watch timer. The terrorist device can be a rental van containing explosive urea nitrate that detonates in the level 2 parking area of the World Trade Center on February 26, 1993, causing six deaths, 1,042 injuries as well as significant economic loss. The device can be a rental truck full of ammonium nitrate and fuel oil that explodes in front of a building on April 19, 1995, killing 168 babies, children, adults, injuring 518 and causing the destruction of Murrah Federal Building and surrounding structures. The terrorist device can be letters containing anthrax, mailed to unsuspecting victims and delivered by dedicated postal employees in September and October 2001. The terrorist device has become hijacked airliners which were deliberately crashed into buildings on September 11, 2001, causing thousands of deaths and shocking the nation and the world. Life has changed for all of us in the United States as well as throughout the world. Major acts of terrorism are no longer confined to Asia, Europe, the Middle East and South America. The terrorists have struck hard within our borders and have brought the violence to our neighborhoods, to our citizens, to our families, to all of us. We are threatened by a man in a cave, thousands of miles away, and by a former Chicago resident named Padilla, who returned to his city and his nation, seeking to carry out a plan of mass destruction. We are improving our WMD capabilities, our intelligence sharing, and our willingness to dedicate personnel and resources to this fight. We, by we I mean the FBI, the CTTF, the public safety community, the public health community, the military, the intelligence agencies, and our allied countries are joined in a battle that may last years, but the alternative of not entering the fight is unacceptable. Chairman Horn, this concludes my prepared remarks. I would like to express my thanks for the opportunity to speak to this subcommittee and for your interest in the state of Counterterrorism Preparedness in Northern Illinois. I am pleased to respond to any questions that you or your members may have. Dr. YOUNG. Thank you, Mr. Chairman. Ms. SCHAKOWSKY. Again, Mr. Chairman, if I could also past President of the American Public Health Association, former medical director, Cook County Hospital and my personal physician. [Laughter.] Dr. YOUNG. Thank you. Mr. Chairman and members of the committee, I am really honored to be invited to present to you. In contrast to all the other members of this panel, I am not a full time professional devoted to defending us in all the ways they are. I rather am a physician celebrating 50 years of practice in my community, whose life has been punctuated by a number of exciting experiences in public health ranging from chairing the large department of medicine at our big public hospital here to service in the Public Health Service when I was much younger. My remarks, Mr. Chairman, will be rather global in an effort to talk about public health policy rather than what I am not qualified to talk about, the delivery of services as my colleagues have been doing. To proceed, the Federal Government must be the mainstay of public health, including the threats from terrorist sources. As such, it is failing to meet its responsibilities in a manner commensurate to the challenge. The inadequacies and weaknesses of our U.S. public health system spring from long-term neglect or policies that do not enhance systemic strengths. Our national, State and local health agencies are underfunded and poorly coordinated. Elementary modern capabilities in computer information systems, round the clock personnel in place, laboratories of a uniform high quality and speedy accessibility, a full public health professional work force are all deficient in various degrees across our country and our State. These deficiencies are the result of decades of inattention and misdirection of resources, stemming from the post-World War II focus on the perceived terror of that day-bacteriological warfare. Overall our policy decisions produced no practical protections against this biological threat. We did buildup stockpiles of our own, only to destroy them during President Nixon's watch, because they could not be used by us. In the latter half of the 20th century, our chronic poor funding and narrow policies for public health resulted in our current plight. And let me underscore that by saying I am fearful that in moving, as we must, to defend ourselves against this new unprecedented threat, that we may abandon principles that can really protect us. And I will go forward with that. In addition to prompt upgrading of our public health capabilities and I am aware that much of the legislation you have before you and have already passed attempts to do just that we have several other tasks to achieve optimum protection for our people: We need a health care system that is financed by an insurance benefit that is universal and managed by the government in simplest terms, Medicare for all. It may not seem responsive to terrorist threats to call for universal health care, but as a practicing physician for half a century, I assure you, ladies and gentlemen, that it is crucial to our defenses against an unexpected catastrophe. We need to untether the directors of our public health agencies from the present arrangement of subservience to the political incumbent at the Federal, State or local health department level. That is the way we do it in this country. My distinguished colleague worked for Governor Ryan and the Surgeon General for the President. Now it is logical, but we need to have more freedom for these crucial professional jobs. It would mean a change in the way we have done things over the years, but unless we liberate-I use the word advisedly-our health system from that political control, which is not necessarily negative or obnoxious, but is always subordinate to other considerations, we can see at moments like this how contrary that can be. And I suggest a separate board like the SEC or the FTC could facilitate achievement long term of public health objectives at all levels in a coordinated fashion, and not be immediately subordinated to the political realities of the moment, which are always important. Finally, we should foster the development of a supportive citizen constituency advocating for a strong public health system. And if I may, Mr. Chairman, that is the essence of my learning over the decades. We do not have a public health constituency in the way we have constituencies for every other kind of issue in this country. We have quasi-public health constituencies. The American Lung, the American Heart and American Cancer support the control of the tobacco scourge public health issue if ever there was one-but I have to return to the generalization that we do not have in place on a regular basis people who can petition Congress in behalf of the public health system in an orderly fashion. We have, in a word, made our public health system the Cinderella of our health system. Thank you. Mr. HORN. Thank you. And we now go to the Illinois Department of Public Health, its director is Dr. John R. Lumpkin. We are glad to have you here. [The prepared statement of Dr. Young follows:] Oral Statement of QUENTIN YOUNG, M.D. Chairman Horn and members of the Subcommittee; The federal government must be the mainstay of public health, including the threats from terrorist sources. As such, it is failing to meet its responsibilities in a manner commensurate to the challenge. The inadequacies and weaknesses of our US public health system spring from long-term neglect or policies that do not enhance systemic strength. Our national, state, and local health agencies are underfunded and poorly coordinated. Elementary modern capabilities in computer information systems, round the clock personnel in place, laboratories of a uniform high quality and speedy accessibility, a full public health professional work force are all deficient. These deficiencies are the result of decades of inattention and misdirection of resources, stemming from the post-World War II focus on the perceived terror of that day -- bacteriological warfare. Overall our policy decisions produced no practical protections against this biological threat. We did build up stockpiles of our own, only to destroy them during President Nixon's watch, because they could not be used by us. In the latter half of the 20th century, our chronic poor funding and narrow policies for public health resulted in our current plight. In addition to prompt upgrading our public health capabilities, we have several other tasks, to achieve optimum protection for our people: We need a health care system that is financed by an insurance benefit that is universal and managed by the government; in simplest terms, Medicare for all. We need to untether the directors of our public health agencies from the present arrangement of subservience to the political incumbent at the Federal, State, or local health department level. A separate board, like the SEC or the FTC, could facilitate achievement, long-term, of public health objectives at all levels in a coordinate fashion. • Finally, we should foster the development of a supportive citizen constituency advocating for a strong public health system. |