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Johns Hopkins Medicine Centennial 2/22/90 [OA 4728]
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6
THE WHITE HOUSE
Office of the Press Secretary
(Baltimore, Maryland)
For Immediate Release
February 22, 1990
REMARKS BY THE PRESIDENT
AT THE JOHNS HOPKINS MEDICINE CENTENNIAL
Shriver Auditorium
Johns Hopkins University
Baltimore, Maryland
4:02 P.M. EST
THE PRESIDENT: Thank you very much, Dr. Muller. Just
before coming out, Steven asked me to get one thing right. The name
of the University. (Laughter.) It's Johns Hopkins. I don't know
why he thought an elitist from Yale would miss that one, but
nevertheless. (Laughter.)
Now, he was given his great-grandmother's last name as
his first name. I told Dr. Muller, "You don't need to explain family
names to somebody called George Herbert Walker Bush." (Laughter.)
I am so glad that Dr. Louis Sullivan, my -- our
distinguished Secretary of HHS, could be here with me today. I am
very proud of him. And it's always good to be with my admired friend
-- wrong political party, but admired friend, Governor Schaefer,
who's doing an outstanding job for this state. (Applause.) And, of
course, my dear personal friend, with whom I've served in the
trenches, Maryland's great Congresswoman Helen Bentley with us here
today. (Applause.) And, of course, my fellow honorees, so many
distinguished scholars and guests, here to honor both the founding of
this historic institution and the 100th anniversary of Johns Hopkins
Medical Institutions.
I'm very pleased to be here. And I want to salute the
society of scholars -- the new ones, the old ones -- and this
distinguished group. And if I could be permitted one anecdote --
when I heard the citations of my fellow honorees, this distinguished
five, I was reminded of the story of the kid that threw a rope around
his mongrel dog and started heading over to Madison Square Garden.
And they said, "Well, where are you going?" He said, "Well, I'm
going to enter him in the Madison Square Garden pet show." And they
said, "Well, do you think he has a shot at winning?" He said, "No,
but he's going to be in some damn fine company." (Laughter and
applause.)
When I listened intently to those citations, I'll admit I
didn't know what half the words meant. (Laughter.) But I know
excellence when I see it, and I am very honored.
I was a bit nervious when I heard I'd be in a gown before
a group of doctors. (Laughter.) At least this one buttons up the
front, though. (Laughter.)
Gathered up here and out there are some of the best
health care professionals in America. And best in America means best
in the world. You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in medicine,
that doesn't quite fit. There's an unease in the health care
community that for all this nation's wealth, for all the money put
into the system, American medicine still faces unprecedented
problems.
MORE
- 2 -
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering. Today,
over 11 percent of our Gross National Product goes to health care,
and we rank number one in the world in per capita health care
expenditures. Yet, we do remain behind other industrialized
countries in life expectancy. And in the developed world, we rank
22nd in infant mortality rates -- 22nd.
Clearly, we have our work cut out for us. And yet,
because of great institutions like Johns Hopkins, we can face these
challenges with a sense of optimism and a sense of confidence. Those
who think our medical problems today are unsolvable or solvable only
by money ought to understand how far we've come.
For example, 19th century hospitals were not so much
centers of healing as of horror. And medical schools of the 1880's
were deplorable and dangerous places. No labs. No patients. No
questions permitted. Rookies became doctors after just 18 months,
often without ever seeing the inside of a hospital.
Today's date marks Washington's birthday, but some
scholars here today may recall his death. Diagnosed with a sore
throat, the doctors bled him four times before he succumbed to its
effects, thus depriving our young nation of perhaps years of service
from its most revered statesmen.
In the primitive days of early medicine, change did come
slowly. Until Johns Hopkins revolutionized the way medicine was
taught for all time -- and launched a movement that brought America
from medical backwater to world leader.
Hopkins' influence was completely out of proportion to
its age or resources. It found its wealth at the source of America's
wealth -- in its ideas, in its people.
New and powerful ideas. Dedicated and far-sighted
people. Linking a medical school with a hospital. Teaching at the
bedside. Developing new methodologies to fight terrible disease.
Bringing scientific research to medicine. Seeing what works.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in thousands
of hospitals for millions of people.
Yet, in our country today, there is a growing awareness
that to make this country as healthy as it can be, all of us -- all
of us -- must accept a share of the responsibility: government, the
health care profession and the America people themselves.
First, the federal government. In my State of the Union
address, I asked Lou -- I asked Dr. Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, the costs, and
the quality of America's health care system. This administration is
committed to health care policies that improve health care quality
while trying to restrain the costs. For example, last December, we
enacted significant new Medicare physician payment reform; and,
recently, we announced the first large-scale program to study medical
treatment effectiveness.
But better, more affordable health care must also be more
accessible. Expanded efforts to reduce infant mortality and expanded
Medicaid eligibility to cover more women and infants are just two of
the steps that we are taking to help.
Yet, if American medicine is to continue to do the job,
we must maintain our world leadership in medical research and
development. It was Hopkins that first isolated a substance that
American government and medicine can always use: Adrenaline. The
clock is ticking. And medical breakthroughs tomorrow depend on
action today. This administration has committed itself and this
nation to not only the largest overall R&D budget, but the largest
MORE
- 3 -
biomedical research budget in our history. We must encourage the
development of new technologies to prevent disease and avoid the
expense of long-term treatment.
A good example of this occurred right here at Johns
Hopkins, where the discovery of three types of polio virus made the
polio vaccine possible. Ultimately, this "high-tech" solution -- the
vaccine -- costs only a few cents per patient, versus the tens of
thousands of dollars that might be required for a lifetime of care in
an old iron lung.
Of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $500 million in the last
fiscal year. You won that support the Johns Hopkins way -- the
American way -- the same way that your lacrosse team makes the
rankings -- by being the very best. (Applause.)
But to keep America medicine the best in the world,
individual health care professionals and institutions must make our
medical system responsive and responsible.
You are the guardians of your profession -- its ethics
and its quality. Your standards must be high and they must be
enforced. The same sense of fiscal discipline that we must apply to
government you must apply also to the medical world in a time of
rising costs.
And I ask you today to avoid the understandable urge to
practice "defensive medicine" where doctors, fearing litigation, too
often dictate treatment that is unnecessary. Where the threat of
lawsuits threatens the very research that is so desperately needed to
save lives. In return, we've got to restore common sense and
fairness to America's medical malpractice system.
I have directed the Domestic Policy Council to determine
steps that the federal government can take to help alleviate this
serious situation. We've got to remember a simple truth: Not every
unfortunate medical outcome is the result of poor medicine. You
cannot make life risk-free. No risk means no progress. And that's
not the American way.
One of Hopkins founders, Dr. William Halsted, was the
gifted surgeon who introduced rubber gloves. In an age of surgical
slashing, he used his scalpel carefully, reducing shock and trauma.
A kinder, gentler surgeon, if you will. (Laughter.) But he was not
without boldness. And Halsted conceived and perfected a daring feat
of surgery: the radical mastectomy, that to this day saves the lives
of thousands of women afflicted with breast cancer.
The procedure in that time was unprecedented --
unprecedented in its time. And yet in today's atmosphere of fear of
malpractice, it probably would never have been attempted. This fear
has not only hurt medical innovation and treatment, it's also hurt
medical volunteerism. Many doctors used to give a day a week to the
needy. And I'm convinced that, if not for the liability issue, many
more. would donate time today.
And I also worry that the fear of malpractice limits the
access of too many Americans in our rural areas to quality medical
care, particularly those with high risk cases. Clearly, we must find
a fair and reasonable solution to the malpractice crisis. But
government and health care professionals alone cannot make this the
healthy and productive country we want it to be. America's health
care system will be best in the world only when every American cares
about his own health.
