Talking Points: CARF Speech
Item
of 1
- Other Media
-
c021_002_001_001_tr.txt - Transcription (Scripto)
- Read Full Text Only
- Extent (Dublin Core)
- 36 Pages
- File Name (Dublin Core)
- c021_002_001_001
- Title (Dublin Core)
- Talking Points: CARF Speech
- Description (Dublin Core)
- Senator Bob Dole delivered this speech to the Commission on Accreditation of Rehabilitation Facilities (CARF) Conference. Dole discusses how he sees the recent attempted coup against Gorbachev in the Soviet Union will impact the United States in the 21st century. This packet of documents includes background information on this speech, a copy of the speech, and Senator Dole's reading copy.
- Date (Dublin Core)
- 1991-08-29
- Date Created (Dublin Core)
- 1991-08-29
- Congress (Dublin Core)
- 102nd (1991-1993)
- Topics (Dublin Core)
- See all items with this valueHealth care reform--United States
- See all items with this valueMedicaid
- See all items with this valueSoviet Union--History--Attempted coup, 1991
- Policy Area (Curation)
- International Affairs
- Creator (Dublin Core)
- West, Maureen
- Record Type (Dublin Core)
- speech (document)
- Names (Dublin Core)
- See all items with this valueDole, Robert J., 1923-2021
- See all items with this valueCommission on Accreditation of Rehabilitation Facilities (U.S.)
- Rights (Dublin Core)
- http://rightsstatements.org/vocab/CNE/1.0/
- Language (Dublin Core)
- eng
- Collection Finding Aid (Dublin Core)
- https://dolearchivecollections.ku.edu/?p=collections/findingaid&id=54&q=
- Physical Location (Dublin Core)
- Collection 021, Box 2, Folder 1
- Institution (Dublin Core)
- Robert J. Dole Institute of Politics, University of Kansas, Lawrence, KS
- Archival Collection (Dublin Core)
- Alec Vachon Papers, 1969-2006
- Full Text (Extract Text)
-
August 29, 1991
TO: Senator Dole
FROM: Mo West
SUBJECT: CARF Speech
You will be speaking before an audience of 1000 people today at the Commission on Accreditation of Rehabilitation Facilities (CARF) Conference being held at the Grand Hyatt Hotel. You are scheduled to speak at 1:30 p.m. for 20 minutes in the Constitutional Ballroom.
The audience would like to hear your thoughts on the sudden turn of events in the Soviet Union and the implications world events will have on government in the 21st Century. Al has prepared talking points for you on this topic. While you are not being asked to speak on disability, I did put together some talking points for you on challenges we face here in the U.S. regarding health care and disability. I'll bring an enlargedprint of my talking points with me to the Grand Hyatt should you want them.
You will be greeted by John Kemp at the front entrance of the Hotel upon your arrival and escorted to the podium for your presentation. Max McCleland will follow your presentation and will speak to specific disability issues and the quality of life for people with disabilities in the 21st Century.
There will be approximately eight Kansans in attendance. After your speech they will organize to meet you outside the Ballroom for a photo op. The Hotel will have a photographer available for this purpose.
TALKING POINTS FOR CARF SPEECH
AUGUST 29,1991
GRAND HYATT HOTEL, WASH, D.C.
You have asked me to address how the federal government will impact on the quality of life in our society in the future ....on the course of events that will carry us into the 21st century.
It hasn't been long since we welcomed home those who fought in the Persian Gulf War. Americans will long remember the bravery of the men and women of Operation Desert Storm. I believe our country can only be as strong abroad as we are at home. And our duty to those who risked their lives for freedom is to build a country dedicated to equal opportunity.
Surely, the recent events in the Soviet Union will bring changes that will take us into the next century. As Communism crumbles and a new world order emerges, United States policies will change. Issues of defense and detente will take on new meanings ....meanings we are just beginning to contemplate.
While we face exciting challenges abroad, we have serious and demanding challenges here at home. We need to ask ourselves, what kind of country will America be as it enters a new century? Will we be truly strong, or barely strong enough? Will we be self-confident, or self doubting? Will we be on the march, or at a standstill?
I have no doubt in my mind that the most important domestic challenge our nation faces as we move into the next century may well be how we provide health care for our citizens and how we pay for it. Perhaps the most daunting problem of all, will be the financing of long term care services for our elderly and disabled.
You all know the grim statistics. We are spending $660 billion per year, or almost $2 billion every day --for a system that serves far too many of us inadequately or not at all. Thirty-some million Americans, almost one-half of them children, have no health insurance, and thus have extremely limited access to any health care.
We spend more per capita on health care than any other nation in the world. Yet we lag behind many countries in key health indicators such as infant mortality and life expectancy.
There is a strong feeling that our health dollars are being sucked into a bottomless pit. Both businesses and government are re-examining their health care programs and making changes. The natural response has been to narrow benefits and lower reimbursement to providers.
The effort to narrow benefits and reduce reimbursement in the public and private sectors is a reaction triggered by both fear and frustration. While, understandable, I do not believe that this is the best response.
