[Congressional Record (Bound Edition), Volume 151 (2005), Part 1]
[Senate]
[Pages 869-879]
[From the U.S. Government Publishing Office, www.gpo.gov]




 NOMINATION OF MICHAEL O. LEAVITT TO BE SECRETARY OF HEALTH AND HUMAN 
                                SERVICES

  The PRESIDING OFFICER. Under the previous order, the Senate will 
proceed to the consideration of the Executive Calendar, which the clerk 
will report.
  The assistant legislative clerk read the nomination of Michael O. 
Leavitt, of Utah, to be Secretary of Health and Human Services.
  The PRESIDING OFFICER. Under the previous order, there will be 2 
hours of debate on the nomination.
  The Senator from Iowa, Mr. Grassley, is recognized.
  Mr. GRASSLEY. Madam President, in the tradition of the work of the 
Senate Finance Committee--and that is basically described in one word, 
bipartisanship--we bring this nomination to the floor. We bring it with 
the unanimous approval of everybody on the committee, saying that 
Governor Leavitt should be the Secretary of Health and Human Services. 
He is a person who is very well qualified for this position, and we 
look forward to working with him on all of the quality-of-life issues 
that come before Congress, whether they deal with Social Security, 
Medicare, Medicaid, welfare--issues that are under the jurisdiction of 
this new Secretary to administer, and issues that are under the 
jurisdiction of the Senate Finance Committee for oversight.
  During his tenure as Governor, he reduced the number of uninsured 
children through his work on the Children's Health Insurance Program, 
he made significant improvements to the child welfare system, and he 
significantly increased the number of those with health insurance 
coverage. So some of the things he has done as Governor are some of the 
things that we are working on in this committee, and some laws are 
already passed. He will have a chance to continue his good work on 
these issues in conjunction with us as a committee and directly himself 
as Secretary of Health and Human Services.
  I am not alone in my high estimation of Governor Leavitt. The people 
of Utah recognize his strong leadership capabilities in reelecting him 
to three consecutive terms as Governor. Certainly big challenges lie 
ahead for this Department, as it does for our committee, and strong 
leadership in that Department is needed. I am glad it comes with 
Governor Leavitt.
  First and foremost, there are an estimated 45 million Americans who 
lack basic health coverage, and those numbers seem to have been 
increasing every year. As Secretary, his leadership will be called upon 
to propose innovative ways that we can help contain costs and increase 
access to health insurance and the health care resulting from that 
insurance.

[[Page 870]]

  The Medicaid Program will also be a key issue this year. Medicaid 
provides health care coverage and benefits for low-income individuals 
and families. It is now the largest Federal care program in terms of 
total spending and served about 51,000 people in 2002.
  It was originally enacted in 1965, and many have suggested it has not 
kept up with the times. Increasingly, States have been forced to rely 
upon what we call the 1115 waiver process to manage the program to fit 
the needs of their State. These waivers are negotiated with little 
congressional oversight. I look forward to working with Governor 
Leavitt to ensure that the Medicaid Program is functioning as 
effectively as it ought to function.
  There is the issue of SCHIP, the State Children's Health Insurance 
Program. Madam President, $1.1 billion in SCHIP allotments expired last 
year and were returned to the Treasury. In addition, there are anywhere 
from 4 million to 6 million children currently uninsured who could 
qualify for this program.
  Over the next 3 years, a growing number of States, including my own 
State of Iowa, are projected to consume their Federal SCHIP allotment. 
When this happens, they will lack the Federal funds necessary to 
provide their current level of coverage and also the level of benefits 
for low-income children.
  We need to recapture the $1.1 billion in SCHIP funds, increase our 
outreach effort to enroll more children, and revitalize the SCHIP 
program so it is on firm financial footing.
  Finally, we need to enact improvements to the 1996 welfare reform 
bill. We have debated this issue now for 3 years. It is time for 
action. The numerous short-term extensions are disruptive to the 
program. I look forward to working with Governor Leavitt to get a 
welfare bill sent to the President this year. I think that process is 
starting with the usual bipartisan cooperation between Senator Baucus's 
side of the aisle and his leadership and the Republicans who I lead.
  The Department also has the important job of implementing the new 
Medicare prescription drug benefit. Under Dr. McClellan's leadership, 
the Centers for Medicare and Medicaid Services has accomplished an 
impressive workload over the last year.
  Dr. McClellan and the staff at the Centers for Medicare and Medicaid 
Services are to be commended for their long hours, hard work, and, most 
importantly, a dedication to doing the best they can.
  This is a crucial year for the drug benefit that was passed and 
signed by the President in 2003. I look forward to working with the 
Governor on this particular issue and continuing the close working 
relationship with Dr. McClellan.
  Medicare still faces significant challenges to be sure. Medicare 
spending grew by 5.7 percent in 2003, and as spending continues to 
increase, there is a growing need to restrain its growth.
  Many have said rising costs and health care can be contained and 
health care quality improved by paying providers based on their 
performance and by utilizing health information technology.
  The Department has taken significant steps to reduce health care 
costs and provide better care through chronic care management 
initiatives and additional preventive benefits that were in the 2003 
legislation.
  The Department also called upon Dr. Brailer, as the National 
Coordinator for Health Information Technology, to develop, maintain, 
and oversee a plan focused on a nationwide adoption of health 
information technology in both the public and private sectors.
  Bringing these initiatives together to reward quality and efficiency 
while reducing medical errors and duplication will be one of the major 
undertakings in health care over the next decade, and strong leadership 
at Health and Human Services is needed to make that happen.
  Another issue on which the Governor's leadership is needed is the 
importation of prescription drugs from Canada and other developed 
nations. That surely is a controversial issue that hopefully we can 
debate in the Senate, because the law must be changed to make that 
happen. American consumers are demanding lower prices for prescription 
drugs, and I believe that legalizing importation under conditions that 
ensure safety is the right thing to do.
  I look forward to working with my colleagues on both sides of the 
aisle to craft legislation that will pass Congress and be signed by the 
President.
  I would also be remiss if I did not address an issue that continues 
to be of great concern. The frail and elderly residing in our Nation's 
nursing homes deserve high-quality care. I am confident that with 
Governor Leavitt's help, we can ensure that they receive no less.
  Besides these issues, the Department faces other significant 
challenges. I have always taken responsibility of conducting oversight 
over the executive branch operations very seriously, and I will 
continue to do that as chairman again. Government truly is the people's 
business, and Americans have the right to know what their Government is 
doing and how it spends their money. Transparency in Government, 
coupled with aggressive oversight by Congress, is critically important 
in helping to make Government transparent, more effective, more 
efficient, and more accountable to the taxpayers, program participants, 
and beneficiaries.
  I am also a firm and ardent supporter of whistleblowers. 
Historically, whistleblowers have been key to uncovering waste, fraud, 
and abuse. Unfortunately, whistleblowers are often as welcome in an 
agency as a skunk at a picnic.
  I look forward to addressing these problems with Governor Leavitt. 
Taking a closer look at Medicaid, SCHIP improvement, implementation of 
the new drug benefit, importation of prescription drugs, enactment of 
welfare reform, and the advancement of information technology and 
quality in health care as a reimbursement tool are just some of the 
priorities I look forward to addressing with Governor Leavitt.
  I close by urging my fellow colleagues to support Governor Leavitt in 
his nomination as Secretary of Health and Human Services. It is a major 
commitment that requires personal sacrifices on many levels, although I 
believe Governor Leavitt and his wife Jackie are the right team for 
this job. I also thank President Bush for his choice of such a 
qualified and competent candidate.
  I thank Senator Baucus not only for his cooperation on this effort, 
but we have had 4 years now of cooperative effort, and we expect that 
to continue. I know he is committed to that.
  I yield the floor.
  Mr. BAUCUS. Madam President, I thank the chairman.
  The PRESIDING OFFICER. The Senator from Montana.
  Mr. BAUCUS. Madam President, I appreciate those remarks and agree 
with them.
  I rise today to support also the nomination of former Utah Governor 
and current EPA Administrator Michael Leavitt to be the 20th Secretary 
of Health and Human Services.
  As Utah's longest-serving Governor, Governor Leavitt earned the 
reputation as an innovator and consensus builder. He is best known for 
his work in Utah to expand health care coverage. While he and I may 
disagree on policy grounds about the Utah approach, Governor Leavitt 
has spoken at length about the importance of transparency, the 
importance of fairness and open debate, all of which are crucial to 
creating sound public policy.
  He is a consensus builder, something that is very much needed not 
only in this town but in the new position he is about to have.
  Governor Leavitt's leadership and social policies stretch beyond 
health care. He also has championed welfare reform. The Utah program 
fulfills many of the goals of the 1996 welfare bill, which I am proud 
to have helped write. It provides support for low-income families, 
addresses barriers faced by welfare recipients, provides education and 
training opportunities to support moving into sustainable employment, 
and ensures that struggling families receive child support.

