Tornicade
2018 RBF League Champion
- Joined
- May 11, 2011
- Messages
- 17,542
- Reaction score
- 10,441
- Points
- 123
States provide almost half of Medicaid funding.
A 2016 NBER paper found that Medicaid has substantial positive long-term effects on the health of recipients: "Early childhood Medicaid eligibility reduces mortality and disability and, for whites, increases extensive margin labor supply, and reduces receipt of disability transfer programs and public health insurance up to 50 years later. Total income does not change because earnings replace disability benefits."[80] The government recoups its investment in Medicaid through savings on benefit payments later in life and greater payment of taxes because recipients of Medicaid are healthier: "The government earns a discounted annual return of between 2 and 7 percent on the original cost of childhood coverage for these cohorts, most of which comes from lower cash transfer payments."[80]
The Medicaid program was established in 1965 specifically to help assist with medical cost for the poor and elderly and be used in conjunction with State programs.
To the Congress of the United States:
In 1787, Thomas Jefferson wrote that, "Without health there is no happiness. An attention to health, then, should take the place of every other object."
That priority has remained fixed in both the private and public values of our society through generations of Americans since.
Our rewards have been immeasurably bountiful. "An attention to health"--of the individual, the family, the community and the nation--has contributed to the vitality and efficiency of our system as well as to the happiness and prosperity of our people.
Today, at this point in our history, we are privileged to contemplate new horizons of national advance and achievement in many sectors. But it is imperative that we give first attention to our opportunities--and our obligations--for advancing the nation's health. For the health of our people is, inescapably, the foundation for fulfillment of all our aspirations.
In these years of the 1960's, we live as beneficiaries of this century's great--and continuing--revolution of medical knowledge and capabilities. Smallpox, malaria, yellow fever and typhus are conquered in this country. Infant deaths have been reduced by half every two decades. Poliomyelitis which took 3,154 lives so recently as 1952 cost only five lives in 1964. Over the brief span of the past two decades, death rates have been reduced for influenza by 88 percent, tuberculosis by 87 percent, rheumatic fever by 90 percent.
A baby born in America today has a life expectancy half again as long as those born in the year the Twentieth Century began. The successes of the century are many. The pace of medical progress is rapid. The potential for the future is unlimited. But we must not allow the modern miracles of medicine to mesmerize us. The work most needed to advance the nation's health will not be done for us by miracles. We must undertake that work ourselves through practical, prudent and patient programs--to put more firmly in place the foundation for the healthiest, happiest and most hopeful society in the history of man.
Our first concern must be to assure that the advance of medical knowledge leaves none behind. We can--and we must-strive now to assure the availability of and accessibility to the best health care for all Americans, regardless of age or geography or economic status.
With this as our goal, we must strengthen our nation's health facilities and services, assure the adequacy and quality of our health manpower, continue to assist our States and communities in meeting their health responsibilities, and respond alertly to the new hazards of our new and complex environment.
We must, certainly, continue and intensify our health research and research facilities. Despite all that has been done, we cannot be complacent before the facts that:
--Forty-eight million people now living will become victims of cancer.
--Nearly 15 million people suffer from heart disease and this, together with strokes, accounts for more than half the deaths in the United States each year.
--Twelve million people suffer arthritis and rheumatic disease and 10 million are burdened with neurological disorders.
--Five and one-half million Americans are afflicted by mental retardation and the number increases by 126,000 new cases each year.
In our struggle against disease, great advances have been made, but the battle is far from won. While that battle will not end in our lifetime--or anytimes to come--we have the high privilege and high promise of making longer strides forward now than any other generation of Americans.
The measures I am outlining today will carry us forward in the oldest tradition of our society--to give "an attention to health" for all our people. Our advances, thus far, have been most dramatic in the field of health knowledge. We are challenged now to give attention to advances in the field of health care--and this is the emphasis of the recommendations I am placing before you at this time.
I. REMOVING BARRIERS TO HEALTH CARE In this century, medical scientists have done much to improve human health and prolong human life. Yet as these advances come, vital segments of our populace are being left behind--behind barriers of age, economics, geography or community resources. Today the political community is challenged to help all our people surmount these needless barriers to the enjoyment of the promise and reality of better health.
