TOPICS: Commencement & Health/Healthcare Issues
Friday, June 10th
2005 Pritzker School of Medicine Commencement
After four long years of endless studying, sleepless nights, and
constant stress, who's ready to kick back, relax, and jump head
first into their residency?
And who wishes
people would stop making that joke? I thought so.
It's an honor
to be back here at the University of Chicago. As most of you know,
I used to teach over at the law school and my wife Michelle is in
charge of community affairs at the hospital, so as a part of the
family we're especially proud of you all right now.
We're also especially
hopeful. With the caliber of talent and amazing dedication represented
here today, I found myself thinking that in one of these chairs
could sit the researcher who will finally win humanity's long battle
against cancer. In one of these chairs could sit the scientist who
transforms AIDS from one of the greatest disasters of the 20th century
to one of the most curable diseases of the 21st. In one of these
chairs could sit the doctor who says "Hey Barack, don't worry
about that trick knee - you're just getting old." So that's
But this hope
that I have for your class - this faith in our ability to overcome
that which threatens to halt the march of human progress - is nothing
new. It is as old as our history and as powerful as the idea of
America itself. And that's because we've been here before.
years ago, when the University of Chicago's first graduating class
sat here ready to collect their diplomas, who would have dared to
believe that before the beginning of the next century, we would
add thirty years to the average lifespan and witness a 90% drop
in the rate of infant death? Who would have dared to believe that
with a simple vaccine, we could eliminate a disease that left millions
without the ability to walk? That we could transplant a heart or
resuscitate one that stopped? That we could unlock the greatest
mysteries of life from the most basic building blocks of our existence?
In a time where
you were lucky to live past fifty and doomed if you came down with
the flu, who would have dared to believe these things?
The people who
once sat in your chairs - they did. The doctors and nurses, researchers
and scientists who came before. Who grew up believing that in America,
the most improbable of all experiments, the place where we continue
to defy the odds and write our own history, they could be the ones
to improve, extend, and save human life. They could be the healers.
As this new century
unfolds, their success and your potential have led us to a moment
of unparalleled promise in health and medicine. Just like a century
ago, technology and treatments that were once barely imagined are
now imminently possible.
Yet, while these
are some of tomorrow's biggest potential breakthroughs, they are
not today's biggest medical challenge. Today, as we continue to
find new ways to live longer and better, the greatest single threat
to the health of our nation is not a scarcity of genius or a failure
of discovery; it is a lack of collective will to ensure that every
single American has access to effective, affordable health care.
It is our inability, after years and years of talk and gridlock,
to finally do something about the crushing cost of health care in
This has long
stopped being about a single issue that politicians bring up during
an election year. This is now a national crisis.
45 million Americans
are uninsured - over 5 million more in the last four years. This
isn't just a moral shame, it's an economic disaster that's catching
Americans in a vicious cycle. Because the uninsured can't afford
health care, they put off seeing a doctor or end up in the ER when
they get sick. Then their care is more expensive, and so premiums
for all Americans go up - to the tune of $922 a family. Because
everyone's premiums go up, more Americans lose their health care.
All the while,
costs just keep climbing and climbing. Family premiums are up by
nearly 65% over the last five years. Deductibles are up 50%. Co-payments
for care and prescriptions are through the roof. From the smallest
mom and pop stores to major corporations like GM, businesses who
can't afford these rising costs cut back on insurance, workers,
or both. States with bigger Medicaid bills and smaller budgets are
being forced to choose whether they want their citizens to be unhealthy
or uneducated. And over half of all family bankruptcies today are
caused by medical bills.
The cost crisis
is affecting your profession too. Whether it's Medicaid reimbursements,
the rising price of medical malpractice insurance, or having HMOs
look over your shoulder, all the hard work and sacrifice you've
put in during medical school isn't as rewarding as it once was.
So now, just like
generations before, you must dare to believe - not only as tomorrow's
physicians, but as tomorrow's parents, workers, business owners,
and citizens. You must choose: Will the groundbreaking miracles
you discover over the next generation reach only the luckiest few?
Or will history look back at this moment as the time when we finally
made care available at a cost that won't bring the world's largest
economy to its knees?
For you guys,
this is about more than just the statistics and the numbers. Part
of the philosophy of the Pritzker School of Medicine has always
been the recognition that "medicine does not exist in a social
vacuum." Living here over the last four years, you've seen
this. Surrounding us right now on the south side of Chicago are
poor kids sitting in those ERs who could never afford a physical.
Children suffering from adult diabetes because parents can't afford
to provide the proper nutrition. Worried mothers thumbing through
checkbooks, not knowing if they can pay for this month's medicine.
There isn't one
person sitting here today who wants to turn a sick patient away
because they can't pay. Not one person who wants the cure they discover
denied to those whose lives depend on it. Each of you has dedicated
yourselves to this calling because where there is a sick person,
you want to heal them. Where there is a life in jeopardy, you want
to save it.
And so today,
when you leave here, it will not only be with great knowledge, but
with even greater responsibility. Because if we do nothing about
the rising cost of health care, experts believe that in ten years,
the number of uninsured will grow to 54 million. And if we do nothing
to expand access to the uninsured, costs will keep rising.
But while this
is a national crisis, it still isn't part of the national conversation.
It's an issue where we haven't seen any leadership over the last
four years; an issue that Washington continues to duck. We just
spent three entire weeks arguing over the filibuster, but I can
count on one hand the number of times we've talked about health
care since I was sworn in last January. Yet, when I come back here
and talk to families in Illinois, that's all they tell me about.
