[Congressional Record Volume 143, Number 121 (Friday, September 12, 1997)]
[Senate]
[Pages S9249-S9251]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         NOMINATION OF DR. DAVID SATCHER TO BE SURGEON GENERAL

  Mr. FRIST. Mr. President, I rise to speak to the nomination for the 
position of U.S. Surgeon General and Assistant Secretary for Health to 
be made by the President of the United States today, which will be sent 
to Congress today for consideration.
  Nearly 4 months ago, I, the only physician in the U.S. Senate, 
publicly called for the immediate nomination of a Surgeon General--
specifically, one who could rise above partisanship, rise above the 
political fray to be a reasoned and nonpartisan spokesman for public 
health. The reason was very simple, and I outlined it at that time, and 
that is that the position of Surgeon General is one of recognition--a 
recognized authority not just in this country, but throughout the 
world. Second, it is a leadership position, leadership that can offer a 
clear, concise, consistent message. Third, I briefly made a point at 
that time of the advantages of actually merging into this position of 
Surgeon General that position of Assistant Secretary for Health.
  For the past year, I have served as chairman of the Subcommittee on 
Public Health and Safety within the Senate Labor Committee. This 
particular subcommittee oversees the statutory jurisdiction of the 
Public Health Service. The Surgeon General oversees the administration 
of the eight agencies of the Public Health Service, and the Surgeon 
General serves as the public's doctor, the Nation's doctor, the 
Nation's physician, in advising the Secretary of Health and Human 
Services. It is in this role that I feel even more strongly that we 
need a Surgeon General to provide that clear, that loud, that visible, 
that understandable voice to promote the health and the safety of our 
citizens.
  Like most Americans of my generation, I vividly remember that very 
famous, well-known--and it's actually referred back to a lot today--
Surgeon General's report back in 1964 warning of the dangers of 
cigarettes. Well, over 30 years ago now, we still point back to that 
single instance, that label, that stepping forth as a benchmark in 
warning our children today, and others, about the dangers of smoking.
  In the 1980's, Dr. C. Everett Koop woke America up to something that 
at that time was terribly misunderstood, and that was the emerging AIDS 
crisis. He spoke with candor and realism that helped the American 
people, helped people who saw him on television, who saw him in person, 
who read his writings, separate fact from fiction about what at that 
time was a very mystical, misunderstood disease.
  Just last summer, the Surgeon General's office issued a significant 
report demonstrating that moderate physical activity does indeed reduce 
the risk of cardiovascular disease and some cancers. All of these 
reports were issued with no political agenda in mind--only the well-
intentioned health of the Nation being the focus. We inevitably still 
face lingering public health problems, and we can only think about and 
imagine the new public health challenges that will face us--the current 
challenges of AIDS, emerging infectious diseases--and, again, who knows 
3 years from now what new virus, bacteria, or resistance to bacteria 
will be a threat to each of our children? There are issues like 
foodborne illnesses, substance abuse, tobacco use by children, 
alcoholism.
  We need to use the same approach today that we have used in the past. 
To do so, I think it can be best accomplished by having a high-profile, 
experienced official who speaks with authority and can educate all of 
us, the public, about the important link between illness and personal 
behavior. Past experience shows that the uniformed position of the U.S. 
Surgeon General, with the right person in that position, can educate 
the Nation on these key public health issues. During Surgeon General 
Koop's tenure, by educating the public on the dangers of smoking, adult 
tobacco use decreased 7 percent. More recently, we have witnessed, 
unfortunately, increased drug and tobacco usage among our youth over 
the past years. Is it coincidental that during this same period the 
Surgeon General position has been vacant?
  I think we as legislators, as trustees of the public, in many ways 
have an obligation, a responsibility, to appoint a Surgeon General and 
to do it as expeditiously as possible, so that we can direct our 
attention to improving the public health.
  Now, clearly, tough problems, whether it is smoking or alcoholism or 
foodborne illnesses, a Surgeon General is not going to be able to fix 
them alone. But what he or she can do is be that one voice. We all know 
how important it is to have a simple message, a straightforward 
message, a concise message, a persistent message given by one voice--
that voice being the Surgeon General.
  Dr. Koop I think summarized the position very well. He said that the 
Surgeon General is a position ``* * * high calling with an obligation 
to interpret health and medical facts for the public.''
  I like the way Dr. Koop expressed it because, first of all, that is a 
calling, and in many ways public service can be a thankless job. So it 
really is a calling. But the obligation is one that the nominees must 
take very seriously; and, that is to interpret the health and medical 
facts for the public. We know that there is a tremendous amount written 
today, with the health advances, with the new discoveries. We just 
simply need to look at the new genes being discovered today, the human 
gene projects. But when a person looks at the medical literature, how 
can they interpret it? The Surgeon General can look at the reports, can 
assimilate the data, and help boil that down into a simple, crystal-
clear message which can improve and affect the health of every 
American.
  Dr. David Satcher today is being forwarded to the Senate as the 
nominee for the position of U.S. Surgeon General and Assistant 
Secretary for Health. It will arrive in Congress today.
  As a result, the Senate is asked to consider this nomination and to 
eventually vote as to whether or not to confirm Dr. Satcher for these 
positions. I hope that my colleagues will consider this nomination 
based on his qualifications and his ability--again, pushing 
partisanship and politics aside.