A. Hospital Insurance for the Aged
Thirty years ago, the American people made a basic decision that the later years of life should not be years of despondency and drift. The result was enactment of our Social Security program, a program now fixed as a valued part of our national life. Since World War II, there has been increasing awareness of the fact that the full value of Social Security would not be realized unless provision were made to deal with the problem of costs of illnesses among our older citizens.
I believe this year is the year when, with the sure knowledge of public support, the Congress should enact a hospital insurance program for the aged.
The facts of the need are well and widely known.
I ask that our Social Security system-proved and tested by three decades of successful operation--be extended to finance the cost of basic health services. In this way, the specter of catastrophic hospital bills can be lifted from the lives of our older citizens. I again strongly urge the Congress to enact a hospital insurance program for the aged. Such a program should:
--Be financed under social security by regular, modest contributions during working years;
--Provide protection against the costs of hospital and post-hospital extended care, home nursing services, and outpatient diagnostic services;
--Provide similar protection to those who are not now covered by social security, with the costs being paid from the administrative budget;
--Clearly indicate that the plan in no way interferes with the patient's complete freedom to select his doctor or hospital.
Like our existing social security cash retirement benefits, this hospital insurance plan will be a basic protection plan. It should cover the heaviest cost elements in serious illnesses. In addition, we should encourage private insurance to provide supplementary protection.
I consider this measure to be of utmost urgency. Compassion and reason dictate that this logical extension of our proven social security system will supply the prudent, feasible and dignified way to free the aged from the fear of financial hardship in the event of illness.
Also, I urge all States to provide adequate medical assistance under the existing Kerr-Mills program for the aged who cannot afford to meet the noninsured costs.
B. Better Health Services for Children and Youth
America's tradition of compassion for the aged is matched by our traditional devotion to our most priceless resource of all--our young. Today, far more than many realize, there are great and growing needs among our children for better health services.
--Acute illness strikes children under 15 nearly twice as frequently as it does adults.
--One in 5 children under age 17 is afflicted with a chronic ailment.
--Three out of every 100 children suffer some form of paralysis or orthopedic impairment.
--At least 2,000,000 children are mentally retarded, with a higher concentration of them from poor families.
--Four million children are emotionally disturbed.
--At age 15, the average child has more than 10 decayed teeth.
If the health of our Nation is to be substantially improved in the years to come, we must improve the care of the health of our 75 million preschool and school-age children and youth.
There is much to do if we are to make available the medical and dental services our rising generation needs. Nowhere are the needs greater than for the 15 million children of families who live in poverty.
--Children in families with incomes of less than $2,000 are able to visit a doctor only half as frequently as those in families with incomes of more than $7,000.
--Public assistance payments for medical services to the 3 million needy children receiving Dependent Children's benefits throughout the Nation average only $2.80 a month, and in some States such medical benefits are not provided at all.
--Poor families increasingly are forced to turn to overcrowded hospital emergency rooms and to overburdened city clinics as their only resource to meet their routine health needs.
Military entrance examinations reveal the consequences. Half of those rejected cannot pass the medical tests. Three-fourths of them would benefit from treatment, and earlier treatment would greatly increase recovery and decrease life-long disability.
The States and localities bear the major responsibility for providing modern medical care to our children and youth. But the Federal Government can help. I recommend legislation to:
--Increase the authorizations for maternal and child health and crippled children's services, earmarking funds for project grants to provide health screening and diagnosis for children of preschool and school age, as well as treatment and follow-up care services for disabled children and youth. This should include funds to help defray the operational costs of university-affiliated mental retardation clinical centers. Provisions should also be made for the training of personnel who will operate medical facilities for children.
--Broaden the public assistance program to permit specific Federal participation in paying costs of medical and dental care for children in medically needy families, similar to the Kerr-Mills program for the aged.
--Extend the grant programs for (a) family health services and clinics for domestic agricultural migratory workers and their children and (b) community vaccination assistance.
C. Improved Community Mental Health Services
Mental illness afflicts one out of ten Americans, fills nearly one-half of all the hospital beds in the Nation, and costs $3 billion annually. Fortunately, we are entering a new era in the prevention, treatment, and care of mental illness. Mere custodial care of patients in large, isolated asylums is clearly no longer appropriate. Most patients can be cared for and cured in their own communities.
