Hon. Louis Sullivan

Former U.S. Secretary of Health & Human Services and President Emeritus of Morehouse School of Medicine, Hon. Louis Sullivan, MD, will address the National Grange delegates on Wednesday November 14th at 11:00am at the National Grange’s 141st National Convention in Reno, NV regarding challenges facing the nation’s health care system. As one of the nation’s leading public health policy experts and a medical practitioner for nearly 50 years, Dr. Sullivan commands wide respect on a broad array of health care issues.

In the U.S. health care system today, there is a growing trend by public and commercial payers to shift the rationale for medical treatment decisions away from patient outcomes toward treatment costs. No segment of our society sees this trend more clearly than rural and farming communities. Unchecked, and unchallenged by thoughtful debate, this practice denies patient access to services and innovative medicines they need to lead productive lives.

Examples of this approach by medical payers to justify shifting costs in the U.S. health system include:

• Mandatory therapeutic substitution of one treatment for another, even when it is against the best judgment of the physician and/or patient.
• Payer directed medical decisions that presumes that there is an optimal one-size-fits-all approach to all treatment and medical decisions that inevitably worsens patient outcomes, stifles competition, and raises health care costs.
• Taking treatment decisions away from doctors and placing them in the hands of public servants and insurance companies.
• Skewing health care delivery in such a way that disproportionately harms already vulnerable populations, such as individuals living in rural communities, who are already currently receiving sub-optimal care.

In his address to the delegates and members attending the 141st Annual National Grange Convention, Dr. Sullivan will assess the state of health services and future health care prospects for millions of citizens living in Rural America, as part of his Symphony of Health Care national speaking tour. Dr. Sullivan believes that the best, most appropriate way for patients to receive care is through a “symphony of health care delivery,” with the doctor acting as the conductor. Elements of health care delivery must be measured and thoughtfully presented. Each aspect of the “symphony” must be transparent and fully appreciated. Too much emphasis on one particular “instrument,” or service area, such as cost control alone, drowns out other important elements. Deviating from this “symphony” approach, Dr. Sullivan believes, leads to discordant, “off key” health care results for patients and their families.

The National Grange recently contacted the Congressional Rural Caucus and strongly urged them to support a permanent extension of the Internet Tax Freedom Act before it expires on November 1, 2007 for the benefit of rural and farming communities across the United States. Congress’s failure to extend this moratorium could subject rural consumers to burdensome new levies on their current Internet access, create new barriers to expansion of high speed Internet services and/or limit future high speed Internet technology choices to millions of farmers and rural consumers who currently lack access to these technologies.

Since 1998, Congress has wisely determined that Internet users should not be subject to state or local taxes, including discriminatory multiple tax burdens on Internet commerce levied by multiple jurisdictions. The current prohibition protects Internet consumers regardless of the technology they use to access the Internet or their geographic location. Tax free access to the Internet reduces the burden of isolation in farming and rural communities by providing family farmers and rural residents with the same access to information, technology, education, health care, public safety and commercial opportunities as residents of urban and suburban communities. It increases the productivity of our nation’s family farms and rural small businesses by giving those farms and businesses access to a global marketplace of information and services. It strengthens civic participation in our society by giving rural residents an equal voice with other Americans in their expression of free speech, in their communications with each other and in their active participation in the political process.

Congress has twice before prudently extended the prohibition on Internet taxation in 2001 and 2004. The National Grange supports a permanent extension of the Act for the benefit of our nation’s family farmers and rural residents.

The National Grange recently provided comments to the World Health Organization Intergovernmental Working Group on Public Health, Innovation and Intellectual Property (IGWG) on the issue of public health, innovation and intellectual property protection as those issues affect rural communities in the developed and developing world. The National Grange expressed deep concerns about a draft global strategy and plan of action that has been recently presented by IGWG to the public. We believe the proposed document will be highly detrimental to the public health interests of billions of the world’s rural citizens in both developed and developing nations.

Access to existing medicines as well as access to future medicines are both equally important goals. The IGWG draft, however, presumes that patent protection and other intellectual property protections are the major inhibitors of access to life saving medications in poorer, rural countries.

There is no evidence that this presumption is supported by fact. The National Grange does not believe that existing patent regimes are a significant barrier to patients’ accessing essential medicines. Rather, it is the overwhelming poverty of the target patients, geographic isolation of patients living in remote farming and rural communities, and other issues that are the biggest barriers to access to life saving medicines for rural people around the world.

To address the major barriers to access to life saving medicines in remote and rural communities across the planet, the National Grange fully supports the considerable progress that has been made in recent years by governments, industry, charitable foundations, and nongovernmental organizations around the world in funding initiatives to develop new products to fight diseases affecting rural communities in developed and developing countries, and to increase access to existing pharmaceutical products. These efforts deserve continued and expanded support by the World Health Organization.

