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tv   Politics Public Policy Today  CSPAN  August 23, 2011 6:00am-7:00am EDT

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how are we responding to that? what did we -- one of the things we did see -- i think the word intelligence is overused. i want to use the word to the chatter. -- chitter chatter. to give you practical examples on that night, through twitter and bbm, there was intelligence and that at the olympic site, and we were able to secure all those places. there poe's locations were protected and we were able to respond -- those locations were protected and we were able to respond. >> that sounds like it was quite
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useful for the police to get into that. what effect would have been if the network had been blocked in some way deck? >> that has been a matter of debate. i have contemplated seeking the authorities to switch it off. the legality of that is very questionable. it is also very useful intelligence. it is a massive amount of information and some of it is quite wrong and rather silly. as a result of that, we did not request that it was turned off. >> blackberry and had offered to cooperate with the authorities. what does that mean? are they prepared to give you
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information that occurs on their machines or are they going to monitor the traffic for you? >> i would like to plead the fifth on that. i would rather not answer the question at the moment. >> are you continuing to work with blackberry? >> we continue to work closely with blackberry and twittered. we work with others to help us with that. >> thank you. >> of your officers reacts to the criticism they have received taxpay? do your officers feel that is a difficult place to be? >> that is what i responded to when i made my comments.
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i do not believe for one second that the men and women of the met were concerned. the vast majority of the people that make up this city, and the support that has been given to the officers on the ground, people have been standing up and clapping them. but people have been invited to dinner. i believe one community has gone from local citizens for the officers. they had a full menu for officers. we tried to dissuade them from spending too much time eating.
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the issue that comes from that is that the met police problem has not had as high a morale as it has now in recent months and years. that is because the people are supportive. they are thanking them for their efforts on that night. as a result, there was a high morale in the met as we speak. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011] >> coming up, former house secretary louis sullivan talks about health care disparities and on "washington journal." will get the latest on the situation in libya and look at the medicare advantage program at 7:00 eastern. >> watch more a video of the candidates and see what political reporters are saying and track the latest campaign contributions with the cspan web
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site 4 camp in 2012. it helps you navigate the political landscape "twitter feeds and facebook updates from the campaign, candidate by as, and the latest polling data and links to the partners in the early primary and caucus states at upper 2012. >> of next, a conversation on u.s. healthcare disparities. we will hear from former health secretary dr. louis sullivan. the institute for the events of multi-cultural and minority medicine hosted this event and this is 50 minutes. >> i hope you are enjoying your lunch. we would like to get started with the next phase of the program. we are so honored and so pleased that dr. louis sullivan has joined us today. as you all know, dr. sullivan
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served as the secretary of the u.s. department of health and human services from 1989-1993. took on big tobacco and a surge of a chevy. -- and the scourges of hiv. dr. sullivan aren't his doctor of medicine degree at the boston university school of medicine in 1958. he completed his internship and residency at new york hospital cornell medical center. he also did some work at the new jersey college of medicine while teaching at harvard medical school and researching at the half thorndike memorial laboratory. that was before becoming the co- director of hematology at boston university medical center. he also founded the boston university hematology service at
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boston city hospital. that was until 1995. that is when he founded the medical education program at morehouse college . he has received dozens of honoree degrees and has been honored by many diverse organizations. such as the southern leadership -- the southern christian leadership conference and the national association of minority medical educators. dr. sullivan and his wife, ginger, have three children. i would now like to introduce you to the hon. dr. louis sullivan. [applause] >> thank you for that generous introduction and it is a great pleasure for me to be here with all of you to see where we are
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in terms of health equity and i have certainly enjoyed the presentations thus far today. i think there are very important. when we look forward to the unveiling of the sculpture in honor of martin luther king jr., i think this gives this conference a special significance. i happen to have been about 10 feet away from martin luther king jr. in 1963 when he gave his talk here at the lincoln memorial. for me personally, my wife and i were here for the inauguration at the other end of the mall of the first african-american president, mr. obama. we have made significant progress in our country but as already has been noted, we still have a lot to accomplish. that depends upon many people but it depends particularly on