[[Page S9250]]

  Dr. Satcher is a family physician. He is an accomplished researcher 
and educator, and he has a very long truly distinguished record in 
promoting public health. I understand his goal is to improve the health 
of our Nation based on science, which is the essential role of the 
Surgeon General's office.
  The confirmation process is, as all of us in this body have seen, a 
fascinating one as we subject our nominees to interrogation. But it is 
critical that we interrogate in the right way--touch on the right 
issues, looking at the substance. It is very clear that we will not--
and I as a physician very likely will not--agree with Dr. Satcher on 
every particular issue and every particular policy. But what I am 
confident of, in knowing Dr. Satcher, is that debate, that discussion, 
will be based on rigorous and disciplined science--not on politics, and 
not on rhetoric. That is what this position deserves, and that is what 
the American people deserve.
  Looking out for this Nation's public health, both domestically and 
abroad, is truly a daunting role. Simply the way I define it is that is 
the public spokesperson for health for the United States of America. 
But I am confident that Dr. Satcher will reclaim the integrity 
surrounding that position that has historically been associated with 
that position of Surgeon General.
  The sort of questions that we need to look at as Dr. Satcher goes 
through the Senate confirmation process are things like: Does this man 
have the commitment? Does he have the intelligence? Does he have the 
training, the honesty, and integrity to be the chief spokesperson for 
Americans on matters concerning public health? And I also would like to 
add--in no small part because I know Dr. Satcher is so strong here--it 
is critical that this person be able to articulate his views with 
clarity, with simplicity, and with dignity.
  We have before us a man with a long record of demonstrated public 
service. He currently serves as Director of the Centers for Disease 
Control and Prevention in Atlanta. In that role over the last several 
years he has demonstrated those very qualities that I mentioned are 
important in this confirmation process. He has been a strong manager. 
He has been an excellent spokesperson for public health. He has been a 
man of scientific integrity.
  As a member of the Labor and Human Resources Committee, I am 
committed to the confirmation process and take very seriously the 
responsibility of voting on this nominee. I approach this with a very 
open mind and will continue to scrutinize everything that comes before 
the committee as information is being made available to the committee 
by the administration.
  I have the one advantage, in that Dr. Satcher spent approximately 11 
years in Nashville, TN, where I am from. I have been able to witness 
firsthand his accomplishments, and have had a chance to go back and 
look at many of his other distinguished qualifications.
  I look forward to hearing his articulation of his goals, his 
statements, and the testimonials of others about him as we go through 
this confirmation process. This is a public process. It should be a 
public process.
  I look forward to meeting with Dr. Satcher personally next week to 
discuss with him the specifics of his plans as the next Surgeon 
General.
  As I mentioned, Dr. Satcher lived in Nashville. I consider him a 
Tennessean from my hometown for about 11 years where he ran a very 
prominent historically black medical college--the Meharry Medical 
School.
  Dr. Satcher has a knowledge of population-based medicine, 
epidemiology, family practice, and a broad understanding of our health 
care system. He is widely respected by his peers in our community of 
Tennessee, in Nashville, and across this country.
  Mr. President, at this juncture I ask unanimous consent that letters 
of support from the Tennessee Medical Association, Vanderbilt 
University Medical Center, and the Phoenix Healthcare Corp. be printed 
in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                Tennessee Medical Association,