This isn't just
limited to one party either. In part, the fear of reform stems from
the experience President Clinton had in the early '90s when he recognized
the emerging health care crisis and sought a comprehensive answer.
For that, he deserves great credit.
But the resulting
political firestorm, fanned by the insurance lobby and other powerful
interests who had a stake in maintaining the status quo, badly singed
the Clinton Administration.
Since then, health
care continues to be fodder for candidates, but quickly recedes
into the background when elections come and go.
And with each
passing year, the problem grows and the solutions become more difficult.
We cannot turn
our heads any longer.
it is, fixing the health care system is not an impossible problem
to solve. I'm not saying it will be easy, or that all the solutions
are right in front of us. We may not be able to build consensus
on every detail right away, but where we do agree, we should act
now to bring down skyrocketing costs.
One place to start
is by bringing the health care system into the 21st century. In
our lifetimes, we've seen some of the greatest advances in the history
of technology and the sharing of information. Yet, you're about
to enter a profession where too much care is still provided with
a pen and paper. Where too much information about patients isn't
shared between doctors or readily available to them in the first
place. And where we still don't have the information to know what
care has worked most effectively and efficiently to make patients
For too many Americans,
the time lost as a result of archaic record-keeping has been the
margin between life and death.
21st century technology is not just about reducing errors and improving
the quality of medical care. It's also about cost.
We spend nearly
one and a half trillion dollars a year on health care in America.
But a quarter of that money - one out of every four dollars - is
spent on non-medical costs; most of it bills and paperwork. Nearly
every other industry in the world has saved billions on these administrative
costs by doing it all online. Every transaction you make at a bank
now costs them less than a penny. Even at the Veterans Administration,
where it used to cost nine dollars to pull up your medical record,
new technology means you can call up the same record on the internet
Yet, because we
haven't updated technology in the rest of the health care industry,
a single transaction still costs up to twenty-five dollars - not
one dime of which goes toward improving the quality of our health
care. Doctors are forced to fumble through paperwork and don't have
all of the information about each patient at the click of a mouse.
Mistakes are easily made and today, patients are given the right
kind of care only half of the time. In fact, a recent study showed
that medical error alone kills up to 98,000 people a year - that's
more than die from AIDS each year. This is due not only to outdated
medical technology, but the fact that we don't have a health care
system that measures the quality of care patients are provided -
that tells us what works, what doesn't, and where mistakes were
But by bringing
our health care system on-line, we could start improving the quality
of care and cutting the cost of it. We could save thousands of lives
and save families billions of dollars. Just imagine if every doctor
and nurse could sit by a patient's bedside with a laptop and pull
up their entire medical history - information from every past doctor
they've seen - with the click of a mouse. If every patient had an
electronic bracelet that you could scan to find out the exact type
and amount of medication they needed so there were no mistakes made.
If you could go on-line and monitor a patient's breathing and heart
rate while they were home to track their recovery.
We know all of
this possible - so what are we waiting for? It's time for this country
to start taking on the big challenges and asking the big questions
again. Why couldn't we help every health care provider who does
business with the federal government that they need to convert their
entire system to electronic transactions? Why couldn't we help connect
our hospitals so they could share technology and information about
what works and what doesn't? This way we could start creating a
virtual system of health care in America where knowledge about each
individual's health needs and health history is readily available
to every single person who provides them care.
And while we're
at it, why couldn't we start rewarding the quality of care and the
effort to prevent disease instead of only rewarding treatment itself?
This way there would be actual incentives to provide good care and
it would cut down on wasteful spending on the wrong kind of care.
As tomorrow's doctors, you can help here too by making sure that
all the drugs you prescribe aren't just the latest pharmaceutical
fad, but the cheapest and most effective medicine for your patients.
So why couldn't
we do all of this? The answer is, we can. We can bring down the
cost of health care in America and insure every American, and your
generation can lead the way.
Of course, no
one's forcing you to meet these challenges. Each of you has been
blessed with extraordinary gifts and talent. And so if you want,
you can leave here and focus on your own medical career and your
own success, not giving another thought to the plight of the growing
millions who can't afford the care you will provide. After all,
there is no community service requirement in the real world; and
no one's forcing you to care.
But I hope that
you do. Not because you have a debt to all of those who helped you
get to where you are, although you do have that debt. Not because
you have an obligation to those are less fortunate, although you
do have that obligation. You need to take on the challenges that
your country is facing because you have an obligation to yourself.
Because our individual salvation depends on collective salvation.
Because it's only when you hitch your wagon to something larger
than yourself that you will realize your true potential.
Looking out at
this class of 2005, I think my hope is well-placed. With the field
you have chosen, you've already shown how much you care about the
lives of others; how strongly you have heard the calling to be healers
in this world. Today, I ask you to remember that call always, and
to remember how it could include more than the patient sitting in
your office. It could also include the patients who can't afford
to get there, the ones who aren't being provided the best care,
and the general health of all Americans.
When you think
about these challenges, I also ask you to remember that in this
country, our history of overcoming the seemingly impossible always
comes about because individuals who care really can make a difference.
America is great because Americans are good.
And as you go
forth from here in your own life, you can keep this history alive
if you only find the courage to try. Good luck with this journey,
and congratulations on all of your achievements. Thank you.