On behalf of APHSA and the Alliance it is our sincere pleasure to welcome to
the summit the Honorable Thomas Price, Secretary Health and Human Services.
Dr. Price was sworn in as the 23rd Secretary of Health and Human Services on February
10th of this year.
He brings to the department a lifetime of service and a
dedication to advancing the quality of health care in America both as a
physician and as a policymaker.
Dr. Price received his Bachelor and Doctor
of Medicine degrees from the University of Michigan and completed the orthopedic
surgery residency at Emory University.
During his 20 years as a practicing physician he also served as medical
director of the orthopedic clinic at Grady Memorial Hospital as well as the
assistant professor and assistant professor at Emory University's School
of Medicine.
Most recently Dr. Price served as the US Representative for Georgia's sixth
congressional district.
He held this office from 2005 to 2017.
During his congressional career Dr. Price served in various leadership roles including
chairman of the House Budget Committee, chairman of the House Republican Policy
Committee and chairman of the Republican Study Committee.
Dr. Price is a strong advocate for a patient-centered
healthcare system that adheres to six key principles: affordability, accessibility,
quality, choices, innovation and responsiveness.
Additionally, he recognizes the Department must be efficient, effective and accountable
as well as willing to partner with those in
our communities who are already doing remarkable work. Under his leadership.
HHS strives to preserve the promises the
society is made to the American people.
Ladies and gentlemen the Honorable Thomas Price.
Thank you.
[applause] Thank you so very much.
Good morning to you.
[Multiple Speakers: Good Morning] Thanks, Tracy, for those wonderfully kind
and generous words, I get tired just thinking about what it was that I went through to get
here.
Thanks so much for all of the work that you do; I am so humbled by the responsibility
that you have and the work that you bring to table, so I can't tell you how much I appreciate
it.
And it really is an honor for me to be able to join you today and to share a few words.
I appreciate the opportunity to address the American Public Human Services Association
and, again, I want to thank you for what you all do to support our fellow citizens.
Our nation's state and local government and local communities do such important work providing
vulnerable of Americans with the services they need to live more enriched lives.
Our team at HHS is really proud to be a partner with all of you and support the crucial and
critical work that's being done.
I really have been remarkably impressed with the work product and the activity that you
all do.
Having served 12 years in Congress, as Tracy's mentioned, I can tell you that sometimes I
appreciate the fact that it's difficult to get folks moving in the same direction.
I know that would be a surprise to some of you folks —
[laughter] — it is.
But in looking at what you all have done, I think it really is a testimony to the dedication
and the commitment you have to the work that you're doing and I commend you for that.
Just under three months ago, as Tracy mentioned, I raised my right hand and took the oath to
assume this office.
And I can't tell you what an incredible privilege it is to hold this office of Secretary of
Health and Human Services.
I'm grateful to the President of the United States for this honor and his confidence in
me to serve as the 23rd Secretary of Health and Human Services.
I'm the third physician to serve as HHS Secretary; Lou Sullivan was a physician as well and Otis
Bowen, back in the day, was a doc.
But for those of you that have any affinity for the healthcare arena, you know that those
two folks were internists and that I'm a surgeon, so there are folks that say that's got to
be a difference right that surgeon is coming to the table?
But the fact of the matter is that we all have compassion and concern for our fellow
citizens, and we're working together to try to make the goals that you have work.
For me, this really feels like the culmination of a life's work.
As Tracy mentioned, I spent over 20 years taking care of patients over on the north
side of Atlanta.
Started a solo practice and grew it into a large private group practice for orthopedic
surgeons, one of the largest in the country in non-academic practices.
Overlapped a little bit with public service, I spent eight years in the state legislature
and state senate in Georgia, and then 12 years in the United States House of Representatives
representing the sixth district of Georgia.
So, for me, this really feels, as I say, like the culmination of a life's work, and I can't
tell you how enthusiastic and excited I am to be able to serve in this capacity in this
point in time, in our nation's history both on the health and human services side.
As a physician, I can tell you that I appreciated that there was much that happened outside
of my office and outside of the operating room that directly affected my patients.
That won't come as any surprise to you.
Either in their ability to get well or, in some cases, to survive.
