ORIGINAL

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ADDRESS

By
C, Everett Koop, M.D,
SURGEON GENERAL
U.S, PupLic HEALTH SERVICE
AND
Deputy ASSISTANT SECRETARY FOR HEALTH
U.S, DEPARTMENT OF HEALTH AND HUMAN SERVICES

——Set”

PRESENTED TO THE SRD ANNUAL SYMPOSIUM ON
PERSPECTIVES ON EMPLOYMENT OF HANDICAPPED INDIVIDUALS
GALLAUDET CoLLEGE, WASHINGTON, D,C,

NovemBer 16, 1984
(GREETINGS TO HOSTS, GUESTS, FRIENDS. ETC.)

I’M DELIGHTED TO JOIN YOU THIS MORNING AT THIS, YOUR LAST
SESSION. I‘VE SEEN YOUR PROGRAM AND I’M IMPRESSED WITH THE RANGE OF
RESOURCE EXPERTS THAT HAVE BEEN HERE SINCE WEDNESDAY. AND ONCE AGAIN,
LET ME SAY THAT IT HAS BEEN A PRIVILEGE FOR THE U.S, PUBLIC HEALTH
SERVICE TO HAVE BEEN A CO-SPONSOR FOR THIS ANNUAL SYMPOSIUM,

THE COMMITTEE RESPONSIBLE FOR YOUR PROGRAM THIS WEEK DESERVES A
STRONG VOTE OF COMMENDATION AND THANKS, AND I WILL ADD MY PERSONAL
THANKS TO YOUR CHAIRMAN, PAUL MEYER, AND TO OUR OWN P.H.S, REPRE-
SENTATIVE, A VERY ABLE AND DEDICATED INDIVIDUAL, MR. JOE FAHA,

I MUST SAY THE EXCELLENCE OF THE PROGRAM OF THE PAST COUPLE OF
DAYS MAKES MY JOB THIS MORNING A LITTLE DIFFICULT. I CAN’T COME UP
HERE WITH A LOT OF FACTS AND FIGURES TO CONVINCE YOU OF THE NEED FOR
EXPANDING EMPLOYMENT OPPORTUNITIES FOR DISABLED PERSONS.
2

THAT'S ALREADY BEEN DONE QUITE WELL BY SUCH SPEAKERS AS FRANK
BOWE AND CLARENCE THOMAS, AND HAROLD RUSSELL, EVERETT ALVAREZ, AND
MANY OTHERS,

WITH THEIR WORDS STILL RINGING IN YOUR EARS, YOU SHOULD LEAVE THE
SYMPOSIUM LATER TODAY AS “TRUE BELIEVERS” AND “REAL ACHIEVERS.” I
CERTAINLY HOPE THAT YOU DO, FOR, THROUGH YOUR EFFORTS, MANY THOUSANDS
OF OTHERS -- DISABLED AND HANDICAPPED PERSONS -- WILL REAP THE MANY
TANGIBLE AND INTANGIBLE BENEFITS OF FEDERAL EMPLOYMENT.

ALSO BENEFITING WILL BE THE AMERICAN TAXPAYER. OUR EMPLOYER, WHO
HAS NEVER BEEN LET DOWN YET BY DISABLED PERSONS IN THE FEDERAL WORK-
FORCE,

BUT YOU'RE THE KEY TO THE OPPORTUNITIES. YOU ARE WHERE THE JOBS
ARE. AND SO WE LOOK TO YOU TO BE YEAR-ROUND ADVOCATES FOR BROADER
EMPLOYMENT OPPORTUNITIES RIGHT TO THE AGENCY, DIVISION, AND BRANCH
LEVEL,
3

I FIRMLY BELIEVE THAT WHEN YOU CARRY OUT THAT KIND OF FUNCTION,
YOU REFLECT THE VERY BEST TRADITIONS OF THE CIVIL SERVICE AND OF
AMERICAN SOCIETY ITSELF,

I DON’T SUPPOSE THAT ASPECT OF THIS SUBJECT WAS TREATED VERY MUCH
AT THIS SYMPOSIUM. IT RARELY IS, PEOPLE FEEL AWKWARD EXPRESSING
THESE KINDS OF SENTIMENTS, BUT I DON’T, AND SO, WITH YOUR
INDULGENCE, I’M GOING TO TALK ABOUT IT JUST A LITTLE BIT THIS MORNING,

