1. For those outside the department, the system should

    • be accessible, transparent, timely, and reliable, and

    • provide useful, privacy-protected information regarding department activities.

  1. The department should demonstrate accountability through continuous critical assessment of program efficiency, equity, impact on health, and cost-effectiveness, and through corrective action for underperforming programs.

  2. The secretary, in collaboration with the surgeon general, should present Congress and the public with an annual “State of the Nation’s Health” report that describes progress toward achieving the vision for the nation’s health and the department’s key health goals.

  3. Congress should establish a new, strategic initiative fund to enable the secretary to support cross-agency and cross-departmental activities that exhibit innovation in responding to twenty-first century challenges, and to respond quickly to new, unforeseen, or expanding public health threats.


Recognizing how important the transition period is to a new secretary and to the department, the committee provides informal advice for achieving a successful transition. It organized the preceding recommendations into a timetable, indicating what should be done in the first 90 days, the first year in office, and throughout the secretary’s term (see Chapter 7). The committee has also translated some of its general thinking—about vision and goals, alignment and accountability, workforce, and its other recommendations—into specific suggestions for action.

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