[Congressional Record (Bound Edition), Volume 163 (2017), Part 6]
[Senate]
[Pages 7640-7647]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           EXECUTIVE SESSION

                                 ______
                                 

                           EXECUTIVE CALENDAR

  The PRESIDING OFFICER. Under the previous order, the Senate will 
proceed to executive session to resume consideration of the Gottlieb 
nomination, which the clerk will report.
  The assistant bill clerk read the nomination of Scott Gottlieb, of 
Connecticut, to be Commissioner of Food and Drugs, Department of Health 
and Human Services.
  The PRESIDING OFFICER. Under the previous order, the time until 12:30 
p.m. will be equally divided in the usual form.
  The assistant Democratic leader.
  Mr. DURBIN. Mr. President, I ask unanimous consent to speak as in 
morning business.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                          Russia Investigation

  Mr. DURBIN. Mr. President, this weekend we saw a peaceful democratic 
election in France, one of our key Western allies in the bedrock of 
European stability after two terrible wars in the last century. What 
happened just before the Sunday election in France? There was a massive 
cyber attack on the leading candidate, the one who prevailed, Emmanuel 
Macron. Whom do experts suspect was behind this cyber attack trying to 
manipulate another Western election, trying to foster mistrust in that 
nation's democratic institutions? Not surprisingly, Russia.
  Yet none of this should surprise anyone. Not only had Russia been 
subsidizing Mr. Macron's opponent, Marine Le Pen, who is seen as more 
sympathetic to Moscow, not to mention trying to interfere in Dutch and 
German elections as well, but we were warned about this by our own 
intelligence agencies 6 months ago.
  In early October last year, the U.S. intelligence community detailed 
Russia's attack on America's election and warned us that other attacks 
would follow. During a recent trip to Eastern Europe, a Polish security 
expert warned me that if the United States didn't respond to an attack 
on its own Presidential election by the Russians, Putin would feel 
emboldened to keep up the attacks to undermine and manipulate elections 
all through the free world.
  What has this administration and this Congress done to respond to the 
cyber act of war by the Russians against America's democracy? Has 
President Trump clearly acknowledged Russia's attack on the U.S. and 
forcefully condemned the actions? No. Has President Trump warned Russia 
to stop meddling in the United States and other democratic elections in 
France, Germany, and other countries? No. Has President Trump proposed 
a plan to help the United States thwart any future attack on the next 
election and to help our States protect the integrity of their voting 
systems? No. Has the Republican-led Congress passed sanctions on Russia 
in response to this attack on our democracy? Has it passed meaningful 
cyber security legislation? No.
  Quite simply, the failure of this President and Congress to address 
the security threat is a stunning abdication of responsibility to 
protect the United States and our democratic values.
  As if the conclusions of 17 U.S. intelligence agencies weren't enough 
to raise concerns, let's review what emerged just over the recent April 
recess. For example, Reuters reported that a Russian Government think 
tank, controlled by Russian dictator Vladimir Putin, developed a plan 
to swing our 2016 Presidential election to Donald Trump and undermine 
voters' faith in our electoral system.
  The institute, run by a retired senior Russian foreign intelligence 
official, appointed by Putin, released two key reports, one in June and 
one in October of last year.
  In the first, it argued that ``the Kremlin launch a propaganda 
campaign on social media and Russian state-backed global news outlets 
to encourage US voters to elect a president who would take a softer 
line toward Russia than the administration of then-President Obama.''
  The second warning said:

       [P]residential candidate Hillary Clinton was likely to win 
     the election. For that reason, it argued, it was better for 
     Russia to end its pro-Trump propaganda and instead intensify 
     its messaging about voter fraud to undermine the US electoral 
     system's legitimacy and damage Clinton's reputation in an 
     effort to undermine her presidency.