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us to in deed but the issues before the country, to lobby for those things that need to be done, to indeed lend support to who have ideas that we think are important, and indeed to see that those individuals are put in positions of authority and power. one of the comments made earlier today about getting politics out of madison -- i agree that that is not the issue. the issue is getting the right political decisions made. in a democracy, politics is in transit to our system but it means we must have individuals who indeed know the issues, who are committed to improving, and who are willing to commit their leadership, their reputations, their energies to solving the problems. that is what is important. before i begin, let me make a
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side comment. i want to thank roger folger for this book on paul rogers that was here when we arrived today. he represented one of the things we lack today. that is a leader in congress who has the capacity, the intellect, the commitment, and the political will to make things happen. there are a number of things that happened during his tenure as a member of congress and while we have friends in the congress now who are interested in health, we don't have the individuals in congress who make that their number one primary priority who are able to convince their fellow members of the legislature that this is something that is not of self- interest but is something that is important for the nation as a whole. it helped that his everything. if -- health touches everything. if we do not have a healthy
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population, everything is secondary. we are concerned about what is happening or not happening in our health-care system. we need to have more people like paul rodgers to really help in the decisionmaking process in the congress as well as in the administration. the title of my talk is " america's journey to help equity." it is an overview of what has happened over the past century, where we are now, and what are our projections for the future. we are at an inflection point and this gives us an opportunity to make such a comment . you have heard about martin luther king's comments in 1966 about the inequality, the lack of health access that is imposed
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and our citizens. the next slide shows where we are as a country today in terms of our spending on health care. this shows that we outrank all of the nation's by far in the dollars we spend in our health- care system with some 16% of our gnp. when i came to washington and 81989, it was 11%. we are spending $1 trillion in 1989 from public and private sources in our health-care system. this is now in excess of $2 trillion plus the $2.40 trillion we are spending on health care some 20 years later.
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we are really having a problem of runaway costs and our health system that is shown by the slide. this compares us with other nations and yet we don't have the best health outcomes in our country comparing us with other countries in the world. those costs are escalating. they are now some 16% of gnp compared to 11% in 1989 and it was 6.5% when medicare and medicaid were instituted in 1965. you can see that we have triple the percentage of gnp going to health services over the last 50 years but yet while we have something to show for it, we have fallen far short of what our needs are. . this slide shows that compared to other nations, we do not well
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in terms of infant mortality. we are out right by most other western countries. it shows that spending money alone is not enough. we have to have infrastructure. have to have participation by our population. simple things like pregnant mothers coming to see their obstetrician and the first trimester of pregnancy. we have to have not only trained individuals and a system that works, we have to have individuals who know the things they must do in order to preserve and enhance their health. this also shows that the disparities between white population and the minority population contributed to almost 900,000 excess deaths over a three-year. in the nation and more than that, this caused our nation some $50 billion in lost productivity as well as the cost of health services.
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that is a study from the joint center of political studies. this slide shows what has happened over the past century. at the time of wb devore in 1906, the major cause of death was contagious diseases like tuberculosis and malnutrition. by 1985, you see that these infectious problems had been replaced by chronic diseases, cancer, cardiovascular disease, cirrhosis of the liver, accidents, homicides, etc. a similar pattern exists today in a report from the cdc in the year 2010. we have made progress in our mortality rates button noted the fact that while there has been
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improvement in mortality by all segments of our population including minorities, striking is the way these lines really don't cross. the black mortality has declined. notice we are about 30 years behind the mortality of the white by police in. -- of the white population. the disparities that existed 50 years ago means we must do better with our minority populations and the port to address those things that contributed to mortality. the data for the hispanic population and asian pacific islands and the native american population are less complete, having been collected in significant amounts only in the last. 30 or 40 years. you will see parallel improvements in mortality rates in all these populations.