[[Page 871]]

  As EPA Administrator, Governor Leavitt came out to visit my State. He 
came out to visit the Superfund site at Libby, MT. We are having a very 
difficult time in Libby. It is a huge Superfund site, one of the 
largest in the country. I tell Governor Leavitt, as I have many times, 
his visit meant a lot to me personally and to the people of Libby who 
have suffered a great deal because of asbestos sickness.
  In short, Mr. Leavitt is a very capable leader and excellent 
candidate to lead this Department. We are fortunate to have his 
leadership, because the challenges he will face are tremendous.
  This year, as Secretary, Mr. Leavitt will implement the new Medicare 
drug benefit and managed care reforms--no small task but an extremely 
important one.
  The final rule to implement major provisions of the new Medicare drug 
law were published last week, 2 days after the confirmation hearing, I 
might add. I am still in the process of reviewing those regulations, 
but at first read, I remain concerned about the transition rule for 
dual eligibles and for consumer protection standards. The final rule 
included much needed improvements in both areas. For example, 
beneficiaries who are dually eligible for Medicare and Medicaid will be 
automatically enrolled into a drug plan. However, the timeframe for 
doing so is short, and it may still cause problems for many low-income, 
vulnerable beneficiaries.
  While the final rule includes expedited timeframes for coverage 
decisions, it still appears drug plans will write their own appeals 
process.
  In addition to Medicare, as HHS Secretary, Governor Leavitt will 
tackle Medicaid reform. Many of us in Congress anticipate an aggressive 
reform proposal will be included in the President's budget. It is true, 
as many claim, that Medicaid costs are growing, but the cost growth is 
due to an increase in enrollment during our recent economic downturn 
and for the same health care cost of inflation that affects every 
insurance plan. In fact, Medicaid growth is lower on a per capita basis 
than is Medicare growth or private insurance growth. It is lower. We 
should also bear in mind that Medicaid covers long-term care, something 
which is quite expensive.
  Also, I disapprove of the administration's use of its 1115 waiver 
authority. The 1115 waiver authority was not intended to achieve 
wholesale reform of Medicaid. We have a Medicaid law. The waiver 
authority was not meant to undermine that law. It was meant to grant 
flexibility to the States but not to undermine the law. It was not 
intended to undermine the fundamental nature of the Medicaid Program.
  I suspect the administration will want to consider Medicaid waivers, 
State flexibility, and Medicaid funding as part of any formal 
discussion.
  Reauthorizing TANF is another task to add to Mr. Leavitt's growing 
list. We cannot continue to extend the program on a 3-month or 6-month 
basis, as these short month extensions have undermined the stability of 
the program. We have to enact and reauthorize welfare reform. We must 
work together on a longer term reauthorization, one that builds on the 
1996 reform law.
  Finally, I hope we can work together to address rising health care 
costs and the uninsured. The United States health system is the most 
expensive in the world, by far. Spending on health care in 2003 reached 
$1.7 trillion, which calculates out to $5,670 per person. That is about 
twice the next highest level in the world, which is Switzerland, and 
they spend half per capita than what we spend. Yet 45 million 
Americans, even though we spend so much more than any other country, 
lack health insurance. What can we do about lack of insurance and 
rising health care costs?
  With respect to the uninsured, every major poll suggests covering the 
uninsured should be at the top of the congressional agenda. Yet this 
issue always seems to take a backseat. I think, however, that we can 
make progress--maybe not sweeping reform but we can address the problem 
incrementally, starting with areas first of general agreement.
  I believe there is a consensus, for example, that we ought to start 
by covering low-income children and the poorest adults below 100 
percent of poverty.
  I have every hope Governor Leavitt, as HHS Secretary, will keep 
working on this, and I pledge to help him.
  With respect to rising health care costs, I believe we can take 
important steps this year to improve health care quality and the way we 
pay for health care in our country. I am counting on the 
administration's support. I am counting on them to back up their 
statements and goals with funding and actions.
  I have no doubt Governor Leavitt is up to the task. He has an 
excellent reputation, not just as Governor of Utah, not just as EPA 
Administrator, not just as a political leader, but as someone who is 
creative, who can think outside the box, and who can work with folks 
from all perspectives.
  Governor Leavitt has my very strong support. He has my vote. I look 
forward to working with him as Secretary Leavitt and with the 
administration to address the many challenges that lie ahead for our 
country.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Utah is recognized.
  Mr. HATCH. Mr. President, as everybody around here knows, I strongly 
support the nomination of Governor Mike Leavitt for Secretary of Health 
and Human Services. I urge my colleagues to confirm Governor Leavitt so 
that he may start his work as quickly as possible.
  I have known Governor Mike Leavitt for a long time, almost 30 years, 
and have worked very closely with him on many health issues, not just 
local and State health issues but national health issues as well. 
Governor Leavitt has a distinguished record. He is highly qualified for 
this job. He is bright, energetic, dedicated, and fair--all of the 
qualities necessary for this important position.
  I say with all respect to those who have gone before him, I can think 
of no better candidate for Secretary of Health and Human Services or no 
better nominee than Mike Leavitt.
  Having said that, I compliment his predecessor, Governor Tommy 
Thompson. To have two great Governors in a row running HHS is a credit 
to this administration and to the country at large. Governor Thompson 
has done a terrific job at HHS under very difficult circumstances. It 
is almost an unmanageable entity because it is so large and so 
important and covers so much of the wealth and costs of this Nation. 
Governor Thompson deserves a great deal of credit. He was a great 
Governor, but so was Mike Leavitt. Between the two of them, we will 
have a continuity that will be very beneficial to all of us.
  Governor Leavitt has devoted much of his life to public service, 
first in Utah and more recently in Washington. He is a smart 
decisionmaker, a tireless worker, and a successful manager and 
executive. He is fair. He is knowledgeable about health care. He is a 
decent family man. The bottom line: He will get the job done.
  As Governor of Utah, Governor Leavitt was a strong leader on issues 
familiar to this body: welfare reform, health care delivery, and, of 
course, Medicaid. During a difficult financial time for our State of 
Utah, Governor Leavitt was able to create a fiscally responsible budget 
and at the same time provide important services to lower income Utah 
citizens of all ages.
  While Congress was working on the 1997 Child Health Insurance Program 
legislation, a bill that I was the prime sponsor of, I talked to 
Governor Leavitt frequently to get his perspective as a leader in the 
National Governors Association. At first he was not very enamored with 
the Hatch-Kennedy bill. On the other hand, I told him the final bill 
was not going to be exactly that bill, which was written a little more 
moderately than I thought it should be. I also wanted the States to 
have more authority and power with the CHIP program, which was more in 
sync with Governor Leavitt's thinking. During that time he provided me 
with valuable insight and has continued to do so as the program has 
grown.
  I would be remiss if I did not also cite Governor Leavitt's great 
work in providing health care coverage to not only