  It was also recently disclosed that the FBI obtained a Foreign 
Intelligence Surveillance Court warrant to monitor the communications 
of former Trump campaign foreign policy adviser Carter Page on the 
suspicion that he was a Russian agent. Add this to the ever-growing 
list of suspicious relationships between those in the Trump circle and 
Russia, from Michael Flynn to Paul Manafort, to Roger Stone, to Felix 
Sater.
  In fact, just last month, the Republican House Intelligence Committee 
chair, Jason Chaffetz, and the ranking Democratic member, Elijah 
Cummings, said General Flynn may have broken the law by failing to 
disclose on his security clearance forms payments of more than $65,000 
from companies linked to Russia. Yet, incredibly, the White House 
continues to stonewall requests for documents related to General Flynn.
  White House ethics lawyer during the George Bush administration, 
Richard Painter, wrote of this stonewalling: ``US House must subpoena 
the docs. . . . Zero tolerance for WH [White House] covering up foreign 
payoffs.''
  Is it any wonder why, in recent testimony to Congress, FBI Director 
Comey acknowledged an investigation of Russian interference in our 
election, which he said included possible links between Russia and 
Trump associates.
  Finally, over the recess--on tax day, to be precise--there were 
nationwide protests calling on President Trump to take the necessary 
step to dispel concerns by releasing his taxes once and for all. The 
concern over his taxes goes to the serious question as to how much 
Russian money is part of the Trump business empire. In 2008, Donald 
Trump, Jr., said Trump's businesses ``see a lot of money pouring in 
from Russia.'' This was despite his father incredibly saying this just 
a few months ago: ``I have nothing to do with Russia--no deals, no 
loans, no nothing!''
  It appears that the Russians were some of the few willing to take on 
the financial risk required to invest in Trump's precarious business 
deals. Any such Russian money, combined with the President's refusal to 
formally separate himself from his business operations during his 
Presidency, demand the release of his tax returns. Trump's response to 
the mounting calls to release these returns--the usual--is to attack 
everyone asking questions and blindly dismiss the issue as being 
irrelevant.
  Of course, the Senate Judiciary Subcommittee had compelling testimony 
yesterday from former Acting Attorney General Sally Yates and former 
Director of National Intelligence James Clapper. Miss Yates discussed 
the urgent warning that she delivered to the White House Counsel on 
January 26 that the National Security Advisor to the President of the 
United States, General Flynn, had been compromised and was subject to 
blackmail by the Russians. It was a warning she repeated in two 
meetings and a phone call.
  What did the White House do in response to the Acting Attorney 
General warning them that the highest adviser in the White House on 
national security could be blackmailed by the Russians? Nothing. For 18 
days, General Flynn continued to staff President Trump for a phone call 
with Vladimir Putin and other highly sensitive national security 
matters.
  Think of that. After being warned by the Attorney General that the 
man sitting in the room with you, the highest level of National 
Security Advisor, could be compromised by the Russians, President Trump 
continued to invite General Flynn for 18 days in that capacity. White 
House Press Secretary Sean Spicer said:

       When the President heard the information as presented by 
     White House Counsel, he instinctively thought that General 
     Flynn did not do anything wrong, and that the White House 
     Counsel's review corroborated that.

  Let's be clear. It is bad enough to have a National Security Advisor 
who

[[Page 7641]]