                                Nashville, TN, September 10, 1997.
     Hon. William Jefferson Clinton,
     President of the United States,
     The White House, Washington, DC.
       Dear President Clinton: On behalf of the 6,800 members of 
     the Tennessee Medical Association, we take this opportunity 
     to offer our wholehearted support for your nomination of 
     David Satcher, MD, as the Surgeon General of the United 
     States. Dr. Satcher has ably proven his leadership 
     capabilities by serving as president of Meharry Medical 
     College in Nashville, Tennessee. During his tenure at 
     Meharry, he presented a strong voice in the Nashville 
     community as a public health advocate. I am especially 
     pleased to commend him to you for consideration in light of 
     his stellar leadership, unparalleled history of community 
     service, and sense of mission in the public health sector.
       Over the last four years, he has only enhanced his position 
     as a leader in the medical community, and displayed his clear 
     commitment to disease prevention, by serving as the director 
     of the Centers for Disease Control. He will make an 
     outstanding spokesman for the nation's health and will be a 
     valued adviser to both you and Secretary Shalala.
       Without reservation, we commend Dr. Satcher's nomination to 
     the U.S. Senate Labor and Human Resources Committee and 
     encourage the full Senate to act responsibly and quickly to 
     confirm his nomination both as Surgeon General and Assistant 
     Secretary for Health.
           Sincerely,
                                             R. Benton Adkins, MD,
     President, Tennessee Medical Association.
                                  ____

                                             Vanderbilt University


                                               Medical Center,

                                Nashville, TN, September 11, 1997.
     President Bill Clinton,
     The White House,
     Washington, DC.
       Dear Mr. President: On behalf of Vanderbilt University 
     Medical Center, I wish to extend our strong support for the 
     nomination of Dr. David Satcher for the positions of 
     Assistant Secretary for Health and Surgeon General at the US 
     Department of Health and Human Services.
       We believe Dr. Satcher is well qualified to fill these two 
     positions where his medical knowledge, executive experience, 
     and very real eloquence on behalf of the nation's health make 
     him uniquely suited. As director of the Centers for Disease 
     Control (CDC) he has lead the health community's effort to 
     increase childhood immunization, expand access to breast and 
     cervical cancer screening, and build a framework that will 
     better enable us to defend against the threats of infectious 
     diseases.
       The announcement today of the nation's health vital 
     statistics are a strong indictor of a strengthened CDC under 
     Dr. Satcher's leadership. These statistics show a 26% decline 
     of mortality from HIV-AIDS between 1995 and 1996 for 25-44 
     year olds; teen birth rate declining for the fifth straight 
     year; a new record low in the infant mortality rate; and 
     continued increase in the number of women obtaining early 
     prenatal care.
       In addition, during Dr. Satcher's tenure at Meharry Medical 
     College he was an absolutely critical voice on behalf of 
     medical education and research, but even more importantly he 
     was a voice on behalf of the underserved and uninsured of 
     Middle Tennessee. We believe he will bring a perspective that 
     will well serve the medical community and the patients we 
     care for.
           Sincerely,
                                          Harry R. Jacobson, M.D.,
     Interim Vice Chancellor for Health Affairs.
                                  ____