[[Page 872]]

CHIP-eligible children but to lower income adults of our State as well 
through innovative new State health care insurance programs like the 
Primary Care Network.
  In addition, Governor Leavitt implemented several new and innovative 
approaches to serving the poor. Governor Leavitt's administration was 
one of the first to implement a philosophy of universal engagement 
wherein every candidate to receive State assistance was assessed and a 
plan to help these individuals become self-sufficient was created. This 
proved to be an enormously valuable tool to helping the disadvantaged 
get the assistance they needed to return to the job market as soon as 
possible.
  As in many aspects of his life as a public servant, Mike Leavitt is a 
visionary who cares deeply about people, exactly the type of a person 
we want in this position.
  Finally, Governor Leavitt has been a strong supporter of the Utah 
Head Start Program. For many children, the Head Start Program is their 
first and only exposure to education and health services. There are 
many examples of how the Utah Head Start Program has made a dramatic 
difference. Let me cite a couple for my colleagues. One little girl 
from Utah was handed a book on her first day in the program and 
literally did not know how to open the book. Another child was 
diagnosed with a brain tumor through the Utah Head Start screening 
process. Surgery was successfully performed, and he returned to the 
program and did extremely well. Governor Leavitt has had firsthand 
experience at overseeing this program and therefore brings an important 
perspective to HHS on why Head Start needs to be continued and even 
strengthened.
  On a personal note, I emphasize to my colleagues that Mike Leavitt is 
a fair man. I know him very well. He will look at all sides of an issue 
before making a policy decision, and my colleagues can count on the 
result to be the right decision. His record as both the Governor of 
Utah and as Administrator of EPA proves this, and he will continue to 
be a great leader when he becomes Secretary of HHS. I can promise my 
colleagues he will be an excellent leader for the programs we all 
support--Medicare, Medicaid, CHIP, welfare and community health 
centers, just to make a few.
  Importantly, we can count on Mike Leavitt, along with the 
Administrator for Medicare and Medicaid Services, Mark McClellan, to 
work closely with our committee on the difficult task of fully 
implementing the Medicare prescription drug program next January. I 
might add that the jurisdiction of a Secretary of Health and Human 
Services is quite broad, it not only includes CMS, which handles 
Medicaid and Medicare among other programs, but it also includes the 
Food and Drug Administration and many other different programs within 
that department.
  In my opinion, the FDA is the single most important consumer agency 
in the world. The FDA handles upwards of 25 percent of all consumer 
products in America, and the agency does an extraordinary job. However, 
there is more and more pressure on FDA every year to try to have a 
fail-safe system where no deleterious results can occur from 
pharmaceutical innovations. There is no way that can ever be, but I 
believe that FDA does as good of a job as possible. In fact, my FDA 
Revitalization Act, authorized the creation of a central campus in the 
Washington, DC, area to house all FDA employees in this greater area 
who are now scattered over more than 30 different facilities, which can 
be very inconvenient and nonproductive. In December 2003, we dedicated 
the first building on the White Oak campus, which is where the full FDA 
campus will be built with state-of-the-art equipment and state-of-the-
art facilities. Individuals who want to work in this area will be given 
an opportunity to work under the best of circumstances.
  One of Governor Leavitt's responsibilities as Secretary will be to 
continue with this centralization, complete with a totally computerized 
and digital FDA campus, created so that we can be even more efficient 
at FDA. It is my hope that this centralized campus will shorten the 
length of time it takes to ensure the safety and efficacy of 
pharmaceutical drugs.
  I will close with one anecdote related to me the other day. After 
attending several briefings with the Secretary designate, an FDA 
official stated: At our first briefing, Governor Leavitt was good. At 
the second meeting, he was excellent. At the last briefing, he was 
teaching us.
  Now, that is the kind of a man Mike Leavitt is. He will be a great 
Secretary. With pride and admiration, I strongly support my fellow 
Utahan Governor Mike Leavitt's nomination for Secretary of Health and 
Human Services. Let us get him confirmed and on the job as soon as 
possible. I have no doubt that will occur. I am very grateful to those 
who are willing to support Governor Leavitt, and I suspect that 
everybody in this body will do so.
  I yield the floor and I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. TALENT. I ask unanimous consent the order for the quorum call be 
rescinded, and I ask unanimous consent to proceed for only about 3 
minutes.
  The PRESIDING OFFICER (Mr. Hatch). Without objection, it is so 
ordered.
  The Senator from Missouri is recognized.


                  The Unborn Child Pain Awareness Act

  Mr. TALENT. Mr. President, I appreciate the Senator for taking the 
chair for just a couple of minutes so I can speak about a bill I have 
introduced along with Senator Brownback. He is the lead sponsor. There 
will be others on the bill as well. We had sponsored the bill last 
year. I want to make a brief statement about it.
  It is a good bill in an area where we often do not see consensus, but 
I believe this bill will promote consensus. It is the Unborn Child Pain 
Awareness Act. It is based on the scientific evidence, which I think is 
a matter of common sense as well, that children in gestation, unborn 
children in the womb, do at a certain point acquire the capability of 
feeling pain. What the bill says is that before an abortion can be 
performed on a child who has been in the womb for 20 weeks or longer, 
the abortion doctor has to inform the mother that the child will feel 
pain and will, in fact, feel intense pain if the procedure is 
performed, and then inform her that if she wants to go ahead anyway, 
the child can be given an anesthetic so that that pain is not felt.
  Apart from the fact that the scientific evidence indicates children 
at this point can feel pain, I have a personal stake, if you will, in 
this. Before we were blessed with the three children we have, my wife 
had several miscarriages in a row. It was pretty obvious what was 
growing inside of her was a person. It makes sense to me to believe at 
a certain point that a child can feel pain, and 20 weeks is actually a 
pretty conservative estimate of when the child is able to feel that 
kind of pain.
  I see no reason a doctor about to perform such a procedure would not 
want to make it known, or a woman who is considering undergoing it 
would not want to know that fact to make a decision.
  Mr. President, you know me and my view on this issue overall. I 
believe unborn children are people. I look forward to and long for the 
day where we believe there is room in our hearts and our homes and our 
laws for them and their moms. We are not there in that fundamental 
sense, but we are at a point where we can work on legislation like this 
which has support broader than either the pro-choice or pro-life side. 
This is legislation which is really designed to perfect the current law 
that says women should be able to make a choice. Then they should be 
able to make an informed choice.
  I hope that is what we do. I hope we have an opportunity to bring it 
up on the floor of the Senate, and if we do have an opportunity to have 
a reasonable debate, we will pass it with a large margin. I hope to 
have that done in this Congress. I am proud to have cosponsored it.

[[Page 873]]