is subject to blackmail by the Russians. The fact that the Trump White 
House didn't see that as an urgent problem is deeply troubling.
  I am glad the Senate Crime and Terrorism Subcommittee held this 
hearing yesterday, but the occasional subcommittee hearing is not 
enough. Let's make sure we know for the record that this subcommittee--
chaired by Senator Lindsey Graham, a Republican of South Carolina, and 
Ranking Member Sheldon Whitehouse, a Democrat of Rhode Island--did a 
yeoman's duty--not just yesterday but in a previous hearing, without 
being allocated any additional resources for this investigation, 
without being given additional staff. They have brought to the 
attention of the American people some important facts about what 
transpired in the Trump White House after it was clear that General 
Flynn had been compromised by the Russians.
  But the occasional subcommittee hearing like this is not enough. We 
need an independent, bipartisan commission with investigative resources 
and the power necessary to dig into all of the unanswered questions. 
Until we do, the efforts of this committee or that committee are not 
enough. It has to be a conscious effort on a national basis by an 
independent commission.
  For President Trump, these issues do not appear to be relevant, yet 
there is a simple way to resolve the many questions that are before us.
  First, disclose your tax returns and clear up, among other questions, 
what your son said in 2008 about a lot of Russian money pouring into 
your family business.
  No. 2, answer all the questions about campaign contacts with the 
Russians, including your former campaign manager Paul Manafort, former 
National Security Advisor Michael Flynn, and former policy advisor 
Carter Page.
  No. 3, quite simply, explain the reports of repeated contacts between 
your campaign operatives and Russian intelligence.
  No. 4, answer all the questions about your close friend Roger Stone's 
comments that suggest he had knowledge of Wikileaks' having and using, 
in strategically timed releases when your campaign was struggling, 
information that had been hacked by the Russians from your opponent's 
campaign.
  No. 5, explain your ties to Russian foreign businessman Felix Sater, 
who worked at the Bayrock Group investment firm, which partnered with 
your business and had ties to Russian money.
  No. 6, provide all requested documents to Congress related to Michael 
Flynn, who concealed his payments from the Russian interests. If there 
is nothing to hide, this is your chance to clear up things once and for 
all.
  To my Republican colleagues I say again that these Russian 
connections may constitute a national security crisis. We need to have 
the facts. How long will we wait for these desperately needed answers 
before we establish an independent commission investigation, as we have 
done when faced with previous attacks on America?
  Finally, how long will we sit by before passing additional sanctions 
on Russia for their cyber attack on the United States of America? That 
attack makes November 8, 2016, a day that will live in cyber infamy in 
America's history. It is time for the Republicans and the Democrats to 
show the appropriate concern for this breach of our national security.
  We have a bipartisan Russian sanctions bill ready to go to the Senate 
Foreign Relations Committee. What are we waiting for?
  I yield the floor.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant bill clerk proceeded to call the roll.
  Mr. MARKEY. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Flake). Without objection, it is so 
ordered.
  Mr. MARKEY. Mr. President, I rise today to speak in opposition to the 
nomination of Dr. Scott Gottlieb to lead the Food and Drug 
Administration.
  The FDA Commissioner is our Nation's pharmaceutical gatekeeper, but 
for years the FDA has granted unfettered access to Big Pharma and its 
addictive opioid painkillers to the American public. The result is a 
prescription drug, heroin, and fentanyl epidemic of tragic proportions 
and the greatest public health crisis our Nation currently faces.
  At a time when we need its leader to break the stronghold of big 
pharmaceutical companies on the FDA, Dr. Scott Gottlieb would be 
nothing more than an agent of Big Pharma. Dr. Gottlieb's record shows 
that he doesn't support using the tools that the FDA has at its 
disposal to minimize the risks to public health from the misuse of 
prescription opioids.
  The current opioid epidemic is a man-made problem. It was born out of 
the greed of big pharmaceutical companies and aided by the FDA, which 
willfully green-lighted supercharged painkillers like OxyContin. But, 
in order for us to understand this public health emergency and the 
critical role that leadership at the FDA has played and will continue 
to play in this crisis, we need a brief history lesson. We need to 
understand where these opioids come from.
  In 1898, a German chemist introduced heroin to the world--a 
reproduction of an earlier form of morphine believed to be 
nonaddictive. The name ``heroin'' was derived from the German word 
``heroisch,'' which means ``heroic.'' That is how men described the way 
they felt after taking the new drug.
  In the first decade of the 20th century, doctors were led to believe 
that heroin was nonaddictive and prescribed it for many ailments. But 
heroin addiction soon became prevalent, so the government began to 
regulate its use, including arresting doctors who prescribed it to 
those who were already addicted, and the medical community began to 
stop prescribing it. Inevitably, the addicted turned to illegal markets 
to feed their dependence.
  Wariness toward prescribing opioid-based painkillers for anything 
other than terminal illnesses continued through the 20th century, all 
the way up until the late 1970s and the early 1980s. At that time, the 
international debate broke out on pain management. The question was 
asked: Was it inhumane to allow patients to suffer needlessly through 
pain when opioid-based medications were available?
  Many advocates for increased use of painkillers pointed to a 1980 
letter to the New England Journal of Medicine, which concluded that 
only 1 percent of patients who were prescribed opiate-based painkillers 
became addicted to their medication. Known as the Porter and Jick 
letter because it was named after the two Boston researchers who 
conducted the research and authored the letter, it fueled a belief that 
opiate-based prescription drugs were not addictive. It was a belief 
that began to permeate the medical community.
  But there was a problem with Porter and Jick's conclusions. They had 
only collected data on patients who were receiving inpatient care. As 
you can imagine, the percentage of patients who became addicted to 
opiates while in the hospital was only a tiny fraction of the patients 
who received opiate prescription drugs in an outpatient setting.
  But the medical community was not the only group espousing theories 
that opiates were not addictive. With the FDA's 1995 approval of the 
original OxyContin, the original sin of the opiate crisis, we can 
literally point to the starting point of this epidemic. The FDA 
approved the original version of OxyContin, an extended-release opioid, 
and believed that it ``would result in less abuse potential since the 
drug would be absorbed slowly and there would not be an immediate 
`rush' or high that would promote abuse.''
  In 1996, Purdue Pharma brought OxyContin to the market, earning the 
company $48 million in sales just that year alone. Purdue Pharma 
claimed OxyContin was nonaddictive and couldn't be abused, and the FDA 
agreed. Neither of those claims turned out to be true.
  Purdue Pharma built a massive marketing and sales program for