IN THE HEAT OF OUR DAILY ACTIVITY, WE SOMETIMES FORGET -- OR
SIMPLY TAKE FOR GRANTED -- THE NATURE OF THE SOCIAL CONTRACT THAT
BINDS TOGETHER ALL AMERICANS, IT’S NOT A SINGLE WRITTEN DOCUMENT. SO
IT CAN'T BE PULLED OFF THE SHELF AT YOUR LOCAL LIBRARY. IN FACT, LIKE
ALL REALLY GOOD CONTRACTS, THIS ONE IS NOT WRITTEN DOWN SO MUCH AS IT
TS HANDED DOWN,
4

OUR SOCIAL CONTRACT SAYS THAT WE ALL COME INTO THE WORLD WITH AN
EQUAL CHANCE TO BE SOMEBODY. EACH OF US IS OBLIGED TO RECOGNIZE AND
ACCEPT THAT ABOUT OUR FELLOW CITIZENS. OVER THE YEARS WE’VE BUILT UP
SOME LAW TO HELP SORT OUT THE MEANING OF THE TERM “EQUAL OPPORTUNITY,”
SO THAT IT DOESN‘T MEAN COMPLIANCE ACHIEVED THROUGH FORCE OR INTIMIDA-
TION OR ANYTHING LIKE THAT, BUT EVEN HERE, WE HAVE A RATHER LONG
AMERICAN TRADITION OF “FAIR PLAY,” TO WHICH THE LAW MAKES ITS
CONTRIBUTION. BUT OUR TRADITION BEGAN BEFORE OUR SYSTEM OF LAW
BEGAN. I THINK EVEN A QUICK READING OF EARLY AMERICAN HISTORY WILL
REVEAL THAT,

OF COURSE. RESTRICTIONS ON FORCE AND FEAR ARE ONE SIDE OF THE
EQUATION, THE NEGATIVE SIDE. THE OTHER SIDE, HOWEVER, IS POSITIVE.
THIS IS THE SIDE THAT SAYS, “YES, REGARDLESS OF WHO YOU ARE AND WHERE
YOU LIVE AND WHO YOUR PARENTS ARE AND WHAT THEY DO FOR A LIVING...YOU
HAVE A RIGHT TO BE THE VERY BEST AND MOST SUCCESSFUL PERSON YOU KNOW
HOW TO BE.”
5

AND THAT, TOO, HAS BEEN DEEPLY EMBEDDED IN THE AMERICAN CON-
SCIOUSNESS, AND WHAT IS RATHER REMARKABLE IS HOW QUICKLY THIS
POSITIVE SIDE TO AMERICAN OPPORTUNITY IS RECOGNIZED AND ACCEPTED BY
NEWCOMERS TO OUR SOCIETY, IMMIGRANTS FROM THE 6 OTHER POPULATED
CONTINENTS,

AND THERE’S ANOTHER CLAUSE IN THAT REMARKABLE SOCIAL CONTRACT,
THIS CLAUSE REQUIRES EACH OF US TO HELP ANOTHER, IF THAT OTHER PERSON
INDEED REQUIRES A HELPING HAND, THIS IS HOW WE DEMONSTRATE THAT FORCE
AND FEAR ARE NOT ACCEPTABLE. WE DO THE REVERSE...WE EXTEND A HAND OF
HELP AND FRIENDSHIP. AND THIS IS HOW WE DEMONSTRATE THAT THOSE
POSITIVE IDEALS OF EQUAL OPPORTUNITY ARE NOT JUST GOOD RHETORIC, BUT
ARE FUNDAMENTAL TO THE WAY WE LIVE.,.DAY-BY-DAY...IN THIS COUNTRY,

IF WE WERE BORN HERE AND GREW UP HERE, THESE ARE THINGS WE ALL
LEARNED FROM THE VERY BEGINNING, AND IF WE ARE LATER ARRIVALS, THESE
ARE THINGS WE’VE BEEN LEARNING EVERY DAY. AS WE NEGOTIATE OUR WAY MORE
DEEPLY INTO AMERICAN LIFE.
6

THE INTERESTING THING IS THAT WE LEARN THESE THINGS REGARDLESS OF
OUR OWN FAMILY’S CULTURAL OR RELIGIOUS TRADITIONS, PRIMARILY BECAUSE
THE PRECEPTS OF LASTING VALUE IN OUR SOCIETY ALSO HAPPEN TO COINCIDE
WITH THE VERY HIGHEST OF HUMAN ASPIRATIONS ANYWHERE.