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life expectancy at birth has improved over the course of the 20th century but here again, the lines are parallel and don't cross. in the year 1900, life expectancy was 47 years, of whites and less than 40 years for blacks. compared to today where it is approaching 80 years for white females and almost 70 years for black males. you will see that while all these lines have improved, you don't see much closing of the gap. some slight closing but much more remains to be done. the report from the public health service in 2010 on health care qualities and disparities show that while access and quality are suboptimal
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especially for minorities and low income groups, quality of care is improving but access to care is not improving. we must do more. many things in pentagon this. one thing we have not talked about very much is health manpower. we're going to bring 32 million people into the health system with the successful implementation of the health reform legislation passed a year and a half ago by the congress. we need professionals to take care of those individuals. in massachusetts, we have seen what happens when we set up an insurance mechanism so that people have an insurance card to pay for care. in some communities in massachusetts, there are waiting times for some seven weeks to see it primary-care physicians because of inadequate manpower to address the unmet
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health needs that were on least -- unleased by the passage of legislation in massachusetts. if we don't address this issue nationwide, we will see similar issues of people having insurance cards but having difficulty at getting health services. we need to address that. i am very pleased that we're getting more attention to prevention in health promotion because it is my view that we will never -- if we never engage our citizens in prevention and health promotion, we will not solve the problem of cost control nor will we see maximum improvement in the health of our citizens. we must first of all have a system that works, having trained individuals, having facilities, all the things that are needed, but in addition, we must have a citizenry that knows proper nutrition, exercise,
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childhood immunization, all of those things that they must do if indeed we are to achieve maximal health. it is well known that the higher level of education attended we see in the population, the health care that population is. poverty, poor health, lower education all go together. we must address them simultaneously if we are to see improvement in the health of all segments of our population. this slide is simply gives a do of bavaria's reports that have been issued over the years concerning health equity in the united states. wb dubois was the first scholar to draw attention to the very close link between health status and poverty. he was looking at the health of
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african-americans in the population, he emphasized the role of poverty in affecting health. the report issued in 1985 by secretary heckler a black and minority health. as was mentioned earlier today, in march of 1983, the association of minority health professional schools met with secretary heckler and presented to her a report called "blacks in the 1980's" black health professionals in the 1980's, a national crisis in time for action. that report was written by an analyst for the association. that was the stimulus for secretary heckler to appoint her on departmental committee headed by tom malone who was deputy
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director of the national institutes of health and the singer african-american in the department. that committee that he shared -- chaired the issue a report in august of 1985, almost 2.5 years after we met with secretary heckler and got her commitment to address this issue. we are pleased that happens. as a result of that report being issued in 1985, she indeed established the office for minority health in the office of the secretary in that same year. other reports that are important -- i am pleased that brian smedley is here. there was a report on on equal treatment showing that when you correct for differences in socio-economic status, african- americans still receive less optimal care than whites.
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that shows a bias in the system, often unconscious, without affecting the quality of care that individuals receive. in 2004, the report from the commission i chaired looking at health manpower and diversity, that report is called "missing persons'" but pointed out that while we had made progress in the '60s, '70s, '80s, in the '90s, we pled said and we show signs of slipping back in terms of minority representation in the health profession. we look at medicine, nursing, dentistry, public health, and psychology. a number of other reports have come out. i draw your attention to the last two on the lower right. first is the memoir, by dr. augustus white who established the orthopedic service at the
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beth israel hospital. i believe that was in the late 1980's or early 1990's. he has become very committed to addressing the issue of health disparities. been as well written memoir of his life, he talked about health disparities. i recommended to all of you because i think it summarizes many of the issues that we confront in the system now. it shows how having grown up in a segregated environment in memphis, really became one of our nation's outstanding physicians and leaders in orthopedics and now one of our current leaders in the area of health disparities. the book on the right by dr richard williams is on health disparities and the effect of health reform in addressing health disparities. there have been a number of publications over the years to address the issue that keeps the
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attention focused but we need to have action by our leaders both in the government as well as in the private sector to address this. the next two schley's simply summarize some of the things that have happened over the years -- the next two slides simply summarize some of the things that have happened over the years. these other factors that have on the systempinged today in. during the second half of the 20th century, because of the very act of civil rights activities, we did see some improvement in many areas. there was legislation and acting medicare and medicaid in the 1960's, improvement and the percentage of minorities entering the health profession. it is far from what was hoped