[[Page 7642]]

OxyContin. From 1996 to 2000, Purdue Pharma's sales force more than 
doubled, from 318 to 671 sales representatives. In 2001 alone, Purdue 
gave out $40 million in sales bonuses to its burgeoning sales force. 
These sales representatives then targeted healthcare providers who were 
more willing to prescribe opioid painkillers.
  As a result of these sales and marketing efforts from 1997 to 2002, 
OxyContin prescriptions increased almost tenfold, from 670,000 in 1997 
to 6.2 million prescriptions in 2002.
  Then, in 2007, Purdue Pharma paid $600 million in fines and other 
payments after pleading guilty in Federal court to misleading 
regulators, doctors, and patients about the risks of addiction to 
OxyContin and its potential for abuse. The company's president, top 
lawyer, and former chief medical officer also pled guilty to criminal 
misdemeanor charges and paid $34 million in fines.
  In many cases, the FDA approved so-called ``abuse-deterrent'' 
opioids, despite warnings from the medical community about the 
potential for abuse. And when it wasn't turning a blind eye to the 
warnings of experts, the FDA simply didn't engage them at all in 
approval of opioids with abuse-deterrent properties. With numerous 
approvals of so-called abuse-deterrent opioids in 2010, the agency 
convened advisory committees of outside experts for less than half of 
them.
  Mr. President, I note the presence of the minority leader on the 
floor. At this time I ask unanimous consent to suspend this portion of 
my statement and to return to it when the minority leader has concluded 
speaking to the Senate.
  The PRESIDING OFFICER. Without objection, it is so ordered.


                   Recognition of the Minority Leader

  The Democratic leader is recognized.
  Mr. SCHUMER. Mr. President, first I wish to thank my friend and our 
great Senator from Massachusetts, Mr. Markey, for the great work he has 
done on the opioid issue. He was one of the first to sound the alarm 
when prescription drugs just began to be overprescribed and has worked 
very, very hard, with many successes, in trying to deal with this 
problem. We have a long way to go. Things would have been a lot worse 
without the great work of the Senator from Massachusetts.
  I see my colleague from New Hampshire on the floor, as well, and the 
same goes for her. She has done an outstanding job. She has worked and 
campaigned on this issue and is keeping her promises, working very hard 
here in the U.S. Senate. We know that their States are among the top 
States with opioid abuse problems.