THERE OBVIOUSLY IS A TRANSCENDANT AMERICAN ETHOS THAT WE LEARN
ABOUT VERY EARLY AND THAT GUIDES MANY OF THE THINGS WE DO FOR THE REST
OF OUR LIVES, AND WE ARE FORTUNATE THAT SUCH IS THE CASE,

WHAT DOES ALL THIS HAVE TO DO WITH THIS SYMPOSIUM? IN MY
OPINION, THESE IDEAS LIE AT THE VERY CENTER OF OUR PURPOSE HERE THIS
WEEK, OF COURSE, IF I ASKED SOME OF YOU WHY YOU’RE ATTENDING, I'M
SURE I’D GET A COLLECTION OF QUITE DIFFERENT ANSWERS:

* YOU'D TELL ME THAT YOUR SUPERVISOR MADE YOU COME...
]

* OR THAT THIS IS AN ADDITIONAL DUTY YOU CARRY AND YOU WANT TO KNOW
MORE ABOUT IT...

* OR THAT YOUR AGENCY DIRECTOR HAS CHOSEN “HIRE THE HANDICAPPED” AS
HIS OR HER NEW GOAL FOR FISCAL YEAR 1985 AND YOU’RE JUST GOING ALONG
WITH IT,

I’M SURE THERE ARE OTHER REASONS, TOO, BUT THEY’RE ALL SECONDARY,
TO MY WAY OF THINKING. I BELIEVE WE’RE HERE BECAUSE...

THE WORK OF EXTENDING OPPORTUNITY TO EVERY CITIZEN IS INTRIN-
SICALLY AMERICAN WORK...AND THE EQUAL EMPLOYMENT AND ANTI-
DISCRIMINATION STATUTES ARE INTRINSICALLY AMERICAN STATUTES,
8

SOME OF US MAY FEEL THAT THE LAWS CAME ALONG QUITE LATE. AND
THAT'S PROBABLY TRUE. WITH THE HELP OF THE COLD LIGHT OF HISTORY, I’D
HAVE TO AGREE. BUT MAYBE IT TAKES US A LITTLE WHILE FOR THE LAW IN
OUR SOCIETY TO CATCH UP WITH ITS VALUES,,,T70 INTERPRET THE BREADTH AND
SCOPE OF ITS TRADITIONS.,.AND TO CARVE OUT A CODE OF CONDUCT THAT
REFLECTS OUR NATIONAL CODE OF ETHICS,

NEVERTHELESS, WE‘RE DOING IT, YEAR BY YEAR, AND FOR THE PAST
DECADE OR SO WE HAVE BEEN ESPECIALLY ATTENTIVE TO THE NEEDS OF DIS-
ABLED PERSONS IN OUR SOCIETY:

THOSE WITH MENTAL OR PHYSICAL LIMITATIONS...

THOSE WHO HAVE A SENSORY DEPRIVATION...

OR THOSE WHO SUFFER FROM AN EMOTIONAL OR PSYCHOLOGICAL DEFICIT.
g

AGAIN, I MUST REMIND YOU THAT THIS DIFFICULT TASK IS COMPLETELY
WITHIN THE STILL UNIQUE AMERICAN TRADITION OF EQUALITY OF OPPORTUNITY
»e AND T SAY “UNIQUE” BECAUSE IT IS SIMPLY NOT TO BE FOUND AS A
NATIONAL COMMITMENT IN ANY OTHER COUNTRY.

IN MY PREVIOUS POSITION AS A PEDIATRIC SURGEON, I HAD MANY
OCCASIONS TO TRAVEL TO OTHER COUNTRIES. AND, OF COURSE, AS SURGEON
GENERAL IT HAS BEEN MY PRIVILEGE TO REPRESENT OUR COUNTRY BEFORE A
NUMBER OF OTHER GOVERNMENTS,

AND I’VE MET MANY GOOD PEOPLE AND I’VE BEEN IMPRESSED WITH THE
GOODNESS AND DECENCY OF MANY OTHER GOVERNMENTS. BUT I CAN TELL YOU
THAT THERE SIMPLY ISN’T ANOTHER COUNTRY WHOSE PEOPLE HAVE DONE WHAT WE
HAVE DONE, THAT IS, NO OTHER SOCIETY HAS SO DELIBERATELY SET ABOUT TO
MAKE A REALITY OF THAT PROMISE OF EQUAL OPPORTUNITY FOR ALL,
10