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would be achieved. we saw some improvement as i know it on this slide, in 1983, we met with secretary heckler and presented her with this report that led her to have her own internal departmental committee to study this issue and come up with the heckler report in august, 1985. we also saw the first asian pacific island health forum established. in 1989, it was my honor to be appointed to the secretary of health and human services and in 1990, i was pleased to establish the office for research in minority health at nih. dr. ruffin was the acting head of nih. he was appointed to head the office and has continued in that leadership position in the current time as that office was elevated to a center in january
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of 2000, some 10 years later. this past year, with the passage of health reform legislation, the center was elevated to an institute reported [applause] . [applause] several of us met with dr. francis collins about the desire and need and imperative to elevate the center to an institute. dr. collins is responsible as well. the center has all of the prerogatives and abilities that an institute has. if it has all of those authorities and responsibilities, it is an institute so why not call it an institute? [laughter] congress agreed with us and indeed passed legislation to establish this instant -- this
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national institute for minority health and health disparities research. we are very pleased with that. it was not too long ago we had our first minority surgeon general who had previously been deputy director of the national institute of child health and human development at nih. the first woman and first hispanic to serve as surgeon general and dr. healy was the first woman to serve as director of nih and established the women's health initiatives at that time and really helped to show that women suffer from heart attacks, strokes and other diseases where they were thought to be somewhat immune from them. dr. keylay did a number of things to address women's health but also minority held. she appointed the first african-
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american director of one of the institutes at nih. kenneth odin was appointed and our support for the office of research in minority health, she contributed quite a bit. we will comment -- i have already commented on the sullivan commission report. what we noted in september of 2004 when the issue this report which was reported by the kellogg foundation was that while we had made progress in increasing diversity in the health profession that progress was far from where we had expected would occur during the 1960's, '70's, and the '80s. in 1950, 2% of american physicians were african- american. by 1990, that was 4.3%.
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opeone could say that one had double the percentage but we doubled from a small base. african-americans represented some 12% of the population, they still fell short of their representation in the general population. why is that important? colleagues at the university of southern california reported in 1996 that black or hispanic physicians with a three--- were three-five times more likely to establish their practices in the ghetto. they're more likely to have higher populations and non- paying patient populations as well. it is not a question of numbers but the kinds of positions that we serve. she showed that the practice patterns of minority physicians were different than white physicians. if we were serious about doing everything we could to address
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the health needs of our minority population, we had to be concerned about the quality of the input into our system, the kinds of individuals if we are going to see that all segments of our population are well- served. there have been a number of studies since that time confirming those findings by dr. miriam comarami and her colleagues. this line shows the 10th grade public health achievements of the united states as reported by the cdc. you can say that -- what does that have to do for health? motor vehicle safety -- we have four-five times as many cars on the road today as it did 50 haves ago but the debtdeaths increased modestly because and
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-- because cars are designed to be safer and safety belt use has increased. when i went to washington in 1989, 47% of drivers used seat belts. legislation and activities in various states were under way so that now that is close to 90% of drivers using a seat belts. yes someone is in an accident in a car, they're much less likely to be killed of an injury that is much less severe. in motor vehicle safety that is one of the things that impress -- contribute to improvement in health. the effect of the environment that we live in whether we have clean air and water, all of these are important health advances as recognized by cdc during the 20th century that have helped to improve the health of our citizens.
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this slide really is a commentary on medical education system. in 1908, abraham flexner was commissioned to examine health education in the united states. we had some proprietary medical schools. there were no standards of medical standards of education. he wrote a report and it makes a very interesting reading. he describes the medical school in a page and a half or less of some of the language is very colorful such as never in my experience have i seen anything so disgraceful masquerading as a higher educational institution as this miserable example. [laughter] his trustees should do the public a service and put it out
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of its misery. because it reflects this report which got plenty of attention, the number of medical schools by 1925 had decreased to 80. accreditation standards were begun in the year 1914 and 1915. a number of the things happen but among the things that happens, there were seven predominantly black medical schools in existence and only two of them survived, howard and mahari. the other schools that were considered weresub par. they were operated for-profit by their owners. the improvement of medical education started with that report but flexner said we needed to have sanitariums to cake -- to take care of the health needs in the black unity
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with things like tuberculosis which could be passed to the white population. his justification for black medical schools was protection for the white population. i would like to get into his mind whether he was doing this for political reasons or he really meant what he said. mahari wereward and preserved among the nation's medical schools after that time. johns hopkins was a model that he held up as the model for medical education. the admissions requirements or that you had to have at least a high-school diploma preferably one or two years of college education to go to medical school. they also had a curriculum structure with the science is being taught with basic medicine and clinical sciences. that model is still call flexnerian model parabol.