It is estimated that 40 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. And common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't smoke
and if you do smoke, stop. Don't abuse alcohol and don't use illegal
drugs.
MORE
- 4 -
We're not talking about lifestyle. We're talking about
life. And the best prescription for better health in America is a
strong, daily dose of individual responsibility. This sense of
responsibility is nothing new. Not far from here, I'm told, is the
famous John Singer Sargent painting of the Founding Fathers of Johns
Hopkins medicine. Sargent began by painting the four doctors, but
something, he said, was missing. It came as an inspiration -- he
knocked down a studio wall to get his new props in and he added a
huge Victorian globe. And above the globe a painting within a
painting, St. Martin giving his cloak to a beggar.
The globe should remind us of the global responsibilities
of American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should remind
us of the special responsibilities of the medical community to reach
out to those most in need.
We live in an age of miracles, we really do. Medical
miracles as dramatic as the artificial heart. Everyday miracles as
commonplace as the healing power of love. I believe in miracles, and
that wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at a place where those
wonders will continue to unfold.
Godspeed you in your work. And God bless medicine and
those who practice. And God bless the United States of America.
Thank you for this esteemed honor. Thank you from the bottom of my
heart. (Applause.)
END
4:17 P.M. EST
# 2490
THE WHITE HOUSE
Office of the Press Secretary
(Baltimore, Maryland)
For Immediate Release
February 22, 1990
REMARKS BY THE PRESIDENT
AT THE JOHNS HOPKINS MEDICINE CENTENNIAL
Shriver Auditorium
Johns Hopkins University
Baltimore, Maryland
4:02 P.M. EST
THE PRESIDENT: Thank you very much, Dr. Muller. Just
before coming out, Steven asked me to get one thing right. The name
of the University. (Laughter.) It's Johns Hopkins. I don't know
why he thought an elitist from Yale would miss that one, but
nevertheless. (Laughter.)
Now, he was given his great-grandmother's last name as
his first name. I told Dr. Muller, "You don't need to explain family
names to somebody called George Herbert Walker Bush." (Laughter.)
I am so glad that Dr. Louis Sullivan, my -- our
distinguished Secretary of HHS, could be here with me today. I am
very proud of him. And it's always good to be with my admired friend
-- wrong political party, but admired friend, Governor Schaefer,
who's doing an outstanding job for this state. (Applause.) And, of
course, my dear personal friend, with whom I've served in the
trenches, Maryland's great Congresswoman Helen Bentley with us here
today. (Applause.) And, of course, my fellow honorees, so many
distinguished scholars and guests, here to honor both the founding of
this historic institution and the 100th anniversary of Johns Hopkins
Medical Institutions.
I'm very pleased to be here. And I want to salute the
society of scholars -- the new ones, the old ones -- and this
distinguished group. And if I could be permitted one anecdote ---
when I heard the citations of my fellow honorees, this distinguished
five, I was reminded of the story of the kid that threw a rope around
his mongrel dog and started heading over to Madison Square Garden.
And they said, "Well, where are you going?" He said, "Well, I'm
going to enter him in the Madison Square Garden pet show." And they
said, "Well, do you think he has a shot at winning?" He said, "No,
but he's going to be in some damn fine company." (Laughter and
applause.)
When I listened intently to those citations, I'll admit I
didn't know what half the words meant. (Laughter.) But I know
excellence when I see it, and I am very honored.
I was a bit nervious when I heard I'd be in a gown before
a group of doctors. (Laughter.) At least this one buttons up the
front, though. (Laughter.)
Gathered up here and out there are some of the best
health care professionals in America. And best in America means best
in the world. You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in medicine,
that doesn't quite fit. There's an unease in the health care
community that for all this nation's wealth, for all the money put
into the system, American medicine still faces unprecedented
problems.
MORE
- 2 -
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering. Today,
over 11 percent of our Gross National Product goes to health care,
and we rank number one in the world in per capita health care
expenditures. Yet, we do remain behind other industrialized
countries in life expectancy. And in the developed world, we rank
22nd in infant mortality rates -- 22nd.
Clearly, we have our work cut out for us. And yet,
because of great institutions like Johns Hopkins, we can face these
challenges with a sense of optimism and a sense of confidence. Those
who think our medical problems today are unsolvable or solvable only
by money ought to understand how far we've come.
For example, 19th century hospitals were not so much
centers of healing as of horror. And medical schools of the 1880's
were deplorable and dangerous places. No labs. No patients. No
questions permitted. Rookies became doctors after just 18 months,
often without ever seeing the inside of a hospital.
Today's date marks Washington's birthday, but some
scholars here today may recall his death. Diagnosed with a sore
throat, the doctors bled him four times before he succumbed to its
effects, thus depriving our young nation of perhaps years of service
from its most revered statesmen.
In the primitive days of early medicine, change did come
slowly. Until Johns Hopkins revolutionized the way medicine was
taught for all time -- and launched a movement that brought America
from medical backwater to world leader.
Hopkins' influence was completely out of proportion to
its age or resources. It found its wealth at the source of America's
wealth -- in its ideas, in its people.
New and powerful ideas. Dedicated and far-sighted
people. Linking a medical school with a hospital. Teaching at the
bedside. Developing new methodologies to fight terrible disease.
Bringing scientific research to medicine. Seeing what works.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in thousands
of hospitals for millions of people.
Yet, in our country today, there is a growing awareness
that to make this country as healthy as it can be, all of us -- all
of us -- must accept a share of the responsibility: government, the
health care profession and the America people themselves.
First, the federal government. In my State of the Union
address, I asked Lou -- I asked Dr. Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, the costs, and
the quality of America's health care system. This administration is
committed to health care policies that improve health care quality
while trying to restrain the costs. For example, last December, we
enacted significant new Medicare physician payment reform; and,
recently, we announced the first large-scale program to study medical
treatment effectiveness.
But better, more affordable health care must also be more
accessible. Expanded efforts to reduce infant mortality and expanded
Medicaid eligibility to cover more women and infants are just two of
the steps that we are taking to help.
Yet, if American medicine is to continue to do the job,
we must maintain our world leadership in medical research and
development. It was Hopkins that first isolated a substance that
American government and medicine can always use: Adrenaline. The
clock is ticking. And medical breakthroughs tomorrow depend on
action today. This administration has committed itself and this
nation to not only the largest overall R&D budget, but the largest
MORE
- 3 -
biomedical research budget in our history. We must encourage the
development of new technologies to prevent disease and avoid the
expense of long-term treatment.
A good example of this occurred right here at Johns
Hopkins, where the discovery of three types of polio virus made the
polio vaccine possible. Ultimately, this "high-tech" solution -- the
vaccine -- costs only a few cents per patient, versus the tens of
thousands of dollars that might be required for a lifetime of care in
an old iron lung.
Of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $500 million in the last
fiscal year. You won that support the Johns Hopkins way -- the
American way -- the same way that your lacrosse team makes the
rankings -- by being the very best. (Applause.)
But to keep America medicine the best in the world,
individual health care professionals and institutions must make our
medical system responsive and responsible.
You are the guardians of your profession -- its ethics
and its quality. Your standards must be high and they must be
enforced. The same sense of fiscal discipline that we must apply to
government you must apply also to the medical world in a time of
rising costs.
And I ask you today to avoid the understandable urge to
practice "defensive medicine" where doctors, fearing litigation, too
often dictate treatment that is unnecessary. Where the threat of
lawsuits threatens the very research that is so desperately needed to
save lives. In return, we've got to restore common sense and
fairness to America's medical malpractice system.