  Mr. CONRAD. Mr. President, I plan to support Governor Michael O. 
Leavitt's nomination to be Secretary of Health and Human Services, HHS.
  Governor Leavitt is taking on a difficult role. There are many 
healthcare challenges facing our Nation. With over 300 separate 
programs and a budget of more than $400 billion per year, the Secretary 
of HHS is responsible for setting the healthcare agenda for the 
administration. It is my hope that implementing the Medicare 
prescription drug benefit will be at the top of Governor Leavitt's 
agenda. This large and complex law will have a tremendous impact on 40 
million Medicare beneficiaries. As we get closer to January 1, 2006--
opening day for the drug benefit--HHS will have many important 
decisions to make. I look forward to working with Governor Leavitt to 
ensure that North Dakota seniors get the options and information they 
need to make the best choice about the right drug benefit for them.
  Also, given his record, I hope Governor Leavitt will take an active 
role in addressing funding shortfalls in the rural healthcare system. 
Many of the provisions in the Medicare Modernization Act that erased 
the inequities that existed between rural and urban providers are due 
to expire in 2006 and 2007. I am committed to reauthorizing these 
important provisions and trust that Governor Leavitt will work with me 
towards this end.
  More generally, it is important that HHS and Congress look at other 
areas where healthcare needs are being unmet and take the appropriate 
steps to improve access to healthcare in rural America. For example, 
Congress should improve the financing of our rural emergency medical 
services. Our rural EMS squads are a vital component of the healthcare 
system, and current Medicare regulations do not adequately reimburse 
these squads for their services. This Congress, I intend to introduce 
legislation to improve the rural EMS system and hope that Governor 
Leavitt will support these efforts.
  As Governor of Utah during the 2002 Winter Olympics, Mr. Leavitt had 
extraordinary experiences with preparing for a possible bioterrorism 
attack that will aid him in his position as Secretary of HHS. Over the 
past years, I have pushed for the enactment of a national emergency 
telemedical communications system that could be used to more 
effectively respond to a bioterrorist attack on a regional level by 
using telehealth technologies. I look forward to working closely with 
Governor Leavitt to move this legislation forward.
  Finally, in his new role as Secretary, Governor Leavitt will be 
charged with preserving and protecting two of our Nation's most 
important health insurance programs--Medicaid and the State Children's 
Heal Insurance Program. It is important that Governor Leavitt be a 
strong advocate for these vital social programs.
  I look forward to working with Governor Leavitt in the coming years 
to improve healthcare for all Americans.
  Mr. KENNEDY. Mr. President, I support the nomination of Michael 
Leavitt to be the next Secretary of Health and Human Services. Our 
Committee on Health, Education, Labor and Pensions has unanimously 
recommended his confirmation, and I urge the Senate to do so as well.
  At the committee hearing on his nomination, Governor Leavitt showed 
the intelligence, honesty and commitment to public service that have 
been the hallmark of his career. While we differ on some issues raised 
at the hearing, there are many issues where we agree and can work 
together to create a bipartisan consensus. I believe that he will lead 
the Department with integrity, skill and vision.
  The Department of Health and Human Services has a broad and deep 
impact on the lives of the American people. Its programs reflect the 
ideals of our nation and our commitment to provide help to all those 
who need our help the most.
  HHS cares for the elderly through Medicare and the Older Americans 
Act. It nurtures the young through Head Start, CHIP, and maternal and 
child health programs. It sustains poor families through the Temporary 
Assistance to Needy Families Act. It brings health care to all in 
poverty through Medicaid. It offers help and hope to patients suffering 
from disease through the National Institutes of Health. It guarantees 
every American that the medicines they take are safe and effective and 
the foods they eat are healthful through the Food and Drug 
Administration. It protects the health of every American against 
epidemics of disease through the Centers for Disease Control and 
Prevention.
  Mr. Leavitt brings impressive skills to this critical post. As a 
former governor he knows how HHS works, and where it needs improvement. 
At EPA, he confronted health issues similar to many of those dealt with 
by HHS. Everyone who knows him respects his intelligence, his high 
energy, and his experience as a manager and problem-solver.
  His new position will test all those skills, and he'll face an 
especially heavy challenge this year. Many of the most important 
programs he oversees get lavish praise but little real support. Last 
year, the administration was able to push through the Congress a flawed 
Medicare drug bill that benefited drug companies and insurance 
companies at the expense of patients. Governor Leavitt will now have to 
implement that flawed bill.
  Press reports indicate that the administration intends to block grant 
Medicaid and cut it deeply, and to cut Medicare deeply as well. More 
than 50 million of the Nation's poor depend on Medicaid for health 
care. Forty-two million senior citizens and disabled Americans depend 
on Medicare. The administration's tax cuts for the wealthy and its 
misguided war in Iraq have created a catastrophic deficit, but it would 
be unconscionable to solve the budget crisis by penalizing the poor and 
the elderly who did nothing to create it, and to ask the wealthy and 
powerful to make no contribution at all.
  We will continue our bipartisan work this year on Head Start--the 
foundation of federal support for the nation's most vulnerable 
children. Head Start has a 40-year track record of success. The 
reauthorization this year is an opportunity to build on that success, 
and do more to open the American dream to many more children who 
deserve our help. A block grant for Head Start would be a giant step 
backwards--we can't turn Head Start into Slow Start or No Start.
  The current extension of welfare reform expires at the end of March, 
and our ability to move the welfare debate forward will require more 
flexibility from an administration willing to work in good faith with 
Congress on this basic issue of what kind of country we are. Governor 
Leavitt led Utah's innovative welfare program, which guarantees 
provides support and services tailored to the individual needs of each 
recipient, including education and training, substance abuse treatment, 
child care and other key assistance.
  Other priorities facing the Department include the need to move our 
health care system into the modern age using information technology, 
and improve FDA's ability to detect and respond promptly to warning 
signals on the effects of new drugs. We must also continue the fine 
work of Secretary Thompson in putting disease prevention and health 
promotion higher on the national agenda. And I hope that Governor 
Leavitt will support the bipartisan efforts led by Senator Dorgan and 
Senator Snowe to import safe FDA-approved drugs at the low prices that 
Canadians and Europeans are charged.
  I welcome Governor Leavitt's strong commitment to using information 
technology to improve the quality of care for America's patients and to 
reducing the costs of health care. I look forward to working with him 
closely to see that we take the actions needed to turn our bipartisan 
vision of an improved health care system into a reality.
  Michael Leavitt is a distinguished and talented public servant, and 
an impressive choice for this important responsibility, and I urge the 
Senate to confirm him as Secretary of HHS.

[[Page 874]]