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by the middle of the century, we can say with confidence that the u.s. had the strongest health profession educational system of any country in. the world. we draw people from all over the world for education not available in their own country. with the establishments of the national institutes of health, we can citizen about our research enterprise which is reflected by the fact that during the course of the 20th century, more nobel prizes in madison and physiology have come to more americans than the rest of the world combined. we have that leadership in science from the institutes of health and a leadership in the quality of medical education. as you can see from this slide, we still are under-
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represented in the overall health profession population. more than 30% of the u.s. population now is either hispanic american, african american, native american, for asian-pacific islander. when you look at the health profession, only 12% of physicians come from one of these groups. 11% of nurses, a 10% of pharmacists, and 10% of dentists. u.s. census bureau as projected by by the year 2042, there will no longer be a white majority population in our country. we are going to a rapid demographic shift in our country. it has been emphasized and shown that cultural confidence among our health professionals is important. we have to have individuals who are scientifically well-trained but we also must be sure they can communicate this knowledge in a way that is understood,
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trusted, and acted upon by their patients. i often say we need to have well trained scientists who operate very well at a social system. having the knowledge alone and not being able to use it is not sufficient. we need to have both good science and good sociology among our health professionals. this slight simply shows the percentage club our physicians by race to. day. it has improved but we still lack the kind of representation that is needed. we have an even greater shortage of minorities among our nations help profession faculty. we need to have a much more diverse faculty because of mentoring, counseling, and the role models these individuals serve within our educational system.
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that is a very important consideration. finally, you heard about the recent article published last friday in science magazine. this shows the outcome of that study. this study by professors ginter from the university of kansas, this is what they found when they look to the likelihood of success of various applicants for ro1 grand ni fromh. for whites applying the first time, 29% were successful when you look at african-americans, you see roughly half as many african-americans were successful with first-time applicants. the percentage of those applicants who apply for a second time for a grant is much
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lower among african-american population. there may be a number of reasons for aon. e is that many of these sizes, from institutions that if these applicants are not successful, the institution does not have the resources to support the individual to try for a second time. that process could take up to one year. those individuals have to seek other ways to support themselves. that is one of the reasons as well as the fact petworth and the number of minorities being concerned as to whether the system is fair, they often will take a turn down as a confirmation of their suspicion that it is not fair and they decide why try again grips they pursue other field. s. this slide shows the progress we have made our last 50 or 60
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years in the percentage of african-americans graduate from u.s. medical school. starting in the late 1960's -- this is after the assassination of martin luther king jr. -- those of you old enough to remember -- in 1968, following the assassination, universities and various colleges and professional schools examines themselves as to where it. they were i was on the faculty of boston university and i graduated in 1958 as the one black student in my class. 10 years later, being on the faculty, there were three black students in the class trip a a member of the faculty i thought this was progress but this was not the kind of progress that would guess anywhere. there were a number of things that happened at universities all over the country. the result of that was the improvement in the percentage of
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minorities being admitted to medical schools. we have special programs we developed at boston university. thanksgiving weekend in 1968, we had a program with 24 black students, one from each of 24 black colleges in the south, come for a long weekend in boston where we had representatives from the medical schools at harvard tufts, university ever vermont, a boston university, we told the students we were interested in you come into our institution. we gave them all the information. the following year a o rathern thane, we had seven entering pratt -- freshman fro. similar things were going on all over the country but something like this needs to be sustained. things platts have -- pl
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thingateaud again and a late -- in p thingslateaued in the late 1980's. we drifted sideways but we need to do much more to address the issue of diversity in the health professions. what about the challenges for the 21st century? there are many. i summarized some of the major ones. improved access to health services for all -- the task is not over. we have members of congress trying to undo what has been started with health care reform. we need to make sure we don't lose ground. we need to build on what has been done. what has been done this far is imperfect. many improvements have to be made but we certainly need to move forward from where we are. the emphasis on health promotion disease prevention is
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important. we need to have our citizens participating actively in this process. we need to have more diversity of our health professionals including primary care providers in our inner cities and rural areas and mid-level providers as well. we must undergo a reshuffle it of responsibility among our health professionals if we are to see citizens get adequate access to health care. we also need to have a more efficient health system that is less bureaucratic. that is very challenging. congress and state legislators and others often put various regulatory issues on the health system in an effort to try and do good but it causes problems and expenses within the health system. we talked earlier about political issue. we need less political ideology and cure legal intrusions into the health system.