I have directed the Domestic Policy Council to determine
steps that the federal government can take to help alleviate this
serious situation. We've got to remember a simple truth: Not every
unfortunate medical outcome is the result of poor medicine. You
cannot make life risk-free. No risk means no progress. And that's
not the American way.
One of Hopkins founders, Dr. William Halsted, was the
gifted surgeon who introduced rubber gloves. In an age of surgical
slashing, he used his scalpel carefully, reducing shock and trauma.
A kinder, gentler surgeon, if you will. (Laughter.) But he was not
without boldness. And Halsted conceived and perfected a daring feat
of surgery: the radical mastectomy, that to this day saves the lives
of thousands of women afflicted with breast cancer.
The procedure in that time was unprecedented --
unprecedented in its time. And yet in today's atmosphere of fear of
malpractice, it probably would never have been attempted. This fear
has not only hurt medical innovation and treatment, it's also hurt
medical volunteerism. Many doctors used to give a day a week to the
needy. And I'm convinced that, if not for the liability issue, many
more would donate time today.
And I also worry that the fear of malpractice limits the
access of too many Americans in our rural areas to quality medical
care, particularly those with high risk cases. Clearly, we must find
a fair and reasonable solution to the malpractice crisis. But
government and health care professionals alone cannot make this the
healthy and productive country we want it to be. America's health
care system will be best in the world only when every American cares
about his own health.
It is estimated that 40 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. And common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't smoke
and if you do smoke, stop. Don't abuse alcohol and don't use illegal
drugs.
MORE
- 4 -
We're not talking about lifestyle. We're talking about
life. And the best prescription for better health in America is a
strong, daily dose of individual responsibility. This sense of
responsibility is nothing new. Not far from here, I'm told, is the
famous John Singer Sargent painting of the Founding Fathers of Johns
Hopkins medicine. Sargent began by painting the four doctors, but
something, he said, was missing. It came as an inspiration -- he
knocked down a studio wall to get his new props in and he added a
huge Victorian globe. And above the globe a painting within a
painting, St. Martin giving his cloak to a beggar.
The globe should remind us of the global responsibilities
of American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should remind
us of the special responsibilities of the medical community to reach
out to those most in need.
We live in an age of miracles, we really do. Medical
miracles as dramatic as the artificial heart. Everyday miracles as
commonplace as the healing power of love. I believe in miracles, and
that wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at a place where those
wonders will continue to unfold.
Godspeed you in your work. And God bless medicine and
those who practice. And God bless the United States of America.
Thank you for this esteemed honor. Thank you from the bottom of my
heart. (Applause.)
END
4:17 P.M. EST
Document No. 114896 SS
WHITE HOUSE STAFFING MEMORANDUM
DATE:
2/22/90
----
ACTION/CONCURRENCE/COMMENT DUE BY:
PRESIDENTIAL REMARKS: JOHNS HOPKINS UNIVERSITY
SUBJECT:
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
WINSTON
DEMAREST
PINKERTON
FITZWATER
BROMLEY
GRAY
LEE
HAGIN
REMARKS:
The attached has been forwarded to the President.
RESPONSE:
James W. Cicconi
Assistant to the President
and Deputy to the Chief of Staff
Ext. 2702
THE WHITE HOUS
1930
FEB
WASHINGTON
21
PM
February 20, 1990
INFORMATION
MEMORANDUM FOR THE PRESIDENT
THROUGH:
CHRISS WINSTON
30
FROM:
EDWARD MCNALLY
SUBJECT:
JOHNS HOPKINS UNIVERSITY SPEECH
I. SUMMARY
Attached are draft remarks for your speech at Johns
Hopkins University's Commemoration Day ceremonies on February 22,
1990 in Baltimore, Md.
II. DISCUSSION
At 3:05 p.m. on Friday, February 22, 1990, you are
scheduled to arrive onstage in Shriver Auditorium at Johns
Hopkins University to address an audience of approximately 1,100
faculty and guests, including medical faculty. Few, if any,
students will attend. You will speak after receiving an honorary
Doctor of Humane Letters at approximately 3:45 p.m.
The speech (15 minutes, Teleprompter) discusses some
current health issues, and acknowledges the role of Johns Hopkins
as the first "modern" school of medicine in America. (Hopkins
Hospital is currently celebrating its 100th anniversary.)
A note on the second joke on Page 1: You will be
wearing an academic cap and gown.
McNally/Simon
February 21, 1990
Draft Four (E:HOP2)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:45 P.M.
Thank you President Steven Muller [MULL-er]. 11 Just
before coming out, Steven asked me to get one thing right. 11
The name of the University. It's JOHNS Hopkins. 11
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
somebody called George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medical Institutions. III
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best health care
professionals in America. And best in America means best in the
world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. There's an unease in the health
care community that for all this nation's wealth, for all the
2
money put into the system, American medicine still faces
unprecedented problems.
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Today, twelve percent of our gross national product goes to
health care, and we rank number one in the world in per capita
health care expenditures. Yet, we remain behind other
industrialized countries in life expectancy. And in the
developed world, we rank 22nd in infant mortality rates.
Clearly, we have our work cut out for us. And yet, because
of institutions like Johns Hopkins, we can face these challenges
with a sense of optimism and confidence. Those who think our
medical problems today are unsolvable or solvable only by money
ought to understand how far we've come.
For example, 19th Century hospitals were not so much centers
of healing as of horror. And medical schools of the 1880's were
deplorable and dangerous places. No labs. No patients. No
questions permitted. Rookies became doctors after just 18
months, often without ever seeing the inside of a hospital.
Today's date marks Washington's birthday, but some scholars
here today may recall his death: Diagnosed with a sore throat,
the doctors bled him four times before he succumbed to its
effects, thus depriving our young Nation of perhaps years of
service from its most revered statesman.
3
In the primitive days of early medicine, change did come
slowly. Until Johns Hopkins revolutionized the way medicine was
taught for all time -- and launched a movement that brought
America from medical backwater to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
wealth -- in its ideas, in its people.
New and powerful ideas. Dedicated and far-sighted people.
Linking a medical school with a hospital. Teaching at the
bedside. Bringing scientific research to medicine. Seeing what
works.
In the final decade of the century, the Hopkins revolution
in methodology helped lick the great killers of the last hundred
years: Cholera. Tuberculosis. Smallpox. The list goes on.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals for millions of people.
Yet, in our country today, there is a growing sense of
urgency
a growing awareness that to make this country as
healthy as it can be, all of us must accept a share of the
responsibility: government, the health care profession and the
American people themselves.
First, the federal government. In my State of the Union
address, I asked Secretary of Health and Human Services Louis
Sullivan to lead a Domestic Policy Council review of options on
the accessibility, cost, and quality of America's health care
4
system. We are committed to health care policies that improve
health care quality while restraining costs. For example, last
December, I signed into law significant new Medicare physician
payment reform; and we recently announced the first large-scale
program to study medical treatment effectiveness.
But better, more affordable health care must also be more
accessible. Expanded efforts to reduce infant mortality and
expanded Medicaid eligibility to cover more women and infants are
just two of the steps we are taking to help.
Yet, if American medicine is to continue to do the job, we
must maintain our world leadership in medical research and
development. It was Hopkins that first isolated a substance that
American government and medicine can always use: Adrenaline.
The clock is ticking. And medical breakthroughs tomorrow depend
on action today. We must encourage basic biomedical research
and develop new technologies that prevent disease and avoid the
expense of long-term treatment. A good example of this was
developed right here at Johns Hopkins, where the discovery of
three types of polio virus made the polio vaccine possible.