We must develop a National Strategy for addressing the health care needs and that includes rehabilitation --of all Americans. How do we do this? I believe we need to take a two-track approach.
First, we must keep our eye on the big picture --on fundamental, structural reform of our entire health care system. Second, because this reform will take some time, we must continue to make incremental improvements in our existing programs.
I firmly believe that our health care system must begin at a significantly earlier stage: with our children. It is unconscionable that children are being born with disabilities that could have been prevented if mothers had access to good perinatal care. It is unconsciousable that a child should develop a serious condition that goes undetected because the family cannot afford basic preventive care.
We have made some incremental progress in meeting these needs. Over the past seven years, we have improved Medicaid's services to pregnant women, to infants, and to children. But clearly more needs to be done.
Organizations like yours play a central role in the delivery system. You set the standard that will carry us into the next century.
Frustrations about the cost of our system is voiced by governments, corporations, individuals and providers and groups like your own. Some questions we need to be asking:
How can we deal with malpractice more reasonably?
What sort of health care should our insurance plans encourage or discourage?
Currently, most insurance, public and private, cover only the middle range of care: They don't cover routine and preventive care, and they don't cover truly catastrophic care. Should we reorient the system toward preventive and primary care?
Finally, can we or should we pay for universal, comprehensive health care by simply restructuring the system? Or will we need to find additional funds? If so, how much are Americans willing to pay for it?
We must take on difficult decisions of this kind. We can restructure our health care system, reorder our priorities, and devise a way to deliver appropriate health care to all Americans. Doing this will take commodities that are even more scare than money these days: creativity, boldness, and a great deal of political will. It will also require the cooperation and assistance of health professionals and the business community.
We certainly do not have all the answers --groups like yours can help us find the solutions to the problems I have noted. Groups like yours play a central role in the delivery system. As accredidators you set the standard for rehabilitation services that will carry us into the next century.
As the new world order emerges so do new opportunities. We have the opportunity not only to share our knowledge but to learn from others. Industrialized nations like ours have historically dealt with persons with disabilities by excluding them through institutionalization.
Rehabilitation facilities produce skilled qualified individuals who become productive members of society. Tax-users become tax-payers in an inclusive workforce.
Your work is critical to improving employment opportunities for people with disabilities and others in need of rehabilitation. You know as well or better than anyone the role technology plays in this regard.
As rehabilitation professionals you have the knowledge,skills, and abilities to improve the quality of life as well as the American economy --the will is here --together we can find the way.
TALKING POINTS FOR CARF SPEECH
AUGUST 29,1991
GRAND HYATT HOTEL, WASH, D.C.
You have asked me to address how the federal government will impact on the quality of life in our society in the future ....on the course of events that will carry us into the 21st century.
It hasn't been long since we welcomed home those who fought in the Persian Gulf War. Americans will long remember the bravery of the men and women of Operation Desert Storm. I believe our country can only be as strong abroad as we are at home. And our duty to those who risked their lives for freedom is to build a country dedicated to equal opportunity.
Surely, the recent events in the Soviet Union will bring changes that will take us into the next century. As Communism crumbles and a new world order emerges, United States policies will change. Issues of defense and detente will take on new meanings ....meanings we are just beginning to contemplate.
While we face exciting challenges abroad, we have serious and demanding challenges here at home. We need to ask ourselves, what kind of country will America be as it enters a new century? Will we be truly strong, or barely strong enough? Will we be self-confident, or self doubting? Will we be on the march, or at a standstill?
I have no doubt in my mind that the most important domestic challenge our nation faces as we move into the next century may well be how we provide health care for our citizens and how we pay for it. Perhaps the most daunting problem of all, will be the financing of long term care services for our elderly and disabled.
You all know the grim statistics. We are spending $660 billion per year, or almost $2 billion every day --for a system that serves far too many of us inadequately or not at all. Thirty-some million Americans, almost one-half of them children, have no health insurance, and thus have extremely limited access to any health care.
We spend more per capita on health care than any other nation in the world. Yet we lag behind many countries in key health indicators such as infant mortality and life expectancy.
There is a strong feeling that our health dollars are being sucked into a bottomless pit. Both businesses and government are re-examining their health care programs and making changes. The natural response has been to narrow benefits and lower reimbursement to providers.
The effort to narrow benefits and reduce reimbursement in the public and private sectors is a reaction triggered by both fear and frustration. While, understandable, I do not believe that this is the best response.
We must develop a National Strategy for addressing the health care needs and that includes rehabilitation --of all Americans. How do we do this? I believe we need to take a two-track approach.
First, we must keep our eye on the big picture --on fundamental, structural reform of our entire health care system. Second, because this reform will take some time, we must continue to make incremental improvements in our existing programs.
I firmly believe that our health care system must begin at a significantly earlier stage: with our children. It is unconscionable that children are being born with disabilities that could have been prevented if mothers had access to good perinatal care. It is unconsciousable that a child should develop a serious condition that goes undetected because the family cannot afford basic preventive care.
We have made some incremental progress in meeting these needs. Over the past seven years, we have improved Medicaid's services to pregnant women, to infants, and to children. But clearly more needs to be done.
