavor will match targeted technical assistance to the needs of cities and urban areas … highlight strategies for reducing the welfare burden on urban areas … and develop and improve the local infrastructure.

H-H-S will convene a meeting of ten urban areas with a high concentration of welfare families in November to begin the process. Technical assistance and training will be delivered to the ten sites to improve their program performance in assisting families to reach self-sufficiency.

We're making all cities with a population of 300,000 or more eligible to compete for the assistance. That's a total of 57 cities in 29 states, plus the District of Columbia. We will be getting the mayors of those cities that qualify application material in the near future.

I should note, too, that I so appreciate the work of people like my friend Mel Martinez and Mayor Menino and so many of you as you seek to provide safe, affordable housing, which is so much a part of empowering people to move into the mainstream of life.

Secretary Martinez and I are members of the Interagency Council on the Homeless, which I'll become chairman of in January. The Council is designed to provide practical, hands-on aid to the homeless.

Mel's Department of Housing and Urban Development provides money for housing. Health and Human Services, which I head, provides funding to assist the homeless with mental health, medical care and other services. Our work together is a very sound model for other types of intergovernmental action.

Our goal is to provide coordinated assistance to the 200,000 chronically homeless men and women … and the other 800,000 who, annually, struggle with homelessness for part of the year.

Whether you're homeless or live in a mansion, you need to stay healthy.

And this leads to another area that has a direct bearing on how we, as public servants, fulfill our duties to our constituents. I'm thinking of preventive health care. Prevention is often ignored as we address the health and well-being of America's families.

Mayor Street of Philadelphia has been a pioneer in this effort. He's put his whole city on a diet. And it's paying off with healthier people and, as a result, a stronger medical system in the City of Brotherly Love.

I've put my department on a diet, too. My staff and I are exercising … eating better … and, yes, losing weight. That includes me - I've shed about 8 pounds and am losing more.

Prevention is an essential component of quality care. Up to 300,000 Americans die needlessly each year from diseases and health conditions related a sedentary lifestyle or poor eating habits. That's nearly as many as the 440,000 people who die each year from smoking -- another preventable cause of death.

The financial costs are staggering: Seventeen million Americans have diabetes right now and 16 million more have pre-diabetes.

Each year, there are 1 million new cases and nearly 200,000 people die from it. The cost to the economy: $100 billion annually in direct and indirect medical costs.

By the way, I was just in San Francisco yesterday to receive an award from the American Diabetes Association. Let me tell you, this is a serious public health issue. We're fighting diabetes with great energy and focus. But we're not fighting it in a vacuum, because there are other serious health needs that prevention can help fight.

Sixty-one percent of American adults are overweight or obese. The cost: $117 billion a year.

As for smoking -- perhaps the most preventable cause of disease -- 19 percent of all deaths in America are due to tobacco. And it costs our health care system $70 billion annually.

These three problems alone kill upwards of 1 million Americans each year and cost our economy roughly $287 billion annually.

Of course, the greater cost in the lives lost and the health damaged. That's not just the greater cost - it's the greater tragedy.

There are so many diseases that are preventable or controllable by making modest and attainable improvements in our level of activity and the food we eat. It is scientifically proven that moderate physical activity can reduce substantially the risk of developing diseases such as heart disease, type 2 diabetes, colon cancer, high blood pressure and obesity.

We can all play a part. On the federal level, we've launched a major preventive health initiative.

Next week, the President is joining us in initiating the second phase of our preventive health effort, and we're very pleased that he's going to be taking such a visible role in prevention.

As another part of our prevention campaign, we've begun a new Healthy Communities Innovation Initiative that will bring together community-wide resources to help prevent diabetes, asthma and obesity.

This new demonstration effort will fund projects in six to ten communities to enhance access to services and encourage better lifestyle and health choices.

At my personal request, the Administration's budget for 2003 includes $20 million for this effort.

This measure is achieving strong bipartisan support and may end up being funded with even greater resources than requested so we can have ten demonstration projects.

And for the mayors whose cities are selected, you can advertise that you are getting help to build a healthier community. That means a stronger economy through healthier workers and families and a stronger tourism base.

Funding aside, there are some things we can all do, and all begin now. Let me suggest three achievable things that can substantially improve health and prevent the onset of disease:

First, be active. By walking 30 minutes a day, five days a week, you can significantly improve your health.

Second, enjoy fruits and vegetables. Adding a couple pieces of fruit throughout the day as well as servings of your favorite vegetables with lunch and dinner will make a difference.
Third, don't smoke. If you do, quit. If you don't, don't start. And make sure the children in your life don't start either.

For inspiration, look to the small town of Dyersville, Iowa, which is proving that good health is not a field of dreams. It's achievable and fun for the whole town.

This small town, where everyone knows each other, came together to get healthy, with neighbor helping neighbor. Dyersville residents lost 2 tons -- nearly 4,000 pounds -- in just 10 weeks. And over the past four years, 1,300 people in this town lost a collective 12,000 pounds.

Well, that's quite a basketful of issues. But underlying all of these things is something more fundamental and more difficult. It's the whole way we deliver health care to the American people.

The current system is the best in the world. We have the finest doctors, nurses and researchers … the better treatments, drugs and medical devices than at any time in history.

Yet, the current system is rooted in a morass of bureaucracy, paperwork, regulations and backward technologies. It makes obtaining quality care difficult, expensive and far too time-consuming. It's got to change.

We will have to fundamentally change the current health care delivery system in our country.

The myriad rules, regulations and restrictions that make obtaining good health care difficult, if not impossible, have to be reviewed carefully and, when necessary, jettisoned like useless ballast.

I'm not talking about tinkering at the edges. I'm thinking of renewal and transformation.

We are taking some significant steps in this direction already. I have established a regulatory reform task force to ferret-out cumbersome, unnecessary rules and regulations.

We're pushing ahead with our comprehensive effort to modernize and improve Medicare. And we're working to extend quality, affordable care to the nearly 40 million Americans who still lack health insurance.

And after Medicare, we have to tackle Medicaid, which is stretching state budget resources and denying many of your cities assistance in other areas.

And we have to move ahead with malpractice reform. On Thursday of this week, The New York Times carried an article that described how, in the state of West Virginia, hundreds of physicians are, and I quote, "dropping high-risk obstetrical and neurosurgical procedures rather than pay premium increases of 30 percent and more."
Why? Because they are tired of being subject to predatory lawsuits.

My friends, we need tort reform, malpractice reform. If we want our health care system to thrive, we have no choice.

We need to re-think the way we provide health care in our country. We must do this not through some government takeover of one-seventh of the U.S. economy, but through effective action that leverages the coming technological advances with the forces of change we see on the horizon, resulting in a more patient-focused world.

There's much more to say, but at least this gives you an idea of what we're doing.
We've made so much progress that it would be irresponsible now to cling to the status quo when the potential to help families climb out of poverty permanently lies within our grasp.

It was Winston Churchill who reminded us that, and I quote, "It is no use saying, 'We are doing our best.' You have got to succeed in doing what is necessary."

The President and I are dedicated to joining you in doing whatever we can to help you make your cities stronger, more prepared and more prosperous than ever.

That's a solemn pledge, and it's made in the knowledge that each of you shares that same vision for our entire nation.

Let's keep working together and build a stronger America. Thank you so very much for all you are doing to make our great country even greater. May God bless you, and may God bless America.