Ultimately, this "high-tech" solution -- the vaccine -- cost only
a few cents per patient -- versus the tens of thousands of
dollars that might be required for a lifetime of care in the old
iron lungs.
This Administration has committed itself and this nation to
the largest R and D budget in our history, including the biggest
amount ever proposed for biomedical research. We want to double
5
the budget of the National Science Foundation and make the
Research and Experimentation Tax Credit permanent. And we want
to significantly increase the Eisenhower Math and Science
Education Grants.
of course, here at Hopkins you are the leading recipient of
federal research dollars -- more than $500 million in the last
fiscal year. You won that support the Johns Hopkins way -- the
American way -- the same way your lacrosse team always makes the
rankings: By being the best. By beating the competition in the
marketplace of excellence, the marketplace of ideas.
But to keep American medicine the best in the world,
individual health care professionals and institutions have an
obligation to make our medical system both responsive and
responsible.
You are the guardians of your profession -- its ethics and
its quality. Your standards must be high and they must be
enforced. The same sense of fiscal discipline that we must apply
to government you must also apply to the medical world in a time
of rising costs.
And I ask you, today, to avoid the understandable urge to
practice "protective medicine" where the fear of litigation too
often dictates treatment that is unnecessary. Where the threat
of lawsuits threatens the very research that is so desperately
needed today to save lives. In return, we've got to restore
common sense and fairness to America's medical malpractice
system. III
6
I have directed the Domestic Policy Council to determine
steps the federal government can take to help alleviate this
serious situation. We've got to remember a simple truth: Not
every unfortunate medical outcome is the result of poor medicine.
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
surgeon who introduced rubber gloves. In an age of surgical
slashing, he used his scalpel carefully. Reducing shock and
trauma. A "kinder, gentler" surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
Yet in today's atmosphere of fear of malpractice -- probably
would never even have been attempted.
This fear has not only hurt medical innovation and
treatment. It's also hurt medical volunteerism. Many doctors
used to give a day a week to the needy. And I'm convinced that,
if not for the liability issue, many more would donate time
today.
I also worry that the fear of malpractice limits the access
of too many Americans in our rural areas to quality medical care
-- particularly those with high risk cases. Often in America,
whenever anything goes wrong, the response is automatic:
"Someone's got to pay. And far too often, that "someone" is
7
determined by who has the resources, rather than by who has the
responsibility. Tort reform is critical to solving the
malpractice liability crisis.
But government and health care professionals alone cannot
make this the healthy and productive country we want it to be.
America's health care system will be the best in the world only
when every American cares about their own health.
It is estimated that 40 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke and if you do smoke ... stop. Don't abuse alcohol -- and
don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the best prescription for better health in America is
a strong, daily dose of individual responsibility.
This sense of responsibility is nothing new. Not far from
here is the far.ous John Singer Sargent painting of the Founding
Fathers of Johns Hopkins medicine. Sargent began by painting the
four doctors, but wasn't satisfied with the composition.
Something, he said, was missing. It came as an inspiration --
and he knocked down a studio wall to get the new props in. He
added a huge Victorian globe, and above the globe a painting
within a painting -- St. Martin giving his cloak to a beggar.
8
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children, the
disabled, the elderly and our poor.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and that wondrous accomplishments,
wondrous breakthroughs, wondrous days are ahead. And I am
privileged to be honored at one of the places where those wonders
will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
377-5933
Document No. 114896
WHITE HOUSE STAFFING MEMORANDUM
DATE: 02/16/90
ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 02/20/90
SUBJECT: PRESIDENTIAL REMARKS:
JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
<
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
A
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
PINKERTON
BROMLEY
DEMAREST
WINSTON
FITZWATER
LEE, Burton
GRAY
HAGIN
REMARKS:
Please provide any comments/recommendations directly to Chriss
Winston by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
Thanks.
RESPONSE:
James W. Cicconi
Assistant to the President
and Deputy to the Chief of Staff
Ext. 2702
McNally/Simon
February 16, 1990
1990 FEB 16 PM 4: 08
Draft Three (B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 P.M.
[MULE -or]
Thank you President Steven Muller. Just before coming
out, Steven asked me to get one thing right. 11
The name of the University. It's JOHNS Hopkins. \\
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
insert
&
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Medical Institutions.
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
health care profess,
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
?
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Twelve
Eleven percent of our gross national product goes to health care
-- a figure that is skyrocketing increasing at a rate that neither the
forever
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
22nd
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
?
bled him four times before he succumbed to its effects
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
and your mouth.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
40
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
and if you do smoke stop Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
We need a system that >
in America's medical malpractice system. Doctors who practice
products americas such But we also need a septem where Guieness
medicine according to their medical malpractice risk are victims
artors are not opraid to practice their ant
to take on the
just like their patients -- just like the taxpayer who foots the
hohruse to sove leves.
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
not every unfortunate medical all frome is the result
of poor medicine
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
And in today's atmosphere of fear and malpractice -- probably
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
Prevent disease and avoid
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs.
On several fronts, there is a growing sense of urgency. It
was Hopkins that first isolated a substance American medicine
needs a little more of today: Adrenaline. The clock is ticking.
medical
And breakthroughs tomorrow depend on action today. That's why
our Administration has called for prompt Congressional action on
our proposals for investing in education -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
Science Foundation. A record increase high in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
MATH and Science
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
500
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
makes the rankings: By being the best. By beating the
competition in the marketplace of excellence, the marketplace of
ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
Document No. 114896
WHITE HOUSE STAFFING MEMORANDUM
DATE: 02/16/90
ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 02/20/90
SUBJECT: PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
PINKERTON
DEMAREST
BROMLEY
WINSTON
FITZWATER
GRAY
LEE, Burton
HAGIN
REMARKS:
Please provide any comments/recommendations directly to Chriss
Winston Thanks. by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
RESPONSE:
Chriss:
& have some real concerns here. Much of speech is good,
saying "money doesn work and "money alone doesn't work". is how we
but parts are way of kilter. we have to realize the fine line between
we spend it and fact that ever-increasing demands Assistant to the
cannot say money is part of the problem it's not. Problem James W. Cicconi more
President
will cause no to reach a breaking pt. we have to and Deputy Ext. to the 2702 Chief of Staff
help the doctors (malpractice, etc) but they have to help us
and their patients by being conscious of costs, etc. Enlist their help we have a
of our budget of SOTU. Needs to be tied together better. If no specifics, how 'Bont
strong case for receiving it. also, our proposed solution is basically a rehash
n tatement of aoals that HHS ⑇ OMB agree on? Thanks Sim
McNally/Simon
February 16, 1990
1990 FEB 16
Draft Three B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 P.M.
Thank you President Steven Muller.
\\
Just
before
coming
out, Steven asked me to get one thing right. \\
The name of the University. It's JOHNS Hopkins.
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush.'
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
This 4 will be misread by media E' the
in
profession. RID that of sure we're belies putting nation imprecedented money is part backs of problem.
But right now, frees American Imprecedented
medicine
challenges.
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross national product goes to health care
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
clearly, we have our work cut out for us.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
either
insolvate
insoluble or
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
commenting wrote a that on medicine not but on don doctors.) the we 19th should century fackle that pt
not good analogy today Chayersky was he
(may be in time, fiont of &
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled him four times before he succumbed to its effects.