Life can send all sorts of detours our way, as you all well know, that often times get
in the way of healthy living.
A parent's loss of work, or a devastating diagnosis, or drug addiction, or unsafe neighborhoods
or family conflicts, all of those things can impair both physical and mental health.
And as you well know, families are the first line of providers on the human services side
that can address these issues, but often time families themselves need support from their
neighbors and from the larger community.
Physicians, doctors, will never be able to get care right for so many of their patients
unless those patients are able to receive a support that they need from the communities
and from the human services realm.
Which is why I tell you it — again it's such an incredible joy for me to be able to
lead the department of health and human services.
Our mission is to improve the health and safety and well-being of the American people, and
our job is to enable the American people to have access to both health care and crucial
human services.
And I believe that it's important, and I know that you appreciate this, that work needs
to be done in concert.
It ought not be in tension, it ought not be at odds with one another, and as I visited
the divisions throughout the Department, I know that the human services side often feels
like the red-headed step child in the HHS.
And we want to make certain that they appreciate that we understand and appreciate that on
any given day, on any given issue at HHS, we're not thinking about health or human services,
we're thinking about health and human services.
There are 27 divisions within HHS, as many of you know.
I wanted to make certain that I visited every one of those either staff or operating divisions
in the early days of my tenure, and I've had the opportunity to do so.
And what I have tried to lay out for folks is the passion and enthusiasm I have for leading
this organization, but also to try to get folks to appreciate that where we are putting
our focus.
There's all sorts of different views and opinions about how we ought to do things, but if we
keep our focus on patients and people and partnerships, patients and people and partnerships,
then well get to the right spot.
The patients that are the end use of the health services, the people that are the beneficiaries
of the human services, and the partnerships that you know so well that must be, must be
in place in order for us to be able to provide the kind of health and human services to our
fellow citizens, incredibly important.
And those partnerships, you all know, are imperative and necessary every single day.
So, what I'd like to do in my brief time with you today is to touch on a few priorities
that I've outlined for our Department and then discuss a bit of the big picture and
how we plan on moving forward at HHS.
When I got to be able to fulfill, or take, this role, I wanted to identify some clinical
priorities, some medical priorities, that also have some significant interface with
the human services side.
We've identified three specific clinical entities that we're going to try to focus on.
One is childhood obesity, and you'll notice a common denominator to these three that I'll
share with you at the end but first is childhood obesity.
We have so many kids, we got 60 percent of the kids in this country who are considered
overweight or obese, 20 percent obese.
These young people, if something doesn't change, they're not going to be health challenges
for themselves and their families or communities and all of us when they're 60 or 70 or 80,
it's going to be when they are 25, 30 and 35, and so we simply must address this incredibly
important issue.
Second is severe mental illness, we have gone a long way in this country toward, I believe,
down the wrong road.
Decades ago, when I was a kid, we housed a lot of the folks with severe mental illness
in substandard clinical settings.
And many of those individuals, in fact probably the majority of them if we're honest with
ourselves, didn't get the kind of treatment they needed.
Over the past 30, 40, 50 years, we've traded that substandard clinical setting for the
criminal justice system or the streets.
Sixty percent of homelessness in this nation — of those individuals who are homeless
estimated have some severe mental illness.
And at the same time, we're not doing the kind of job we need to do to treat those individuals,
and all of these bleeds over into the human services side as well.
And the third clinical area is the opioids crisis, which knows no bounds in our nation,
it cuts across all classes, all sectors of our society, destroying lives, destroying
families, destroying communities.
And the numbers are overwhelming.This gray hair on my head means that I've been around
a little while to witness a few things, and one of the things that I was witness to was
the Vietnam War, which is — it happened during my childhood.
We lost, in Vietnam, 58,000 Americans, over 50,000 Americans.
We lose, here in the United States today, 52,000 of our fellow citizens to overdose
deaths every single year.
We lose a Vietnam because of overdose deaths every single year, 33,000 of those due to
opioids.
You know this all too well, this is absolutely unacceptable as a nation, and we've got to
get that under control and do the kinds of things that will reduce that tide.
So, childhood obesity, severe mental illness, and the opioid crisis.
