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U.S. Department of Health and Human Services

Randall R. Bovbjerg and Pablo Aliaga The Urban Institute, Health Policy Center Josephine Gittler University of Iowa, College of Law February 2006

U.S. Department of Health and Human Services

U.S. Department of Health and Human Services

U.S. Department of Health and Human Services

U.S. Department of Health and Human Services

In some cases, achieving our strategic goals and objectives may be impeded by factors that are beyond the control of the Department of Health and Human Services (HHS). For example, national or local economic conditions can influence whether we are successful in helping families on welfare become economically independent. In some cases, there may b

External ethical oversight provides additional protection for research subjects. Prime examples in the U.S. are the Institutional Review Boards (IRBs) that supervise human-subjects research conducted under Federal jurisdiction, which is very broad. IRBs are carefully constituted boards that conduct independent oversight of research. 73

Basic research develops the fundamental science that underpins all applied research. It uses every experimental approach possible, every kind of instrumental observation, every epidemiological and other analytic technique. It uses social-scientific methods where these can illuminate basics. It studies simplified "model" systems, in search of insig

Just as varied as the types of health data, of course, are the types of individuals and organizations who hold or process the data. Data are processed by:

The ethos surrounding research on humans was recast and codified after World War II, as the world coped with the revelation of the medical atrocities perpetrated by the Nazis. The resulting "Nuremberg Code"—the opening sentence of which was, "The voluntary consent of the human subject is absolutely essential"—established principles having to d

The public are rightly concerned about the erosion of privacy of information about health, for at least the following reasons taken together.

The Federal Common Rule and other laws and regulations require many protections for human subjects of research. The main social instruments are informed consent of the data- subject, and Institutional Review Board (IRB) supervision. Both of these mechanisms have served society well. But both now need to be renewed.

We will strengthen mechanisms for ensuring protection of human subjects by: increasing and enhancing the educational opportunities for clinical investigators and Institutional Review Board (IRB) members and staff to facilitate their understanding and application of federal requirements for the protection of human subjects.

How We Will Accomplish Our Objective We will work with state governments to reduce the disparity in health insurance coverage through improved outreach and enrollment efforts to minority groups in our Medicaid and State Children's Health Insurance Program.

How We Will Accomplish Our Objective We will provide funding and technical support for education campaigns to deliver the anti-tobacco message. Our efforts will focus on: leading a national campaign to educate Americans about the health effects of tobacco use.

In the early part of this century, physicians, most of them practicing alone, delivered 85 percent of all medical services in the country.

One need only glance at the dramatic changes in our country during the last hundred years to understand why the relationship between organizational record keeping and personal privacy has become an issue in almost all modern societies. The records of a hundred years ago tell little about the average American, except when he died, perhaps when and

The imbalance in the relationship between individuals and record-keeping institutions today is pointedly illustrated by the experiences of Catherine Tarver, a "welfare mother" from the State of Washington, and Mitchell Miller, a businessman from Kathleen, Georgia.

Despite the many limitations that can be noted about the federal commitment to data gathering on persons with mental retardation and related conditions in institutional settings, there have been a number of useful recent sources of national statistics, all conducted or substantially supported by Federal government agencies. The most significant an