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
mneeded-- beg
question
Common sense tells us what that means. It's not
fed.
arguably could
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't save lives)
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractice system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
But And in today's atmosphere of fear and malpractice -- probably might
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
are the But because offer costs
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs
On several fronts, there is a growing sense of urgency. It
Hopkins that first isolated a substance American medicine
fear
a little more of today: Adrenaline. The clock is ticking.
they
And breakthroughs tomorrow depend on action today. That's why
don't but how THE THE THE not hi Rey suits to is to use mach learning use, it.
our Administration has called for prompt Congressional action on
our proposals for investing in education -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
Science Foundation. A record increase in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
talk for most This more ur hospitols. CMB on
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
et's arry the not
makes the rankings: By being the best. By beating the
competing in the marketplace of excellence, the marketplace of
ideas.
an
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
THE WHITE HOUSE
WASHINGTON
2-20-90
FROM: BOB SIMON ps
SUBJECT: INSERT FOR UOHNS HOPKINS ACKNOWLEDGMENT:
INSERT AFTER "Helen Bentley." II
"And I should salute one of your own up
here today -- one of America's finest
scientists -- Dr. Daniel Nathans -- who
is a member of my Council of Advisors on
Science and Technology."
Insert A.
see other
changes
McNally/Simon
February 16, 1990
1990 FEB 16 PH 4: 08
Draft Three (B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 us P.M.
[MULE-er]
Thank you President Steven Muller. Just before coming
out, Steven asked me to get one thing right.
The name of the University. It's JOHNS Hopkins.
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
* INSERT
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross national product goes to health care
increasing
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
22nd
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled him four times before he succumbed to its effects.
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractice system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
And in today's atmosphere of fear and malpractice -- probably
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs.
On several fronts, there is a growing sense of urgency. It
was Hopkins that first isolated a substance American medicine
needs a little more of today: Adrenaline. The clock is ticking.
And breakthroughs tomorrow depend on action today. That's why
our Administration has called for prompt Congressional action on
our proposals for investing in education - -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
high
Science Foundation. A record increase in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
makes the rankings: By being the best. By beating the
competition in the marketplace of excellence, the marketplace of
ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
Document No. 114896
1308
WHITE HOUSE STAFFING MEMORANDUM
DATE: 02/16/90
ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 02/20/90
SUBJECT: PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
У
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
P
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
PINKERTON
BROMLEY
DEMAREST
>
WINSTON
FITZWATER
LEE, Burton
GRAY
HAGIN
REMARKS:
Please provide any comments/recommendations directly to Chriss
Winston by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
Thanks.
RESPONSE:
February 20, 1990
TO: CHRISS WINSTON
NSC clears the Presidential remarks for the Johns Hopkins Medicine
Centennial.
8th : Rata
Brent Scowcroft
James W. Cicconi
Assistant to the President
CC: James W. Cicconi
and Deputy to the Chief of Staff
Ext. 2702
McNally/Simon
February 16, 1990
1990 FEB 16 PM 4: 08
Draft Three (B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 P.M.
Thank you President Steven Muller. Just before coming
out, Steven asked me to get one thing right.
The name of the University. It's JOHNS Hopkins.
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross national product goes to health care
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him. II
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled him four times before he succumbed to its effects.
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractice system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
And in today's atmosphere of fear and malpractice -- probably
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs.
On several fronts, there is a growing sense of urgency. It
was Hopkins that first isolated a substance American medicine
needs a little more of today: Adrenaline. The clock is ticking.
And breakthroughs tomorrow depend on action today. That's why
our Administration has called for prompt Congressional action on
our proposals for investing in education -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
Science Foundation. A record increase in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
makes the rankings: By being the best. By beating the
competition in the marketplace of excellence, the marketplace of
ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
Document No. 114896
WHITE HOUSE STAFFING MEMORANDUM
DATE: 02/16/90
ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 02/20/90
SUBJECT: PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
9
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
PINKERTON
BROMLEY
DEMAREST
>
WINSTON
FITZWATER
>
LEE, Burton
GRAY
HAGIN
REMARKS:
Please provide any comments/recommendations directly to Chriss
Winston by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
Thanks.
RESPONSE:
nc
90 FEB 20 P4 : 33
James W. Cicconi
Assistant to the President
and Deputy to the Chief of Staff
Ext. 2702
McNally/Simon
February 16, 1990
1990 FEB 16 PM 4: 08
Draft Three (B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 P.M.
Thank you President Steven Muller. Just before coming
out, Steven asked me to get one thing right.
The name of the University. It's JOHNS Hopkins.
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross national product goes to health care
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not SO much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled him four times before he succumbed to its effects.
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractice system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
And in today's atmosphere of fear and malpractice -- probably
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs.
On several fronts, there is a growing sense of urgency. It
was Hopkins that first isolated a substance American medicine
needs a little more of today: Adrenaline. The clock is ticking.
And breakthroughs tomorrow depend on action today. That's why
our Administration has called for prompt Congressional action on
our proposals for investing in education -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
Science Foundation. A record increase in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
makes the rankings: By being the best. By beating the
competition in the marketplace of excellence, the marketplace of
ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
Ed- pls new
it by policy
McNally/Simon
statt level
February 15, 1990
Draft Two B:HOPKINS)
informally
and
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
statf
it.
SHRIVER AUDITORIUM, BALTIMORE, MD.
Thank you President Steven Muller. \\ Just before coming
THURSDAY, FEB. 22, 1990, 3:30 P.M. today AD
out, Steven asked me to get one thing right.
The name of the University. It's Johns Hopkins.
He was given his great-grandmother's last name, as his first
family names
name. I told Steven: "You don't need to explain that to a man
named George Herbert Walker Bush.
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when
in a your
your invitation first arrived. When I heard I'd be appearing
At least this one buttons in the front.
before a group of doctors. in a gown, I was relieved to find out
it wasn't the kind they make you put on in the hospital
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world. The best
deservedly the best -- that money can buy
But increasingly, relentlessly, the role of money in health
care has become less and less part of the solution -- and more
and more part of the problem.
it
fit.
Sometimes you dalk know, about when we the best' we That add money the But can in doesn medicine .T quite
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross, national product goes to health care
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But far behind other
And
industrialized countries in life expectancy.
Just
18th
in
the
world in infant mortality rates.
we can
And yet -- here at Johns Hopkins -- it's easy to face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to look back a
mere 100 years understand how for we we come.
Hample,
Medical schools of the 1880's were deplorable, dismal,
dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
main
medical treatment was often as likely to kill you as save you.
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled
him
four
times
before
he
succumbed
to
its
effects.
That's 1970?
Change came slowly. Until 90 years later, when Johns
Hopkins burst upon the scene and changed the way medicine was
who finally bellows to his staff' get we this kell patient him out of here before
Reminds me of the hongital frustrafed administrator in the movie "Hospital'
3
taught for all time -- and launched a movement that brought
America from medical backwater to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation.
C.P.R.'s simple
and it's cheap, and it requires just two things:
Your hands.
And they say the Hopkins paper on C.P.R. may have saved more
lives than any other medical manuscript in the past 100 years.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated with some of the world's
4
most vicious diseases -- as one observer noted -- "We've killed
all the wolves in the forest, and now the termites are eating
us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means.
Our grandmothers knew what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
abuse tobacco or alcohol -- and don't use illegal drugs.
We're not talking about a lifestyle. We're talking about
/
a
first
life. And the best prescription for better health in America is
a strong, daily dose of individual responsibility.
It's ironic to note the lunacy of those young Americans who
work out, eat granola, check food labels to guard against
artificial ingredients -- and then voluntarily ingest powerful,
impure and illegal chemicals.
If a doctor prescribed a drug, even a legal drug, that was
as impure and as debilitating as cocaine, they'd probably sue for
malpractice.