NOBODY SAYS THAT IT’S EASY, FOR ONE THING, WE ARE TRYING 10
CORRECTLY RECOGNIZE DIFFERENCES, BUT AT THE SAME TIME TRYING 10
OVERCOME ANY DIVISIONS BETWEEN AND AMONG THOSE DIFFERENCES. OUR
COMMITMENT AS A PEOPLE HAS BEEN TO EXTEND THE FRUITS OF THE AMERICAN
DREAM TO EVERYONE... YOUNG AND OLD...MALE AND FEMALE... WHITE, BLACK,
BROWN, YELLOW, AND RED,..ABLE-BODIED AND DISABLED, 100,

I’M SURE THAT SOMEONE OVER THE PAST COUPLE OF DAYS HAS POINTED
QUT THE COST-EFFECTIVENESS OF HIRING AND PROMOTING THE HANDICAPPED,
AND THERE MAY BE SOMETHING TO THAT,..BUT IT IS NOT CENTRAL TO WHO WE
ARE,

AND NO DOUBT THE ARGUMENT HAS BEEN MADE THAT THE DISABLED HAVE
CERTAIN PERSONAL QUALITIES AND RESPONSES THAT MAKE THEM ESPECIALLY
GOOD EMPLOYEES, 1 KNOW THAT’S TRUE FOR MANY PERSONS, BUT THIS ALSO IS
NOT THE REAL REASON WE CARE ABOUT THEM,
1]

AND NATURALLY SOMEONE HAS NOTED THE FACT THAT EXTENDING
OPPORTUNITIES TO THE HANDICAPPED IS NOW THE LAW OF THE LAND AND SO, IF
YOU WANT TO STAY OUT OF TROUBLE, YOU’D BETTER GET WITH IT AND OPEN UP
YOUR OFFICE TO DISABLED INDIVIDUALS. YOU SHOULD, BUT NOT BECAUSE YOU
ARE LEGALLY BOUND TO. AS I INDICATED BEFORE, THE LAW HAS FOLLOWED IN
THE TRACKS OF OUR TRADITION. IT’S NOT THE OTHER WAY AROUND,

NO, ALL THOSE REASONS AND PROBABLY A DOZEN OTHERS HAVE BEEN
OFFERED HERE THIS WEEK, AND THEY’RE ALL VALID, AS FAR AS THEY GO,
BUT I WILL SUBMIT TO YOU THAT THEY DO NOT REPRESENT THE WHOLE STORY
BECAUSE THEY DON’T ADEQUATELY EXPRESS THE FUNDAMENTAL REASON WHY WE
EXTEND OPPORTUNITIES TO THE DISABLED AT ALL.

WE DO IT BECAUSE WE LIVE AND WORK HERE...BECAUSE WE ARE BOUND BY
THE SOCIAL CONTRACT THAT EXISTS FOR US ALL HERE...AND BECAUSE SUCH
EFFORTS ARE EXPRESSIONS NOT SO MUCH OF ECONOMIC WISDOM OR POLITICAL
POWER OR SOCIAL SAVVY BUT, RATHER, THEY ARE EXPRESSIONS OF WHAT OUR
COUNTRY ESSENTIALLY IS AND WHAT IT FUNDAMENTALLY STANDS FOR...RIGHT
HERE.
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AS I WAS PREPARING THESE REMARKS, A THOUGHT STRUCK ME. AND SO,
OUT OF CURIOSITY. I ASKED THE AMERICAN ASSOCIATION OF FUND-RAISING
COUNSEL TO GIVE ME AN IDEA OF THE SCOPE OF THE AMERICAN HABIT OF
GIVING, SPECIFICALLY, I ASKED THEM WHAT THE RECORD OF CONTRIBUTIONS
HAS BEEN LIKE FOR THE YEARS 1980 THROUGH 1983,

I HAD A HUNCH, MY HUNCH WAS THAT -- IN GOOD TIMES AS WELL AS IN
POOR TIMES -- AMERICANS WILL CONTINUE TO OPEN THEIR HEARTS AND THEIR
POCKETBOOKS TO SUPPORT GOOD CAUSES. AND SO THEY HAVE,

BACK IN 1980 YOU MAY REMEMBER THAT INFLATION WAS UP IN THE DOUBLE
DIGITS, SO WAS UNEMPLOYMENT. NEVERTHELESS, THE FUND-RAISING PEOPLE
TELL ME THAT, OF THE TOTAL AMOUNT OF MONEY CONTRIBUTED BY ALL
AMERICANS TO GOOD CAUSES OF ONE KIND OR ANOTHER, 14 PERCENT WENT TO
THE CATEGORY OF “HEALTH AND HOSPITALS,” TO PLACES LIKE THE CANCER
SOCIETY AND MUSCULAR DYSTROPHY AND MT. SINAI HOSPITAL AND ST, JUDE'S,