  Mr. DOMENICI. Mr. President, I rise today in strong support of the 
nomination of Michael Leavitt to be the Secretary of the Department of 
Health and Human Services. Michael is an overwhelmingly qualified 
candidate and the kind of leader the Agency needs. I am confident he 
will work hard to serve the public health needs of our Nation.
  Michael Leavitt will bring considerable executive experience to this 
post. As the former Governor of Utah, he improved access to health care 
for thousands of children and adults, while keeping rising health care 
costs in check. To date, Utah's uninsured rate remains below the 
Nation's average. Michael has also proven himself a capable leader in 
his former positions as chairman of the National Governor's 
Association, and most recently, administrator of the Environmental 
Protection Agency.
  The Department of Health and Human Services, HHS, helps to protect 
the health, safety, and well-being of the American people. HHS is among 
our Nation's largest and most important Federal departments, overseeing 
more than 300 programs with a budget in excess of $580 billion. HHS is 
responsible for the management of such vital programs as the Food and 
Drug Administration, Indian Health Services, the Centers for Disease 
Control and Prevention, and the Centers for Medicare & Medicaid 
Services. The Medicaid and Medicare programs alone help provide needed 
health care to nearly 80 million Americans.
  I applaud President Bush for his choice of an accomplished leader to 
head this vital department. I look forward to working with Secretary 
Leavitt on critical issues such as implementation of the Medicare 
prescription drug program, medical liability reform and finding ways to 
reduce the cost of health care.
  Mrs. FEINSTEIN. Mr. President, I support the nomination of Governor 
Michael O. Leavitt to be U.S. Secretary of Health and Human Services.
  Governor Leavitt has had a lengthy career in public service, having 
served most recently as the 10th Administrator of the United States 
Environmental Protection Agency.
  In 1992, Leavitt was elected the 14th Governor of Utah and was that 
State's longest-serving Governor.
  During his three terms as Utah's Governor, he was chosen by the 
Nation's Governors to represent States in working with Congress on 
welfare reform, Medicaid and children's health insurance. He chaired 
the National Governors Association, the Western Governors Association, 
the Republican Governors Association and Council of State Governments.
  Governor Leavitt established an innovative welfare reform waiver 
program focused on increasing family income using an approach that 
emphasized employment and child support, but also addressed initial 
problems with families in need such as domestic violence, education, 
training, language barriers, and substance abuse issues to promote 
sustainable employment.
  This year, the HHS Secretary will have the critical task of 
overseeing the implementation of the first ever drug benefit in 
Medicare as well as the implementation of several program 
reauthorizations such as Ryan White, Temporary Assistance for Needy 
Families, and the State Children's Health Insurance Program, all within 
an ever-constrained budgetary picture.
  As someone who voted for the Medicare Modernization Act, it is my 
hope that Governor Leavitt will work with me to address some of the 
weaknesses of the bill in addition to ensuring that the more than 41 
million Medicare beneficiaries know about this new benefit in Medicare 
and its low-income subsidies.
  Of greatest concern to me is the cost of prescription drugs. In 
voting for the Medicare bill, I said on the Senate floor that one of 
the greatest weaknesses of the bill was that it not only did not do 
enough to control the rising cost of prescription drugs but it 
specifically prohibited the HHS from using the bulk purchasing power of 
the Federal Government to negotiate with prescription drug plans to 
lower drug prices for Medicare beneficiaries. I believe this 
prohibition should be stricken and that there should be a role for the 
HHS Secretary in what Medicare and beneficiaries pay for their drugs.
  I am committed to working with the HHS Secretary to find real 
solutions for lowering drug costs for our Nation's seniors.
  As the Medicare drug benefit is enacted, I am also hopeful that 
Governor Leavitt will work to ensure access to all needed medications 
for people living with HIV and AIDS, to allow for adequate transition 
time for the most vulnerable low-income seniors and to provide 
sufficient incentives and transparency for employers to retain their 
retirees' health care coverage.
  Governor Leavitt will oversee the Department of Health and Human 
Services at a time of rising deficits and this will require tough 
decisions. But these decisions must be balanced with the needs of the 
millions of Americans, young and old, who rely on Medicare, Medicaid 
and SCHIP to provide their health care insurance.
  Medicaid provides insurance to 40 million Americans, about 8 million 
of whom live in California. It covers 55 percent of all poor children 
and it pays for the births of one-third of all American children. It 
serves 50 percent of all people with AIDS and as many as 90 percent of 
children with AIDS.
  Medicaid is the insurer of last resort. If Medicaid did not exist, 
these individuals and families would be uninsured.
  But it is also the biggest budget items in many States. There is no 
question we can improve the efficiency and quality of Medicaid to 
ensure our dollars are being well-spent but we also cannot lose site of 
the fact that increases in spending per enrollee from 2000 until 2003 
were slower than increases in private insurance spending.
  There are 45 million Americans without health insurance today. 
Arbitrary limits on Federal Medicaid spending will only increase the 
number of uninsured, driving up overall health care costs and burdening 
our nation's already overcrowded emergency rooms.
  There is a great deal of work to be done, and I look forward to a 
productive working relationship with Governor Leavitt.
  Mr. DURBIN. Mr. President, as you know, I am passionate about health 
care issues, and I want to talk today about two issues of particular 
interest to me, which Health and Human Services Secretary Nominee 
Michael Leavitt has promised to review when he takes the helm at that 
department.
  Leavitt promised to look at the legislation which Senate Judiciary 
Chairman Orrin Hatch, R-Utah, and I are developing to require dietary 
supplement manufacturers to submit reports to the Food and Drug 
Administration when they cause serious injury or death to consumers. 
Under current law, these manufacturers of these products, which are 
widely sold, do not have to report to the government if their products 
are suspected of causing someone taking them to become ill or even die. 
This happens even to people who are seemingly healthy, such as 17-year-
old Sean Riggins from Lincoln, IL. Sean was a rising star on his high 
school football team in 1992 and wanted to enhance his performance in 
the big game. Sean took ``Yellow Jackets,'' a supplement promising 
increased energy, which contained ephedra. Sean was killed by those 
pills.
  While dietary supplements are safely consumed by millions of 
Americans every day, unfortunately, this is not always the case. 
Ephedra is perhaps the best-known dangerous supplement ingredient; it 
has caused at least 150 deaths, forcing HHS to pull it off the market. 
There are other supplements that have raised questions, such as 
aristolochic acid, usnic acid, kava kava and yohimbine, and the problem 
is, we just don't have the data centrally located to help the agency 
determine the products' safety. The law assumes products containing 
these substances are safe until proven unsafe.
  Senator Hatch and I do not always agree, but on this issue, we do. 
There should be a clearinghouse at the Food and Drug Administration for 
these manufacturers to provide data about the safety of their products. 
And most of the industry and consumer groups are on our side, so as we 
develop legislation this year, Administrator Leavitt

[[Page 875]]

has agreed to review it. I look forward to working with him.
  Administrator Leavitt also promised to remain active on the issue of 
tobacco control. Mr. Leavitt is a former charter member of the American 
Legacy Foundation board, the foundation established by the Master 
Settlement Agreement to educate youth and the public about the 
addictiveness and health effects of smoking.
  More than 90 percent of adult smokers began smoking as teenagers. The 
American Legacy Foundation's public education campaign is helping to 
produce dramatic decreases in youth smoking rates. The work of the 
American Legacy Foundation is more important than ever to this 
country's health.
  I support Administrator Leavitt's nomination to serve as Secretary of 
Health and Human Services and welcome the opportunity to work with him 
to reduce smoking among young people, acquire quality safety data on 
dietary supplements, and address other critical health concerns.
  Mr. DODD. Mr. President, I rise today as the nomination of current 
Environmental Protection Agency, EPA, Administrator and former Utah 
Governor Michael Leavitt for the position of Secretary of Health and 
Human Services comes before the Senate. I plan to support this nominee 
as I did a little more than one year ago when Governor Leavitt's 
nomination to lead the EPA came before this body. I do so with the 
intention of working with him once he is confirmed as the 
administration's leading health care advocate to protect our Nation's 
vital health care infrastructure.
  Once confirmed as Secretary of Health and Human Services, Governor 
Leavitt will oversee the administration of the Department of Health and 
Human Services, HHS, the vast federal agency overseeing the Medicare 
and Medicaid programs, the National Institutes of Health, NIH, the Food 
and Drug Administration, FDA, the Centers for Disease Control and 
Prevention, CDC, the Health Resources and Services Administration, 
HRSA, and the Administration for Children and Families, which oversees 
child care, welfare and Head Start. HHS operates more than 300 
critically important programs that represent almost a quarter of all 
federal outlays. In fact, the Medicare and Medicaid programs alone 
provide health insurance for one in four Americans.
  Current research tells us that well crafted, well researched, and 
comprehensive public health initiatives spearheaded by the office of 
the Secretary of Health and Human Services could lead millions of 
Americans to efficiently and successfully address health concerns 
before they become critical. However, just as important as the 
development of lifesaving preventive services is support for those 
programs already providing services to those already struggling with 
disease or impairment. In order to be successful in his new role as 
Secretary of Health and Human Services, Governor Leavitt will need to 
balance these sometimes competing needs so as to effectively lead our 
nation's federal health care systems into the 21st Century.
  Let me just take a moment to lay out several areas that I hope 
Governor Leavitt will make a priority as secretary. First, I think it 
is imperative that we take steps to ensure that the prescription drugs 
that are already on the market will not harm the millions of Americans 
that rely on them for their health and well-being. Serious questions 
have been raised about the ability of the Food and Drug Administration 
to ensure the safety of medicines. In the coming days, I will be 
introducing a bill to reform the FDA and give it the authority and 
resources to effectively monitor prescription drugs that are on the 
market, and take action if a safety issue is identified. I look forward 
to working with Governor Leavitt on this issue, and I hope that he will 
make it one of his top priorities.
  Of additional concern are possible efforts to modify our nation's 
Medicaid program, the federal and state health insurance program for 
those with low incomes. Currently this valuable program serves more 
than 50 million low-income children, pregnant women, elderly and 
disabled Americans, providing a vital safety net of health care 
services to these often vulnerable populations. I plan to work with the 
new Secretary to ensure that any modifications to this important 
program do not endanger its continued ability to provide for the health 
of its needy beneficiaries.
  I am also hopeful that Governor Leavitt will expand the work done by 
his predecessor to bring the health care system into the information 
age. Expanding the use of information technology, IT, in health care 
settings will save patients' lives and improve the quality of care. In 
addition, estimates suggest that investment in health IT is one of the 
most effective tools we have to control skyrocketing health care costs, 
making health care more affordable for all Americans.
  I urge Governor Leavitt to take a close look at an issue affecting 
the health of infants in this country. The Advisory Committee on 
Heritable Disorders and Genetic Diseases in Newborns and Children is 
close to issuing a report recommending a standard set of genetic 
disorders that all states should test for at birth. Newborn screening 
saves thousands of lives every year, but the current inconsistency in 
state testing policies means that too many children still suffer from 
disorders that are not detected until it's too late. I hope that 
Governor Leavitt will work with me to ensure that states can adopt the 
recommendations of the advisory committee, so no more infants fall 
through the gaps in newborn screening.
  Tragically, we know that each and every day in America 7,000 children 
under the age of sixteen have their first alcoholic drink. We also know 
that 4,500 children under the age of 21 will lose their lives due to 
the abuse of alcohol each year. At the same time, the social costs 
associated with underage drinking total close to $53 billion annually 
including $19 billion from automobile accidents and $29 billion from 
associated violent crime. In 2003, the Institute of Medicine released a 
study, ``Reducing Underage Drinking--A Collective Responsibility,'' 
that laid out the national problems presented by consumption of alcohol 
by youth and established a multi-tiered national strategy to reduce 
underage drinking's toll. Sadly, however, there has yet been little 
progress made in instituting this strategy. It is my desire to work 
with the new Secretary toward implementation of this important report's 
recommendations.
  I also look forward to working with Governor Leavitt to increase the 
availability of medical devices for children. Many essential medical 
devices used extensively by pediatricians are not designed and sized 
for children's special needs. Because the number of children needing a 
particular device is often quite small, there's simply little financial 
incentive for manufacturers to make pediatric appropriate devices. As a 
result, health care providers are forced to use adult devices ``off-
label'' without a clear understanding of the risks involved or to use 
older, less optimal, or more invasive interventions. Pediatricians tell 
us that the development of cutting-edge medical devices suitable for 
children's smaller and growing bodies can lag 5 or 10 years behind 
those for adults. In my view, this is an issue that demands our 
attention.
  Lastly, if I could take a moment to talk about some of the issues 
related to poverty that this Congress will face and how important it 
will be that we are able to work with a Secretary of Health and Human 
Services who will be prepared to listen and to objectively assess 
options and, when appropriate, to help bring compromise toward a 
bipartisan solution. In the coming months, we will be working on 
legislation to further strengthen Head Start, to improve the quality of 
child care and to provide additional funding for child care in order to 
ensure that we do not pit the working poor against the welfare poor, 
legislation to reauthorize the Community Services Block Grant, CSBG, as 
well as the Low Income Home Energy Assistance Program, LIHEAP. I am 
interested in working with Mr. Leavitt to reach bipartisan support for