The National Grange is further concerned that a weakening of patent protections on intellectual property would profoundly affect the health of rural patients fighting the spread infectious diseases in both developing and developed countries. A weakening of patent protection on intellectual property would have the potential for significantly decreasing the pipeline for essential drugs needed for infectious diseases, such as HIV/AIDS, malaria, and tuberculosis which are disproportionately found in rural areas.

The National Grange concluded that future innovative pharmaceutical medical technologies, generated under the cooperative effort of private industry, academia and government supported research and working in the free market environment under the protection of intellectual property rights regimes that provide for a return on investment of time, labor, research and education are critically necessary if rural areas in the developed and developing world will be prosperous, healthy and vibrant communities in the 21st Century.

The National Grange recently wrote to Senator Max Baucus, Chairman of the Senate Finance Committee, in support of H.R. 2881, the House Transportation & Infrastructure FAA reauthorization bill. This bill will provide the funds needed for modernization of our air traffic control system while protecting America’s farm and rural communities that depend upon small aircraft and general aviation without resorting to new fees or taxes.

The Senate Commerce Committee narrowly passed a different version of FAA reauthorization –Senate Bill 1300. This bill contains a radical and unnecessary overhaul of the current simple, efficient excise tax system in favor of new unnecessary taxes and fees that would greatly harm farmers and small towns that rely on small aircraft. S.1300’s proposal to finance modernization of our air traffic control system by replacing the proven and reliable fuel tax is a classic case of a cure proving worse than the disease.

The National Grange asked Senator Baucus to oppose the creation of any new fees or taxes on aviation and embrace the common-sense approach provided in H.R. 2881 that is supported by the findings of these objective sources.

National Grange President, Bill Steel, recently submitted testimony on the Universal Service Fund (USF), which has brought telecommunications services to millions of rural residents, farms, ranches and businesses over the past decade. In the testimony, President Steel stated that broadband and advanced telecommunications services are a keystone infrastructure for rural communities in the 21st Century.

The National Grange has always been a vocal proponent of USF from the time of its inception. However, it has become Universal Service Fund programs, must be reformed and updated if they are going to continue the critical mission of providing affordable telephone service to every American as well as meet the needs of the changing telecommunications landscape.

The National Grange urged the Federal Communications Commission (FCC) and Congress to immediately explore the problems with USF and take action to ensure the program remains a source of support for connecting rural America to modern technologies.

The Grange suggested that pilot projects based on a model of wiring only critical facilities are insufficient. Deployment and access to broadband for all Americans, especially rural Americans, must be the overriding policy objective of any pilot programs. Successful pilot programs must show more detailed data about current and actual broadband deployment in rural and underserved communities. Pilot programs should be designed to demonstrate strategies for generating additional demand for broadband services and for aggregating existing potential demand for broadband in underserved rural communities. Finally, pilot programs should demonstrate how to engage third party payers and third party service providers in the discussion of the advantages of rural broadband deployment.

Steel concluded by stating, “The spirit and skills of rural America are as vibrant as ever. The people of rural America deserve the opportunity to thrive along with the entire United States. The Universal Service Fund has played a major role in helping rural America keep pace in the 20th Century. To make USF work in the 21st Century to support the deployment of advanced communications technology, the FCC should work with an entrepreneurial spirit and seek the most nimble and proficient way or ways to encourage broadband deployment.”

National Grange recently joined numerous groups, writing to the Federal Communications Commission (FCC), to express deep concern over what is feared to be a re-regulatory direction being taken at the FCC in the broadband enterprise marketplace, including proposed price controls on the wholesale prices for broadband services that are charged between businesses. Specifically, the Grange and its allies are concerned that the FCC is strongly considering government intervention and prescriptive price control regulation that would push the government to pick winners and losers in the competitive broadband marketplace. This would be an abject policy failure, would reduce broadband deployment in underserved rural and farming communities and would effectively undo the success of the FCC’s previous deregulatory approach to this market over the past ten years in creating a pro-investment environment for the broadband marketplace.

The Coalition told the FCC that it should continue the deregulatory approach for the wholesale broadband marketplace. Major telecommunications companies, like Sprint, do not need the unfair advantage of government price controls to provide cost effective Internet access or cell phone services to their customers. This is especially true when these same companies would flatly reject any similar call for retail price controls on the services they provide to their customers. Instead, the Grange urged the FCC to look comprehensively at the nature of today’s broadband market and consider the growing competition that has come about as a result of the Commission’s pro-investment broadband policies.