                                     Phoenix Healthcare Corp.,

                                Nashville, TN, September 11, 1997.
     President Bill Clinton,
     The White House,
     Washington, DC.
       Dear Mr. President: I am honored and pleased to write this 
     letter in support of Dr. David Satcher for Surgeon General 
     and Assistant Secretary for Health. I have known Dr. Satcher 
     since 1982 when he became President of Meharry Medical 
     College where I served as Vice President of Finance and 
     Business from 1973-1977. During his tenure at Meharry, we 
     worked very closely on a number of local community and health 
     care issues, including the merger of Metropolitan General 
     Hospital and Meharry Hubbard Hospital. Dr. Satcher and I, 
     during his tenure in Nashville, were also Deacons in First 
     Baptist Church--Capitol Hill and members of 100 Black Men of 
     Middle Tennessee.
       Dr. Satcher is a physician-scholar with a strong public 
     health focus. Intellectually, Dr. Satcher will make an 
     excellent person for the position of Assistant Secretary for 
     Health which is responsible for health policy. His experience 
     and ability to articulate with passion on matters promoting 
     health and preventing disease, injury and premature death 
     makes him also capable of being the national physician, 
     Surgeon General of the United States. His thoughtful 
     presentations on health care matters and administrative 
     experience will enhance the health status of Americans 
     generally as he has done during his tenure at the CDC where 
     childhood immunization rates have increased from 55% in 1992 
     to 78% in 1996. Finally, one could not get a person with 
     higher moral and ethical standards than Dr. Satcher.
       I certainly hope that the nation will accept the services 
     of Dr. Satcher as Surgeon General and Assistant Secretary for 
     Health. The country will be well served by a person of his 
     ability.
           Sincerely,
                                                 Samuel H. Howard,
                                                         Chairman.

  Mr. FRIST. Mr. President, if I just look at these letters from 
Vanderbilt

[[Page S9251]]

University Medical Center, Dr. Harry Jacobson in one sentence describes 
very well what his peers feel about Dr. Satcher.
  I quote from that letter.

       We believe Dr. Satcher is well qualified to fill these two 
     positions where his medical knowledge, executive experience, 
     and very real eloquence on behalf of the Nation's health make 
     him uniquely suited.

  From the Tennessee Medical Association, talking about his tenure at 
Meharry--remember, he was there for 11 years--Dr. Benton Adkins, who is 
President of the Tennessee Medical Association, writes:

       During his tenure at Meharry, he presented a strong voice 
     in the Nashville community as a public health advocate. I am 
     especially pleased to commend him to you for consideration in 
     light of his stellar leadership, unparalleled history of 
     community service, and sense of mission in the public health 
     sector.

  In the third letter, Mr. Samuel Howard, chairman of Phoenix 
Healthcare Corp., who had known him well through working together at 
Meharry, says:

       Dr. Satcher is a physician-scholar with a strong public 
     health focus.

  Those are just samplings of the sort of recommendations by his 
associates.
  I urge my colleagues to focus on Dr. David Satcher's qualifications 
to hold the two positions of U.S. Surgeon General and Assistant 
Secretary for Health. As I mentioned, he is a family physician. He 
respects the role of the family within the community. He is an 
accomplished scientist and researcher. He has a Ph.D. as well as a 
medical degree. His Ph.D. is in cytogenetics--he allows science to 
drive decisionmaking, not politics. He is a proven public health 
leader--an experienced public health leader--having served as Director, 
where he currently serves, of the Centers for Disease Control and 
Prevention in Atlanta, GA, which is that Health and Human Service 
agency responsible for promoting health and preventing disease, injury, 
and premature death, with 11 major branches and worldwide 
responsibilities.
  Mr. President, in closing, as a physician, I will have to say that 
ultimately much of my feeling comes back to putting faith in the trust, 
which is a very vital part of the doctor-patient relationship. I look 
at this very similarly. The Surgeon General is the people's doctor. 
And, to be truly effective, Dr. Satcher must earn and maintain the 
public's trust on health issues. Trust I think will be a large part of 
this nomination. It was the main reason, if we look at failures, I 
think that occurred in the past as related to this position.
  From everything that I know of Dr. Satcher, he not only has the 
ability to be a reasoned scientific voice but he has the ability to win 
the trust of the American people.
  I am fortunate to have known Dr. Satcher in his capacity as 
physician, as a president of a medical school, and as the head of one 
of our great public health agencies.
  I will work with my colleagues in the U.S. Senate in this nomination 
process, and I urge their full, fair, and expeditious consideration of 
Dr. Satcher's nomination.
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. DASCHLE. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Smith of New Hampshire). Without 
objection, it is so ordered.

                          ____________________