Patrick Conway: Secretary Margaret Heckler convened the first group of
experts to conduct a comprehensive study of the health status of
minorities in the early 1980's. What was resulted was a report of the
secretary's Task Force on Black and Minority Health, also known as the
Heckler Report, which elevated minority health to the national stage.
It served as a driving force for monumental changes in research
policies, programs, and legislation to advance health equity of the
national, state, tribal, territorial, and local levels. The findings
and recommendations of this report, released in 1985, helped to chart
the work ahead in addressing health disparities for future
generations. This year marks the 30th anniversary of the Heckler
Report. Two years prior to its release, Secretary Heckler noted in an
annual report of the nation's health that while health and longevity
of all Americans continue to improve, there were significant
disparities between non-Hispanic whites and racial and ethnic
minorities in the United States. Secretary Heckler also noted that
the sad and significant fact of a continuing disparity in the burden
of death and illness experienced by minorities. Secretary Heckler
subsequently established the Task Force on Black and Minority Health,
which represented the first U.S. government group of experts convened
to conduct a comprehensive study of the health status of minorities.
The findings in the Heckler Report were a landmark in our
understanding of the extent to which racial and ethnic minorities
experience significant health disparities. Thank you Secretary
Heckler for being here with us today. Thank you.
[applause] Margaret Heckler: [inaudible] Thank you so much, Dr.
Conway. What a pleasure it is to be here today. I -- and to be with
all of you in this very impressive building. I'm very delighted that
the Heckler Report has brought us all together, in one small way. And
each of you has been participants in the development of the continuing
story of American health. You may wonder how such a thing began, and
I'll share a story with you. As a child, I knew a women who is an
African American lady, very knowledgeable, very brilliant, very kind
and very helpful. She left a mark on me, and I've always remembered
her. Her name was Christina, and when I became secretary of Health
and Human Services at the appointment of President Reagan, I was very
interested in of course learning everything about health and health
care. I had served in Congress for 16 years, I had been a lawyer, but
I also had been on the Veterans' Affairs Committee, and that was my
introduction to health. For 16 years, I was considerably
knowledgeable on that subject. I had to learn everything about health
care in a broader sense. And one of the first things that I did, of
course, was to try to read everything possible, and gather the data
that might be available for the decisions that I was going to have to
make. And I was quite shocked when I learned of the disparity in
longevity between African Americans and the white population. And
this surprised me so much. It reminded me of Christina. This
wonderful woman who was so bright and so able and so helpful
throughout my childhood. How is it that her outlook for longevity,
her lifespan, was likely to be limited beyond anything I would've
expected? And my approach was to find out what could be done about
this. For the first time in my life, there was an opportunity for me
to make a difference, not because I had such a knowledge of
healthcare, but because I was surrounded by the experts of HHS, and
the department that I headed, and the experts in the private sector.
And so I commissioned this first study of black and minority health.
The results were amazing. The advocates and those who'd been
caregivers in the field came forward with their voluntary
contributions. Nine volumes of information were collected and
published, and available now for history, because that was the
beginning of the study which led us to our meetings today, to our
office of the guardian and black health. Our feelings on this
particular experience, in bringing the experts together, and delving
through the archives and also through the medical history available,
through the personal testimony that people offered, was the beginning
of a new approach in health care. Earlier, we had data from --
primarily from white males, and of course that was in the --
inadequate in my view, but beyond that, this was hardly the
fundamental research available for the kind of health care changes
that we espoused as Americans, for all Americans, that all would have
equal opportunity and access and care of the highest quality. This
American experience was very much bolstered by the expertise and the
information which the Heckler Report gathered, and it was the
beginning of our new approach to healthcare and to healthcare study.
As we come together today with the experts that we have heard thus far
with Dr. Ginnis, who was one of my mentors, very available and so
brilliant, and so particularly incisive in his analysis and his
expertise. His presence today is very meaningful to me, as is Dr.
Conway. I'm so happy to see that the accomplishments he's achieved
here at CMS have culminated in this incredible meeting, and it is 50th
anniversary of Medicare and Medicaid. And to Cara James, Dr. James,
the director of the particular section involved with the minority
healthcare issues who hosted me today, and I thank her for that
invitation. We are all here to look at the difficulties of our
American healthcare system, as we did, as I did, in 1985, when it all
began. We look back and see how different life is today than it was
then, and how much more needs to be done in every area. Our eyes are
sharpened and our capacity to heal, to deal with the problems of the
American population, has increased as we gain more information, more
scientific knowledge, and more expertise. This is the product of --
and this is the opportunity for this meeting, which will lead us into
new passages and new opportunities. Nonetheless, the challenge
continues on for the -- as I can -- I have to congratulate all of you
who have been part of this, because many of you have been along the
way with your own testimonies, your own involvement, your own
experiences that have been and being shared constantly in this
evolving story of American healthcare. As we stand here today and
ponder what the future will hold, I have to rely on the time-old
sentiments and the mantra of my own life in looking toward issues of
great importance and of great seriousness, and I -- my own mantra was
very simple. Work hard, study hard, pray hard. And some of you may
be surprised at the last comment. Nonetheless, I feel it has been one
of the most powerful areas of my growth, and I say so with full
respect for all religions, and also the American freedoms, the right
not to protect -- not to believe in anything more than ourselves. In
fact, I have found the contributions of science and theology as much
more compatible than I would have thought in the past. Science is
moving ahead, but the creator of creation is also aware and in the
leadership, in my view and in my mind and, in my belief system, in the
leadership of all that we are doing. We are searching for that goal of
pure excellent health care for all at all levels, and as we do this, I
congratulate you to be a part of it, for the roles that you play as
part of the collaborations of the extricies [spelled phonetically] of
our nation. As important as CMS is, it cannot be replaced with any
other system in the world, and nothing is equal to it, both in its
goals and its strengths and its capacity to reach out. And so the
crisis and the challenge remains. Nothing has been resolved, but much
has been learned, and that I'm happy to see. It began in some measure
through the Heckler Report. I congratulate you for your participation
at all levels, and your continuing to serve the challenge that goes --
the challenge that we all face. We are in this together. We are all
Americans. We have to take advantage of every opportunity to learn
the best science, investigate the best science, follow our hearts, and
also share with others the contemplations and the outcomes that we
have witnessed and been part of in our journey through this health
care field. So I just join you today in that spirit, with great joy
that the beginning questions that have been asked and answered by so
many on the panel on the first team and Dr. Ginnis was one who was
very helpful from the very beginning. We are now we are 30 years
later, and much has been done, but much more remains to be done. I
feel very strongly that the most important thing today is to realize
that we are in this together. We are not black, and we are not white.
We are not Asians, we are not Hispanics. We are Americans. And as
the American answer, which will lead the world into healthcare. If we
work together, not in our polarized particles, in our polarized
section where we pay attention to only one thing and one group, and
only our own interests, the result will not be the same. But working
together, as a team, as we all are, for what is best for America, what
is best under the Constitution, to achieve healthcare for all and
access for all at all levels of our society. Working together, for
better or for worse, will achieve the great goals -- the greatest
goals that we have in our hearts. May God bless you and your work. I
congratulate you. May God bless America.
[applause]