An important beginning toward community preparation has been made through the legislation enacted by the 88th Congress authorizing aid for constructing community mental health centers. But facilities alone cannot assure services.
--It has been estimated that at least 10,000 more psychiatrists are needed.
--Few communities have the funds to support adequate programs, particularly during the first years.
--Communities with the greatest needs hesitate to build centers without being able to identify the source of operating funds.
--Most of the people in need are children, the aged, or patients with low incomes.
I therefore recommend legislation to authorize a 5-year program of grants for the initial costs of personnel to man community mental health centers which older comprehensive services.
D. A New Life for the Disabled
Today, we are rehabilitating about 120,000 disabled persons each year. I recommend a stepped-up program to overcome this costly waste of human resources. My 1966 budget will propose increased funds to rehabilitate an additional 25,000.
Our goal should be at least 200,000 a year. I recommend legislation to authorize:
--Project grants to help States expand their services.
--Special Federal matching so that rehabilitative services can be provided to a greater number of the mentally retarded and other seriously disabled individuals.
--Construction and modernization of workshops and rehabilitation centers.
II, STRENGTHENING THE NATION'S HEALTH FACILITIES AND SERVICES In our urbanized society today, the availability of health care depends uniquely upon the availability and accessibility of modern facilities, located in convenient and efficient places, and on well organized and adequately supported services. The lack of such facilities and services is, of itself, a barrier to good health care.
A. Multi-purpose Regional Medical Complexes
In this century, we have made more advance than in all other centuries toward overcoming diseases which have taken the heaviest toll of human life. Today we are challenged to meet and master the three killers which alone account for 7 out of 10 deaths in the United States each year--heart disease, cancer and stroke. The Commission on Heart Disease, Cancer and Stroke has pointed the way for us toward that goal.
The newest and most effective diagnostic methods and the most recent and most promising methods of treatment often require equipment or skills of great scarcity and expense such as,
--open heart surgery,
--advanced and very high voltage radiation therapy,
--advanced disease detection methods.
It is not necessary for each hospital or clinic to have such facilities, equipment, or services, but it is essential that every patient requiring such specialized and expensive procedures and services have access to them. Multi-purpose medical complexes can meet these needs. They would:
--speed the application of research knowledge to patient care, so as to turn otherwise hollow laboratory triumphs into health victories,
--save thousands of lives now needlessly taken annually by the three great killers-heart disease, cancer and stroke--and by other major diseases.
A plan to improve our attack upon these major causes of death and disability should become a part of the fabric of our regional and community health services. The services provided under this plan will help the practicing physician keep in touch with the latest medical knowledge and by making available to him the latest techniques, specialized knowledge, and the most efficient methods.
To meet these objectives, such complexes should:
--Be regional in scope.
--Provide services for a variety of diseases--heart disease, cancer, stroke, and other major illnesses.
--Be affiliated with medical schools, teaching hospitals and medical centers.
--Be supported by diagnostic services in community hospitals.
--Provide diagnosis and treatment of patients, together with research and teaching in a coordinated system.
--Permit clinical trial of advanced techniques and drugs.
Medical complexes--consisting of regional organizations of medical schools, teaching hospitals, and treatment centers tied into community diagnostic and treatment facilities-represent a new kind of organization for providing coordinated teaching, research and patient care. When we consider that the economic cost of heart disease alone amounts to 540,000 lost man years annually-worth some $2.5 billion--the urgency and value of effective action is unmistakable.
Action on this new approach, stemming from recommendations of the Commission on Heart Disease, Cancer and Stroke, will provide significant improvements in many fields of medicine.
I recommend legislation to authorize a 5-year program of project grants to develop multi-purpose regional medical complexes for an all out attack on heart disease, cancer, stroke, and other major diseases
A. Health Grants to Communities and States
In safeguarding and advancing the nation's health, States and communities have long had special responsibilities. General and special purpose health grants have proved an effective means of strengthening the Federal Government's partnership with them in improving the public health.
I have directed the Secretary of Health, Education, and Welfare to study these programs thoroughly and to recommend to me necessary legislation to increase their usefulness.
