A REALLY TERRIFIC SERMON BY C, EVERETT KOOP, MD DEPUTY ASSISTANT SECRETARY FOR HEALTH AIiD SURGEON GENERAL US, DEPARTMENT OF HEALTH AND HlMAM SERVICES -l- (GREETINGS TO HOSTS, GUESTS, ETC,) I WANT YOU TO KNOkJI HOW PLEASED I AM TO BE HERE THIS EVENING, IN THE WARMTH OF YOUR FRIENDSHIP, WHICH HAS BEEN -2 AND I'M SURE k/ILL CONTINUE TO BE -- A SOURCE OF GREAT COMFORT TO ME AND MY FAMILY IN THE MONTHS AND YEARS AHEAD, IT'S NOT SECRET THAT I SPENgA VERY DIFFICULT FIRST YEAR IN WASHINGTON, BUT I HAD SUPPORT DURING THOSE HARD WEEKS AI'JD MONTHS THE PRESIDENT AND HIS STAFF STOOD BY ME, SECRETARY SCHWEIKER STOOD BY ME, ASSISTANT SECRETARY FOR HEALTH, DR. ED BRANDT, ALSO STOOD BY ME, AND I SOMETIMES blONDERED WHY, IT WOULD HAVE BEEN SO MUCH EASIER FOR ANY OF THEM -- AT AtJY ii TIME -- TO HAVE SAID THE OBVIOUS THING, THE EASY THING: "WE TRIED, CHICK, BUT IT'S NOT GOIfJG TC \!ORK, THAPJKS VERY MUCH,,,, AND THE NEXT TIME HE'RE IN PHILADELPHIA, WE'LL CERTAINLY GIVE YOU A CALL," BUT THEY DIDN'T SAY THAT, AND SENATOR ORRIN HATCH, HHO HEADS ONE OF THE MOST IMPORTAfJT COMf4ITTEES IiJ THE CONGRESS, AEJD THE MAN WHO HAD TO SHEPHERD r?/lY 1JOFlITJATIOFJ THROUGH THE BRAMBLES AND POTHOLES OF THE LEGISL'iTIVE PROCESS, SEIJATOR HATCH b/AS A' SOURCE OF GREAT STRENGTH AND COMFORT, ALSO, -2- BUT THOSE ARE JUST THE PEOPLE HERE IN MY NEW "HOME TOWN," LET ME SAY THAT I WOULD HAVE MADE THE CHOICE MANY MONTHS AGO, TO RE-PACK MY SUITCASES AND RETURPJ lJITH MY WIFE, BETTY, TO OUR HOME IN PHILADELPHIA, HAD IT NOT BEEtJ FOR THOUSANDS UPON THOUSANDS OF PEOPLE, LIKE THE GOOD PEOPLE IN THIS AUDIEiJCE THIS EVENING amPEOPLE IN EVERY \rJALK OF LIFEu,aPE@PLE IN ALL THE STATES 11, #PEOPLE OF DIFFERENT RELIGIOUS BACKGROUNDS,, , ,BUT DECENT PEOPLE, STRONG PEOPLE, THE KIND OF PEOPLE YOU SEND YOUR MESSAGES TO EVERY WEEK,,,, THE PEOPLE kfHOF1 I WAS ASKED TO SERVE,, t, THEY WROTE ME AND PHONED ME AND DROPPED BY TO VISIT MEa a a m AND THEY GAVE !lE A TREMEIJDOUS FEELING OF COMMITMENT TO SERVE, I HEARD THOSE tIESSAGES OF GOOD WILL AND I READ THE LETTERS AND THE POST-CARDS AND I KfJEIII THAT I WOULD BE HERE FGR THE LONG HAUL, YOU`AND I HAVE TALKED ON MATTERS OF THE SPIRIT BEFORE, I HAD THE PLEASURE OF ADDRESSING YOUR 1980 CONVENTION IN MIIJIJEAPOLIS, WE KNON EACH OTHER AND, I WOULD LIKE TO BELIEVE, NE HAVE BEEN GOOD FRIENDS, AND I WANT YOU TO KNOW HOW MUCH I NEEDED YOUR FRIENDSHIP DURING THE PAST YEAR AIJD -- HAVING RECEIVED IT -- HOW MUCH I HAVE VALUED IT AND WILL CONTINUE TO VALUE IT, -3- SO I PRESENT MYSELF BEFORE YOU THIS EVENING AS A FRIEND, AS A SUPPORTER OF