And yes, medical malpractice is another problem that
requires a fundamental change in attitude. Too often in America,
whenever anything goes wrong, the response is automatic:
"Someone's got to pay." And far too often, that "someone" is
determined by who has the resources, rather than by who has the
responsibility.
for example,
the
5
who
victims
We've got to restore common sense and fairness in America's
like the
just
medical malpractice system. And we've got to remember some
the Taxpayer
just like
patients
simple truths: You cannot compensate every loss with money. You
cannot make life risk-free. No risk means no progress. And
that's not the American way.
who will Lools
One of Hopkins founders, Dr. William Halsted, was the gifted
the
h-1
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
gats.
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy
the lives 06
from afflicted with
that to this day saves thousands of women from the ravages of
breast cancer. The procedure was unprecedented in its time. And
in today's atmosphere of entitlement, fear and malpractice --
probably would never even have been attempted.
this fear
Our malpractice system hasn't only hurt medical innovation and
treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
that some of our needent individuals don 'γ have
And I also worry about the reduced access to medical care --
those
chese new denies some of
particularly in rural areas. that excessive malpractice awards
the my State of the June I the ashed Secretary Sullwar to
have caused. our neediest individual quality
H
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
That's why we must invest in the future and use high tech
to replace high costs And Johns Hopkins is demonstrates a great example of
what one biomedical research establishment can do to change and
improve health care in thousands of hospitals. using high tech
to
And it was Hopkins that first isolated a substance American
replace high -Corts
medicine needs a little more of today: Adrenaline.
On several fronts, there is a growing sense of urgency.
The
clock is ticking. And breakthroughs tomorrow depend on action
today. That's why our Administration has called for prompt
Congressional action on our proposals for investing in education
-- investing in our children -- and investing in intellectual
capital. Reforming product liability laws. Doubling the budget
of the National Science Foundation. A record increase in funds
for R & D. Making the Research and Experimentation Tax Credit
permanent. And the Eisenhower Education Grants for math and
science would grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
7
current fiscal year. You won that support the Johns Hopkins way
the American way -- the same way your lacrosse team always makes
the rankings
wins: By being the best. By beating the competition in the
marketplace of excellence, the marketplace of ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the new global responsi-
bilities of American medicine -- reaching out to relieve the
terrible suffering of innocents like the AIDS babies in Romania, or the
ton or the duldren of africa suffering
And St. Martin's gesture should remind us of the special
children of famine in africa.
responsibilities of the medical community to reach out to those
most in need -- to children, women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
8
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
SENT BY:Xerox Telecopier 7020 ; 2-20-90 ; 2:32PM ;
2024562397-
2024566218:# 1
WHITE HOUSE STAFFING MEMORANDUM
Document No. 114896
DATE: 02/16/90
ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 02/20/90
SUBJECT: PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
9
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
PINKERTON
BROMLEY
DEMAREST
WINSTON
FITZWATER
LEE, Burton
GRAY
HAGIN
REMARKS:
Please provide any comments/recommendations directly to Chriss
Winston Thanks. by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
RESPONSE:
All comments from HHS
90 FEB 20 P2: 32
James W. Cicconi
Assistant to the President
and Deputy to the Chief of Staff
Ext. 2702
SENT BY:Xerox Telecopier 7020 ; 2-20-90 ; 2:33PM ;
2024562397-
2024566218:# 2
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
percent of our gross national product goes to health care
12%
--
a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
SENT BY:Xerox Telecopier 7020 ; 2-20-90 ; 2:33PM ;
2024562397-
2024566218;# 3
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands. and mouth.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractics system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
THE WHITE HOUSE
WASHINGTON
February 20, 1990
MEMORANDUM FOR CHRISS WINSTON
DEPUTY ASSISTANT TO THE PRESIDENT
FOR COMMUNICATIONS
FROM:
FREDERICK D. NELSON
F.BN.
ASSOCIATE COUNSEL TO THE PRESIDENT
SUBJECT:
Presidential Remarks: Johns Hopkins
Medical Center
Counsel's Office makes no legal objections to the draft remarks
for delivery at Johns Hopkins, and defers to the policy makers
with regard to the substance of the speech. We do note two
points of semantics.
On page 4, we would rewrite the second sentence of the last
(carry-over) paragraph. In an ideal world, where the malpractice
system made sense, you would want doctors to practice according
to their malpractice risk. The point here, we take it, is that
the medical malpractice structure has become flawed. Maybe after
the word "risk" we could add "in a system that has become
distorted, if that is the point to be gotten across.
We wonder, also, whether the last line on page 2 about money
becoming "more and more part of the problem,' might be taken out
of context to support proposals that the Administration opposes;
on that concern, too, we obviously defer to the policy makers.
Document No. 114896
WHITE HOUSE STAFFING MEMORANDUM
DATE: 02/16/90
90 FEB 20 : P2: 16 02/20/90
ACTION/CONCURRENCE/COMMENT DUE BY:
SUBJECT: PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
d
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
P
BATES
UNTERMEYER
CARD
ROGERS
>
PINKERTON
CICCONI
BROMLEY
DEMAREST
>
WINSTON
FITZWATER
>
LEE, Burton
GRAY
HAGIN
REMARKS:
Please provide any comments/recommendations directly to Chriss
Winston by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
Thanks.
RESPONSE:
James W. Cicconi
Assistant to the President
and Deputy to the Chief of Staff
Ext. 2702
McNally/Simon
February 16, 1990
1990 FEB 16 PH 4: 08
Draft Three (B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 P.M.
Thank you President Steven Muller. 11 Just before coming
out, Steven asked me to get one thing right. 11
The name of the University. It's JOHNS Hopkins.
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross national product goes to health care
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled him four times before he succumbed to its effects.
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractice system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
And in today's atmosphere of fear and malpractice -- probably
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs.
On several fronts, there is a growing sense of urgency. It
was Hopkins that first isolated a substance American medicine
needs a little more of today: Adrenaline. The clock is ticking.
And breakthroughs tomorrow depend on action today. That's why
our Administration has called for prompt Congressional action on
our proposals for investing in education -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
Science Foundation. A record increase in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
makes the rankings: By being the best. By beating the
competition in the marketplace of excellence, the marketplace of
ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
Document No. 114896
WHITE HOUSE STAFFING MEMORANDUM
DATE: 02/16/90
ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 02/20/90
SUBJECT: PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
<
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
9
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
PINKERTON
BROMLEY
DEMAREST
WINSTON
FITZWATER
LEE, Burton
GRAY
HAGIN
REMARKS:
Please provide any comments/recommendations directly to Chriss
Winston by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
Thanks.
RESPONSE: See comments
st : 1d 06
James W. Cicconi
Assistant to the President
and Deputy to the Chief of Staff
Ext. 2702
McNally/Simon
February 16, 1990
1990 FEB 16 PM 4: 08
Draft Three (B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 P.M.
Thank you President Steven Muller. Just before coming
out, Steven asked me to get one thing right.
The name of the University. It's JOHNS Hopkins.
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross national product goes to health care
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world
per capita health care expenditures. But behind other
inscording
22nd
to Budget
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled him four times before he succumbed to its effects.
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractice system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
And in today's atmosphere of fear and malpractice -- probably
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs.
On several fronts, there is a growing sense of urgency. It
was Hopkins that first isolated a substance American medicine
needs a little more of today: Adrenaline. The clock is ticking.
And breakthroughs tomorrow depend on action today. That's why
our Administration has called for prompt Congressional action on
our proposals for investing in education -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
Science Foundation. A record increase in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
Math and Science
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
makes the rankings: By being the best. By beating the
competition in the marketplace of excellence, the marketplace of
ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
Document No. 114896
WHITE HOUSE STAFFING MEMORANDUM
DATE: 02/16/90
ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 02/20/90
SUBJECT: PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
>
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
9
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
PINKERTON
BROMLEY
DEMAREST
WINSTON
FITZWATER
>
LEE, Burton
GRAY
HAGIN
REMARKS:
Pm122
Please provide any comments/recommendations directly to Chriss
Winston by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
Thanks.
