and by congresswoman christiansen, and my other colleagues, representing the u.s. territories, but i am very pleased that this act includes provisions that will finally bring a quality and health and health care to the u.s. territories. for example, this bill includes provisions that ensure that the public health programs in the u.s. territories will finally be structured and will finally have the

so congresswoman christiansen now will come forward. she is our physician, medical doctor from the virgin islands who had championed this with our [inaudible conversationstri-cau. >> thank you. thank you and all of our other great chairs for your outstanding leadership and my tri-caucus colleagues for your untiring efforts on be half of health equity and thank you all for joining us today. clearly, we are at a very pivotal and a very exciting time. one that he tri-caucus tends to take full advantage of. for those of us who have been calling for health disparity elimination legislation, that will diversify the health workforce, focus our prevention, apply our community eccentric, approach to health disparities and the tens of thousands of premature preventable deaths every year, and improve the health and of all americans, for us it's a more even more exciting time. because the reform that's about to take place in our health care system, we are about to take it to another level of transformation with the legislation that we are about to

of congress here on stage, senator dodd, senator bourbon, senator harkin, representative waxman, rep christiansen, and rep platz, all who did a big part to move this legislation forward. [applause] i want to thank all of them. there are three members of congress that i have to especially thank, representative waxman, representative dodd, -- senator dodd, and most importantly, senator ted kennedy who cannot be here today. [applause] and the legislation i am signing today represents a change that has been decades in the making. since the middle of the last century, we have known about the deadly effects of tobacco products. more than 400,000 americans now die of tobacco related illnesses each year, making it the leading cause of preventable deaths in the united states. more than 8 million americans suffer from at least one serious illness caused by smoking. these health problems caused us all more than $100 billion a year. what is even worse are the effects on our children. one out of every five children in our country are now current smokers by the time believe high school. think about that statis

miss christiansen? >> thank you, mr. chairman. i guess there is some benefit, i guess, at least in this instance, to being a delegate. and not having to go to vote. welcome, madam secretary. good to see you. last week we had some very good conversations on health disparities. but i note that at least in reading your testimony, because i had to step out both in the senate and here, there was very little, if any, reference made to this very important issue that by itself, results in close to 100,000 premature preventible deaths every year. i hope you'll work to make sure your entire department is sensitive to this critical issue, and office of minority health, and in particular the office of the national senate for minority health disparity research will be elevated that's critical to goals of eliminating health disparities. the b the bill directs that there will have to be a bridging between the health care disparities. how will the agency for health care, quality and research be involved since they have been doing national health

i just want to comment on that because i think there's some real lessons in clay christiansen's book about this and frankly i think there are real opportunities for pharmacists to do more for allied health professionals to do more, and what we were talking about in our ongoing care initiative, many physicians can handle a number more patients if they had an ongoing care capability also attached to their office. we are finding as we talk to health systems about the payment for ongoing care that lots of health systems have health professionals who want to work part-time, and they would like to be involved in some of that part-time activity in this on light-year mode. so there are ways of extending the current system. i think if we look at the current system is a how do we do everything today for more people, we've got a big problem. we have to think about how do we change what we do today to accommodate more people. and i think that's really a core component to thinking about an innovation philosophvelocity to health care. >> but, i mean, here again we shouldn't overdo the problem. as