3

Work with the White House and Congress from the outset of health reform efforts (Chapter 2).

Health reform cannot be successfully achieved without the cooperation of the White House, Congress, and the department. The department should play a major role in national health reform efforts because it will ultimately inherit the responsibility of implementing any health reform legislation that is enacted.

4

Review plans and obtain funding for an improved information system (Chapter 6).

Commission rapid review of the current information system; identify reporting capacity needed and gaps in capabilities; develop a plan for investments and staging, with attention to security, simplified access, and usability, among other priorities.

5

Seek to secure predictable funding of the science agencies (Chapter 3).

The NIH, CDC, FDA, and AHRQ must be able to underwrite multiyear investigations and campaigns.

6

Evaluate the state of public health, and ensure its vitality and strength (Chapters 3 and 5).

Conduct a review of the adequacy of the public health workforce, and charge agency heads to review how public health principles, including health promotion and disease prevention, can be more fully integrated into their activities.

7

Evaluate the state of science in HHS, and ensure its vitality and strength (Chapters 3 and 5).

Constant threats are that the scientific workforce will lack the resources and credibility necessary to engage private-sector scientists authoritatively, that agency decisions will reflect politically preferred social values rather than valid and reliable findings, and that programs will calcify rather than adjust to new findings and demonstrated best practices.