Authorizations for many of these programs expire at the close of fiscal year 1966. So that a thorough review may be made, I recommend that the Congress extend the authorizations through June 30, 1967.
B. Consumers Health Protection
Modernization of the Federal Food, Drag and Cosmetic Act is imperative if our health protection program is to keep pace with the technological and industrial advances of recent years.
Yet, despite recent improvements in food and drug legislation, serious gaps in our ability to protect the consumer still exist. The law should be strengthened to provide adequate authority in the regulation of nonprescription drugs, medical devices, cosmetics, and food.
Narcotics are not alone among the hazardous, habit-forming drugs subject to improper use. Barbiturates, amphetamines, and other drugs have harmful effects when improperly used. Widespread traffic resulting from inadequate controls over the manufacture, distribution, and sale of these drugs is creating a growing problem which must be met. We must also counter the threat from counterfeit drugs.
I recommend legislation to bring the production and distribution of barbiturates, amphetamines, and other psycho-toxic drugs under more effective control.
For the fuller protection of our families, I recommend legislation to require:
--Adequate labeling of hazardous substances.
--Safety regulation of cosmetics and therapeutic devices by pre-marketing examination by the Food and Drug Administration.
--Authority to seize counterfeit drugs at their source.
CONCLUSION I believe we have come to a rare moment of opportunity and challenge in the evolution of our society. In the message I have presented to you--and in other messages I shall be sending--my purpose is to outline the attainable horizons of a greater society which a confident and prudent people can begin to build for the future.
Whatever we aspire to do together, our success in those enterprises--and our enjoyment of the fruits that result--will rest finally upon the health of our people. We cannot and we will not overcome all the barriers--or surmount all the obstacles--in one effort, no matter how intensive. But in all the sectors I have mentioned we are already behind our capability and our potential. Further delay will only compound our problems and deny our people the health and happiness that could be theirs.
The Eighty-eighth Congress wrote a proud and significant record of accomplishment in the field of health legislation. I have every confidence that this Congress will write an even finer record that will be remembered with honor by generations of Americans to Come,
LYNDON B. JOHNSON
The White House
January 7, 1965
http://www.presidency.ucsb.edu/ws/?pid=27240
-Condensed due to posting limitations
A 2016 NBER paper found that Medicaid has substantial positive long-term effects on the health of recipients: "Early childhood Medicaid eligibility reduces mortality and disability and, for whites, increases extensive margin labor supply, and reduces receipt of disability transfer programs and public health insurance up to 50 years later. Total income does not change because earnings replace disability benefits."[80] The government recoups its investment in Medicaid through savings on benefit payments later in life and greater payment of taxes because recipients of Medicaid are healthier: "The government earns a discounted annual return of between 2 and 7 percent on the original cost of childhood coverage for these cohorts, most of which comes from lower cash transfer payments."[80]
The Medicaid program was established in 1965 specifically to help assist with medical cost for the poor and elderly and be used in conjunction with State programs.
To the Congress of the United States:
In 1787, Thomas Jefferson wrote that, "Without health there is no happiness. An attention to health, then, should take the place of every other object."
That priority has remained fixed in both the private and public values of our society through generations of Americans since.
Our rewards have been immeasurably bountiful. "An attention to health"--of the individual, the family, the community and the nation--has contributed to the vitality and efficiency of our system as well as to the happiness and prosperity of our people.
Today, at this point in our history, we are privileged to contemplate new horizons of national advance and achievement in many sectors. But it is imperative that we give first attention to our opportunities--and our obligations--for advancing the nation's health. For the health of our people is, inescapably, the foundation for fulfillment of all our aspirations.
In these years of the 1960's, we live as beneficiaries of this century's great--and continuing--revolution of medical knowledge and capabilities. Smallpox, malaria, yellow fever and typhus are conquered in this country. Infant deaths have been reduced by half every two decades. Poliomyelitis which took 3,154 lives so recently as 1952 cost only five lives in 1964. Over the brief span of the past two decades, death rates have been reduced for influenza by 88 percent, tuberculosis by 87 percent, rheumatic fever by 90 percent.