All three of those, the common theme to those is that we're losing the battle on each and
every one of them, and we ought not be.
So, we're going to make that a focus of the Department, and I look forward to your assistance
as we try to move our nation in a better direction on all these three things.
Let me drill down a little bit on the opioid crisis because the health and human services
clearly come together in this arena, one where the situation we're facing across our land
truly is absolutely critical and the numbers I mentioned give witness to that.
You all know what kind of burden and complications the rising rates of opioid addition and overdose
deaths have created for vulnerable Americans.
Just one example, it's absolutely heartbreaking to look at what this has done to our foster
care system.
When the Senate Committee on Aging is holding hearings on grandparents raising their grandchildren
because the parents have died of an overdose or are incarcerated or otherwise incapacitated,
we know something has gone seriously wrong.
The opioid epidemic is one of the top priorities for President Trump.
He and I have had this conversation on multiple occasions.
He's established a commission on the opioid crisis, put Governor Christie to lead that
commission, and I'm pleased to be able to provided assistance on both the health and
human services side.
A couple weeks ago, due to some legislation that was passed in Congress, we were able
to distributed $485 million in monies to the states to try to focus on the kinds of correct
treatment and services being provided who found themselves in the midst of this crisis.
We've got a five-point strategy through the Health and Human Services Department to strengthen
public health and surveillance and data gathering, getting appropriate date and real-time data;
improving access to treatment and recovery services; targeting availability and distribution
of overdose reversing drugs.
There's some exciting work that's being done in this area in NIH and elsewhere.
Supporting that cutting-edge research will turn this challenge around so that we no longer
have those incredible numbers in overdose and death.
Imaging if you will, imagine if you will, a vaccine that will make it so that addition
doesn't occur to opioids.
An exciting prospect and it really is within our reach.
And, finally, advancing with practice of pain management itself.
We will continue to enlist your help and work to treat addiction before its consequences
of its vulnerable folks out of control and to support people struggling with addiction
as they enter recovery.
I know that you all have all sorts of wonderful stories.
And some of you have remarkable best practices.
Vermont is one state, we've got some folks from Vermont I think here.
They left?
Oh no, here we are, right here.
[laughter] Good deal.
You all are doing incredible in the area of opioid treatment.
They've got a model of that uses a spoke and hub plan where pain addiction specialists
serve at the center of the, and initially treating and communicating with the patients
— that's the hub of the spoke and hub — and then a team that coordinates primary care
and a multi-disciplinary team that goes out as the spokes and addresses the health and
human services needs for individual citizens.
And this level of explicit coordination and integration has produced incredibly remarkable
results in Vermont, and I know that many other states are looking to that as model.
So, we want to better understand how we can better support you on this issue.
How can we help the Vermonts of this nation be able to successfully address the challenges?
You are where the rubber hits the road on much of this, and we want to be able to help
the work that you're doing.
Getting this right will literally help and save the lives of many, many Americans.
And it's absolutely that important to do so.
Another topic that I want to touch on, a non-clinical topic that I know is of great interest and
importance to you all and is a matter of gainful employment and independence, it's one of the
priorities that you all have.
We all know well, from both a health perspective and a human services perspective, that good
health is essential in order to work and support oneself.
Good health plays such an important role, in leading role in a fulfilling life.
But we spend less time, if you think about it, we spend less time thinking about how
work can actually encourage good health.
And when it comes to looking at what in our lives contributes to our health, we too often
forget how big a deal work itself actually is.
And there's quite a bit of academic literature in this arena.
As you know there's a recent study out of Britain that reviewed academic evidence on
whether or not work is good for one's health and well-being.
And their findings were really remarkable I thought.
And let me just share with you one of the conclusions that they reached.
Work meets certain psychosocial needs, seems to be obvious.
Work is central to individual identity and social roles and social status, and employment
and socio-economic status are the main drivers of social gradients and physical and mental
health and mortality.
They've concluded, conversely that there's a strong association with worklessness and
poor health.
So, if we're not designing our programs to support and encourage work, we're doing a
disservice to the health and well-being of our citizens.
I know that all of you have been working diligently in this area; you have put a credible amount
of work in this area and I want to commend you for it.