YOUR Ok/N GOOD WORKS, AND AS THE SURGEON GENERAL OF THE UNITED STATES PUBLIC HEALTH SERVICE, AND, AS FRIENDS AND CONCERNED CITIZENS OF THIS GREAT COUNTRY, I HOPE WE CAN COUNSEL TOGETHER THIS EVENING ON A VERY IMPORTAIJT OPPORTUH ITY THAT IS OURS, THESE ARE VERY DIFFICULT TIMES,,,,TIt:ES OF TURMOIL AND FRUSTRATION a, a #TIMES OF QUESTIOMIfJG AND THE R4ISING OF DOUBTS ABOUT ONE'S OkiN WORTH, ABOUT OUR SOCIETY'S WORTH, THE PRESIDENT CAME INTO OFFICE LAST YEAR AND ASKED EVERY AMERICAN TO ASK THOSE TOUGH QUESTIONS ABOUT LIFE ItJ AMERICA: * HOW MUCH OF WHAT i/E ARE SHOULD WE Oi/E TO OURSELVES AND HOW MUCH SHOULD WE OWE TO THE GOVERNMENT? + HOW MUCH OF WHAT WE HAVE IS A RESULT OF THE SOARING OF OUR SPIRIT -- OR THE RESULT OF A DENIGRATION OF THE SPIRIT? * HOW MUCH OF h'HAT 1JE DO IS DESIGNED TO TAKE CARE OF ONLY OURSELVES AND OUR FATlILIES -- OR DO WE STILL ACT IN THE NAME OF MANKIND, a,, DO WE KNOW OF THE HIGHER SERVICE? -4- LET ME SAY THAT NOBODY LIKES TO ASK THOSE KINDS OF QUESTIONS -- BUT THIS IS PROBABLY THE ONLY COUNTRY LEFT ON EARTH WHERE THEY ARE ASKED NEVERTHELESS, I KNOW HOW MANY OF YOU FEEL ABOUT THE MORAL AJJD ETHICAL FIBER OF THIS COUNTRY, I KNOW YOUR FEELINGS HAVE MUCH EVIDENCE TO BACK THEM UP, BUT I AM A HOPEFUL MAN, AND WE ARE A HOPEFUL ADMINISTRATION, AND THE RAISING OF HARD, SOUL-SEARCHIIJG QUESTIOtJS IS THE FIRST STEP TOWARD REALIZING YOUR HIGHEST HOPES, AtJD \/EVE GOT TO DO THAT, AHD LET ME TELL YOU, THE QUESTIOFJS ARE VERY HARD, IMDEED, IN ALMOST EVERY AREA OF HUMAN ENDEAVOR IN WHICH GOVERNMENT HAS HAD SOME INTEREST, IN THE AREA OF HUMAN HEALTH -- PHYSICAL AIJD MENTAL WELL-BEING -- C~JE HAVE HAD TO sTAtiD BACK ,mD iooK'i0t~~ At41) HARD AT Cl/HAT SOCIETY HAD ASSUtlED AS SOCIETY'S JOB AND AT 1JHAT EACH INDIVIDUAL MUST ASSUME AS 'HIS OR HER OWN RESPONSIBILTY, I I CAN TELL YOU, THAT'S ALMOST REVOLUTIONARY, FOR'MAIIY, MANY YEARS WE HAVE TRAHSLATED THIS COUNTRY'S ESSENTIAL COMPASSION AND DECENCY INTO DOLLARS AND PROGRAMS THAT SOMEBODY ELSE -- SOME OTHER GROUP OF PEOPLE, SOME ORGANIZATION OR OTHER -- WOULD SPEiJD AND ORGANIZE, ItJ THE AREA OF Hut-IAN HEALTH, THIS BASIC, DECENT INCLINATION HAS COME TO COST OVER $70 BILLION OF FEDERAL MONEY, OUR FRIENDS IN STATE~GOVERNMEIJT HAVE SPENT OVER $35 -5- MILLIOld A YEAR, IM OTHER WORDS, OVER $100 J'lILLION A YEAR HAS BEEN SPENT BY FEDERAL AND STATE GOVERtdtlEtdTS ON THE PHYSICAL AND MEI'dTAL HEALTH OF AMERICANS, AfJD THE QUESTION IS, "HOW MUCH OF THIS IS APPROPRIATE?,,,, HOW MUCH OF THIS OUGHT TO HAVE BEEN TAKE/d CARE OF BY THE PEOPLE THEMSELVES, OR BY THE !O&GOVERNMENT SECTOR, THE PRIVATE SECTOR?" THIS ISSUE, b!HICH WAS RAISED BY THE PRESIDENT DURING HIS CAMPA I GEJ FOR OFF ICE A[dD HAS BEEN RETURNED TO AGA IM AND AGAIN, IS IdOT FUlJDAMEtdTALLY A MOfdEY ISSUE. I DONfT WANT TO GIVE THAT IMPRESSIOtJ, YES, THE COSTS ARE HIGH -- BUT THE FUNDAMENTAL ISSUE k/E ARE GRAPPLItdG WITH IS FIRST PERCEIVED Iid DOLLARS, BUT, THEN IS CORRECTLY PERCEIVED It'd TERPlS OF AREAS OF RESPOtJSIBILITY, AidD THOSE ARE THE TERMS TO WHICH I WAidT TO DIRECT MY 'REMARKS -- AND YOUR ATTENTION -- FOR THE NEXT FEW MCtlEtdTSa IJKIDEtdTALLY, I KfdOW THAT, TO A CERTAIPJ EXTENT, 17'4 BRItdGING COALS TO WEWCASTLE, YOU KNOW A GRtiT DEAL ABOUT PERSOtdAL RESPOKIBILTY, THAT IS A DOtlINAPdT THEME It4 MUCH OF YOUR PROGRAMMING, REGARDLESS OF THE PARTICULAR RELIGIOUS TRADITIOE OR DEt~OMItdATION YOU SERVE, AIdD IT HAS BEEId A PART OF TIY LIFE FOR MANY YEARS AS WELL, -6- MAlJY OF YOU KJdOW THAT, FOR SOME 20 YEARS, I WAS PRESIDENT CF THE EVAtdGELICAL FOUNDATION, Id@! KIJOWM AS THE EVAiJGELICAL MINISTRIES, IN THAT POSITION, AtdD THROUGH 'KJdOWING THE GOOD WORK OF ORGAMIZATIONS SUCH AS THIS, DEVOTED TO RELIGIOUS BROADCASTING, I LEARldED A GREAT DEAL ABOUT THE EXTENT TO bJHICH INDIVIDUALS, FAMILIES, AND COMtlUtdITIES COULD ASSUME PRItlARY RESPONSIBILITIES FOR THEIR OWJ WELFARE'AND THEIR O';iN DESTItdIES, PEOPLE LIKE DONALD @33R@c=~y BARIJHOUSE AidD BEN HAYDEN, REGINALD THOMAS AND JAMES MOtdTGOMERY ' BOiCE -- THESE MEN ItdFLUEtdCED MY THIMKING AtJD MY.ACTIOI\JS DURItdG THE YEARS OF INVOLVEMENT IN THE FOUtdDATIOMt AND THEY BROUGHT TO MY ATTEtdTION COUtdTLESS EXAMPLES OF PERSOtdAL STRENGTH OR COMtWI\IIN SUPPORT IN TIME OF NEED, SO YOU KtdO\! AWD I KtdOk/ THAT THE AMERICAN PEOPLE- HAVE A STRONG AtdD ItdDPEldDEtdT BASE UPOfd WHICH TO BUILD, I TH ItdK k/E BOTH b1OULD AGREE THAT THE ROLE OF GOVERNMEtdT IN THE PAST FEW YEARS -- WHILE A RESPONSE TO GENUINE NEEDS IN THE HEALTH AREA -- MAY HAVE GROWfd FAR BEYOtdD THE BOUNDS OF WHAT A HEALTHY DEMOCRATIC SOCIETY CAtd SUPPORT FOR THE LOtdG TERM IS THERE AN ALTERNATIVE? IS THERE AHOTHER WAY TO LOOK AT PROBLEMS AND POSSIBLE SOLUTIONS? I BELIEVE THERE IS, I BELIEVE, AS THE PRESIDENT BELIEVES, THAT k/E HAVE TO RETURN TO A FAMILIAR, -7- TIME-TESTED, AMERICAId WAY OF GETTING AT MAidY OF OUR PROBLEMS I!J HEALTH AJdD SOCIAL SERVICES, AT THE PRESIDEJdT'S FIRST MEETING WITH HIS TASK FORCE ON PRIVATE SECTOR INITIATIVES, HE SAID WE NEED TO "REDISCOVER AMERICA, 8, a THE APIER ICA BEYOFJD THE POTOf4AC RIVER, THE AMERICA WHOSE INITIATIVE, INGE!dUITY, AND INDUSTRY MADE OUR COUMTRY THE EiJVY OF THE \JORLD, THE AMERICA WHOSE RICH TRADITIOId OF GE!iEROSITY BEGAN WITH SIMPLE ACTS OF NEIGHBOR CARING FOR 1JEIGHBORa" I LIKE HIS USE OF THE PHRASE "REDISCOVER AMERICA,m REDISCOVER,, t 1" IN OTHER WORDS,IT'S HERE, ALL AROUIJD US, THE SOLUTION WE'RE LOOKI;dG FOR, THE AtdSWER TO WEAFdIfdG THE .: COUtJTRY AWAY FROM THE SUPPORT OF THE PUBLIC TREASURY, GETTIfdG THE COUNTRY BACK TO A HIGHER DEGREE OF SELF-SUFFICIEtdCY AFdD SELF-RELIAJdCE, IT'S THERE, IT'S ALWAYS BEEN THERE. WE NEED TO FIFdD IT AGAIld, IT WAS DISCOVERED IN THIS RICH AIJD BEAUTIFUL COUNTRY THREE CENTURIES AGO, NOW WE NEED TO REDISCOVER THAT SPIRIT OF SELF-HELP, OF cotltwtdITY, OF FAMILY STRE~~GTH, THAT SPIRIT OF IJdDEPEIdDEfdCE THAT IS FNdDAtlEtdTAL TO THE HUMAN SPIRIT IN AMERICA, THE TERM MOST COMMONLY USED TO ElIBRACE THIS COldCEPT IS "VOLUbJTAR 191," I DON'T LIKE MOST "ISMS," BUT I LIKE THAT ONE, -8- 1 GREW UP WITH THE SPIRIT OF VOLUidTARISM PREACHED TO ME BY MY OMiJ FAMILY Ai\lD BY MY CLERGY, AtJD I'M tdOT THE EXCEPTION, I THIJdK MY EXPERIEtJCE IS THE RULE Itd THIS COUtdTRYa THE PRESIDEHT HAS STRUCK A DEEP AND RESObJAtdT CHORD Itd THE AMERICAN COtdSCIEtdCE BY HIS EMPHASIS OtJ VOLUtdTARISM, IT RESOMATES Itd MY OWtJ COtdSCIENCE, IN THE CONSCIEidCE OF MY CHILDREH, IJ'J MY COLLEAGUES BACK IH THE PHILADELPHIA MEDICAL COMMUtdIN AS WELL AS MY tdEW- FOUtJD COLLEAGUES HERE It1 WASHINGTOM, I THItdK THE PRESIDENT'S CALL FOR GREATER EFFORTS BY THE VOLUtdTARY SECTOR OF AMERICAld SOCIETY IS IM THE MAItJSTREAM OF AMERICAN TRADITIOtJ, GOItdG BACK TO THE PREREVOLUTIOCJARY DAYS OF THE FOUtdDItdG COLOtdIES AT-ID COJJTItdUItdG RIGHT UP TO TODAY, IT IS td0T Atd OLD IDEA -- IT IS A WEW AND RE-NEWED IDEA THAT OUR SOCIETY JdOURISHES DOWN THROUGH THE &JERATIONS: * AMERICAtJS CONTRIBUTE SOME $47 BILLIOtt TO CHARITABLE \ AJJD RELIGIOUS ORGAtdIZATIOEJS EVERY YEAR, * OUR CITIZENS PERFORM WORK OF A CHARITABLE MATURE THAT WOULD BE WORTH $100 BILLIOIJ, IF YOU HAD TO HIRE PEOPLE TO DO IT, + Itd THE HEALTH FIELD, 19 VOLUtJTARY ORGANIZATIOtdS RECEIVED A HALF-BILLION DOLLARS IJd COtdTRIBUTIONS Itd 1910 -- -9- GROUPS LIKE THE AMERICAtd CANCER SOCIETY AND THE EPILEPSY FOUNDATIOtd, THE EASTER SEAL SOCIETY, THE MARCH OF DItlES-BIRTH DEFECTS FOUtdDATIOtd, AldD THE COMMITTEE TO COMBAT HUkJTItdGTOH'S DISEASE, AS GOOD AS THAT IS, MY MESSAGE THIS EVEN IHG- AtdD FOR MAMY MOtdTHS TO COrllE IS -- WE'VE GOT TO DO BETTER, Itd ALL HUMILITY I BRII-JG THAT MESSAGE TO YOU IN THE HOPE THAT YOU WILL SEtdD THAT !lESSAGE OUT TO THE PEOPLE OF THIS COUtJTRY, THE GOOD PEOPLE \1JHO LISTEN TO AtJD \JATCH YOUR