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one of the great challenges is the overlay of liability risk in the health system. we need to address that in ways we can assure our citizens that everything will be done to give high-quality care but still we are dealing with biological being sprayed we cannot guarantee a perfect outcome. if something goes wrong, it does not automatically mean that someone does something wrong. we have to find ways to see the things that are done in the right way. if they're not done, we have to make sure there is a proper discipline but not have a russian roulette type of system that drives physicians and hospitals to cover the waterfront with every possible test they can think of, not for medical reasons, but for liability reasons. that eds costs, bureaucracy and inconvenience to the system. we need to address that. we also need to continue to address the highest ethical standards in our system. we can do much more today than
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we could 50 years ago. that means we also have to be much more careful as we tend to infringe on some ethical issues on people's religious beliefs. that is an ongoing challenge going forward. as our technology grows in the health system, we must not lose our humanity. ultimately, part of the healing process is a relationship between the health professional and the individual seeking services. i still remember the second year pathology laboratory showing the power of placebo or one of my laboratory partners received an injection of this clear liquid and we had just had lectures about the autonomic nervous system. he was convinced that he was getting adrenalin. he had all the symptoms.
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he disappeared for three days [laughter] . we want to make sure he was still alive. he came back next week u had gotten isotonic sailing. sal --iune. there is a relationship between the health professional and a provider. if the individual trusts the health professional and believes that person is knowledgeable and has their interests at heart, that contributes to the healing process. we must never let technology replace the humanism that is involved in the health-care system. that is something we have to guard against. as we go forward into the 21st century with our growing technology and growing of the issues, we know if we are successful in maintaining humanism and the system as well
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as incorporating actions by the citizens themselves, 100 years from now, hopefully, the kinds of data we look at today will not exist and we will have a healthier and more prosperous population. thank you. [applause] >> but dr. sullivan has kindly agreed to take a few questions. and let's go ahead and ask from the floor. sir? >> your presentation shows how our health care costs are growing faster in this country than any other. our disparities are not now rolling. narrowing. health-care spending, 30%, is
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unnecessary. is there a system where the savings and health care system can be captured and redirected so the social determinants of health can be systematically addressed? can it be part of an integrated system? >> thank you for your question. in short answer is yes. as was commented earlier today, but we have a system. that is dysfunctional in a number of ways. if you continue doing the same thing, you would be surprised at this time results. one thing we have right now today is a shortage of primary- care physician. s. we tried to recruit bright young people to become physicians.
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we put them in a system where they have to go into debt so they graduate 08 $200,000. we made a change in the mid 1970's and 1960's and early 1970's, there were many sources of scholarship support for our students. it was decided that help professionals because, they are high earners should pay for their own education out of future earnings per s. that is why today -- we have student loan programs -- it was recognized that we as a nation need to invest in the manpower we need, to address the needs of the population. that change is a good example of the unintended consequences.