Organizations like yours play a central role in the delivery system. You set the standard that will carry us into the next century.
Frustrations about the cost of our system is voiced by governments, corporations, individuals and providers and groups like your own. Some questions we need to be asking:
How can we deal with malpractice more reasonably?
What sort of health care should our insurance plans encourage or discourage?
Currently, most insurance, public and private, cover only the middle range of care: They don't cover routine and preventive care, and they don't cover truly catastrophic care. Should we reorient the system toward preventive and primary care?
Finally, can we or should we pay for universal, comprehensive health care by simply restructuring the system? Or will we need to find additional funds? If so, how much are Americans willing to pay for it?
TALKING POINTS FOR
CARF SPEECH
AUGUST 29,1991
GRAND HYATT HOTEL,
WASH, D.C.
YOU HAVE ASKED ME TO ADDRESS HOW THE FEDERAL
1
GOVERNMENT WILL IMPACT ON THE QUALITY OF LIFE IN OUR SOCIETY IN THE FUTURE....ON THE COURSE OF EVENTS THAT WILL CARRY US INTO THE 21ST CENTURY.
IT HASN'T BEEN LONG SINCE WE WELCOMED HOME THOSE WHO FOUGHT IN THE
2
PERSIAN GULF WAR. AMERICANS WILL LONG REMEMBER THE BRAVERY OF THE MEN AND WOMEN OF OPERATION DESERT STORM. I BELIEVE OUR COUNTRY CAN ONLY BE AS STRONG ABROAD AS WE ARE AT HOME. AND OUR DUTY TO THOSE WHO RISKED THEIR LIVES FOR FREEDOM IS TO
3
BUILD A COUNTRY DEDICATED TO EQUAL OPPORTUNITY.
SURELY, THE RECENT EVENTS IN THE SOVIET UNION WILL BRING CHANGES THAT WILL TAKE US INTO THE NEXT CENTURY. AS COMMUNISM CRUMBLES AND A NEW WORLD ORDER EMERGES, UNITED
4
STATES POLICIES WILL CHANGE. ISSUES OF DEFENSE AND DETENTE WILL TAKE ON NEW MEANINGS....MEANINGS WE ARE JUST BEGINNING TO CONTEMPLATE.
WHILE WE FACE EXCITING CHALLENGES ABROAD, WE HAVE SERIOUS AND DEMANDING
5
CHALLENGES HERE AT HOME. WE NEED TO ASK OURSELVES, WHAT KIND OF COUNTRY WILL AMERICA BE AS IT ENTERS A NEW CENTURY? WILL WE BE TRULY STRONG, OR BARELY STRONG ENOUGH? WILL WE BE SELF-CONFIDENT, OR SELF DOUBTING? WILL WE BE ON THE MARCH, OR AT A STANDSTILL?
6
I HAVE NO DOUBT IN MY MIND THAT THE MOST IMPORTANT DOMESTIC CHALLENGE OUR NATION FACES AS WE MOVE INTO THE NEXT CENTURY MAY WELL BE HOW WE PROVIDE HEALTH CARE FOR OUR CITIZENS AND HOW WE PAY FOR IT. PERHAPS THE MOST DAUNTING PROBLEM OF ALL,
7
WILL BE THE FINANCING OF LONG TERM CARE SERVICES FOR OUR ELDERLY AND DISABLED.
YOU ALL KNOW THE GRIM STATISTICS. WE ARE SPENDING $660 BILLION PER YEAR, OR ALMOST $2 BILLION EVERY DAY - -FOR A SYSTEM THAT SERVES
8
FAR TOO MANY OF US INADEQUATELY OR NOT AT ALL. THIRTY-SOME MILLION AMERICANS, ALMOST ONE-HALF OF THEM CHILDREN, HAVE NO HEALTH INSURANCE, AND THUS HAVE EXTREMELY LIMITED ACCESS TO ANY HEALTH CARE.
WE SPEND MORE PER
9
CAPITA ON HEALTH CARE THAN ANY OTHER NATION IN THE WORLD. YET WE LAG BEHIND MANY COUNTRIES IN KEY HEALTH INDICATORS SUCH AS INFANT MORTALITY AND LIFE EXPECTANCY.
THERE IS A STRONG FEELING THAT OUR HEALTH
10
DOLLARS ARE BEING SUCKED INTO A BOTTOMLESS PIT. BOTH BUSINESSES AND GOVERNMENT ARE RE-EXAMINING THEIR HEALTH CARE PROGRAMS AND MAKING CHANGES. THE NATURAL RESPONSE HAS BEEN TO NARROW BENEFITS AND LOWER REIMBURSEMENT TO PROVIDERS.
11
THE EFFORT TO NARROW BENEFITS AND REDUCE REIMBURSEMENT IN THE PUBLIC AND PRIVATE SECTORS IS A REACTION TRIGGERED BY BOTH
12
FEAR AND FRUSTRATION. WHILE, UNDERSTANDABLE, I DO NOT BELIEVE THAT THIS IS THE BEST RESPONSE.