A baby born in America today has a life expectancy half again as long as those born in the year the Twentieth Century began. The successes of the century are many. The pace of medical progress is rapid. The potential for the future is unlimited. But we must not allow the modern miracles of medicine to mesmerize us. The work most needed to advance the nation's health will not be done for us by miracles. We must undertake that work ourselves through practical, prudent and patient programs--to put more firmly in place the foundation for the healthiest, happiest and most hopeful society in the history of man.
Our first concern must be to assure that the advance of medical knowledge leaves none behind. We can--and we must-strive now to assure the availability of and accessibility to the best health care for all Americans, regardless of age or geography or economic status.
With this as our goal, we must strengthen our nation's health facilities and services, assure the adequacy and quality of our health manpower, continue to assist our States and communities in meeting their health responsibilities, and respond alertly to the new hazards of our new and complex environment.
We must, certainly, continue and intensify our health research and research facilities. Despite all that has been done, we cannot be complacent before the facts that:
--Forty-eight million people now living will become victims of cancer.
--Nearly 15 million people suffer from heart disease and this, together with strokes, accounts for more than half the deaths in the United States each year.
--Twelve million people suffer arthritis and rheumatic disease and 10 million are burdened with neurological disorders.
--Five and one-half million Americans are afflicted by mental retardation and the number increases by 126,000 new cases each year.
In our struggle against disease, great advances have been made, but the battle is far from won. While that battle will not end in our lifetime--or anytimes to come--we have the high privilege and high promise of making longer strides forward now than any other generation of Americans.
The measures I am outlining today will carry us forward in the oldest tradition of our society--to give "an attention to health" for all our people. Our advances, thus far, have been most dramatic in the field of health knowledge. We are challenged now to give attention to advances in the field of health care--and this is the emphasis of the recommendations I am placing before you at this time.
I. REMOVING BARRIERS TO HEALTH CARE In this century, medical scientists have done much to improve human health and prolong human life. Yet as these advances come, vital segments of our populace are being left behind--behind barriers of age, economics, geography or community resources. Today the political community is challenged to help all our people surmount these needless barriers to the enjoyment of the promise and reality of better health.
A. Hospital Insurance for the Aged
Thirty years ago, the American people made a basic decision that the later years of life should not be years of despondency and drift. The result was enactment of our Social Security program, a program now fixed as a valued part of our national life. Since World War II, there has been increasing awareness of the fact that the full value of Social Security would not be realized unless provision were made to deal with the problem of costs of illnesses among our older citizens.
I believe this year is the year when, with the sure knowledge of public support, the Congress should enact a hospital insurance program for the aged.
The facts of the need are well and widely known.
I ask that our Social Security system-proved and tested by three decades of successful operation--be extended to finance the cost of basic health services. In this way, the specter of catastrophic hospital bills can be lifted from the lives of our older citizens. I again strongly urge the Congress to enact a hospital insurance program for the aged. Such a program should:
--Be financed under social security by regular, modest contributions during working years;
--Provide protection against the costs of hospital and post-hospital extended care, home nursing services, and outpatient diagnostic services;
--Provide similar protection to those who are not now covered by social security, with the costs being paid from the administrative budget;
--Clearly indicate that the plan in no way interferes with the patient's complete freedom to select his doctor or hospital.
Like our existing social security cash retirement benefits, this hospital insurance plan will be a basic protection plan. It should cover the heaviest cost elements in serious illnesses. In addition, we should encourage private insurance to provide supplementary protection.
I consider this measure to be of utmost urgency. Compassion and reason dictate that this logical extension of our proven social security system will supply the prudent, feasible and dignified way to free the aged from the fear of financial hardship in the event of illness.
Also, I urge all States to provide adequate medical assistance under the existing Kerr-Mills program for the aged who cannot afford to meet the noninsured costs.
B. Better Health Services for Children and Youth
America's tradition of compassion for the aged is matched by our traditional devotion to our most priceless resource of all--our young. Today, far more than many realize, there are great and growing needs among our children for better health services.
--Acute illness strikes children under 15 nearly twice as frequently as it does adults.
--One in 5 children under age 17 is afflicted with a chronic ailment.
--Three out of every 100 children suffer some form of paralysis or orthopedic impairment.
--At least 2,000,000 children are mentally retarded, with a higher concentration of them from poor families.