However we simply must do a better job.
And we look forward to collaborating with you and partnering with you to try to move
forward on real solutions in this area.
Before I close, I'd like to touch on a couple 30,000- or 40,000-foot issues, a couple of
the broader issues.
We're all prisoners of our own experience, and one of my experiences, as Tracy mentioned,
was to have the privilege of chairing the Budget Committee in the House of Representatives.
Some people would say that's a real prison sentence —
[laughter] — to be able to chair the Budget Committee
of the House.
But I'd be remiss if I didn't mention a couple of things, and they are issues that you all
know so well and they affect the human services side and will affect it to a greater degree
as we move forward.
And they're the demographics of our society and the debt we have as a nation.
We're an aging nation, the demographics dictate that we will see huge challenges as a nation
because of my generation, the boomers; there's a few of you out here, anybody born between
1946 and 1964.
I'm smack in the middle of the boomer generation.
There are 10,000 of us reaching retirement age every single day — 10,000.
Eighty million or so moving through the system and there were, in 2010, there were about
40 million American that were over the age of 65.
In 2050, there will be 88 million Americans over the age 65.
And just the cost to human services and to our health care system will, of necessity,
increase.
It's not a bad thing, it's a good thing that we have more individuals reaching that age.
But it's absolutely imperative that we recognize it and plan for it.
And I want to touch on one of the consequences of that.
From a fiscal standpoint, our debt and our debt service, is likely to have a more significant
effect on the resources available for human service than any of us would care to admit.
$20 trillion in debt right now, the unfunded liability, depending on who you ask, is somewhere
between three and five times of that with the services that we have promised to the
American people.
Interest on the debt is increasing such that the discretionary funds available, that pie
of resources, that are available.
Not on the mandatory side but on the discretionary side, which is where so much of the human
service side comes from.
The discretionary side which is where so much of the human services money comes from, on
that discretionary side.
That portion of the pie gets smaller and smaller and smaller every single year, a necessity
because of the mandatory side and the aging of our population.
So, how we solve these challenges is incredibly important.
But it's clear there is one thing that is true and that is that states will be asked
to do a lot more in the provision of services.
Which brings me to my final point, and that is our desire at HHS to partner with you,
to collaborate with you, in a reimagined HHS that is much more collaborative and supportive
of your work.
Yesterday, we kicked off an evaluation of the Health and Human Services Department through
a department-wide project to identify greater efficiencies and more affective organization
that will allow us to accomplish our mission, regardless of the circumstances.
And you can help us with this, and I want to urge you to consider how you might be able
to assist in ways that you might have imagined at one point in the past but we're either
told "Oh no, don't worry about that."
Or "We've got it handled."
And I want to tell you that the Department now is in the receiving mode.
We want to receive your ideas, whether it's on regulatory reforms and changes that would
be helpful, that would be able to allow you to do more.
Whether it's lowering the burden, decreasing the hurdles, lowering the hurdles, removing
the hurdles to allow you to be able to do the work that you do.
Combining funding streams, which I think is an exciting opportunity that we all have,
providing greater flexibility and greater visibility is very important.
As I said, you are where the rubber hits the road, and you know better how to make these
programs work and assist individuals to get them to work much better than we do in our
Department.
And working across departments in collaborative ways, whether it's HHS working with Education,
whether it's HHS working with Labor.
On and on, whether it's HHS working with HUD, we believe that it's incredibly important
that we work together in a collaborative fashion.
So, I ask you, I challenge you, to think creatively and expansively about how you can help us
to be able to assist you in doing your jobs.
As we all look to be certain that the — in our service to our fellow citizens — is
accomplished so that we ensure their ability to realize their dreams by enriching their
lives.
It's all about the three P's that I mentioned: people, patients and partnership, and we recognize
and I appreciate, and sincerely appreciate, the work that you do.
The partnership that we have together and the partnership that I want to have flourish
together is recognized at HHS, and we want to water that plant just as much as we can.I
look forward to making the most of these valuable partnerships and through them improving the
health and safety and well-being of the American people.
Thank you for the work that you do, God bless you in your endeavors.
Thank you so much.
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