WE MUST DEVELOP A NATIONAL STRATEGY FOR ADDRESSING THE HEALTH CARE NEEDS --AND THAT INCLUDES REHABILITATION --OF ALL
13
AMERICANS. HOW DO WE DO THIS? I BELIEVE WE NEED TO TAKE A TWO-TRACK APPROACH.
FIRST, WE MUST KEEP OUR EYE ON THE BIG PICTURE --ON FUNDAMENTAL, STRUCTURAL REFORM OF OUR ENTIRE HEALTH CARE SYSTEM. SECOND, BECAUSE THIS REFORM WILL
14
TAKE SOME TIME, WE MUST CONTINUE TO MAKE INCREMENTAL IMPROVEMENTS IN OUR EXISTING PROGRAMS.
I FIRMLY BELIEVE THAT OUR HEALTH CARE SYSTEM MUST BEGIN AT A SIGNIFICANTLY EARLIER STAGE: WITH OUR CHILDREN. IT IS
15
UNCONSCIONABLE THAT CHILDREN ARE BEING BORN WITH DISABILITIES THAT COULD HAVE BEEN PREVENTED IF MOTHERS HAD ACCESS TO GOOD PERINATAL CARE. IT IS UNCONSCIOUSABLE THAT A CHILD SHOULD DEVELOP A SERIOUS CONDITION THAT GOES UNDETECTED BECAUSE THE
16
FAMILY CANNOT AFFORD BASIC PREVENTIVE CARE.
WE HAVE MADE SOME INCREMENTAL PROGRESS IN MEETING THESE NEEDS. OVER THE PAST SEVEN YEARS, WE HAVE IMPROVED MEDICAID'S SERVICES TO PREGNANT WOMEN, TO INFANTS, AND TO
17
CHILDREN. BUT CLEARLY MORE NEEDS TO BE DONE.
ORGANIZATIONS LIKE YOURS PLAY A CENTRAL ROLE IN THE DELIVERY SYSTEM. YOU SET THE STANDARD THAT WILL CARRY US INTO THE NEXT CENTURY.
18
FRUSTRATIONS ABOUT THE COST OF OUR SYSTEM IS VOICED BY GOVERNMENTS, CORPORATIONS, INDIVIDUALS AND PROVIDERS AND GROUPS LIKE YOUR OWN. SOME QUESTIONS WE NEED TO BE ASKING:
HOW CAN WE DEAL
19
WITH MALPRACTICE MORE REASONABLY?
WHAT SORT OF HEALTH CARE SHOULD OUR INSURANCE PLANS ENCOURAGE OR DISCOURAGE?
CURRENTLY, MOST INSURANCE, PUBLIC AND
20
PRIVATE, COVER ONLY THE MIDDLE RANGE OF CARE: THEY DON'T COVER ROUTINE AND PREVENTIVE CARE, AND THEY DON'T COVER TRULY CATASTROPHIC CARE. SHOULD WE REORIENT THE SYSTEM TOWARD PREVENTIVE AND PRIMARY CARE?
21
FINALLY, CAN WE OR SHOULD WE PAY FOR UNIVERSAL, COMPREHENSIVE HEALTH CARE BY SIMPLY RESTRUCTURING THE SYSTEM? OR WILL WE NEED TO FIND ADDITIONAL FUNDS? IF SO, HOW MUCH ARE AMERICANS WILLING TO PAY FOR IT?
22
WE MUST TAKE ON DIFFICULT DECISIONS OF THIS KIND. WE CAN RESTRUCTURE OUR HEALTH CARE SYSTEM, REORDER OUR PRIORITIES, AND DEVISE A WAY TO DELIVER APPROPRIATE HEALTH CARE TO
23
ALL AMERICANS. DOING THIS WILL TAKE COMMODITIES THAT ARE EVEN MORE SCARE THAN MONEY THESE DAYS: CREATIVITY, BOLDNESS, AND A GREAT DEAL OF POLITICAL WILL. IT WILL ALSO REQUIRE THE COOPERATION AND ASSISTANCE OF HEAL TH PROFESSIONALS AND THE BUSINESS COMMUNITY.
24
WE CERTAINLY DO NOT HAVE ALL THE ANSWERS - - GROUPS LIKE YOURS CAN HELP US FIND THE SOLUTIONS TO THE PROBLEMS I HAVE NOTED. GROUPS LIKE YOURS PLAY A CENTRAL ROLE IN THE DELIVERY SYSTEM. AS ACCREDIDATORS YOU SET THE STANDARD FOR REHABILITATION SERVICES THAT
25
WILL CARRY US INTO THE NEXT CENTURY.
AS THE NEW WORLD ORDER EMERGES SO DO NEW OPPORTUNITIES. WE HAVE THE OPPORTUNITY NOT ONLY TO SHARE OUR KNOWLEDGE BUT TO LEARN FROM OTHERS. INDUSTRIALIZED NATIONS LIKE
26
OURS HAVE HISTORICALLY DEALT WITH PERSONS WITH DISABILITIES BY EXCLUDING THEM THROUGH INSTITUTIONALIZATION
REHABILITATION FACILITIES PRODUCE SKILLED QUALIFIED INDIVIDUALS WHO BECOME PRODUCTIVE MEMBERS OF
27
SOCIETY. TAX-USERS BECOME TAX-PAYERS IN AN INCLUSIVE WORKFORCE.
