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HHS in the 21st Century: Charting a New Course for a Healthier America
ity, and providing health services for vulnerablepopulations in the most efficient, cost-effectiveways.
To maximize value in the health care system, thesecretary muststrengthen the scientific base andcapabilities of the departmentand ensure thatagencies’ research findingsare shared department-wide and thatcurrent best evidence is usedfor departmental decision making, including theCenters for Medicare and Medicaid Services(CMS) reimbursement policy.
Congress should allocatesufficient, predictablefunding for NIH, CDC, FDA, and AHRQin orderto preserve and enhance these agencies’ scientificmissions. Congress should also establish aspecificbudget line for AHRQthat isindependentof appropriations to other HHS agencies.
To address the growing threat of food-borne illnesses, Congress shouldunify the USDA’s FoodSafety and Inspection Service and the food safetyactivities of FDA within HHSand ensure provision of adequate resources for high-quality inspection, enforcement, and research.
INCREASE EFFECTIVENESS AND EFFICIENCYOF THE U.S. HEALTH CARE SYSTEM
Health care accounts for nearly one-sixth of the U.S. gross domestic product, and Medicare and Medicaid account for 85 percent of HHS expenditures. These programs significantly contribute to rising national debt, and continued escalating costs threaten their sustainability.
Worse, our high national health care expenditures have not produced commensurate gains in the health of the nation or in the quality of care Americans receive. Research comparing the marked differences in care patterns (frequency of surgery, for example) provided in different parts of the country shows that not only are some patterns much more expensive, but residents of these high-cost areas have no better—and sometimes worse—health outcomes.