--Four million children are emotionally disturbed.
--At age 15, the average child has more than 10 decayed teeth.
If the health of our Nation is to be substantially improved in the years to come, we must improve the care of the health of our 75 million preschool and school-age children and youth.
There is much to do if we are to make available the medical and dental services our rising generation needs. Nowhere are the needs greater than for the 15 million children of families who live in poverty.
--Children in families with incomes of less than $2,000 are able to visit a doctor only half as frequently as those in families with incomes of more than $7,000.
--Public assistance payments for medical services to the 3 million needy children receiving Dependent Children's benefits throughout the Nation average only $2.80 a month, and in some States such medical benefits are not provided at all.
--Poor families increasingly are forced to turn to overcrowded hospital emergency rooms and to overburdened city clinics as their only resource to meet their routine health needs.
Military entrance examinations reveal the consequences. Half of those rejected cannot pass the medical tests. Three-fourths of them would benefit from treatment, and earlier treatment would greatly increase recovery and decrease life-long disability.
The States and localities bear the major responsibility for providing modern medical care to our children and youth. But the Federal Government can help. I recommend legislation to:
--Increase the authorizations for maternal and child health and crippled children's services, earmarking funds for project grants to provide health screening and diagnosis for children of preschool and school age, as well as treatment and follow-up care services for disabled children and youth. This should include funds to help defray the operational costs of university-affiliated mental retardation clinical centers. Provisions should also be made for the training of personnel who will operate medical facilities for children.
--Broaden the public assistance program to permit specific Federal participation in paying costs of medical and dental care for children in medically needy families, similar to the Kerr-Mills program for the aged.
--Extend the grant programs for (a) family health services and clinics for domestic agricultural migratory workers and their children and (b) community vaccination assistance.
C. Improved Community Mental Health Services
Mental illness afflicts one out of ten Americans, fills nearly one-half of all the hospital beds in the Nation, and costs $3 billion annually. Fortunately, we are entering a new era in the prevention, treatment, and care of mental illness. Mere custodial care of patients in large, isolated asylums is clearly no longer appropriate. Most patients can be cared for and cured in their own communities.
An important beginning toward community preparation has been made through the legislation enacted by the 88th Congress authorizing aid for constructing community mental health centers. But facilities alone cannot assure services.
--It has been estimated that at least 10,000 more psychiatrists are needed.
--Few communities have the funds to support adequate programs, particularly during the first years.
--Communities with the greatest needs hesitate to build centers without being able to identify the source of operating funds.
--Most of the people in need are children, the aged, or patients with low incomes.
I therefore recommend legislation to authorize a 5-year program of grants for the initial costs of personnel to man community mental health centers which older comprehensive services.
D. A New Life for the Disabled
Today, we are rehabilitating about 120,000 disabled persons each year. I recommend a stepped-up program to overcome this costly waste of human resources. My 1966 budget will propose increased funds to rehabilitate an additional 25,000.
Our goal should be at least 200,000 a year. I recommend legislation to authorize:
--Project grants to help States expand their services.
--Special Federal matching so that rehabilitative services can be provided to a greater number of the mentally retarded and other seriously disabled individuals.
--Construction and modernization of workshops and rehabilitation centers.
II, STRENGTHENING THE NATION'S HEALTH FACILITIES AND SERVICES In our urbanized society today, the availability of health care depends uniquely upon the availability and accessibility of modern facilities, located in convenient and efficient places, and on well organized and adequately supported services. The lack of such facilities and services is, of itself, a barrier to good health care.
A. Multi-purpose Regional Medical Complexes
In this century, we have made more advance than in all other centuries toward overcoming diseases which have taken the heaviest toll of human life. Today we are challenged to meet and master the three killers which alone account for 7 out of 10 deaths in the United States each year--heart disease, cancer and stroke. The Commission on Heart Disease, Cancer and Stroke has pointed the way for us toward that goal.
The newest and most effective diagnostic methods and the most recent and most promising methods of treatment often require equipment or skills of great scarcity and expense such as,
--open heart surgery,
--advanced and very high voltage radiation therapy,
--advanced disease detection methods.
