DHHS' Secretary Thompson Comments on Privacy Re-Opening

Text of Speech at HIPAA Summit on March 1, 2001.

I know that you are all here this week to talk about the Health Insurance Portability and Accountability Act. Specifically, you are all concerned about one of the results of that legislation . the privacy regulations that the Department of Health and Human Services has been working on for the past several years.

That is a very important issue to President Bush and the Department of Health and Human Services. The regulations are incredibly complex. That's why I decided that we would take advantage of the delay in the implementation date to take a very careful look at this regulation . to ensure that this department has not overstepped its authority . and to examine what some of the unintended consequences might be.

We all agree that protecting the confidentiality of patient's records is our number one concern. But we don't want to make the regulations so burdensome that your husband or wife can't go to the pharmacy to pick up a prescription for you when you are sick.

That being said, I think it's important to remember why HIPAA was passed in the first place. The law was crafted to make sure that you could take your health insurance with you from one job to the next . to make sure that in this new economy, you would continue to have access to health insurance, as you moved more frequently from job to job.

Access to quality care and quality coverage. That was the issue that was facing us when HIPAA was passed in 1996, and it's still facing us today.

Each of us in this room is well aware of the very serious health care issues that we must contend with as we embark on the new century.

The cost of prescription drugs have become too expensive for some of our neediest citizens, health care costs are on the rise, and we must continually strive to improve the quality of care in America . just to name a few.

While nearly everyone agrees that there are problems, each side has its own priorities and we lose sight of what the ultimate goal is . to solve those complicated problems before they spin out of control.

As John F. Kennedy said, "The time to repair the roof is when the sun is shining."

Ladies and gentlemen, we must act before the downpour comes. It is time for all sides of the health care debate . doctors, nurses, insurers, administrators, regulators, lawyers, everyone . to come together, sit down and talk.

We must abandon the rhetoric and not publicly draw lines in the sand. We must talk frankly and work together to increase access to and improve the quality of health care.

While I don't pretend to have all the answers, I can tell you one thing: It should not be a top-down, federally mandated solution.

Too often, there is a quick impulse to look to the federal government to provide all the answers. Too often, we neglect to look to the states and local governments . where truly innovative programs are born and are taking hold.

This administration strongly agrees with President Reagan when he said that he hoped that "while much of the 20th century saw rise of the federal government, the 21st century will be the century of the states."

Instead of more federal regulations and a deeper thicket of bureaucracy, President Bush and we at the Department of Health and Human Services seek to work with states and private enterprise to develop bold and innovative solutions.

We seek to continue a change that began in the 1990s, when President Bush and I were still governors.

Thanks to the leadership and innovative thinking of our nation's governors, states led the way in setting the national agenda throughout the `90s, finding creative solutions to society's most vexing problems . from welfare to health care reform.

Yes, welfare reform was a state invention, though some at the federal level have been eager to claim credit. But the groundbreaking reforms were born in Wisconsin and states across the country .
pushing the federal government to join the cause.

And once it did, look what we accomplished . together. Welfare rolls have been cut by more than half across the nation.

Let me give you another example: In Wisconsin, we created BadgerCare. As many of you know, we sought federal waivers to help our citizens who made too much money to be eligible for Medicaid but aren't given health coverage by their employers.

It has proven to be popular beyond our wildest dreams . attracting more than 77,000 enrollees at last count. And senators at my confirmation hearing were very supportive of the program.

This is the kind of innovation we need to encourage. If we do so, we will develop innovative solutions to vexing problems.

In his budget address to the nation Tuesday night, President Bush announced significant steps to improve the quality of health care in America and much of our focus will be on preventative health care.

In conjunction with the president's budget, I am announcing today that the Department of Health and Human Services will lead a nationwide campaign focusing on preventative medicine. So many of our health problems can be avoided . through diet, exercise and making sure we taking care of ourselves.

This campaign will aim to improve the quality of health care, the quality of life for all Americans, promote healthy lifestyles and reduce health care costs dramatically.