[[Page 876]]

these measures, which frankly should have bipartisan support. We should 
not be politicizing poverty.
  I am very concerned about the direction that the administration wants 
to take with regard to Head Start. I, too, believe there are further 
actions we can take to strengthen the literacy and cognitive 
development of Head Start children. But, Head Start is not just about 
literacy. It is about overall school readiness which includes the 
social, emotional, physical, and cognitive development of children, 
development of the ``whole'' child. The Head Start bill approved by the 
House last year and supported by the administration would repeal the 
Head Start performance standards--standards which help ensure the 
comprehensive quality of the program. I think that is a mistake. We can 
and should further strengthen the Head Start program and I look forward 
to working with Governor Leavitt to do so. But, if we are serious about 
strengthening Head Start, then we cannot repeal the performance 
standards which are the foundation for quality accountability.
  As I mentioned earlier, another issue I hope to work with Governor 
Leavitt on is child care. When Governor Leavitt appeared before the 
Committee on Health, Education, Labor and Pensions, we talked about the 
need to expand access to the children of working poor families, not 
just the welfare poor, and to improve the quality of care. Again, if we 
are serious about improving the school readiness of our Nation's 
youngest, then we need to ensure that the child care they receive is 
related to child development. Some 700,000 children are in state pre-
kindergarten programs. Another 900,000 children are in Head Start 
programs. But, some 14 million children younger than six are in child 
care arrangements for many hours every day, every week. If we ignore 
the quality of care that these children receive, we are missing an 
opportunity to ensure that these children enter school ready to learn. 
It is these children, largely from working poor families, who aren't in 
Head Start, who aren't in a 2-3 hour day pre-kindergarten program 
because their parents work, who are most at-risk of being left behind. 
I am hopeful that we can work to achieve a bipartisan increase in child 
care funding to better address the needs of the working poor while 
improving the quality of care the children in these families receive.
  These issues of concern offer only a handful of the multitude of 
items facing the office of the Secretary of Health and Human Services. 
In his new role as Secretary of Health and Human Services, Governor 
Leavitt will have the opportunity to touch the lives of millions of 
Americans who often struggle to adequately address their health care 
needs.
  However, as we all know, with great opportunity also comes great 
responsibility. As we learned painfully with the bioterrorist attacks 
of 2001, we now face as a nation threats to our public health that we 
could never have imagined only a few short years ago. In this new era, 
it is critical that we are prepared to meet these new challenges head 
on. I look forward to working with Governor Leavitt in his new role and 
in the future to ensure that the public health infrastructure of the 
Unites States is prepared to adequately address these new threats.
  So it is with great optimism that I support this nomination. I can 
think of few more influential positions within federal service than the 
position of Secretary of Health and Human Services. This position 
brings with it a great opportunity to not only shape the way we as 
Americans learn about the importance of health but literally has the 
ability to save lives. I hope to be able to have the opportunity to 
work with Governor Leavitt in his new role as Secretary of Health and 
Human Services to enhance the health and well-being of all Americans.
  Ms. STABENOW. Mr. President, I rise today to discuss the nomination 
of former EPA Administrator and Utah Governor Michael Leavitt to be the 
Secretary of Health and Human Services.
  I respect Governor Leavitt. He and I have enjoyed a good working 
relationship when he was the EPA administrator. Governor Leavitt always 
kept an open door, and he worked closely with me on important Michigan 
issues such as Canadian trash and air quality standards.
  But today, he stands ready to take a new role. This is an immense 
honor and carries even greater responsibility. HHS oversees many of the 
agencies that affect Americans' lives the most. For example, the 
Secretary oversees Medicare and Medicaid, which covers over 70 million 
people, from children and mothers to seniors and the disabled. The 
National Institutes of Health drives our Nation's biomedical research, 
and the Food and Drug Administration works to make sure what we eat is 
safe.
  Unfortunately, HHS also has a series of missteps. In today's 
Washington Post, we learned that HHS, like the Department of Education, 
paid a journalist to write supportive statements about administration 
policy in her column. This is on top of findings that HHS improperly 
used federal money for political purposes. HHS officials also stopped 
the CMS actuary from giving important information to Congress about the 
true cost of the Medicare drug bill. I urge Governor Leavitt to work to 
correct these abuses.
  I intend to vote to confirm Governor Leavitt, but I do want to use 
this opportunity to raise some major concerns about health care. First, 
I am concerned about Governor Leavitt's position on Medicaid. My State 
has made great strides in stretching each Medicaid dollar, including an 
innovative drug purchasing plan with other States.
  We should encourage States to find innovative ways to save money, but 
having flexibility and innovation does not mean cutting people's 
benefits. I am concerned about rumors about ``block granting'' 
Medicaid. That would be a dangerous proposition to our most vulnerable 
populations that rely on this important State-Federal partnership.
  Second, we need to have a full and open debate about reimportation. 
Last Congress, I was deeply disappointed that after numerous bipartisan 
attempts to bring the issue of drug reimportation to the Senate floor, 
the leadership blocked a fair discussion on a sensible way to bring 
down drug prices. I am glad that my friend and colleague Senator Dorgan 
secured an agreement with Senators Frist and Enzi on having a HELP 
committee hearing on reimportation by April 25.
  We urgently need to have a reimportation bill brought to the floor. I 
am very troubled by allegations of delays while our seniors and 
businesses pay the price. For example, there are allegations that the 
administration is putting strong pressure on our neighbors to the north 
to block reimportation. In fact, we have heard complaints that almost 
immediately after U.S. trade officials visited Canada in December, the 
Canadian health minister began looking into ways to block 
reimportation.
  I have heard too many stories from my constituents that without lower 
priced, FDA-approved drugs from Canada, they would not be able to 
afford their rent or buy their groceries. In the America that we want 
for ourselves and our children, no one should ever have to choose 
between paying their rent or their medicine.
  It is unacceptable that they cannot purchase their medicine here in 
the United States. In this great Nation, a pharmacist in Detroit should 
be able to do business safely and securely with a pharmacist in 
Windsor.
  I am glad that Governor Leavitt is keeping a more open mind about 
reimportation than others in the administration . . . so far! In fact, 
during his nomination hearing in the Finance Committee, he stated: ``If 
it can be shown that it can be done safely, then it's a discussion we 
should have.''
  I hope Governor Leavitt will continue to keep an open mind as we 
debate reimportation under the agreement with leadership. Again, we 
need to have an open debate here in Congress about reimportation.
  Finally, I hope that Governor Leavitt would keep an open mind about 
allowing the Federal Government to negotiate drug purchases on behalf 
of Medicare.