YOUR WORK IS CRITICAL TO IMPROVING EMPLOYMENT OPPORTUNITIES FOR PEOPLE WITH DISABILITIES AND OTHERS IN NEED OF REHABILITATION. YOU KNOW AS WELL OR BETTER
28
THAN ANYONE THE ROLE TECHNOLOGY PLAYS IN THIS REGARD.
AS REHABILITATION PROFESSIONALS YOU HAVE THE KNOWLEDGE, SKILLS, AND ABILITIES TO IMPROVE THE QUALITY OF LIFE AS WELL AS THE AMERICAN ECONOMY --THE
29
WILL IS HERE --TOGETHER WE CAN FIND THE WAY.
30 -
August 29, 1991
TO: Senator Dole
FROM: Mo West
SUBJECT: CARF Speech
You will be speaking before an audience of 1000 people today at the Commission on Accreditation of Rehabilitation Facilities (CARF) Conference being held at the Grand Hyatt Hotel. You are scheduled to speak at 1:30 p.m. for 20 minutes in the Constitutional Ballroom.
The audience would like to hear your thoughts on the sudden turn of events in the Soviet Union and the implications world events will have on government in the 21st Century. Al has prepared talking points for you on this topic. While you are not being asked to speak on disability, I did put together some talking points for you on challenges we face here in the U.S. regarding health care and disability. I'll bring an enlargedprint of my talking points with me to the Grand Hyatt should you want them.
You will be greeted by John Kemp at the front entrance of the Hotel upon your arrival and escorted to the podium for your presentation. Max McCleland will follow your presentation and will speak to specific disability issues and the quality of life for people with disabilities in the 21st Century.
There will be approximately eight Kansans in attendance. After your speech they will organize to meet you outside the Ballroom for a photo op. The Hotel will have a photographer available for this purpose.
TALKING POINTS FOR CARF SPEECH
AUGUST 29,1991
GRAND HYATT HOTEL, WASH, D.C.
You have asked me to address how the federal government will impact on the quality of life in our society in the future ....on the course of events that will carry us into the 21st century.
It hasn't been long since we welcomed home those who fought in the Persian Gulf War. Americans will long remember the bravery of the men and women of Operation Desert Storm. I believe our country can only be as strong abroad as we are at home. And our duty to those who risked their lives for freedom is to build a country dedicated to equal opportunity.
Surely, the recent events in the Soviet Union will bring changes that will take us into the next century. As Communism crumbles and a new world order emerges, United States policies will change. Issues of defense and detente will take on new meanings ....meanings we are just beginning to contemplate.
While we face exciting challenges abroad, we have serious and demanding challenges here at home. We need to ask ourselves, what kind of country will America be as it enters a new century? Will we be truly strong, or barely strong enough? Will we be self-confident, or self doubting? Will we be on the march, or at a standstill?
I have no doubt in my mind that the most important domestic challenge our nation faces as we move into the next century may well be how we provide health care for our citizens and how we pay for it. Perhaps the most daunting problem of all, will be the financing of long term care services for our elderly and disabled.
You all know the grim statistics. We are spending $660 billion per year, or almost $2 billion every day --for a system that serves far too many of us inadequately or not at all. Thirty-some million Americans, almost one-half of them children, have no health insurance, and thus have extremely limited access to any health care.
We spend more per capita on health care than any other nation in the world. Yet we lag behind many countries in key health indicators such as infant mortality and life expectancy.
There is a strong feeling that our health dollars are being sucked into a bottomless pit. Both businesses and government are re-examining their health care programs and making changes. The natural response has been to narrow benefits and lower reimbursement to providers.
The effort to narrow benefits and reduce reimbursement in the public and private sectors is a reaction triggered by both fear and frustration. While, understandable, I do not believe that this is the best response.
We must develop a National Strategy for addressing the health care needs and that includes rehabilitation --of all Americans. How do we do this? I believe we need to take a two-track approach.
First, we must keep our eye on the big picture --on fundamental, structural reform of our entire health care system. Second, because this reform will take some time, we must continue to make incremental improvements in our existing programs.
I firmly believe that our health care system must begin at a significantly earlier stage: with our children. It is unconscionable that children are being born with disabilities that could have been prevented if mothers had access to good perinatal care. It is unconsciousable that a child should develop a serious condition that goes undetected because the family cannot afford basic preventive care.
We have made some incremental progress in meeting these needs. Over the past seven years, we have improved Medicaid's services to pregnant women, to infants, and to children. But clearly more needs to be done.
Organizations like yours play a central role in the delivery system. You set the standard that will carry us into the next century.
Frustrations about the cost of our system is voiced by governments, corporations, individuals and providers and groups like your own. Some questions we need to be asking:
How can we deal with malpractice more reasonably?
What sort of health care should our insurance plans encourage or discourage?