PROGRAMMING, THERE IS tlUCH G?JORK TO BE DOfJE Itd HEALTH CARE AND SOCIAL SERVICE Ifd THIS COUtdTRY, GOVERNPlENT ISN'T GOItJG TO DO IT ALL AtdYMORE, IT DID FOR A b/H I LE, BUT THAT AGE HAS PASSED AND \ilE NEiD TO SHARE THAT UfdDERSTANDItdG WITH ALL OUR CITIZEk 'I DEEPLY BELIEVE THEY WANT TO KNOW, THEY WANT TO LEARN HOW THEY CAFJ COWTRIBUTE, THEY 1JAtdT TO HAVE THAT SHItJIbJG FRAGMEtJT OF THE HERITAGE OF AMERICA PUT BACK Itd PLACE IH THE GREAT ARCH OF DEPIOCRACY b/E BUILT Otd THIS CONTIkdEMT, PARTICIPATIOtd IN THE GOOD WORK OF AMERICA IS PARTICIPATIOH Itd THE RICH HISTORY THAT HAS BEEid AMERICA, THAT'S A BEAUTIFUL, AS WELL AS A TIMELY, MESSAGE TO SElJD THROUGHOUT OUR LAldDn SOME PEOPLE WOULD SAY THAT THIS EMPHASIS OtJ VOLUHTARISM IS REALLY A BUDGET ISSUE, I GAVE YOU SOME tdUMBERS EARLIER, BUT - 10 - THIS IS MOT A MOI;IEY ISSUE, THIS IS A CARING ISSUE, THIS IS A COMPASSION ISSUE, THIS IS Atd ISSUE THAT ILLUMIJdATES THE ESSEI'JTIAL DECENCY AMD HUMAPdITY OF OUR SOCIETY, NOT LOI\JG AGO, THE COPJGRESS HAD TO PASS A LA! THAT ALLOWED THIS COWdTRY TO HAVE A DEBT IN EXCESS OF ONE TRILLIOtd DOLLARS, THAT'S A LOT OF MOikY, EVEN TO PEOPLE WHO CAlJ CONCEIVE OF SUCH A tJUMBER, I CAWT, AtiD SO I'VE BEEN TOLD OPJ GOOD AUTHORITY THAT Oi!E TRILLIOtd DOLLARS IS A LOT OF NOfJEY, BUT IT IS A FEW DOLLARS SHORT OF THE VALUE OF A VISIT BY SOflE YOUNG PEOPLE EACH WEEK TO THE APARTI\"iEFdT OF A1d ELDERLY PERSON SHUT IN BY ILLfdESS, ONE TRILLION DOLLARS IS IdOT QUITE THE PRICE YOU OUGHT TO PAY FOR AN OLDER MAN TO SPEt'J~=A'FEW HOURS EACH WEEK WITH A YOUMG BOY WHO MAY BE FATHERLESS, OUT OF SCHOOL, AfdD OUT OF k!ORK, A TRILLIOM DOLLARS IS LESS THAN HALF THE VALUE OF A NEIGHBOR KEEPIIJG TABS OJJ HOW WELL A YOUNG MOMAFJ IS DOIIJG DURItdG HER PREGJJAIJCY, OFFERII-dG TO DO CHORES FOR A PERSON RECOVERItdG FRO!1 A/J AUTO ACCIDEtJT, PREPARING MEALS FOR A PERSOIJ AT HOI"-IE AtJD DISABLED- BY A DETERIORATIIJG DISEASE, THESE ARE THE GOOD WORKS OF THE SPIRIT, THEY ARE PRICELESS, -ll- THERE IS NO COUNTY, STATE, OR FEDERAL BUDGET THAT k/ILL EVER BE BIG ENOUGH TO BUY THE ACTS OF GOODNESS THAT AMERICANS VOLUNTARILY PERFORM, BUT b/E HAVE GOtJE THROUGH A PERIOD RECENTLY WHEtd WE TRIED VERY HARD TO BUILD THOSE KItJDS OF BUDGETS, AtJD WE DISCOVERED -- I HOPE tdOT TOO LATE -- THAT IT COULD tdOT BE DONE, SO WE HAVE RETURtdED TO "REDISCOVER AMERICA", ,a ,TO REWEW OUR SOCIETY,,,, TO REVITALIZE OUR iiMMUtJITIES o ,a ,TO REAWAKEN%iR BELIEF IN OURSELVES , , , ITO REKIfdDLE THE LOVE OFiiE HUMAtJ BEIFJG FOR ANOTHER --- WITHOUT AFdY ?iICE-TAG ON EITHER ONE, (TO BE CONTINUED)