[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.
____________________