We will announce more details of this campaign in the coming weeks. I welcome your input and any suggestions you would like to offer.

Together, we must build a healthier America.

As I said, this campaign will tie in with the President Bush's health care agenda.

One of our top priorities is doubling resources for the National Institutes of Health, which provides grants for many of the world's top scientists who are doing truly remarkable work.

NIH-backed scientists are conducting cutting-edge research all over the country into diseases that threaten the lives of many Americans, including cancer, diabetes, Alzheimer's and Parkinson's,
among many others.

The potential that lies in these projects is why President Bush's plan to double resources for the NIH by 2003 . and increase funding by $2.75 billion this year . is so vital.

If we can find the cure for these diseases, we will cut health care costs in this country exponentially and . more importantly . improve the quality of life for millions of Americans.

We are doing so much more at the department, which has more than 60,000 employees and encompasses a quarter of the federal budget.

We must ensure that we do not miss this opportunity for fundamental Medicare reform. We will modernize Medicare so it is responsive, effective and financially sound for today's . and tomorrow's . seniors.

As a part of that effort, the president has offered the Immediate Helping Hand initiative to provide the neediest seniors and the disabled affordable access to prescription drugs.

And we are working to develop a patient's bill of rights that recognizes that many states already have these protections on the books . and not to punish them for being out in front of the federal government.

Also, this must be a bill that ensures that businesses are not punished for providing health insurance to employees. We must make sure that patients have recourse when they are improperly denied medical care, but that recourse should not invite frivolous lawsuits.

The president's budget also:

Provides tax incentives to help lower-income families buy private health insurance.

Recommends increasing funding by $124 million for Community Health Centers, again giving more of our citizens access to quality health care.

The budget recommends increasing funding for block grants and other programs by $111 million to increase the availability of substance abuse treatment services.

Under the budget, HHS will allocate $400 million to promote comprehensive health care for women and children through the Health Communities Innovation Fund Initiative.

And the president's budget creates a new $400 million program to provide states with grants to help parents obtain after-school child care with a high quality education focus.

This truly is a budget that is responsible and reasonable . providing tax cuts and debt relief while meeting our priorities, such as health care, education and Social Security.

This administration has brought a new attitude to Washington, one that recognizes the importance of building bridges to states and local communities, families, and . of course . businesses.

We understand that the federal government should not and must not place undue burdens on society, preventing states from developing innovative initiatives such as welfare, education or health care reform.

Nor should it place burdensome restrictions on business, preventing them from flourishing and creating jobs.

President Bush has charged all of us in the cabinet with finding ways to reform and streamline cumbersome regulations. He has created a working group on federalism whose mission it is to promote the principles of federalism . including creating opportunities for flexible funding streams, regulatory waivers and other opportunities to return flexibility, innovation and accountability to the state and local level.

In that spirit, we are in the process of making the Department of Health and Human Services more efficient and more effective in serving all Americans.

As I've visited with doctors, business leaders, patients, hospital administrators, all of you have told me how burdensome the regulatory process has become . how it hinders quality of care.

In the months to come, I intend to implement a review process of our regulations and I will be seeking your input. Between now and the end of the year, we will report back to the president on regulations and rules that are unnecessarily hindering our health care industry.

Government should not work counter to innovation and quality care. Government should work to promote innovation and quality care.

As a former governor, I understand just how cumbersome regulations can be . especially when seeking waivers. In fact, I sought more waivers from HHS than any other governor . and probably waited longer and more impatiently than anybody.

I learned some lessons from those waits. In the four weeks since I came to Washington, I personally have approved three waivers.

Just as President Bush arrived at his tax cut proposal after a careful study of the tax code, we are taking a thorough, exact and extensive examination of the department to see how best to serve you, the states and communities, and . most importantly . America's families.

This is not change for the sake of change. As the poet Robert Frost said, "Don't ever take a fence down until you know why it was put up."

We are working hard at the Department of Health and Human Services to find out why the fences are there . how we can best tear down the unnecessary fences that prohibit us from serving you better.

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