Richard M. Nixon said:
To the Congress of the United States:
An all-directions reform of our health care system--so that every citizen will be able to get quality health care at reasonable cost regardless of income and regardless of area of residence--remains an item of highest priority on my unfinished agenda for America in the 1970s.
In the ultimate sense, the general good health of our people is the foundation of our national strength, as well as being the truest wealth that individuals can possess.
Nothing should impede us from doing whatever is necessary to bring the best possible health care to those who do not now have it--while improving health care quality for everyone--at the earliest possible time.
In 1971, I submitted to the Congress my new National Health Strategy which would produce the kind of health care Americans desire and deserve, at costs we all can afford.
Since that time, a great national debate over health care has taken place. And both branches of the Congress have conducted searching examinations of our health needs, receiving and studying testimony from all segments of our society.
The Congress has acted on measures advancing certain parts of my National Health Strategy:
--The Comprehensive Health Manpower Training Act of 1971 and the Nurse Training Act of 1971, which I signed last November, will spur the greatest effort in our history to expand the supply of health personnel. Additionally and importantly, it will attract them to the areas of health care shortages, helping to close one of the most glaring gaps in our present system.
--The Congress also passed the National Cancer Act which I proposed last year. This action opens the way for a high-intensity effort to defeat the No. 2 killer and disabler of our time, an effort fueled by an additional $100 million in the last year. A total of $430 million is budgeted for cancer programs in fiscal year 1973, compared to $185 million in fiscal year 1969.
--The Congress responded to my statement of early 1970 on needed improvements in veterans medical care by authorizing increased funds in 1971 and 1972, increases which have brought the V^ hospital-to-patient ratios to an all-time high and have provided many additional specialty and medical services, including increased medical manpower training.
--The Congress also created a National Health Service Corps of young professionals to serve the many rural areas and inner city neighborhoods which are critically short on health care. By mid-summer, more than 100 communities around the Nation will be benefiting from these teams.
These are important steps, without doubt, but we still must lay the bedrock foundations for a new national health care system for all our people.
The need for action is critical for far too many of our citizens.
The time for action is now.
I therefore again urge the Congress to act on the many parts of my health care program which are still pending so that we can end--at the earliest possible time-the individual anguishes, the needless neglects and the family financial fears caused by the gaps, inequities and maldistributions of the present system.
The United States now spends more than $75 billion annually on health care--and for most people, relatively good service results.
Yet, despite this huge annual national outlay, millions of citizens do not have adequate access to health care. Our record in this field does not live up to our national potential.
That sobering fact should summon us to prompt but effective action to reform and reorganize health care practices, while simultaneously resisting the relentless inflation of health care costs.
MORE THAN MONEY IS NEEDED
When the subject of health care improvements is mentioned, as is the case with so many other problems, too many people and too many institutions think first and solely of money--bills, payments, premiums, converges, grants, subsidies and appropriations.
But far more than money is involved in our current health care crisis.
More money is important--but any attempted health care solution based primarily on money is simply not going to do the job.
In health care as in so many other areas, the most expensive remedy is not necessarily the most effective one.
One basic shortcoming of a solution to health care problems which depends entirely on spending more money, can be seen in the Medicare and Medicaid programs. Medicare and Medicaid did deliver needed dollars to the health care problems of the elderly and the poor. But at the same time, little was done to alter the existing supply and distribution of doctors, nurses, hospitals and other health resources. Our health care supply, in short, remained largely the same while massive new demands were loaded onto it.
The predictable result was an acute price inflation, one basic cause of our health economic quandary of the past 11 years.
In this period, national health expenditures rose by 188 percent, from $26 billion in fiscal 1960 to $75 billion in fiscal 1971. But a large part of this enormous increase in the Nation's health expenditure went, not for more and better health care, but merely to meet price inflation.
If we do not lessen this trend, all other reform efforts may be in vain.
That is why my National Health Strategy was designed with built-in incentives to encourage sensible economies--in the use of health facilities, in direct cost-control procedures, and through more efficient ways to bring health care to people at the community level. That is also why we have given careful attention to medical prices in Phase II of the Economic Stabilization Program.
Several months ago, the Price Commission ruled that increases in physician fees must be kept to within 2 1/2 percent. Rules also were issued to hold down runaway price increases among hospitals, nursing homes and other health care institutions. All of these efforts were directed toward our goal of reducing the previous 7.7 percent annual price increase in total health care costs to half of that level, 3.85 percent this year.
These actions should buy us some time. But they are, at best, a temporary tourniquet on health care price inflation.
We must now direct our energies, attentions and action to the long-range factors affecting the cost, the quality and the availability of medical care.
My overall program, of course, is one that would improve health care for everyone. But it is worthy of special note that these recommendations have a particular importance and a high value for older Americans, whose health care needs usually rise just as their incomes are declining.
WE SHOULD BUILD ON PRESENT STRENGTHS
When we examine the status of health care in America, we always must be careful to recognize its strengths. For most Americans, more care of higher quality has been the result of our rising national investment in health, both governmental and private.
We lead the world in medical science, research and development. We have obliterated some major diseases and drastically reduced the incidence of others. New institutions, new treatments and new drugs abound. There has been a marked and steady gain in the number of people covered by some form of health insurance to 84 percent of those under 65, and coverages have been expanding. Life expectancy has risen by 3.4 percent since 1950 and the maternal death rate has declined 66 percent. Days lost from work in the same period are down 3.5 percent and days lost from school have declined 7.5 percent--both excellent measures of the general good state of our health.
All of this is progress--real progress. It would be folly to raze the structure that produced this progress--and start from scratch on some entirely new basis-in order to repair shortcomings and redirect and revitalize the thrust of our health system.
To nationalize health care as some have proposed, and thus federalize medical personnel, institutions and procedures-eventually if not at the start-also would amount to a stunning new financial burden for every American taxpayer.
The average household would pay more than $1,000 a year as its share of the required new Federal expenditure of more than $80 billion each and every year. Such a massive new Federal budget item would run counter to the temper of the American taxpayer.
Also, such a massive new Federal budget item would run counter to the efforts of this Administration to decentralize programs and revenues, rather than bring new responsibilities to Washington.