IN 1981 AND 1982, THE ECONOMY BEGAN TO TURN AROUND. WE BROUGHT
DOWN INFLATION. BUT AT THE SAME TIME WE WENT THROUGH A DIFFICULT
PERIOD OF RECESSION, INFLATION CAME DOWN BUT UNEMPLOYMENT WENT UP.
AND MANY AMERICANS WERE NOT HAVING AN EASY TIME OF IT,
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THAT SITUATION ALSO TURNED AROUND IN 1983, INFLATION STAYED
DOWN...AND UNEMPLOYMENT CAME DOWN, T00. IT WAS A KIND OF ROLLER-
COASTER PERIOD, HOWEVER, DURING EACH OF THOSE YEARS OF 1980 THROUGH
1983, THE TOTAL NUMBER OF DOLLARS GIVEN TO WORTHY CAUSES CONTINUED TO
CLIMB, FROM $48 BILLION IN 1980 UP TO $65 BILLION IN 1983,

AND, OF EQUAL IMPORTANCE, THE PORTION OF THAT MONEY THAT WENT TO
"HEALTH AND HOSPITALS” REMAINED THE SAME: A STEADY 14 PERCENT OF ALL
GIVING IN AMERICA YEAR AFTER YEAR. IT’S A LITTLE EERIE, LIKE ADAM
SMITH'S “INVISIBLE HAND” IN THE FREE MARKETPLACE. BUT WHATEVER THE
REASON, THE FACT IS THAT THE FIGURE FOR “HEALTH AND HOSPITALS” ALSO
ROSE STEADILY THROUGHOUT THOSE FOUR YEARS, ALONG WITH THE STEADY RISE
IN THE OVERALLA TOTAL. THE “HEALTH AND HOSPITALS” SHARE WENT FROM
$6.6 BILLION IN 1980 TO $9.2 BILLION IN 1983, A RISE OF 50 PERCENT
OVER 4 YEARS,

I THINK THAT RECORD IS ANOTHER OF MANY EXAMPLES OF HOW WE
AMERICANS TRY TO LIVE UP TO OUR IDEAL OF TOGETHER SHOULDERING A COMMON
BURDEN,
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LET ME REPEAT, THEN, THAT I’M REALLY HAPPY TO COME ALONG AT THE
END OF THIS SYMPOSIUM. IT’S GIVEN ME THIS CHANCE TO TALK ABOUT WHAT
IS, FOR ME. THE REAL MOTIVATION IN THE WHOLE FIELD OF EQUAL OPPORTUNI-
TY AND CIVIL RIGHTS, IT'S A RATHER SIMPLE MOTIVATION, BUT A VERY
POWERFUL ONE.

I AM MOVED TO TRY TO BE THE VERY BEST KIND OF PERSON FOR THIS,
THE VERY BEST KIND OF SOCIAL SYSTEM, I WANT TO BE PART OF WHAT THIS
SYSTEM TRULY MEANS, NOT JUST IN ORDER TO BENEFIT MYSELF PERSONALLY BUT
FOR THE BENEFIT OF EVERYONE WHO IS BOUND TO ME IN OUR AMERICAN SOCIAL
CONTRACT...WHATEVER THEIR COLOR OR HERITAGE OR SEX OR AGE OR CONDITION
OF PHYSICAL OR MENTAL HEALTH,
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SO I ASK YOU TODAY TO LEAVE THIS SYMPOSIUM, ARMED WITH MUCH NEW
INFORMATION, NEW KNOWLEDGE, AND NEW SENSITIVITY, AND RETURN TO YOUR
AGENCIES WITH A RENEWED COMMITMENT TO PUT ALL THAT NEW MATERIAL TO THE
SERVICE OF A VERY OLD IDEA -- A COUPLE OF CENTURIES AT LEAST -- THE
IDEA THAT EVERYONE IN OUR COUNTRY HAS THE RIGHT TO TRY TO BECOME THE
VERY BEST, MOST SUCCESSFUL PERSON HE OR SHE CAN BE, AND EACH ONE OF
US IS OBLIGATED, BY VIRTUE OF BEING A CITIZEN HERE. TO DO THE VERY

BEST WE CAN TO HELP.

THANK YOU,
te HH #