It is not necessary for each hospital or clinic to have such facilities, equipment, or services, but it is essential that every patient requiring such specialized and expensive procedures and services have access to them. Multi-purpose medical complexes can meet these needs. They would:
--speed the application of research knowledge to patient care, so as to turn otherwise hollow laboratory triumphs into health victories,
--save thousands of lives now needlessly taken annually by the three great killers-heart disease, cancer and stroke--and by other major diseases.
A plan to improve our attack upon these major causes of death and disability should become a part of the fabric of our regional and community health services. The services provided under this plan will help the practicing physician keep in touch with the latest medical knowledge and by making available to him the latest techniques, specialized knowledge, and the most efficient methods.
To meet these objectives, such complexes should:
--Be regional in scope.
--Provide services for a variety of diseases--heart disease, cancer, stroke, and other major illnesses.
--Be affiliated with medical schools, teaching hospitals and medical centers.
--Be supported by diagnostic services in community hospitals.
--Provide diagnosis and treatment of patients, together with research and teaching in a coordinated system.
--Permit clinical trial of advanced techniques and drugs.
Medical complexes--consisting of regional organizations of medical schools, teaching hospitals, and treatment centers tied into community diagnostic and treatment facilities-represent a new kind of organization for providing coordinated teaching, research and patient care. When we consider that the economic cost of heart disease alone amounts to 540,000 lost man years annually-worth some $2.5 billion--the urgency and value of effective action is unmistakable.
Action on this new approach, stemming from recommendations of the Commission on Heart Disease, Cancer and Stroke, will provide significant improvements in many fields of medicine.
I recommend legislation to authorize a 5-year program of project grants to develop multi-purpose regional medical complexes for an all out attack on heart disease, cancer, stroke, and other major diseases
A. Health Grants to Communities and States
In safeguarding and advancing the nation's health, States and communities have long had special responsibilities. General and special purpose health grants have proved an effective means of strengthening the Federal Government's partnership with them in improving the public health.
I have directed the Secretary of Health, Education, and Welfare to study these programs thoroughly and to recommend to me necessary legislation to increase their usefulness.
Authorizations for many of these programs expire at the close of fiscal year 1966. So that a thorough review may be made, I recommend that the Congress extend the authorizations through June 30, 1967.
B. Consumers Health Protection
Modernization of the Federal Food, Drag and Cosmetic Act is imperative if our health protection program is to keep pace with the technological and industrial advances of recent years.
Yet, despite recent improvements in food and drug legislation, serious gaps in our ability to protect the consumer still exist. The law should be strengthened to provide adequate authority in the regulation of nonprescription drugs, medical devices, cosmetics, and food.
Narcotics are not alone among the hazardous, habit-forming drugs subject to improper use. Barbiturates, amphetamines, and other drugs have harmful effects when improperly used. Widespread traffic resulting from inadequate controls over the manufacture, distribution, and sale of these drugs is creating a growing problem which must be met. We must also counter the threat from counterfeit drugs.
I recommend legislation to bring the production and distribution of barbiturates, amphetamines, and other psycho-toxic drugs under more effective control.
For the fuller protection of our families, I recommend legislation to require:
--Adequate labeling of hazardous substances.
--Safety regulation of cosmetics and therapeutic devices by pre-marketing examination by the Food and Drug Administration.
--Authority to seize counterfeit drugs at their source.
CONCLUSION I believe we have come to a rare moment of opportunity and challenge in the evolution of our society. In the message I have presented to you--and in other messages I shall be sending--my purpose is to outline the attainable horizons of a greater society which a confident and prudent people can begin to build for the future.
Whatever we aspire to do together, our success in those enterprises--and our enjoyment of the fruits that result--will rest finally upon the health of our people. We cannot and we will not overcome all the barriers--or surmount all the obstacles--in one effort, no matter how intensive. But in all the sectors I have mentioned we are already behind our capability and our potential. Further delay will only compound our problems and deny our people the health and happiness that could be theirs.
The Eighty-eighth Congress wrote a proud and significant record of accomplishment in the field of health legislation. I have every confidence that this Congress will write an even finer record that will be remembered with honor by generations of Americans to Come,
LYNDON B. JOHNSON
The White House
January 7, 1965
http://www.presidency.ucsb.edu/ws/?pid=27240
-Condensed due to posting limitations