[[Page 877]]

  Even outgoing HHS Secretary Thompson said at his December 3 
resignation press conference that he would have liked to have had the 
opportunity to negotiate lower drug prices.
  I know that Secretary-designate Leavitt has said he does not believe 
that the Secretary should have the power to negotiate with drug 
manufacturers to secure lower prices for Medicare beneficiaries. 
Rather, he believes that the Medicare law provides enough safeguards to 
keep drug prices in check.
  How is that possible when researchers at Boston University have found 
that the pharmaceutical industry will actually make $139 billion more 
under this plan?
  In fact, a recent study published in the prestigious Health Affairs 
journal found that if Medicare could negotiate and bring drug prices 
more in line with other nations' costs, we could close the doughnut 
hole.
  I am disappointed that Governor Leavitt does not believe in using the 
market power of over 40 million people to get the best prices for 
seniors, the disabled, and the American taxpayer. It is a good market-
based solution.
  More than ever, we need to work to keep down the costs of drugs. It 
is hurting our businesses, it is hurting our families, and it is going 
to hurt every American taxpayer when the new Medicare drug program 
begins in 2006.
  Yesterday the Wall Street Journal published a sampling of this 
month's prescription drug price increases, finding that the prices of 
31 of the 50 biggest selling medications have increased dramatically 
since our November elections. These drugs included popular drugs such 
as the cholesterol-lowering drugs Lipitor and Pravachol; the pain-
killer Celebrex; the antidepressant Zoloft; and the blood-thinner 
Plavix.
  One health research group stated that pharmaceutical companies are 
marking up their prices now in anticipation of the Medicare drug 
program coming out in 2006.
  It is outrageous that Medicare can't negotiate prices just like 
businesses, states, and even other Federal agencies can.
  This is a great nation, and in the past month, we have seen how 
strong our democracy is. But we also have room for debate and 
discussion. I urge Governor Leavitt to keep an open mind and to work 
with all Members of Congress to bring down the cost of prescription 
drugs for all Americans.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. DORGAN. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Talent). Without objection, it is so 
ordered.
  Mr. DORGAN. Mr. President, the business before the Senate is the 
nomination of Governor Leavitt to be the Secretary of Health and Human 
Services. I come to the floor to express my support for Governor 
Leavitt. He has come to Washington in recent years to be the head of 
the Environmental Protection Agency. He is someone of considerable 
talent, and he is someone with whom I have worked when he was Governor 
of the State of Utah.
  I have great respect for him, and I am very pleased that someone of 
his capability and talent would offer himself again for this Cabinet 
post. I am very pleased to support his nomination.
  I do want to say that one of the issues that he will confront as the 
Secretary of Health and Human Services is the issue of the 
reimportation of prescription drugs. It has been a hotly debated issue 
in the U.S. Congress. Sufficient votes exist in both the House and the 
Senate to pass legislation allowing for the reimportation of 
prescription drugs. The only reason that legislation has not been 
passed and gone to the President is it has been blocked by a minority, 
and blocked by those who want, apparently, to protect the President 
from having to veto legislation that includes reimportation.
  The President has indicated opposition to the reimportation of 
prescription drugs.
  Let me describe why the reimportation issue is important. The fact 
is, American people pay the highest prices in the world for 
prescription drugs. That occurs because the pharmaceutical industry can 
charge those prices. Unlike most other industrialized countries, we 
have no price controls. There, in fact, are some price controls, but 
the controls are in the hands of the pharmaceutical industry. They 
actually control prices in this country, and they control prices 
because of a piece of legislation that was passed a couple of decades 
ago that prohibits the reimportation of prescription drugs, except by 
the drug manufacturer itself. For that reason, unlike other countries, 
citizens in our country are not able to routinely purchase an FDA-
approved drug which is sold for a much less expensive price in other 
countries.
  There is an exception to that, which is the allowance for 
prescription drug reimportation for personal use by someone who 
actually travels personally across the border to Canada or Mexico and 
purchases the FDA-approved prescription drug. They are allowed to bring 
a 90-day supply for personal use into our country. With the exception 
of that, a pharmacist from this country is not able to purchase from a 
pharmacist in Canada, and a licensed distributor in this country is not 
able to purchase from a licensed distributor in Canada.
  The fact is, that is an exception to what is happening in other parts 
of the world--Europe for over 20 years. If you are living in Germany 
and want to buy a prescription drug from Italy, no problem. You can do 
that. If you are in Spain and want to buy a prescription drug from 
France, that is not a problem, either. It is called parallel trading. 
Those engaged in it in Europe have testified before Congress and 
indicated it has been going on for decades with no safety issues at 
all. Yet in this country, we have this artificial barrier that prevents 
a pharmacist from Grand Forks, ND, from buying an FDA-approved drug 
sold by a pharmacist in Winnipeg, Canada. It makes no sense at all.
  We were not able to pass this legislation because the pharmaceutical 
industry has great influence here and with the Administration. As a 
result, the legislation has been blocked.
  Yesterday, Senator Olympia Snowe from Maine and I met with Majority 
Leader Frist and Senator Enzi. We indicated that we would be 
reintroducing our bipartisan legislation. Senator Snowe and myself, 
Senator McCain, Senator Kennedy, Senator Stabenow, and many other of 
our colleagues, will cosponsor the major bipartisan piece of 
legislation dealing with the reimportation of prescription drugs.
  We had a commitment yesterday that was expressed publicly last 
evening; that the bipartisan piece of legislation dealing with the 
reimportation of prescription drugs will have a hearing on its own 
merit exclusively directed at that bill before the Health, Education, 
Labor and Pensions Committee. I appreciate that very much. That is the 
first step in getting this kind of legislation passed through the 
Congress.
  Our approach is to try to put downward pressure on prescription drug 
prices because we think it is unfair that the consumers in this country 
pay the highest prices in the world.
  With your consent, Mr. President, I will show two pill bottles--two, 
of a dozen, I could show. The bottles that I hold up today are bottles 
of Lipitor. As one can see, they are identical in color, identical in 
shape and size, and they contain an identical tablet. It is something 
called Lipitor for the reducing cholesterol. The medicine taken is one 
of the most popular medicines sold in this country taken to lower 
cholesterol levels in patients. It is sold in Canada and in the United 
States.
  As you can see, the same pill is put in the same bottle, is made by 
the same company, and is FDA-approved in both cases. The difference? 
Price. The American consumer is charged $1.86 per tablet and the 
Canadian consumer, $1.10 per tablet. Why would one justify charging 
nearly double the price to the American consumer? What justifies that? 
These pills are, in most cases,