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what has happened is that we have loaded this expense on students so those who are successful in going through the system are faced with repaying 200,050 -- two and $50,000. -- $250,000. when they finish training, they tried to establish an office and i have a mortgage and a family and we say go into the rural areas into primary care were as they might earn $120,000 when their colleagues who go into orthopedics could earn $750,000. i have personally had many students say that they would love to do primary-care but that cannot afford it. that is a systemic problem. beyond that, i am convinced on the basis of an informal survey we did a decade ago at morehouse school of medicine, we have set up a system that frightens away
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low income student. at that time, the average family income of african-americans in the country was around $20,000. $48,000 was the average at morehouse. we were not getting poorer students. we were getting those students who decided that maybe this is a possibility. the poorest in said this was not a field for me. afterf they don't make it medical school? expect their parents to support them? that is a systemic problem. high-loan debrt began low compensation. since we are a capitalistic system, that says that we contribute value to earning capacity.
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that's as primary care is less valued. that is something that needs to change. we need to reward for commented- based services and needs-based services. we set up a system to pay for procedures. we should be paying for good health outcomes â those are some of the dysfunctional things in the system. if we do a better job of informing our citizens of those banks that they must do, simple things like regular access us the proper diet, vaccinations for their children -- when i was secretary, i went to philadelphia and california and in dallas and san diego and talk to groups where we had measles outbreaks. we had deaths from measles and encephalitis because of failure of immunization for our children.
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we had the vaccines. understanding in the community was not there. we have to make sure our citizens know those things they must do themselves. if we could do that, the savings could go into other areas. what we have now is unsustainable in terms of the cost escalation. we have to make those multiple changes. >> let's take one more question, please. ma'am. >> i am an osteopathic physician. with a new deal school in mississippi which is a baptist university. the first year, we received about 1200 applications. the second year, we receive 1700 applications 10 the same0 seats. the need is there and that people are willing. as a side note, as a physician
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training doctors in my office, they have got to learn how to do a good physical examination. you will destroy some of the unnecessary testing because you know how to examine a patient. the college president of the mississippi william carey college came to the dene and asked how many democrats you have in this year's class tax [laughter] we don't take political parties into consideration. he said democrats like obama. we happen to have 10% black students at that university that first year and that is what -- dr. king is president of the college. that's what he was getting at. he is still there.
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>> that is an example where we have made good progress in some areas, in many other areas, we have not. we have to address those kinds of issues. there have been improvements but there are many challenges. on fortunately, some of those will take time and demonstrate to the population that those students at your school, out and give services to the community that help improve the community so that kind of thought process can change. but i am very intreat by the article in " the new york times" about the new medical school in sablan is, kansas where students are being trained in rural areas with the hope that they can stay in the rural areas. the other feature of that school was there was no tuition. this is so there would not load
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a heavy debt burden on to those students that might draw them away from rural areas into an urban area where the income potential could be much greater. we are following that with interest. the cleveland clinic is starting a medical school where there is no tuition for the students. that is something we will be following with great interest. as a nation, we had many serious mistake by simply letting the tuition is to get out of control at the same time we have undercut student financial aid and expect our students to behave in the way we want them to be a rather than be a big as rational, thinking human beings who have to discharge a financial obligation they have encouraged during their years in help school. -- help schools >> . dr. sullivan, it has been more
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than a privilege to have a [applause] view. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011] >> a couple of events to tell you about this morning. on c-span 3, a quarterly report on the health of u.s. banks released by the federal deposit insurance corporation. we will hear from the acting head of the fdic live at 10:30 eastern. at 11:00 a.m. on c-span 2, a discussion on homeland security challenges 10 years after 9/11. the panel will examine current counter-terrorism tools and talk about a number of terrorist attacks that have been foiled since 9/11. live coverage is from the heritage foundation. >> for politics and public affairs, nonfiction books, and american history, it is the cspan network's all available on television, radio, and online and social media sites.
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search, watch, and share our programs any time with our video library and we are on the road with their cspan to bu digitals bus showing events from around the country. it is watching your way. he sees the networks, created by cable and provided as a public service. >> "washington journal" business next where we will look at the day's news and take your phone calls. congress is in its august recess. the house will come in this morning for what should be a brief pro forma session at 10:00 eastern here on c-span. coming up this morning, we will get an update on the situation in libya. we will talk with a reporter in tripoli and a momenta -- in a moment.


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