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PAPERBACK list:$47.00 Web:$42.30 add to cart Rights & Permissions Free PDF Access Free Resources Sign in to download PDF book and chapters PDF EXECUTIVE SUMMARY PDF Report Brief Display this book on your site! Related Titles Quality Through Collaboration: The Future of Rural Health Care From Cancer Patient to Cancer Survivor: Lost in Transition Other Related Titles HHS in the 21st Century: Charting a New Course for a Healthier America (2009) Web Search Builder Use this book's key terms to search within this book, across our collection, or across the Web. Skim This Chapter Skim this chapter and use this chapter's key terms to search within this book. Reference Finder Paste in your own text to find books that relate to your topic. Page 163   E-mail  Facebook  Digg  Stumble  Twitter More The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. B Letter from Congressmen Waxman and Davis HENRY A. WAXMAN, CALIFORNIA, CHAIRMAN TOM LANTOS, CALIFORNIA EDOLPHUS TOWNS, NEW YORK PAUL E. KANJORSKI, PENNSYLVANIA CAROLYN B. MALONEY, NEW YORK ELIJAH E. CUMMINGS, MARYLAND DENNIS J. KUCINICH, OHIO DANNY K. DAVIS, ILLINOIS JOHN F. TIERNEY, MASSACHUSETTS WM. LACY CLAY, MISSOURI DIANE E. WATSON, CALIFORNIA STEPHEN F. LYNCH, MASSACHUSETTS BRIAN HIGGINS, NEW YORK JOHN A. YARMUTH, KENTUCKY BRUCE L. BRALEY, IOWA ELEANOR HOLMES NORTON, DISTRICT OF COLUMBIA BETTY McCOLLUM, MINNESOTA JIM COOPER, TENNESSEE CHRIS VAN HOLLEN, MARYLAND PAUL W. HODES, NEW HAMPSHIRE CHRISTOPHER S. MURPHY, CONNECTICUT JOHN P. SARBANES, MARYLAND PETER WELCH, VERMONT ONE HUNDERED TENTH CONGRESS Congress of the United States House of Representatives COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM 2157 RAYBURN HOUSE OFFICE BUILDING WASHINGTON, DC 20515–6143 MAJORITY (202) 225–5051 FACSIMILE (202) 225–4784 MINORITY (202) 225–5074 www.oversight.house.gov TOM DAVIS, VIRGINIA, RANKING MINORITY MEMBER DAN BURTON, INDIANA CHRISTOPHER SHAYS, CONNECTICUT JOHN M. McHUGH, NEW YORK JOHN L. MICA, FLORIDA MARK E. SOUDER, INDIANA TODD RUSSELL PLATTS, PENNSYLVANIA CHRIS CANNON, UTAH JOHN J. DUNCAN, JR., TENNESSEE MICHAEL R. TURNER, OHIO DARRELL E. ISSA, CALIFORNIA KENNY MARCHANT, TEXAS LYNN A. WESTMORELAND, GEORGIA PATRICK T. McHENRY, NORTH CAROLINA VIRGINIA FOXX, NORTH CAROLINA BRAIN P. BILBRAY, CALIFORNIA BILL SALI, IDAHO JIM JORDAN, OHIO June 20, 2007 Harvey V. Fineberg, M.D., Ph.D. President Institute of Medicine 500 Fifth Street, NW Washington, DC 20001 Dear Dr. Fineberg: Our nation faces a dual challenge of growing public health threats and soaring health care costs. A number of pressing public health problems, including the growing burden of chronic disease driven in part by an epidemic of obesity, and the threat of pandemic flu and other emerging infectious diseases, require a focused national response. Meanwhile, the capacity of the federal government, American businesses, and the ability of individual citizens to purchase health care is threatened by rampant growth in health care costs. The steadily rising cost of health care is already eroding employer-sponsored health insurance and placing enormous pressure on public coverage through Medicare and Medicaid. These challenges are interrelated: for example, the burden of chronic disease has major implications for health care spending. These challenges are not confined to particular states or regions of the country, and for that reason, they cannot effectively be addressed by individual states or private employers. The federal government must be involved. We are concerned, however, that the key federal department in this effort, the Department of Health and Human Services (HHS), may be hindered in meeting this challenge by its organizational structure. The existing mix of HHS agencies and missions evolved over several Administrations in a largely ad hoc manner. For this reason, HHS may not be optimally configured to achieve the twin goals of advancing health and controlling health care costs. Page 163 Front Matter (R1-R20) Summary (1-20) 1 Introduction (21-38) 2 Define a Twenty-First Century Vision (39-54) 3 Foster Adaptability and Alignment (55-86) 4 Increase Effectiveness and Efficiency of theU.S. Health Care System (87-104) 5 Strengthen the HHS and U.S. Public Healthand Health Care Workforces (105-124) 6 Improve Accountability and Decision Making (125-146) 7 The Transition (147-158) Appendix A Acronyms and Abbreviations (159-162) Appendix B Letter from Congressmen Waxman and Davis (163-164) Appendix C HHS Organizational Chart and Missions (165-168) Appendix D U.S. Secretaries of Health, Education, andWelfare (1953–1979) and HHS (1980–Present) (169-170) Appendix E Recommendations Directed to Congress (171-174) Appendix F Dissenting Opinions on Recommendation 3a (175-190) Appendix G The Reorganization Option:Views from Former Secretaries of the U.S.Department of Health and Human Services (191-208) Appendix H Statutory Framework for the Organization and Management of the U.S.Department of Health and Human Services (209-274) Index (275-290)