Currently, most insurance, public and private, cover only the middle range of care: They don't cover routine and preventive care, and they don't cover truly catastrophic care. Should we reorient the system toward preventive and primary care?
Finally, can we or should we pay for universal, comprehensive health care by simply restructuring the system? Or will we need to find additional funds? If so, how much are Americans willing to pay for it?
We must take on difficult decisions of this kind. We can restructure our health care system, reorder our priorities, and devise a way to deliver appropriate health care to all Americans. Doing this will take commodities that are even more scare than money these days: creativity, boldness, and a great deal of political will. It will also require the cooperation and assistance of health professionals and the business community.
We certainly do not have all the answers --groups like yours can help us find the solutions to the problems I have noted. Groups like yours play a central role in the delivery system. As accredidators you set the standard for rehabilitation services that will carry us into the next century.
As the new world order emerges so do new opportunities. We have the opportunity not only to share our knowledge but to learn from others. Industrialized nations like ours have historically dealt with persons with disabilities by excluding them through institutionalization.
Rehabilitation facilities produce skilled qualified individuals who become productive members of society. Tax-users become tax-payers in an inclusive workforce.
Your work is critical to improving employment opportunities for people with disabilities and others in need of rehabilitation. You know as well or better than anyone the role technology plays in this regard.
As rehabilitation professionals you have the knowledge,skills, and abilities to improve the quality of life as well as the American economy --the will is here --together we can find the way.
TALKING POINTS FOR CARF SPEECH
AUGUST 29,1991
GRAND HYATT HOTEL, WASH, D.C.
You have asked me to address how the federal government will impact on the quality of life in our society in the future ....on the course of events that will carry us into the 21st century.
It hasn't been long since we welcomed home those who fought in the Persian Gulf War. Americans will long remember the bravery of the men and women of Operation Desert Storm. I believe our country can only be as strong abroad as we are at home. And our duty to those who risked their lives for freedom is to build a country dedicated to equal opportunity.
Surely, the recent events in the Soviet Union will bring changes that will take us into the next century. As Communism crumbles and a new world order emerges, United States policies will change. Issues of defense and detente will take on new meanings ....meanings we are just beginning to contemplate.
While we face exciting challenges abroad, we have serious and demanding challenges here at home. We need to ask ourselves, what kind of country will America be as it enters a new century? Will we be truly strong, or barely strong enough? Will we be self-confident, or self doubting? Will we be on the march, or at a standstill?
I have no doubt in my mind that the most important domestic challenge our nation faces as we move into the next century may well be how we provide health care for our citizens and how we pay for it. Perhaps the most daunting problem of all, will be the financing of long term care services for our elderly and disabled.
You all know the grim statistics. We are spending $660 billion per year, or almost $2 billion every day --for a system that serves far too many of us inadequately or not at all. Thirty-some million Americans, almost one-half of them children, have no health insurance, and thus have extremely limited access to any health care.
We spend more per capita on health care than any other nation in the world. Yet we lag behind many countries in key health indicators such as infant mortality and life expectancy.
There is a strong feeling that our health dollars are being sucked into a bottomless pit. Both businesses and government are re-examining their health care programs and making changes. The natural response has been to narrow benefits and lower reimbursement to providers.
The effort to narrow benefits and reduce reimbursement in the public and private sectors is a reaction triggered by both fear and frustration. While, understandable, I do not believe that this is the best response.
We must develop a National Strategy for addressing the health care needs and that includes rehabilitation --of all Americans. How do we do this? I believe we need to take a two-track approach.
First, we must keep our eye on the big picture --on fundamental, structural reform of our entire health care system. Second, because this reform will take some time, we must continue to make incremental improvements in our existing programs.
I firmly believe that our health care system must begin at a significantly earlier stage: with our children. It is unconscionable that children are being born with disabilities that could have been prevented if mothers had access to good perinatal care. It is unconsciousable that a child should develop a serious condition that goes undetected because the family cannot afford basic preventive care.
We have made some incremental progress in meeting these needs. Over the past seven years, we have improved Medicaid's services to pregnant women, to infants, and to children. But clearly more needs to be done.
Organizations like yours play a central role in the delivery system. You set the standard that will carry us into the next century.
Frustrations about the cost of our system is voiced by governments, corporations, individuals and providers and groups like your own. Some questions we need to be asking:
How can we deal with malpractice more reasonably?
What sort of health care should our insurance plans encourage or discourage?
Currently, most insurance, public and private, cover only the middle range of care: They don't cover routine and preventive care, and they don't cover truly catastrophic care. Should we reorient the system toward preventive and primary care?
Finally, can we or should we pay for universal, comprehensive health care by simply restructuring the system? Or will we need to find additional funds? If so, how much are Americans willing to pay for it?
TALKING POINTS FOR
CARF SPEECH
AUGUST 29,1991
GRAND HYATT HOTEL,
WASH, D.C.
YOU HAVE ASKED ME TO ADDRESS HOW THE FEDERAL
1
GOVERNMENT WILL IMPACT ON THE QUALITY OF LIFE IN OUR SOCIETY IN THE FUTURE....ON THE COURSE OF EVENTS THAT WILL CARRY US INTO THE 21ST CENTURY.
