Monitor Breakfast with Health and Human Services Secretary Tommy Thompson

Excerpts from a Monitor breakfast on Medicare's long-term challenges.

Before being named Secretary of Health and Human Services by President Bush, Tommy Thompson served 14 years as Wisconsin's Governor. He was the guest at Friday's Monitor breakfast in Washington.

On the need to update medical record keeping:

"Grocery stores are more technologically advanced than hospitals. And that, to me, is uncalled for when you spend $1.4 trillion on the health care delivery system, 14.8 percent of (gross domestic product).

On the need for additional international action to combat HIV/AIDS:

"I would hope the media would do a better job of reporting on [it] because it is badly needed. We have to alert not only Americans but the world that this is growing so exponentially that unless we stand up soon and fight this fight it is going to be a runaway train wreck in India, and in China, and in Russia and it is going to come into America from Central America and the Caribbean where it is also in a very explosive situation."

On the likelihood of a bioterrorism attack on America if the US goes to war with Iraq:

"I think the probabilities of a biological terrorism attack - I don't want to limit it to Iraq because I am not so sure it is going to happen if there is a war with Iraq. Lots of people are, we are not as certain as a lot of the speculators are out there that it will. But there is no question sometime in the future the probabilities of a bioterrorism attack is very good on America. We are able to respond. How well prepared are the medical systems in America? It depends upon location."

On responding to a biological attack:

"We are able to respond very quickly. If a bioterrorism attack would happen in any city, we can move 50 tons of medical supplies and equipment into any city in America within seven hours. We can deploy any one of...8,000 individuals or how many it is going to take in very quick time. ...So even in those areas that the healthcare system may be a little frail or may be a little lax, we would be able to support it very quickly and effectively."

On the outlook for permanently fixing Medicare's long-term funding problems:

"People say, why don't you try to fix it all at once. Well, let's all be honest. You think this Congress would ever be able to do that? They haven't been able to even pass a simple Medicare bill with just the dessert which is prescription drugs which everybody wants. You've got to look at what is doable. ...let's be honest. It is very doubtful anything will pass in a presidential year when you have at last count nine people from the Capitol already running and how many more are going to be."

On options for fixing Medicare's long-term funding problems:

"I can give you some ideas but these are not embraced by the administration. These are not being advanced by me. These are just ideas - means testing, age testing, all of these things you know are considered. Co-pays could be added. Limitations could be placed upon it - limitations on people who make over $500,000 a year (who) may not be able to get the same kind of benefit as a poor federal employee like me. I want to be very crystal clear. These things are not being advanced by this administration."

On problems facing HHS:

"Is there any newspaper or publisher in this room that still has 30 year old software? We run the largest Medicare system with a billion transactions a year and ... some of our billion transactions are used on 30 year old software. And being Irish, I know it is going to break down on my term. I have taken it on myself to change the whole department. I am making it instead of a decentralized confederation, a unified one department and we are bringing all the assets in to one department."

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