[Congressional Record Volume 140, Number 90 (Wednesday, July 13, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: July 13, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
      IN HONOR OF THE PUBLIC HEALTH SERVICE ACT'S 50TH ANNIVERSARY

  Mr. DURENBERGER. Mr. President, Tuesday, July 12, marks the 50th 
anniversary of the Public Health Service Act. In 1944, the Public 
Health Service [PHS] Act helped establish institutions that are 
dedicated to improving the health of the citizens of this Nation: The 
National Institutes of Health, the Centers of Disease Control and 
Prevention, and other agencies of the PHS. The 1944 law armed the PHS 
for a broader role--keeping Americans healthy.
  PHS has built an excellent track record in a variety of areas to 
improve health. It rushes medical teams to earthquakes, floods, and 
other disasters. It supports birth control clinics and tracks and 
isolates such diseases as toxic shock syndrome. It identified AIDS. It 
led the world-wide drive that eliminated small pox. PHS research has 
garnered Nobel Prizes and has undertaken such watershed disease-
prevention activities as the publication of the 1964 Surgeon General's 
Report on Smoking and Health and the 1988 mailing of Understanding AIDS 
to every household in America. At the same time, PHS helps the 
medically under-served by paying tuition for medical students who are 
willing to serve in isolated areas, and by supporting community and 
migrant health centers.
  The 50 years of the modern PHS have seen great progress: 
Cardiovascular deaths have declined dramatically; diabetes mellitus is 
under better control; many cases of childhood leukemia are now curable; 
polio has not been seen in the United States since 1979; and 
researchers are on the verge of genetic breakthroughs and diagnostic 
and therapeutic revolutions.
  In spite of that progress, individuals growing up today face 
substantial challenges in their everyday lives that contribute to their 
health and medical care needs. We are facing violence, drug abuse, 
accidents, infant mortality, and AIDS, among others. Individuals are 
not seeking prenatal and preventive care because they are faced with 
everyday problems of food, safety, and shelter. Until we address the 
underlying factors that contribute to the health of our citizens we 
will not be able to resolve our escalating medical care costs.
  Prevention is critical not just because it is cheaper to prevent than 
to cure--prevention is better for people. The issue we must tackle as 
we reform our health care delivery system is how to create a system 
that builds in incentives for healthy personal behavior. I believe that 
preventive care cannot simply be mandated, we need to institutionalize 
a process to facilitate and promote change, specifically behavioral 
change.
  In spite of advances in health care technology, the health of 
Americans is eroding due to poor personal choices. It has become 
increasingly evident that an individual's unhealthy behavior is most 
likely a determinant to heart disease, cancer, and stroke. Behaviors 
such as smoking, a high-fat diet, and obesity, lack of exercise and 
lifestyle choices which lead to high blood pressure and stress are 
subject to behavior modifications. Not far behind them are accidents, 
injuries, suicide, and homicide, many of which are generally 
preventable.

  Every day over 1,000 Americans die from preventable diseases. Heart 
disease and lung cancer are two of the most prominent causes of death 
among men and women in the United States. Each year, 40 percent of 
deaths from heart disease and 85 percent of deaths from lung cancer in 
this country are attributable to smoking. It is not coincidental that 
as smoking has increased among women over the last decade, lung cancer 
is now surpassing breast cancer as the leading cause of cancer death 
for American women.
  In addition, a mother's chemical dependency is an escalating social 
problem, as well as health problem. Premature infants suffering from 
crack addiction or fetal alcohol syndrome must endure more expensive 
care than a normal, healthy infant in the first year of life. In many 
cases, the consequences are apparent for a lifetime.
  These spreading health problems stem from poverty, poor education, 
and lack of access to care that would prevent tuberculosis, AID's, and 
other scourges. Responsible family planning, prenatal care, and 
abstinence from drugs and alcohol during pregnancy would substantially 
reduce the incidence of premature births in this country.
  Obviously, a problem exists and has been defined. However, I urge my 
colleagues to define this problem in the broadest possible manner. The 
Federal Government has articulated its acceptance of the economic 
problems associated with health care--spiraling medical costs have had 
a negative impact on both individuals and businesses in this country. 
Health reform needs to look beyond medicine and recognize the effect 
improvements in education, welfare and crime prevention will also have.
  The entities created by the Public Health Service Act are attempting 
to tackle many of these problems. ``Healthy Goals 2000'' establishes 
goals that encompass the broader definition of health in this Nation. 
Any message on health care must communicate an understanding that 
health care costs and access have a personal impact on every American.
  We must put the public back in public health. Unhealthy and self-
destructive behavior, addiction, abuse, AID's, violence, and failure to 
maximize immunization and other preventive health care needs all feed 
inefficiencies into the system. Individuals must accept greater 
responsibility in health care delivery and the Federal Government must 
provide incentives for them to do so.
  I want to stress the importance of prevention. Our lifestyles, 
families, and communities must all assume their fair share. We must 
remember that just because these are common problems does not mean they 
have a common Federal answer. Indeed, good health promotion and needed 
solutions to our current health dilemma are more effectively located at 
the State and local levels, through schools and most importantly 
through efforts by all Americans to focus and better understand the 
problem.
  If we, as legislators, can encourage preventive care and wellness 
attitudes in our communities and as individuals, we can reduce 
violence, substance abuse, accidents, and smoking. As a result, we will 
see remarkable changes in the quality of our health and in our demands 
on the medical system.
  The PHS is focusing on reaching public health goals set in 1990 for 
the turn of the century. I commend them on their past successes and 
applaud their continued efforts.

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