B
Letter from Congressmen Waxman and Davis

HENRY A. WAXMAN, CALIFORNIA, CHAIRMAN

TOM LANTOS, CALIFORNIA

EDOLPHUS TOWNS, NEW YORK

PAUL E. KANJORSKI, PENNSYLVANIA

CAROLYN B. MALONEY, NEW YORK

ELIJAH E. CUMMINGS, MARYLAND

DENNIS J. KUCINICH, OHIO

DANNY K. DAVIS, ILLINOIS

JOHN F. TIERNEY, MASSACHUSETTS

WM. LACY CLAY, MISSOURI

DIANE E. WATSON, CALIFORNIA

STEPHEN F. LYNCH, MASSACHUSETTS

BRIAN HIGGINS, NEW YORK

JOHN A. YARMUTH, KENTUCKY

BRUCE L. BRALEY, IOWA

ELEANOR HOLMES NORTON, DISTRICT OF COLUMBIA

BETTY McCOLLUM, MINNESOTA

JIM COOPER, TENNESSEE

CHRIS VAN HOLLEN, MARYLAND

PAUL W. HODES, NEW HAMPSHIRE

CHRISTOPHER S. MURPHY, CONNECTICUT

JOHN P. SARBANES, MARYLAND

PETER WELCH, VERMONT

ONE HUNDERED TENTH CONGRESS

Congress of the United States

House of Representatives

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM

2157 RAYBURN HOUSE OFFICE BUILDING

WASHINGTON, DC 20515–6143

MAJORITY (202) 225–5051

FACSIMILE (202) 225–4784

MINORITY (202) 225–5074

www.oversight.house.gov

TOM DAVIS, VIRGINIA, RANKING MINORITY MEMBER

DAN BURTON, INDIANA

CHRISTOPHER SHAYS, CONNECTICUT

JOHN M. McHUGH, NEW YORK

JOHN L. MICA, FLORIDA

MARK E. SOUDER, INDIANA

TODD RUSSELL PLATTS, PENNSYLVANIA

CHRIS CANNON, UTAH

JOHN J. DUNCAN, JR., TENNESSEE

MICHAEL R. TURNER, OHIO

DARRELL E. ISSA, CALIFORNIA

KENNY MARCHANT, TEXAS

LYNN A. WESTMORELAND, GEORGIA

PATRICK T. McHENRY, NORTH CAROLINA

VIRGINIA FOXX, NORTH CAROLINA

BRAIN P. BILBRAY, CALIFORNIA

BILL SALI, IDAHO

JIM JORDAN, OHIO

June 20, 2007

Harvey V. Fineberg, M.D., Ph.D.

President

Institute of Medicine

500 Fifth Street, NW Washington, DC 20001

Dear Dr. Fineberg:

Our nation faces a dual challenge of growing public health threats and soaring health care costs. A number of pressing public health problems, including the growing burden of chronic disease driven in part by an epidemic of obesity, and the threat of pandemic flu and other emerging infectious diseases, require a focused national response. Meanwhile, the capacity of the federal government, American businesses, and the ability of individual citizens to purchase health care is threatened by rampant growth in health care costs. The steadily rising cost of health care is already eroding employer-sponsored health insurance and placing enormous pressure on public coverage through Medicare and Medicaid. These challenges are interrelated: for example, the burden of chronic disease has major implications for health care spending.


These challenges are not confined to particular states or regions of the country, and for that reason, they cannot effectively be addressed by individual states or private employers. The federal government must be involved.


We are concerned, however, that the key federal department in this effort, the Department of Health and Human Services (HHS), may be hindered in meeting this challenge by its organizational structure. The existing mix of HHS agencies and missions evolved over several Administrations in a largely ad hoc manner. For this reason, HHS may not be optimally configured to achieve the twin goals of advancing health and controlling health care costs.



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B Letter from Congressmen Waxman and Davis 163

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164 HHS IN THE 21ST CENTURY