Statement on Signing the Healthcare Research and Quality Act of 1999

Today I am pleased to sign S. 580, the "Healthcare Research and Quality Act of 1999," which authorizes appropriations for the Agency for Health Care Policy and Research (and renames it the "Agency for Healthcare Research and Quality") and authorizes a new grant program to support children's hospitals with graduate medical education programs.

This legislation combines two important health care priorities of my Administration: first, ensuring that our Nation's children, especially those who suffer from complex or unusual diseases, continue to receive the highest quality care that our health care system can provide; and second, developing the scientific evidence that we need to improve the quality and safety of our health care system.

The Act takes an important first step to ensure the delivery of high quality health care for America's children by investing Federal funds in graduate medical education at freestanding children's hospitals. This long overdue initiative was included in my Administration's FY 2000 budget and was strongly advocated by the First Lady. Her leadership in this area is longstanding, and it is with great pride that I sign this groundbreaking legislation.

In an increasingly competitive health care market dominated by managed care, teaching hospitals struggle to cover the significant costs associated with training and research as private reimbursements decline. Millions of American children each year are treated by physicians affiliated with or trained in one of 60 independent children's hospitals across the country. While other teaching hospitals receive support for these costs through Medicare, children's hospitals receive virtually no Federal funds, even though they train nearly 30 percent of the Nation's pediatricians and nearly 50 percent of all pediatric specialists. This inequity exacerbates an already difficult financial situation for children's hospitals, which often serve the poorest, sickest, and most vulnerable children. In many cases, they provide the regional safety net for children, regardless of medical or economic need, and they are the major centers of research on children's health problems.

This Act creates a new grant program to provide much-needed support for the training of these critical health providers. I am pleased that the Consolidated Appropriations Act that I recently approved included my full $40 million request to get this program started.

The Act also authorizes appropriations through 2005 for the Agency for Healthcare Research and Quality (AHRQ) and represents the culmination of a genuine bipartisan effort to make better information available to health care decisionmakers to use to improve health care. AHRQ will help close the numerous data gaps throughout the health care delivery system. It will also serve as a bridge between the best science in the world with the best health care in the world.

The AHRQ will build on the foundation of strong scientific approaches to health services research established by the Agency for Health Care Policy and Research. This legislation was passed on an overwhelmingly bipartisan basis by the Congress, which is a tribute to the many members of both chambers, from both sides of the aisle. I particularly want to single out Senators Frist and Kennedy and Congressmen Bliley, Dingell, Bilirakis, and Brown, who have championed quality information for quality health care, for their commitment to this important reauthorization.

The AHRQ is now designated the lead Federal agency in health care quality to help meet the needs of decisionmakers and work in partnership with the private sector. AHRQ will develop a national report on quality, stimulate evidence-based medicine, sponsor primary care research, help eliminate medical errors, and apply the power of information systems and technology in a manner that assures adequate patient privacy protections. AHRQ will also be a principal source of research that will guide health plans, purchasers, health care systems, clinicians, and policymakers as they seek to improve access to health care and make it affordable for all Americans.

I am delighted to sign S. 580, which will support research needed to improve health care and help train new pediatricians and pediatric sub-specialists who will be able to put this knowledge to work for America's children.

WILLIAM J. CLINTON

The White House, December 6, 1999.