[Congressional Record Volume 147, Number 9 (Wednesday, January 24, 2001)]
[Senate]
[Pages S516-S519]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




   NOMINATION OF TOMMY THOMPSON TO BE SECRETARY OF HEALTH AND HUMAN 
                          SERVICES--Continued

  The PRESIDING OFFICER. The Senator from Pennsylvania.
  Mr. SPECTER. Mr. President, I have sought recognition to speak in 
support of the nomination of Governor Tommy Thompson to be Secretary of 
Health and Human Services. Governor Thompson brings an extraordinary 
record to Washington, DC, and he has accomplished a great deal as 
Governor of the State of Wisconsin.
  He began his political life in the Wisconsin State Assembly in 1966. 
He was elected to an unprecedented third term in Wisconsin, and then he 
broke his own record by being elected to a fourth term--of course again 
unprecedented. He has had remarkable accomplishments in the field of 
education, and tax cuts, where the tax rolls in Wisconsin have been 
very substantially reduced, in crime control, and perhaps his greatest 
achievement has been in welfare reform in Wisconsin. While Governor, 
Wisconsin got more waivers from the Department of Health and Human 
Services than any other State. Now it will be interesting to see how, 
in his capacity as Secretary of the Department, he will function to 
create policies in a climate where the Federal Government can 
articulate and implement policies which will not require States to seek 
waivers, as he was so successful at doing.
  His reform of the welfare system in Wisconsin has received national 
acclaim. He initiated the program called ``Learnfare.'' He was able to 
change the approach in Wisconsin to have work instead of welfare--all 
enormous accomplishments.
  When I looked at the record of Governor Thompson, candidly, I 
wondered why he did not run for President with those accomplishments 
behind him. I know some consideration had been given by Governor 
Thompson to that. It is an onerous road, considering all the 
difficulties. Perhaps foremost was the formidable candidacy of Gov. 
George Bush of Texas, who is now our President. So we have done very 
well indeed on the Presidency, and on the designation of Secretary 
Thompson for Health and Human Services.
  He will be facing some very difficult problems. One of the problems 
he will be facing is the controversial issue of stem cells, where I and 
others have introduced legislation to remove the ban on Federal funding 
for the extraction of stem cells from embryos. This has been a 
controversial matter because I think it is really not understood that 
the embryos from which the stem cells are extracted are to be 
discarded. They had been created for in vitro fertilization and are not 
to be used. So, instead

[[Page S517]]