IT HASN'T BEEN LONG SINCE WE WELCOMED HOME THOSE WHO FOUGHT IN THE
2
PERSIAN GULF WAR. AMERICANS WILL LONG REMEMBER THE BRAVERY OF THE MEN AND WOMEN OF OPERATION DESERT STORM. I BELIEVE OUR COUNTRY CAN ONLY BE AS STRONG ABROAD AS WE ARE AT HOME. AND OUR DUTY TO THOSE WHO RISKED THEIR LIVES FOR FREEDOM IS TO
3
BUILD A COUNTRY DEDICATED TO EQUAL OPPORTUNITY.
SURELY, THE RECENT EVENTS IN THE SOVIET UNION WILL BRING CHANGES THAT WILL TAKE US INTO THE NEXT CENTURY. AS COMMUNISM CRUMBLES AND A NEW WORLD ORDER EMERGES, UNITED
4
STATES POLICIES WILL CHANGE. ISSUES OF DEFENSE AND DETENTE WILL TAKE ON NEW MEANINGS....MEANINGS WE ARE JUST BEGINNING TO CONTEMPLATE.
WHILE WE FACE EXCITING CHALLENGES ABROAD, WE HAVE SERIOUS AND DEMANDING
5
CHALLENGES HERE AT HOME. WE NEED TO ASK OURSELVES, WHAT KIND OF COUNTRY WILL AMERICA BE AS IT ENTERS A NEW CENTURY? WILL WE BE TRULY STRONG, OR BARELY STRONG ENOUGH? WILL WE BE SELF-CONFIDENT, OR SELF DOUBTING? WILL WE BE ON THE MARCH, OR AT A STANDSTILL?
6
I HAVE NO DOUBT IN MY MIND THAT THE MOST IMPORTANT DOMESTIC CHALLENGE OUR NATION FACES AS WE MOVE INTO THE NEXT CENTURY MAY WELL BE HOW WE PROVIDE HEALTH CARE FOR OUR CITIZENS AND HOW WE PAY FOR IT. PERHAPS THE MOST DAUNTING PROBLEM OF ALL,
7
WILL BE THE FINANCING OF LONG TERM CARE SERVICES FOR OUR ELDERLY AND DISABLED.
YOU ALL KNOW THE GRIM STATISTICS. WE ARE SPENDING $660 BILLION PER YEAR, OR ALMOST $2 BILLION EVERY DAY - -FOR A SYSTEM THAT SERVES
8
FAR TOO MANY OF US INADEQUATELY OR NOT AT ALL. THIRTY-SOME MILLION AMERICANS, ALMOST ONE-HALF OF THEM CHILDREN, HAVE NO HEALTH INSURANCE, AND THUS HAVE EXTREMELY LIMITED ACCESS TO ANY HEALTH CARE.
WE SPEND MORE PER
9
CAPITA ON HEALTH CARE THAN ANY OTHER NATION IN THE WORLD. YET WE LAG BEHIND MANY COUNTRIES IN KEY HEALTH INDICATORS SUCH AS INFANT MORTALITY AND LIFE EXPECTANCY.
THERE IS A STRONG FEELING THAT OUR HEALTH
10
DOLLARS ARE BEING SUCKED INTO A BOTTOMLESS PIT. BOTH BUSINESSES AND GOVERNMENT ARE RE-EXAMINING THEIR HEALTH CARE PROGRAMS AND MAKING CHANGES. THE NATURAL RESPONSE HAS BEEN TO NARROW BENEFITS AND LOWER REIMBURSEMENT TO PROVIDERS.
11
THE EFFORT TO NARROW BENEFITS AND REDUCE REIMBURSEMENT IN THE PUBLIC AND PRIVATE SECTORS IS A REACTION TRIGGERED BY BOTH
12
FEAR AND FRUSTRATION. WHILE, UNDERSTANDABLE, I DO NOT BELIEVE THAT THIS IS THE BEST RESPONSE.
WE MUST DEVELOP A NATIONAL STRATEGY FOR ADDRESSING THE HEALTH CARE NEEDS --AND THAT INCLUDES REHABILITATION --OF ALL
13
AMERICANS. HOW DO WE DO THIS? I BELIEVE WE NEED TO TAKE A TWO-TRACK APPROACH.
FIRST, WE MUST KEEP OUR EYE ON THE BIG PICTURE --ON FUNDAMENTAL, STRUCTURAL REFORM OF OUR ENTIRE HEALTH CARE SYSTEM. SECOND, BECAUSE THIS REFORM WILL
14
TAKE SOME TIME, WE MUST CONTINUE TO MAKE INCREMENTAL IMPROVEMENTS IN OUR EXISTING PROGRAMS.
