VIDEO of Today's Senate Confirmation Hearing: Daschle for HHS

The work of reforming United States health care delivery begins, in earnest, now:

If you cannot see a video feed pane, below, click this, RIGHT HERE, and enable pop-up windows, to see the archived video stream, courtesy of C-Span.org.

From former Senator Daschle's opening remarks, this morning (full PDF file):

. . . .The Department of Health and Human Services touches the lives of all Americans in crucial and fundamental ways. It is called upon to protect our citizens as well as offer them assistance in fulfilling essential tasks for their well being. It is called upon to ensure the safety of food and the effectiveness of drugs a mother gives her child; to help find the cure to the disease afflicting a parent and to educate a community on preventing disease; to help the struggling family afford child care so parents can work; to ensure children are receiving the social and developmental care they need as they enter school and prepare to learn; to help the family struggling with caring for an aging parent; and of course, to help our seniors and most vulnerable families by providing health care, which many would otherwise go without.

This Department also will be central to tackling one of the greatest challenges of our time: reforming the U.S. health care system. The flaws in our health system are pervasive and corrosive. They threaten our health and economic security that is why the President-Elect has crafted the new White House Office of Health Reform and I am honored to be chosen to serve in this role as well. If confirmed, I will use these dual roles to marshal the talent and energy necessary to at last succeed in making health care affordable and accessible for all Americans. . . .

Ensuring all Americans have health care is integral to the mission of HHS and the well-being of our families –- but to achieve this goal, we will have to work together to tackle tough challenges. While our investments in research and pioneering work by our scientists lead innovation, too often, patients don’t actually get our best.

In 1994, we had 37 million uninsured. Today, we have nearly 46 million. In 1987, one dollar out of fifteen went toward health care for the average family. Today, it’s one out of six. And even though the U.S. spends more on health care than any other country, we rank low on life expectancy and infant mortality. President-elect Obama recognizes that many of you have been working for many years on these issues, and that any effort at reform will require close collaboration with Congress.

He also realizes that change cannot be dictated from the White House and Washington out –- but must come from the grassroots of this country and involve as many Americans as possible in the process of reform. In addition, to being a collaborative process, it also needs to be an open, transparent process where people know their voices are being heard.

We have already begun to listen. During the Transition, we reached millions of Americans via our website, Change.gov, to get their input on how best to change our health care system. Tens of thousands of Americans shared their greatest concerns about health reform, and thousands more opened up their homes to host Health Care Community Discussions. We are currently compiling their reports to share, but one thing was crystal clear: America cannot afford more of the same when it comes to health care in this country. On this, I think we all can agree.

It is unacceptable that in a nation of approximately 300 million people, nearly one in six Americans don’t have health insurance. As we face a harsh and deep recession, the problem of the uninsured is likely to grow.

But the number of uninsured only describes part of the problem. Even Americans who do have health insurance don’t always get the care they need, especially high-value preventative care. In some cases, this is due to a shortage of providers –- especially primary care providers in rural areas that we must work to address.

In other cases, it is simply because our health care system is not oriented toward prevention, and therefore, fails to incentivize the screenings and lifestyle changes that can do so much to improve health. Any health care reform plan must make sure every American has preventative care that prevents disease and disability. Coverage after you get sick should be a second line of defense. Today, it’s often the first line of defense.

In addition to being sound medicine, this is sound fiscal policy. Studies have shown that for every $1 spent on prevention we could net a return of $5.60 in health care costs – totaling upwards of $16 billion annually within five years.

But it’s not enough to give every American care. It needs to be high-quality care.

By some measures, nearly one third of the care Americans receive is at best inadequate, and at worst harmful. While we have pockets of excellent care, too often recommended care is not provided.

This quality gap contributes to racial and ethnic disparities in outcomes. On the Pine Ridge reservation in South Dakota, half the people over 40 have diabetes, and the life expectancy is just 47 years, or what life expectancy was for the rest of the country. . . in 1900. This, too, is unacceptable. . . .