RESPONSE:
Good Falk! DAR
James W. Cicconi
D. Allan Bromley
to : 21d
Assistant to the President
Assistant to the President for
and Deputy to the Chief of Staff
Science and Technology
Ext. 2702
2/20/90
McNally/Simon
February 16, 1990
1990 FEB 16 PM 4: 08
Draft Three (B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 P.M.
Thank you President Steven Muller. Just before coming
out, Steven asked me to get one thing right.
The name of the University. It's JOHNS Hopkins.
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross national product goes to health care
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled him four times before he succumbed to its effects.
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractice system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
And in today's atmosphere of fear and malpractice -- probably
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs.
On several fronts, there is a growing sense of urgency. It
was Hopkins that first isolated a substance American medicine
needs a little more of today: Adrenaline. The clock is ticking.
And breakthroughs tomorrow depend on action today. That's why
our Administration has called for prompt Congressional action on
our proposals for investing in education -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
Science Foundation. A record increase in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
makes the rankings: By being the best. By beating the
competition in the marketplace of excellence, the marketplace of
ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
Document No. 114896
WHITE HOUSE STAFFING MEMORANDUM
DATE: 02/16/90
ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 02/20/90
SUBJECT: PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
(02/16 Draft Three)
ACTION FYI
ACTION FYI
VICE PRESIDENT
MCCLURE
SUNUNU
NEWMAN
SCOWCROFT
PORTER
DARMAN
ROGICH
BATES
UNTERMEYER
CARD
ROGERS
CICCONI
PINKERTON
BROMLEY
DEMAREST
WINSTON
FITZWATER
LEE, Burton
GRAY
HAGIN
REMARKS:
Please provide any comments/recommendations directly to Chriss
Winston by 2:00 p.m. on Tuesday, 02/20, with a copy to my office.
Thanks.
RESPONSE:
article - we may want to
Planots attached
tailar some specifics in
James W. Cicconi
anticipation protest OZ 02 833 06
Assistant to the President
and Deputy to the Chief of Staff
Ext. 2702
S.R
McNally/Simon
February 16, 1990
1990 FEB 16 PM 4: 08
Draft Three (B:HOPKINS)
PRESIDENTIAL REMARKS: JOHNS HOPKINS MEDICINE CENTENNIAL
SHRIVER AUDITORIUM, BALTIMORE, MD.
THURSDAY, FEB. 22, 1990, 3:30 P.M.
Thank you President Steven Muller. Just before coming
out, Steven asked me to get one thing right. 11
The name of the University. It's JOHNS Hopkins. 11
He was given his great-grandmother's last name, as his first
name. I told Steven: "You don't need to explain family names to
a man named George Herbert Walker Bush."
It's always good to see Governor Schaefer and Mayor Schmoke.
Maryland's great Congresswoman -- my great friend -- Helen
Bentley. And of course my fellow honorees, so many distinguished
scholars and guests, here to honor both the founding of this
outstanding, historic institution and the 100th anniversary of
Johns Hopkins Medicine.
I'm pleased to be here. Although I was a bit nervous when I
heard I'd be in a gown before a group of doctors. At least this
one buttons in the front.
Gathered in this auditorium are some of the best doctors in
America. And best in America means best in the world.
You know, sometimes when we talk about "the best" of
anything -- we add the phrase "that money can buy." But in
medicine, it doesn't quite fit. Increasingly, relentlessly, the
role of money in health care has become less and less part of the
solution -- and more and more part of the problem.
2
Medical malpractice. Uninsured families. An aging
population. Cancer, heart disease, AIDS, drug addiction,
Alzheimer's, mental illness. The price tag is staggering.
Eleven percent of our gross national product goes to health care
-- a figure that is skyrocketing at a rate that neither the
American family nor the American people can long afford.
And it's not paying off. We rank number one in the world in
per capita health care expenditures. But behind other
industrialized countries in life expectancy. And just 18th in
the world in infant mortality rates.
And yet -- here at Johns Hopkins -- we can face these
challenges with a sense of optimism and confidence.
Because those who think our medical problems today are
insolvable -- or solvable only by money -- ought to understand
how far we've come.
For example, medical schools of the 1880's were deplorable,
dismal, dangerous places. No labs. No patients. No questions
permitted. Rookies became doctors after just 18 months, often
without ever seeing the inside of a hospital. And hospitals were
not so much centers of healing as of horror: 19th century
medical treatment was often as likely to maim you as save you.
Reminds me of the frustrated administrator in the movie
"Hospital" who finally bellows to his staff, "Get this patient
out of here before we kill him."
3
Today's date marks Washington's birthday, but today's debate
recalls his death: Diagnosed with a sore throat, the doctors
bled him four times before he succumbed to its effects.
Change came slowly. Until Johns Hopkins burst upon the
scene and changed the way medicine was taught for all time -- and
launched a movement that brought America from medical backwater
to world leader.
Hopkins' influence was completely out of proportion to its
age or resources. It found its wealth at the source of America's
greatest wealth -- in its ideas, in its people.
New and powerful ideas. Young and far-sighted people.
Linking a medical school with a hospital. Teaching at bedside.
Bringing scientific research to medicine. Seeing what works.
Here at Hopkins, in the final decade of the century, a
revolution was launched that helped lick the great killers of the
last hundred years: Cholera. Tuberculosis. Measles. Smallpox.
Diphtheria. Typhoid and scarlet fever.
And here at Hopkins, in the final decade of this century,
you can help launch a new revolution, a revolution that completes
the promise of the American experiment -- equal opportunity for
health and prosperity for all Americans.
A new revolution -- but many of the old rules still apply.
One is that not every great medical innovation needs to cost a
lot of money -- or even any money at all. C.P.R. -- Cardio-
Pulmonary Resuscitation -- was developed at Hopkins when an
electrical engineer made a chance observation. They say the
4
Hopkins paper on C.P.R. may have saved more lives than any other
medical manuscript in the past 100 years. C.P.R.'s simple and
it's cheap, and it requires just two things: Your hands.
Today, some of the most expensive problems are some of the
cheapest to prevent. Having defeated some of the world's most
vicious diseases -- as one observer noted -- "We've killed all
the wolves in the forest, and now the termites are eating us."
It is estimated that 50 to 70 percent of the causes of
premature death in America are preventable deaths -- unnecessary
deaths. Washington can't save you. But you can.
Common sense tells us what that means. It's not
complicated. Eat sensibly. Exercise. Wear seatbelts. Don't
smoke or abuse alcohol -- and don't use illegal drugs.
We're not talking about lifestyle. We're talking about
life. And the first prescription for better health in America is
a strong, daily dose of individual responsibility.
Often in America, whenever anything goes wrong, the response
is automatic: "Someone's got to pay." And far too often, that
"someone" is determined by who has the resources, rather than by
who has the responsibility.
For example, we've got to restore common sense and fairness
in America's medical malpractice system. Doctors who practice
medicine according to their medical malpractice risk are victims
just like their patients -- just like the taxpayer who foots the
bill for escalating health care costs. And we've got to remember
some simple truths: You cannot compensate every loss with money.
5
You cannot make life risk-free. No risk means no progress. And
that's not the American way.
