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REMARKS BY:	DONNA E. SHALALA,  U.S. SECRETARY OF HEALTH & HUMAN SERVICES
EVENT:		Emergency Nurses Association Annual Conference,  Washington D.C.
DATE:		October 1, 1999

If someone asked you, "what does an emergency nurse do?" I'm sure you'd tell them how you provide cutting edge, beat-the-clock medical care. And, of course, you'd be right.

But, to my way of thinking, you're also educators. Certainly all of you -- the chief guardians of patient care -- have helped teach America's families a thing or two about our health, our lives, ourselves. And even though we're sometimes slow learners, I know you've also taught America's doctors a thing or two, as well.

But, more than any of that, through your work, you teach us every day about the lengths of human kindness . the strength of human character . and the true definition of what it means to care. So let me begin today by simply saying, "thank you." Thank you for your sharp minds, your watchful eyes, your nerves of steel -- and your hearts of gold.

And, thank you, in particular, for your leadership in the cause of accident prevention. Over the years I know many of you have worked closely with HHS -- and CDC in particular -- on a wide range of accident prevention initiatives.

And I want to tell you, today, that you've made a difference. In fact, if there's one thing our experience has taught us, it's that -- when it comes to accident prevention -- partnerships make the difference.

And at HHS we've made it our practice to reach out to all kinds of partners - from schools to soap operas - to reach Americans with our prevention messages.

Just last week, for example, we launched the Playing it Safe at Home campaign with the help of our partners at McDonald's and businesses on the Internet. Now, when parents go to McDonald's, they'll receive a guide to innovative and interactive solutions for children's safety.

In addition to giving tips on promoting safety in the home, our guide includes a chance for parents to take a fire safety quiz; information about food safety; and our new Federal Safety Hotline: (1-888-252-7751). That spirit of cooperation and dedication is exactly what we need for the future.

But you and I both know that no amount of prevention will ever diminish the critical importance of the care you provide. And I'll bet there isn't a person in this room who needs to be reminded that fulfilling the "Nightingale Pledge" is getting tougher every year.

In his Comedy of Errors, Shakespeare wrote, "there is something in the wind." Today, it's no exaggeration to say what's in the wind feels like a revolution. I'm talking about revolutions in patient care that have led to shorter hospital stays and more emphasis on home health care; revolutions in technology and biomedical research; and, of course, revolutions in the delivery of health care.

Nobody needs to tell you how the face of medicine has changed. Or about the new hurdles you face to putting patients first. That's why it's up to us to ensure that the winds of change not sweep away what's best about American medicine. It's our common mission to harness those winds and see to it that America's health care system remains the best in the world.

That's the single, simple, revolutionary idea behind the Patients' Bill of Rights. A bill of rights to guarantee health care quality for everyone-no matter where they live.who they are.or who they see.

As the chief guardians of patient care, the Patients' Bill of Rights will change your lives-because it will change the future of health care. And because you -- the women and men on the front lines of patient care - - will be helping to keep our medical system the very best in the world.

We need your support, because what you think -- and what you say -- about the Patients' Bill of Rights will speak volumes in this city -- and across America. We know there's a lot of support out there, when a movie character complains about her HMO, and the audience erupts in applause. It's a modern version of the Boston Tea Party.

Our challenge is to guarantee to health care consumers what the original Bill of Rights in our Constitution guarantees to all Americans -- our basic well being.

Next week the House will begin their debate over a Patients' Bill of Rights. Let me be clear: There's only one Patients' Bill of Rights that's acceptable -- and that's the bipartisan Norwood/Dingell bill.

This Patients' Bill of Rights legislation calls for quality.access.choice.and recourse for shoddy care. It says that every type of health insurance, whether managed care or fee for service, or employee sponsored, PPO or HMO, must deliver high quality health care.for every American.every day.everywhere.

But we've not waited for legislation. By executive order -- by the stroke of his pen -- the President has guaranteed that everybody in a federal health insurance plan is covered by the Patients' Bill of Rights.

That's 80 million Americans -- one third of all Americans. That includes every federal employee . every veteran and their families . all of our military personnel . and of course, everyone on Medicare or Medicaid.

We are also using the vast purchasing power of the federal government to raise the standards of the American health care system for good. We're saying to any prospective insurer, that if you want to play in the federal system- you must promise everyone in this program that you will uphold the Patients' Bill of Rights.,p> And so, for those Americans not in the federal system, we need Congress to pick up its collective pen -- to follow the President's example and finish the job-by extending the protections of the Patients' Bill of Rights to the remaining two-thirds of our citizens.

Our message to Congress is this: Guarantee the rights of patients now, to all Americans. Guaranteeing patients' rights is the first step in ensuring the quality of our health care.

We are also developing a blueprint to improve health care quality across America, and to specifically address the quality problems we identified that affect everyone. First, to reduce the underlying causes of illness, injury, and disability. Second, to expand research on new treatments and their effectiveness. Third, to ensure the appropriate use of health care services. Fourth, to reduce health care errors. Fifth, to address oversupply and undersupply of health care resources. And sixth, to increase patients' participation in their own care.

We also called for development of uniform national measurement standards so that health care plans can compete on quality-not just on cost.

But, of course, this isn't a job for government alone. We certainly need you to work with us to improve medical outcomes-and we're going to help you do this.

Because we know that quality health care ultimately depends on watchful eyes, careful hands, nerves of steel -- and of course, hearts of gold. In other words, quality depends on you-the health care professionals who have played the leading role in ensuring quality since the days of Florence Nightingale.

We need nurses and other health professionals to take the lead in helping us not only measure the quality of care-but also to help us improve the quality of care. We need your spirit of the Nightingale Pledge . your intellect and imagination . your compassion and commitment . your experience and ethics.

The challenge for all of us is to harness the winds of change in health care, so that we'll be able to give our patients the best care modern medicine can provide. Our challenge is to fight any attempts to sacrifice the art of medicine to the business of medicine. Our challenge is to never allow the sacred duty of putting the patient first to be swept out of the halls of medicine. And our challenge is to continue to bring not only our knowledge, but our character and our humanity, to medicine.

I've no doubt that we can do it.that we must do it.that we will do it.

And by doing so, we'll help ensure that the tradition of compassion is never lost to the technology of change.we'll help ensure that a patient's primary "life line" remains as close as his nurse's call button.and we'll help ensure that our health care system remains the best in the world for every American.every day.everywhere.

Thank you.