of discarding them, it seems most appropriate to use them to save 
lives.
  The stem cells are a veritable Fountain of Youth, with stem cells 
already having been very useful in efforts to cure Parkinson's and 
spinal cord injuries. There is great promise for stem cells on 
Alzheimer's, perhaps in heart ailments to replace cells in the 
circulatory system and in the heart, and perhaps even on cancer. That 
is an issue which Senator Lott, our distinguished majority leader, has 
promised listing on a free-standing bill.
  Governor Thompson will also be a key player in implementing the 
distribution of organ transplants. We will, perhaps, call on him to 
implement a system which has been put into effect that he personally 
disagreed with as Governor of Wisconsin but now, as a national 
officeholder looking after the interests of 50 States, there is 
obviously going to be a different perspective.
  In Wisconsin, there had been great success in encouraging people to 
donate organs so there was an abundance of organs. Perhaps those 
techniques can be implemented by the new Secretary of Health and Human 
Services to create a national response, to have more organs donated so 
we need not have the controversy we have on the distribution of organs. 
As the chairman, for the past two Congresses, of the subcommittee on 
Labor, Health, Human Services and Education, I have had the role of 
working on the legislation of organ transplants, which we finally have 
worked out. It is my hope we will retain the policy which we have in 
effect.
  Mr. DOMENICI. Mr. President, I rise today in strong support of 
Governor Tommy G. Thompson, the nominee for Secretary of Health and 
Human Services.
  I am extremely pleased with President Bush's choice to be the next 
Secretary of Health and Human Services because I believe Governor 
Thompson's extensive background will bring a fresh approach to an 
agency that has a history of underachievement.
  Unfortunately, the Department of Health and Human Services, HHS, has 
far too often operated with a Washington knows best mentality, instead 
of taking into account what a state or local community might actually 
need.
  As a former Governor, Secretary Thompson, will bring an invaluable 
wealth of experience to HHS and more importantly the practical 
experience of having confronted and addressed the unique problems and 
needs that arise at the local level.
  Governor Thompson has gained a reputation for his innovative 
approaches to implementing Welfare and Medicaid reform during his 
tenure as the Governor of Wisconsin. Moreover, during that time he 
dealt with the Health Care Financing Administration, HCFA, on a regular 
basis and I believe that experience will serve him well, as he also 
knows first hand the frustrations shared by many Members of Congress in 
dealing with HCFA.
  While Governor, he completely overhauled Wisconsin's Welfare system 
and reduced welfare rolls by 93 percent and additionally, he attempted 
to provide individuals with the tools to succeed by increasing 
subsidies for child care, health insurance, and job training.
  Governor Thompson also created Wisconsin's State Children's Health 
Insurance Program, SCHIP, ``BadgerCare'' and eighteen months ago the 
program became the first state in the nation to offer health coverage 
to the parents of eligible children.
  I also believe that New Mexico stands to benefit from the leadership 
of Secretary Thompson. For instance, HCFA has previously denied several 
waiver requests by the New Mexico Department of Human Services to 
obtain greater flexibility regarding the use of unspent SCHIP funds and 
I am hopeful Secretary Thompson will review any similar request 
submitted by New Mexico.
  I am also looking forward to working with Secretary Thompson on the 
issue of Medicare reimbursement disparity between states like New 
Mexico and the remainder of the country. Just last year Congress took a 
first step to address the issue by passing the ``Medicare Geographic 
Fair Payment Act of 2000.'' Specifically, the law raises the 
reimbursement rates for historically underpaid areas under the 
Medicare+Choice program.
  In closing, I think we all begin the 107th Congress with unlimited 
opportunities to improve our nation's health through a prescription 
drug benefit for Medicare, Medicare reform, and a continued commitment 
to medical research.
  I believe there is a lot of agreement on the need to emphasize these 
issues and I look forward to working with Secretary Thompson to address 
these important issues for not only New Mexico, but our country.
  Mr. KENNEDY. Mr. President, few appointees in the Cabinet are more 
important than the Secretary of Health and Human Services. The agency's 
63,000 dedicated employees serve America well. With its budget of $427 
billion, if it were a country, HHS would have a GNP larger than all but 
14 of the nations in the world.
  But the vast importance of the Department cannot be measured by 
numbers of employees or dollars of spending. As the HHS motto itself 
states, ``Hope is the anchor of life.'' The programs directed by the 
Secretary are an anchor of life for tens of millions of Americans. They 
bring hope to the hopeless and help to the helpless. They express the 
best ideals of our country.
  It has been said that the measure of a society is how it treats the 
very old and the very young. The Secretary of the Department is 
responsible for stewardship of Medicare, which along with Social 
Security, states the promise of our society to our senior citizens that 
their golden years will be as healthy and secure as possible. Medicare 
is a compact between the American people and their government. It says 
work hard and contribute to your country during your working years--and 
you will have good medical care in your senior years.
  For the very young, the Secretary has an equally profound 
responsibility. The Secretary is the leader of Head Start, one of the 
most effective government programs to help disadvantaged children join 
the mainstream of American life. It brings help and hope for millions 
of children who would otherwise have no chance at the American dream--
but it still serves only half of all those who are eligible.
  Whether the issue is health care for the disadvantaged or assistance 
for low-income families, HHS is the lead federal agency for some of the 
most serious challenges the nation faces. HHS safety net programs are 
the protection of last resort for millions of Americans, and other HHS 
programs are also vital to the well-being of affluent and average 
Americans alike.
  Without the Food and Drug Administration, Americans could not go to 
the grocery store with any confidence that the food they buy is safe 
and healthy. No American could be confident that their prescription 
drugs are safe and effective, and no American needing a medical device 
could be sure that the device will do more good than harm.
  Biomedical research supported by the National Institutes of Health is 
unequaled by any other country. NIH leads the world in the effort to 
conquer cancer, heart disease, mental illness and other dread diseases 
that threaten the life and happiness of American families.
  We all know the important challenges that the new Congress, the new 
President, and the new Secretary of Health and Human Services will face 
this year. We need to enact prescription drug coverage under Medicare, 
to assure that the promise of health security in retirement will 
finally be fulfilled. We must expand health insurance, so that the 
right to health care can be a reality for every American, not just an 
expensive privilege for the few. We must pass a strong, enforceable 
Patients' Bill of Rights to end the abuses of managed care and give 
every patient the confidence that their health insurance will be there 
when they need it.
  We should expand quality day care, child care, and Head Start, so 
that we mean what we say when we state that no child shall be left 
behind. We must maintain our commitment to biomedical research at the 
NIH, to reap the benefits of the century of the life sciences that has 
just begun, and increase our commitment to research on health care 
quality and the delivery and utilization of health services.
  I hope we can move forward together in a spirit of bipartisanship to 
address each of these great challenges. But it is