One of Hopkins founders, Dr. William Halsted, was the gifted
and conservative surgeon who introduced rubber gloves. In an age
of surgical slashing, he used his scalpel carefully. Reducing
shock and trauma. Controlling bleeding. A "kinder, gentler"
surgeon, if you will.
But he was not without boldness. Halsted conceived and
perfected a daring feat of surgery -- the radical mastectomy --
that to this day saves the lives of thousands of women afflicted
with breast cancer. The procedure was unprecedented in its time.
And in today's atmosphere of fear and malpractice -- probably
would never even have been attempted.
This fear hasn't only hurt medical innovation and treatment.
It's also hurt medical volunteerism. Many doctors used to give a
day a week to the needy. And I'm convinced that, if not for the
liability issue, many more would donate time today.
And I also worry that some of our neediest individuals don't
have access to quality medical care -- particularly those in
rural areas. In my State of the Union address, I asked Secretary
of Health and Human Services Louis Sullivan to lead a Domestic
Policy Council review of options on the accessibility, cost, and
quality of America's health care system.
Individual responsibility and tort reform are two basic ways
America can reduce costs and improve its leadership in the health
care revolution. Another way is equally basic -- encouraging
6
basic biomedical research. To develop new, preventative
technologies that will spare the expense of long-term treatment.
A good example of this was developed right here at Johns
Hopkins, where the discovery of three types of polio virus made
the polio vaccine possible. Ultimately, this "high-tech"
solution -- the vaccine -- cost only a few cents per patient --
versus the tens of thousands of dollars that might be required
for a lifetime of care in the old iron lungs.
Johns Hopkins demonstrates what one biomedical research
establishment can do to change and improve health care in
thousands of hospitals, using high-tech to replace high costs.
On several fronts, there is a growing sense of urgency. It
was Hopkins that first isolated a substance American medicine
needs a little more of today: Adrenaline. The clock is ticking.
And breakthroughs tomorrow depend on action today. That's why
our Administration has called for prompt Congressional action on
our proposals for investing in education -- investing in our
children -- and investing in intellectual capital. Reforming
product liability laws. Doubling the budget of the National
Science Foundation. A record increase in funds for R & D.
Making the Research and Experimentation Tax Credit permanent.
And the Eisenhower Education Grants for math and science would
grow by 70 percent, to $230 million.
And of course, here at Hopkins you are the leading recipient
of federal research dollars -- more than $600 million in the
current fiscal year. You won that support the Johns Hopkins way
7
-- the American way -- the same way your lacrosse team always
makes the rankings: By being the best. By beating the
competition in the marketplace of excellence, the marketplace of
ideas.
Yes, our commitment is based on a new sense of urgency --
but also an old sense of responsibility. Not far from here is
the famous John Singer Sargent painting of the Founding Fathers
of Johns Hopkins medicine. Sargent began by painting the four
doctors, but wasn't satisfied with the composition. Something,
he said, was missing. It came as an inspiration -- and he
knocked down a studio wall to get the new props in. He added a
huge Victorian globe, and above the globe a painting within a
painting -- St. Martin giving his cloak to a beggar.
Sometime late at night, sometime during their tenure here, I
suppose every weary Resident must pause before that canvas in the
library, peering at the faces of these giants.
The globe should remind us of the global responsibilities of
American medicine -- reaching out to relieve the terrible
suffering of innocents like the AIDS babies in Romania, or the
children of famine in Africa. And St. Martin's gesture should
remind us of the special responsibilities of the medical
community to reach out to those most in need -- to children,
women, minorities and our poor.
Before closing, I'd like to note one other exciting
development. In less than two months, a new shuttle flight will
8
carry the Hubble Space Telescope into orbit. The ground center
for this mission is on this campus.
It's been called "the world's most extraordinary looking
glass" -- 50 times the power of the largest telescope on Earth.
In its first minutes of operation, it will catapult the vision of
humankind faster and farther than any leap since Galileo first
gazed into the heavens. Back, perhaps, to the very beginnings of
time. Forward, perhaps, to the very ends of the Universe.
We live in an age of miracles. Medical miracles as dramatic
as the artificial heart. Everyday miracles as commonplace as the
healing power of love.
I believe in miracles, and in the miracle of America.
Wondrous accomplishments, wondrous breakthroughs, wondrous days
are ahead. And I am privileged to be honored at one of the
places where those wonders will continue to unfold.
Thank you for your warm greeting and this great honor.
Godspeed you in your work. And God bless the United States of
America.
#
#
#
several hours later at a Leesburg motel, police said.
icize the president's policies.
The body of Dell Eugene Driggers, 29, of Taney-
"I think there is no health policy. The
town, Md., was found about 2 p.m. on the floor of
vice given to helping the disadvantage
his room at the Best Western off East Market
cludes the sick, the homeless and othe
Street.
fact there's no real effort being made to i
Police said Driggers had an apparently self-in-
of these problems," said Phillip Zieve,
flicted gunshot wound to the head; a handgun was
medical professor and physician in chief
found near the body.
Scott Key Hospital.
Driggers was wanted in connection with the fatal
Constance Nathanson, director of the
shooting of Susan Miller, 32, also of Taneytown in
kins Population Center, said the proteste
Carroll County, at the Silver Dollar Lounge in Fred-
focus on the issues of abortion and family
erick around 1:30 yesterday morning, police said.
"Despite its opposition to abortio
Nancy Armiger, 42, also of Taneytown, was shot
Bush's administration has shown no le;
in the chest and was listed in critical condition last
support of either access to family plannir
night at the University of Maryland Shock Trauma
or contraceptives development in tl
Unit in Baltimore. A third victim, Joseph Finck III of
States," she said. "These are critical pu
Mount Airy, was listed in stable condition at the
issues."
ospital, police said.
Trump Shuttle Forced to Land a
omb' Turns Out to Be Camera in Va.
A Trump Shuttle aircraft on approach 1
An aluminum box believed to contain a bomb
Airport yesterday afternoon was forced
npted the evacuation of an Alexandria office
Dulles International Airport after its cre
ing late Friday, police said yesterday.
having mechanical problems, a Dulles :
ortly before midnight, Alexandria police and a
said.
,inia State Police bomb squad detonated their
No one was injured in the incident invo
n explosive device next to the box, which had
p.m. shuttle flight from New York to W
en left in front of a building at the Park Center
authorities said.
Complex in the 4500 block of Ford Avenue in the
One passenger reported that the sce
city's West End. The building houses federal and
the plane was "pandemonium-everyone
other offices.
and hollering," as it landed, and said that
Examining the box's contents, police found a tele-
plane's wings appeared to be damaged.
vision camera with Army stickers on it, said Donald
Hayes, an Alexandria police spokesman.
U.S. Rethinks Lawsuit Against 1
The camera was not damaged, and it was not
The Justice Department has backed i
known yesterday who left it in front of the building.
its threat to take action against Virgini
Institute if the Lexington school does 1
Bush Honorary Degree Stirs Protest
Tuesday to admit women.
Medical staff, faculty and students at Johns Hop-
A Justice spokeswoman said Frida
kins University vowed yesterday to protest the
ment lawyers would file responses t
school's plans to award an honorary degree this
by Virginia Attorney General Mary
week to President Bush because of objections to his
the VMI Foundation before con
health policies.
next move.
Representatives of the Baltimore school's health
In a letter last month, the der
care community said the president's policies on
L. Douglas Wilder and Joseph
ident of the VMI Board of Vi
health care do not merit the recognition.
Bush is scheduled to speak and receive an hon-
supported school's men-only
lated federal law.
orary degree during the Hopkins Commemoration
Day celebration Thursday, which marks the centen-
The department gave
nial of Johns Hopkins Medical Institutions.
agree to admit women or 5
From news servic
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