I FIRMLY BELIEVE THAT OUR HEALTH CARE SYSTEM MUST BEGIN AT A SIGNIFICANTLY EARLIER STAGE: WITH OUR CHILDREN. IT IS
15
UNCONSCIONABLE THAT CHILDREN ARE BEING BORN WITH DISABILITIES THAT COULD HAVE BEEN PREVENTED IF MOTHERS HAD ACCESS TO GOOD PERINATAL CARE. IT IS UNCONSCIOUSABLE THAT A CHILD SHOULD DEVELOP A SERIOUS CONDITION THAT GOES UNDETECTED BECAUSE THE
16
FAMILY CANNOT AFFORD BASIC PREVENTIVE CARE.
WE HAVE MADE SOME INCREMENTAL PROGRESS IN MEETING THESE NEEDS. OVER THE PAST SEVEN YEARS, WE HAVE IMPROVED MEDICAID'S SERVICES TO PREGNANT WOMEN, TO INFANTS, AND TO
17
CHILDREN. BUT CLEARLY MORE NEEDS TO BE DONE.
ORGANIZATIONS LIKE YOURS PLAY A CENTRAL ROLE IN THE DELIVERY SYSTEM. YOU SET THE STANDARD THAT WILL CARRY US INTO THE NEXT CENTURY.
18
FRUSTRATIONS ABOUT THE COST OF OUR SYSTEM IS VOICED BY GOVERNMENTS, CORPORATIONS, INDIVIDUALS AND PROVIDERS AND GROUPS LIKE YOUR OWN. SOME QUESTIONS WE NEED TO BE ASKING:
HOW CAN WE DEAL
19
WITH MALPRACTICE MORE REASONABLY?
WHAT SORT OF HEALTH CARE SHOULD OUR INSURANCE PLANS ENCOURAGE OR DISCOURAGE?
CURRENTLY, MOST INSURANCE, PUBLIC AND
20
PRIVATE, COVER ONLY THE MIDDLE RANGE OF CARE: THEY DON'T COVER ROUTINE AND PREVENTIVE CARE, AND THEY DON'T COVER TRULY CATASTROPHIC CARE. SHOULD WE REORIENT THE SYSTEM TOWARD PREVENTIVE AND PRIMARY CARE?
21
FINALLY, CAN WE OR SHOULD WE PAY FOR UNIVERSAL, COMPREHENSIVE HEALTH CARE BY SIMPLY RESTRUCTURING THE SYSTEM? OR WILL WE NEED TO FIND ADDITIONAL FUNDS? IF SO, HOW MUCH ARE AMERICANS WILLING TO PAY FOR IT?
22
WE MUST TAKE ON DIFFICULT DECISIONS OF THIS KIND. WE CAN RESTRUCTURE OUR HEALTH CARE SYSTEM, REORDER OUR PRIORITIES, AND DEVISE A WAY TO DELIVER APPROPRIATE HEALTH CARE TO
23
ALL AMERICANS. DOING THIS WILL TAKE COMMODITIES THAT ARE EVEN MORE SCARE THAN MONEY THESE DAYS: CREATIVITY, BOLDNESS, AND A GREAT DEAL OF POLITICAL WILL. IT WILL ALSO REQUIRE THE COOPERATION AND ASSISTANCE OF HEAL TH PROFESSIONALS AND THE BUSINESS COMMUNITY.
24
WE CERTAINLY DO NOT HAVE ALL THE ANSWERS - - GROUPS LIKE YOURS CAN HELP US FIND THE SOLUTIONS TO THE PROBLEMS I HAVE NOTED. GROUPS LIKE YOURS PLAY A CENTRAL ROLE IN THE DELIVERY SYSTEM. AS ACCREDIDATORS YOU SET THE STANDARD FOR REHABILITATION SERVICES THAT
25
WILL CARRY US INTO THE NEXT CENTURY.
AS THE NEW WORLD ORDER EMERGES SO DO NEW OPPORTUNITIES. WE HAVE THE OPPORTUNITY NOT ONLY TO SHARE OUR KNOWLEDGE BUT TO LEARN FROM OTHERS. INDUSTRIALIZED NATIONS LIKE
26
OURS HAVE HISTORICALLY DEALT WITH PERSONS WITH DISABILITIES BY EXCLUDING THEM THROUGH INSTITUTIONALIZATION
REHABILITATION FACILITIES PRODUCE SKILLED QUALIFIED INDIVIDUALS WHO BECOME PRODUCTIVE MEMBERS OF
27
SOCIETY. TAX-USERS BECOME TAX-PAYERS IN AN INCLUSIVE WORKFORCE.
YOUR WORK IS CRITICAL TO IMPROVING EMPLOYMENT OPPORTUNITIES FOR PEOPLE WITH DISABILITIES AND OTHERS IN NEED OF REHABILITATION. YOU KNOW AS WELL OR BETTER
28
THAN ANYONE THE ROLE TECHNOLOGY PLAYS IN THIS REGARD.
AS REHABILITATION PROFESSIONALS YOU HAVE THE KNOWLEDGE, SKILLS, AND ABILITIES TO IMPROVE THE QUALITY OF LIFE AS WELL AS THE AMERICAN ECONOMY --THE
29
WILL IS HERE --TOGETHER WE CAN FIND THE WAY.
30
Position: 609 (14 views)