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HHS in the 21st Century: Charting a New Course for a Healthier America B Letter from Congressmen Waxman and Davis HENRY A. WAXMAN, CALIFORNIA, CHAIRMAN TOM LANTOS, CALIFORNIA EDOLPHUS TOWNS, NEW YORK PAUL E. KANJORSKI, PENNSYLVANIA CAROLYN B. MALONEY, NEW YORK ELIJAH E. CUMMINGS, MARYLAND DENNIS J. KUCINICH, OHIO DANNY K. DAVIS, ILLINOIS JOHN F. TIERNEY, MASSACHUSETTS WM. LACY CLAY, MISSOURI DIANE E. WATSON, CALIFORNIA STEPHEN F. LYNCH, MASSACHUSETTS BRIAN HIGGINS, NEW YORK JOHN A. YARMUTH, KENTUCKY BRUCE L. BRALEY, IOWA ELEANOR HOLMES NORTON, DISTRICT OF COLUMBIA BETTY McCOLLUM, MINNESOTA JIM COOPER, TENNESSEE CHRIS VAN HOLLEN, MARYLAND PAUL W. HODES, NEW HAMPSHIRE CHRISTOPHER S. MURPHY, CONNECTICUT JOHN P. SARBANES, MARYLAND PETER WELCH, VERMONT ONE HUNDERED TENTH CONGRESS Congress of the United States House of Representatives COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM 2157 RAYBURN HOUSE OFFICE BUILDING WASHINGTON, DC 20515–6143 MAJORITY (202) 225–5051 FACSIMILE (202) 225–4784 MINORITY (202) 225–5074 www.oversight.house.gov TOM DAVIS, VIRGINIA, RANKING MINORITY MEMBER DAN BURTON, INDIANA CHRISTOPHER SHAYS, CONNECTICUT JOHN M. McHUGH, NEW YORK JOHN L. MICA, FLORIDA MARK E. SOUDER, INDIANA TODD RUSSELL PLATTS, PENNSYLVANIA CHRIS CANNON, UTAH JOHN J. DUNCAN, JR., TENNESSEE MICHAEL R. TURNER, OHIO DARRELL E. ISSA, CALIFORNIA KENNY MARCHANT, TEXAS LYNN A. WESTMORELAND, GEORGIA PATRICK T. McHENRY, NORTH CAROLINA VIRGINIA FOXX, NORTH CAROLINA BRAIN P. BILBRAY, CALIFORNIA BILL SALI, IDAHO JIM JORDAN, OHIO June 20, 2007 Harvey V. Fineberg, M.D., Ph.D. President Institute of Medicine 500 Fifth Street, NW Washington, DC 20001 Dear Dr. Fineberg: Our nation faces a dual challenge of growing public health threats and soaring health care costs. A number of pressing public health problems, including the growing burden of chronic disease driven in part by an epidemic of obesity, and the threat of pandemic flu and other emerging infectious diseases, require a focused national response. Meanwhile, the capacity of the federal government, American businesses, and the ability of individual citizens to purchase health care is threatened by rampant growth in health care costs. The steadily rising cost of health care is already eroding employer-sponsored health insurance and placing enormous pressure on public coverage through Medicare and Medicaid. These challenges are interrelated: for example, the burden of chronic disease has major implications for health care spending. These challenges are not confined to particular states or regions of the country, and for that reason, they cannot effectively be addressed by individual states or private employers. The federal government must be involved. We are concerned, however, that the key federal department in this effort, the Department of Health and Human Services (HHS), may be hindered in meeting this challenge by its organizational structure. The existing mix of HHS agencies and missions evolved over several Administrations in a largely ad hoc manner. For this reason, HHS may not be optimally configured to achieve the twin goals of advancing health and controlling health care costs.

OCR for page 164
HHS in the 21st Century: Charting a New Course for a Healthier America We are therefore writing to request that the Institute of Medicine undertake a study of whether HHS is ideally organized to meet the public health and health care cost challenges that our nation faces. What are the missions of the Department and its individual agencies, and how do those missions relate to the challenges confronting us? How effectively are the agencies organized to achieve their missions? Could the missions of individual HHS agencies be consolidated or realigned to make them more effective? What recommendations would the IOM make to the Congress and HHS to improve the focus of individual agencies, enhance their accountability, and improve their efficiency? What recommendations would IOM make to more effectively integrate promotion of public health and control of health care costs across the Department? To be of the most benefit, this study should be concluded within the next year and a half and should produce recommendations that are administratively feasible, can be implemented in a relatively short time frame, and will not require substantial new resources. Thank you for your consideration of this request. Sincerely, Henry A. Waxman Chairman Tom Davis Ranking Minority Member