[[Page 878]]

made in the same plants, put in the same bottle, but shipped to two 
different places with two different pricing schemes. In almost every 
case, the pricing scheme with medicine of this type is to price the 
brand-name prescription drug at a higher price in the United States 
than exists in other countries. We think that is unfair to the American 
consumer. We don't propose price controls. Rather, we suggest the 
American consumer have the same access to be able to purchase the FDA-
approved medicine from other major, industrialized nations with drug 
safety systems comparable to our own.
  We recently had some testimony at a gathering here in the Congress 
that I want to review for a moment. Dr. Peter Rost, who is a drug 
industry executive, says:
  The biggest argument against reimportation is safety. What everyone 
has conveniently forgotten to tell you is that in Europe reimportation 
of drugs has been in place for 20 years--
  And done safely.
  Then he continues by saying the following:

       During my time response for a region in northern Europe, I 
     never once--not once--heard the drug industry, regulatory 
     agencies, the government, or anyone else saying that this 
     practice is unsafe. And personally, I think it is outright 
     derogatory to claim that Americans would not be able to 
     handle reimportation of drugs, when the rest of the educated 
     world can do this.

  This, from a drug industry executive. He obviously wasn't treated 
well by the industry when he said this. But it took great courage for 
him to say what is obvious to everyone. There is no safety issue. That 
is a specious argument by the pharmaceutical industry and those who 
support it to try to head off the Congress passing legislation that 
would allow for the reimportation of prescription drugs.
  The bipartisan group of legislators, Republicans and Democrats, who I 
and others have worked with, will introduce our legislation in the 
coming days. We now have a commitment for a formal hearing on that 
legislation. We will push for a vote on the floor of the Senate. I am 
confident there are sufficient votes in the Senate to pass this 
legislation. I do not think this legislation can continue to be blocked 
as it was in the last Congress.
  Mr. President, I wanted to make this point during the discussion 
about the nomination of Mr. Leavitt.
  Mr. Leavitt is a person, as I said, of considerable talent. I am 
enormously pleased that he is assuming this role. He will understand, 
as I understand, that he is duty bound in his new role as Secretary of 
Health and Human Services to follow what the White House dictates on 
this issue. The White House, at least at this point, is continuing to 
oppose reimportation legislation. In fact, when Tommy Thompson and I 
put together a task force to study this issue, they issued a report at 
the end of last year which could have been classified as ``recently 
incompetent humor''--this commission conceived in this report that 
there was a safety issue. To show you how irresponsible it was to put 
the task force together to reach a foregone conclusion that the 
Administration previously held, they proposed that Dr. McClellan head 
the group. He was the point person, who was the head of the FDA at the 
time, who raised all the issues and was vigorously opposed to 
reimportation and raised those issues in a manner that would befit 
someone working for the pharmaceutical industry.
  There was such a stink raised by Dr. McClellan to be selected to run 
the task force that the Administration finally backed away and had 
someone else run the task force. But the task force did not take a 
``level look'' at what this was about. They came up and conducted the 
safety issue.
  There is no safety issue. Dr. Rost tells you; and I encourage any of 
my colleagues who wish to know; go to Europe, or ask the Europeans to 
come over here and testify. They will tell you they have been doing 
this for years. The reimportation of drugs between countries has been 
done routinely year after year without any safety issues at all. That 
is just a specious issue raised by those who want to support the 
pharmaceutical industry and who don't want to support the interests of 
the American consumers who should not be charged the highest prices in 
the world for prescription drugs.
  Let me conclude as I started. Mr. Leavitt will assume the job of 
Secretary of Health and Human Services. I am anxious to work with him. 
I look forward to working with him. I have great respect for him. My 
hope is that he can convince this Administration to change its policy 
on reimportation.
  This should not continue: The same pill put in the same bottle, made 
in the same plant, both approved by the FDA, should not be shipped to 
two places, one of which will impose upon the U.S. consumer the highest 
prices in the world. That is not fair to Americans, and this Congress 
ought to have the courage and the backbone to stand up for the 
interests of the American people on this important issue.
  Within a matter of days, we will reintroduce our bipartisan piece of 
legislation. Within 90 days, we will have a hearing and we intend in 
every way possible to press this case on the floor of the Senate.
  I yield the floor, and I yield the remainder of the time on this 
side.
  The PRESIDING OFFICER. The Senator from North Dakota yields the floor 
and yields back the remainder of the time on the Democratic side.
  The Senator from Wyoming.
  Mr. ENZI. Mr. President, I rise today to express my support for the 
nomination of Governor Mike Leavitt, who has been the Administrator of 
the Environmental Protection Agency, to serve as our next Secretary of 
Health and Human Services.
  President Bush chose wisely when he nominated Governor Leavitt for 
this important post. He is a strong leader and an able administrator 
and his record provides the proof for his ability to get results.
  I have known Governor Leavitt for some time. We worked together far 
back in my public service career when he helped found the Western 
Governors University. His service as Utah's Governor gives him a wealth 
of experience in the challenges of providing access to affordable 
health care. As a Governor of Utah, his state had a diverse mix of both 
a very rural and a very urban population. Accordingly, he brings 
diverse views on how to handle a wide variety of issues. As a 
westerner, he also understands the particular health care problems that 
affect folks who live in those rural areas as well as the more rural 
frontier areas.
  His perspective will serve him well as Secretary. We have much work 
to do together with Governor Leavitt. We need to improve our health 
care system and increase patient safety through better and more 
widespread use of information technology. We need to ensure that the 
medications we take are safe and effective. We need to redouble our 
efforts to protect our Nation from the present danger of bioterrorism. 
We need to strengthen our health care safety net to protect the most 
vulnerable among us, and perhaps most importantly we need to do 
everything we can so that more affordable health insurance options are 
available to working families and small businesses. That important task 
will include making our medical liability system work better for 
patients and providers.
  I am pleased that I will have the opportunity to work with Secretary 
Leavitt in my new capacity as chairman of the Committee on Health, 
Education, Labor and Pensions. My committee is looking forward to 
working with Governor Leavitt to craft solutions to the health care 
challenges we face as a nation. During his confirmation hearing, he 
agreed to informally sit down with Senator Kennedy and I and others who 
are interested to informally discuss some of these solutions.
  I believe we will succeed in meeting the shared challenges because 
Secretary Leavitt has succeeded in every step he has taken in his 
career. More importantly, Secretary Leavitt has great appreciation of 
the importance of the family, which is the cornerstone of our society 
and the basic building block of our communities. Governor Leavitt is 
both a good man and a strong leader. I look forward to working with him 
on the health care issues that affect our families so directly.

[[Page 879]]

  I urge my colleagues to vote to confirm Governor Leavitt as the next 
Secretary of Health and Human Services.
  Mr. President, it is my understanding the other side has yielded back 
their remaining time. Knowing no other Republican wishes to speak, I 
yield back the remainder of our time, as well.
  The PRESIDING OFFICER. The Senator from Wyoming yields back the 
remainder of the time on the Republican side. All time having expired, 
under the previous order, the Senate will proceed to a vote on the 
confirmation of the nomination.
  The question is, Will the Senate advise and consent to the nomination 
of Michael O. Leavitt, of Utah, to be Secretary of Health and Human 
Services.
  The nomination was confirmed.
  The PRESIDING OFFICER. The President will be notified of the Senate's 
action.

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