Albert Lasker
Clinical Medical Research Award

Special Remarks by Paul Rogers

I'm delighted to be with you today. The Lasker Foundation Medical Research Awards are among the highest of honors bestowed on the men and women in medicine and science, and today's recipients can be assured that they have gained the respect and esteem of their peers and of those of us in public life that are charged with responsibilities in the health field.

The record is clear that no lay person has devoted more of her life, talents, and resources to the health of man than has Mary Lasker. And those of us who know Mary Lasker know that her work is far from finished.

We can all agree that 1971 was cancer's most important year in the history of this country, for it signified a new beginning and a national commitment to conquer cancer.

The debate over the proper structure of the federal cancer research efforts is now behind us.

A new emphasis on targeted research, a new accountability to the Congress and the American public, and a new responsibility to apply findings of research quickly to those in need, is the mandate to the National Cancer Institute in the National Institutes of Health. With this new emphasis on needed target research, the Congress will insist upon the proper balance with basic research. Basic research is a major key in improving health care in America.

The provisions of the National Cancer Act make the intent of Congress clear: Discoveries that scientists make in their laboratories must be converted more quickly into treatment for cancer victims. Dr. Letton's recent statement that the number of cancer patients saved has increased from 33 percent to 60 percent is encouraging. But what is disturbing is his statement, that if our best forms of therapy and early detection were in widespread use, our five-year survival rate no longer would be 50 percent—it would be just under two-thirds. This potential will surely increase dramatically with the certain advent of new discoveries and refinements of traditional therapy and diagnosis. Today's challenge is to ensure that research results such as the findings of these excellent men honored today are brought swiftly from the laboratory to the day-to-day practice of medicine in every community. The gap between discovery and application must be closed. If this gap is not closed, then our legislative efforts will have been useless, our intent perverted, and the increased mission of the National Cancer Institute will have failed.

Eighty percent of all cancer patients are first seen in community hospitals, which receive input from our major research centers haphazardly and with no clear channel of communication. Indeed, a cancer patient can live two blocks from the Sloan-Kettering Institute and be denied the fruits of its research through the lack of dissemination of information on diagnosis and therapy. This is an irresponsible waste of national resources of knowledge and lives—and it must not continue.

I'm happy to report to you that changes are in view. Dr. Rauscher advises me that the National Cancer Program Plan mandated by the Cancer Institute has embarked on a plan to establish twenty clinics throughout the United States for the early detection of breast cancer. These clinics will be co-funded in February 1973 with the National Cancer Society, and will be fully operational by early 1974. Eight of the fifteen comprehensive cancer centers mandated under the Act will be operational prior to the end of 1973. All fifteen will be operational by mid-1974. These are the kinds of action that must be initiated if the intent of the Congress is fulfilled and if the American people are truly to reap the rewards of this nation's cancer efforts.

This type of planning—planning for research, for treatment and control programs, for location, for direction—is what is sadly lacking in the entire health area. Many of the criticisms of the National Cancer Institute voiced during the last year's hearings were valid—there was a lack of direction for application of knowledge, a lack of proper planning, and a lack of action for people. But the problems with our cancer program were merely representative of the total problem with health programs in this country. And this larger problem will not be solved by further fragmenting health priorities with a rumored HEW health revenue-sharing proposal that carries a catchy public relations title, but which, in fact, would spell the death knell of carefully designed health programs to conquer the major diseases of this nation. The first step in solving the health problems of this country is to consolidate our decision-making process and focus total attention on the health of America. This requires establishment of a separate Department of Health.

In 1953, when HEW was established, the Department had a budget of approximately two billion dollars. Ten years later, that figure stood at six billion. Today, the appropriation for HEW sent to the President exceeded 30 billion dollars. As the President stated in a recent interview, "HEW is too far, too bloated." I agree with the President. HEW is too large for any one Secretary—no matter how competent—to handle and make proper decisions. We must have a weight-reducing program for HEW, and a first reduction would be to create a separate Department of Health which will bring about better health programs for the nation. A Secretary of Health who can devote all of his attention and time to the health of our people will allow health programs to be run by health experts, and not the accountants at the Office of Management and Budget. The President deserves to have a health expert at his table.

I see a great future for improved cancer research and treatment. I see a great future for the status of health care in this country, with increased emphasis on health in the 1970s—with better planning and administration, more adequate research, and perhaps more importantly, the goal of getting our knowledge applied quickly, to people.

I congratulate each of today's recipients. I am honored to have been here.

Thank you.