[[Page S518]]

also important that we do not move backward by advancing partisan and 
divisive proposals that would undermine the accomplishments of the 
past.
  We must not undermine the federal commitment to guaranteed health 
care for poor children, poor parents, senior citizens, and the 
disabled. A new effort to enact a Medicaid block grant would be 
counterproductive. And so would an attempt to repeal the Medicaid 
commitment by stealth, through the use of the waiver process in a way 
that undermines the Medicaid entitlement, rather than providing 
services in new and better ways.
  Congress approved the CHIP program for children's health by an 
overwhelming bipartisan majority, because it struck the right balance 
between state flexibility and achievement of national goals. Steps to 
provide additional flexibility should be carefully considered--and 
should not be undertaken without congressional review. I know that 
Governor Thompson is interested in expanding coverage to parents of the 
children covered by Medicaid and CHIP. I hope that he will support our 
bipartisan efforts to provide new funds and clear authority to support 
states that want to accomplish this important objective, rather than 
using the waiver process and limited Title XXI funds to cover parents 
at the expanse of children.
  We must be more sensitive to ethical concerns in federally financed 
medical research--but we must also not roll back existing research 
commitments because of ideology--and certainly not without 
congressional action to guarantee that the commitment to such change is 
bipartisan.
  We must maintain our commitment to comprehensive family planning 
services--and not return to the old days of ``gag rules'' and 
harassment of family planning clinics.
  We must not politicize the scientific judgements of the Food and Drug 
Administration.
  We must do more--much more--to reduce youth smoking, and protect as 
many children as possible from the dangers of tobacco.
  We should improve Medicare, in addition to prescription drug 
coverage, by adding measures to assure the highest quality care to 
senior citizens and the disabled. We must place a new emphasis in 
Medicare on keeping beneficiaries healthy rather than simply caring for 
them after they become ill. We can expedite Medicare's coverage of 
beneficial new products and procedures, and provide more adequate 
financial support for the nation's great teaching hospitals, its 
community hospitals, its nursing homes, and its home health agencies. 
But reform should not be an excuse to undermine Medicare's commitment, 
to impose additional financial burdens on the elderly, or to force 
senior citizens to give up conventional Medicare and join HMOs. And the 
failure to reach rapid consensus on Medicare reforms should not be an 
excuse for failure to act promptly on the most important reform of 
all--Medicare coverage of prescription drugs.
  Finally, responsible leadership at HHS requires support for new 
measures and new ideas to meet the challenges facing our country. To 
stand still is to fall behind in all these ongoing battles of our time.
  Governor Thompson comes to us with a genuinely outstanding record of 
accomplishment in Wisconsin. He recognizes that access to good health 
insurance, child care, job training and transportation services are 
critically important if families are to successfully leave welfare for 
work. Wisconsin's Badger Care health insurance program is a path-
breaking model for the nation. Governor Thompson was an early and 
active supporter of the Jeffords-Kennedy work incentives legislation to 
help persons with disabilities work without fear of losing their health 
insurance, and he has created a long-term care initiative that would 
give families the freedom to choose the best forum for their long-term 
care needs--whether in the home or in the community.
  Governor Thompson is a hard worker, and a man of strong convictions. 
But he is also pragmatic and willing to work with others who have 
different views in order to achieve a common goal.
  Though the Senate is voting today, members of the Health, Education, 
Labor, and Pensions Committee are submitting written questions to 
Governor Thompson on issues that were unable to be fully explored at 
last Friday's hearing.
  I intend to vote for Governor Thompson's confirmation, and I look 
forward to working with him in the years ahead to improve and protect 
the nation's health and welfare.
  Mr. SANTORUM. Mr. President, I rise today to support the nomination 
of Gov. Tommy Thompson to be Secretary of Health and Human Services, 
and also to speak to a vital public health issue on which I know many 
of my colleagues are looking forward to working with him: namely, the 
implementation and enforcement of policies to improve our nation's 
organ procurement and allocation system.
  I hold Governor Thompson in very high regard for his expertise in 
health care policy and for his long and distinguished record on 
innovations in health care delivery in the state of Wisconsin, and I am 
optimistic that in his new role as guardian of public health laws and 
regulations for the country we can work together toward ensuring that 
national interests triumph over parochial ones.
  As my colleagues well know, over the past several years Congress has 
been unable to reach consensus on reauthorizing the National Organ 
Transplant Act, NOTA, though I look forward to working with Governor 
Thompson this Congress to reauthorize this important public law, and 
especially to develop a clear mandate and strategies for increasing 
organ donation. But in the absence of NOTA reauthorization, the country 
has benefitted immensely from the credible scholarship of the Institute 
of Medicine's 1999 study which underscored not only the need for 
reforming organ procurement and allocation, but also the proper role 
that the federal government should play in overseeing and enforcing 
such reforms.
  I cannot fathom that the American public would countenance that a 
life-and-death issue such as organ allocation would be based on 
principles of geographic happenstance, instead of medical necessity. 
But it is just this outdated paradigm that has largely contributed to 
the fact that about 4,000 Americans die each year--at least 11 per 
day--while awaiting organ transplants. Of those, it is estimated that 
1,000 Americans--more than 3 each day--might have been saved if the 
system operated more fairly.
  In light of harrowing statistics such as these, following the release 
of the IOM study and in the absence of NOTA reauthorization, the 
Department of Health and Human Services last year put forth a Final 
Rule which enjoyed bipartisan support here in Congress and which 
engendered the primary recommendation of the IOM study: to establish 
goals for the Organ Procurement and Transplantation Network, OPTN, to 
make changes that would assure equity with regard to patient access to 
organs.
  On March 16, 2000 the Final Rule governing the OPTN took effect, 
establishing that the medical and allocation policies of the OPTN 
remain the responsibility of transplant professionals, in cooperation 
with transplant centers, patients and donor families represented on the 
OPTN board. The Final Rule also rightly provides--as NOTA intended and 
the IOM study recommended--for the public accountability that is 
necessary for a national program on which so many lives depend.
  Toward the goal of public accountability, the Final Rule requires the 
Nation's OPTN contractor to submit to the Secretary new policies 
governing liver allocation to needy patients, in order to achieve the 
following performance goals: utilize standardized, objective criteria 
to determine medical urgency; give highest priority to the most 
medically urgent candidates, based upon such new criteria; and 
distribute organs over as broad a geographic area as is feasible.
  I am pleased that the current contractor has submitted a proposal to 
the Department that meets many of the criteria stipulated in the Final 
Rule and the recently renewed OPTN contract. The contractor's proposal 
would create a more precise scale for determining how sick waiting 
patients are, thereby allowing the network to direct more livers to the 
sickest patients. However, the proposal would do nothing to break down 
the geographic barriers that dictate organ distribution,

[[Page S519]]

which was one of the pivotal tenets of both the Final Rule and the new 
OPTN contract.
  Mr. President, I share the belief of many of my colleagues that 
Governor Thompson is eminently qualified to meet the many and varied 
policy challenges that will be incumbent on the next Health and Human 
Services Secretary, ranging from sustaining and expanding the successes 
to date of welfare reform, to assessing options on how best to put 
Medicare on sound financial and actuarial footing for the long-term. I 
have confidence that Governor Thompson will approach the duties of his 
office with probity and rectitude. I am hopeful that the Governor will 
work with Congress to reauthorize NOTA and to support and ensure 
compliance with the regulations put forth last year relating to the 
operation of the organ procurement and transplantation network in the 
United States.
  Mr. GRASSLEY. Mr. President, if it is necessary for me to yield back 
time, I will, but I did not want to yield back time until I knew 
exactly where we were with other people who had time.
  Mr. President, I yield back my time.
  The PRESIDING OFFICER. All time having been yielded back, the 
question is, Will the Senate advise and consent to the nomination of 
Tommy G. Thompson, of Wisconsin, to be Secretary of Health and Human 
Services? The yeas and nays have been ordered. The clerk will call the 
roll.
  The legislative clerk called the roll.
  The result was announced--yeas 100, nays 0, as follows:

                       [Rollcall Vote No. 4 Ex.]

                               YEAS--100

     Akaka
     Allard
     Allen
     Baucus
     Bayh
     Bennett
     Biden
     Bingaman
     Bond
     Boxer
     Breaux
     Brownback
     Bunning
     Burns
     Byrd
     Campbell
     Cantwell
     Carnahan
     Carper
     Chafee
     Cleland
     Clinton
     Cochran
     Collins
     Conrad
     Corzine
     Craig
     Crapo
     Daschle
     Dayton
     DeWine
     Dodd
     Domenici
     Dorgan
     Durbin
     Edwards
     Ensign
     Enzi
     Feingold
     Feinstein
     Fitzgerald
     Frist
     Graham
     Gramm
     Grassley
     Gregg
     Hagel
     Harkin
     Hatch
     Helms
     Hollings
     Hutchinson
     Hutchison
     Inhofe
     Inouye
     Jeffords
     Johnson
     Kennedy
     Kerry
     Kohl
     Kyl
     Landrieu
     Leahy
     Levin
     Lieberman
     Lincoln
     Lott
     Lugar
     McCain
     McConnell
     Mikulski
     Miller
     Murkowski
     Murray
     Nelson (FL)
     Nelson (NE)
     Nickles
     Reed
     Reid
     Roberts
     Rockefeller
     Santorum
     Sarbanes
     Schumer
     Sessions
     Shelby
     Smith (NH)
     Smith (OR)
     Snowe
     Specter
     Stabenow
     Stevens
     Thomas
     Thompson
     Thurmond
     Torricelli
     Voinovich
     Warner
     Wellstone
     Wyden
  The nomination was confirmed.

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