                          Russia Investigation

  Mr. President, at yesterday's Judiciary Committee hearing, we heard 
from former Deputy Attorney General Sally Yates and former Director of 
National Intelligence James Clapper. In their testimony, both of them 
confirmed what we already know--that Russia tried to interfere in our 
elections and likely will do so again. Underline ``likely will do so 
again.''
  In particular, Deputy AG Yates made the point that General Flynn 
misled the Vice President about his contact with the Russian Ambassador 
and was vulnerable to blackmail since the Russians knew about those 
conversations.
  It is still an open question whether or not the Trump administration 
will hold General Flynn accountable under our criminal law. Needless to 
say, his presence in the administration and the length of time it took 
to dismiss him raise serious questions about why the President brought 
him onboard to begin with and why the President and his staff did not 
respond more quickly to protect our national security.
  Both parties in Congress should be focused on the threat posed by 
Russia's hacking activities and Russia's attempt to influence foreign 
elections, especially ours. Make no mistake about it. These cyber 
attacks will not be limited to any one party or any President. Anyone 
who draws the ire of President Putin--President, Senator, Member of 
Congress, elected official--could be subject to these dark attacks. 
Whatever is good for Russia at the moment, whatever hurts the United 
States the most, that is what he will pursue.
  Director Clapper testified that Russia likely feels ``emboldened'' to 
continue its hacking activities, given their success at disrupting our 
2016 elections. He said:

       If there has ever been a clarion call for vigilance and 
     action against a threat to the very foundation of our 
     democratic political system, this episode is it.

  Those are his words, not mine.

       I hope the American people recognize the severity of this 
     threat and that we collectively counter it before it further 
     erodes the fabric of our democracy.

  I couldn't agree more with Mr. Clapper. I hope these hearings are 
just the start of a bipartisan discussion on how to combat these 
efforts and safeguard the integrity of our elections. Democrats and 
Republicans should join together and figure out what Russia had done to 
us in the past and how we prevent it from happening in the future. 
Again, as Director Clapper said, the very foundation of our democracy 
is at stake.
  The Founding Fathers, in their wisdom, wrote in the Constitution that 
we had to worry about foreign interference. It is happening now in a 
way that has never happened before, and in a bipartisan way we must 
act.


                               TrumpCare

  Mr. President, now a word on healthcare. The bill the House of 
Representatives passed last week is devastating in so many ways and to 
so many groups of Americans--to older Americans, who would be charged 
five times as much as others; to middle-class Americans, who will be 
paying on average $1,500 a year more for their coverage in the next few 
years; to lower income Americans, who are struggling to make it into 
the middle class and who will be paying thousands of dollars more per 
year; to women, for whom pregnancy could now become a preexisting 
condition--amazing.
  Why are they making these cuts? For all too many on the other side of 
the aisle, it is for one purpose: to give a massive tax break to the 
wealthy--folks making over $250,000 a year. God bless the wealthy. They 
are doing well. They don't need a tax break at the expense of everyone 
else, especially when it comes to something as important as healthcare.
  Amazingly, this bill is even devastating to our veterans. That is 
what I would like to focus on for the remainder of my time this 
morning.
  You would think that when the House of Representatives was writing 
its bill, the House Members would be more careful to make sure that our 
veterans, who put their lives on the line for our country, wouldn't be 
hurt by their legislation. In their haste to cobble together a bill 
that could pass the House, the Republican majority actually prohibited 
anyone who is eligible for coverage at the VA from being eligible for 
the tax credits in this bill.
  I am sure my Republican friends who rushed to draft this bill thought 
that was a perfectly fine policy. After all, our veterans can get care 
at the VA. In fact, many veterans don't get their care from the 
Department of Veterans Affairs. Yes, they are eligible, but many live 
in rural communities that don't have a VA facility. Many can't go to 
the VA because of means testing. Some get treated at the VA for a 
specific injury related to their service but rely on private insurance 
for the rest of their healthcare. I am sure some veterans would simply 
prefer the choice to have private insurance rather than go through the 
VA.
  Under TrumpCare, any veteran who falls into one of these categories 
would be denied the tax credits they need to get affordable coverage. 
Let me repeat that. As many as 7 million veterans, possibly more, who 
qualify for VA healthcare wouldn't be eligible for the tax credits they 
need to get affordable insurance on the private market.
  For the sake of perspective, under TrumpCare, folks who make over 
$250,000 a year get a massive tax break while taxes and costs would go 
up for so many of our brave veterans.
  I am not sure it is possible for a bill, and for the party that 
passed it, to get its priorities more wrong than that. It is the 
shameful consequence of a slapdash, partisan bill that was thrown

[[Page 7643]]

together at the last minute--a bill whose purpose, it seems, is not to 
provide better coverage or lower costs or even to provide better care 
for our veterans. Its purpose seems to be to provide tax breaks to the 
very wealthy.
  For the President, who lobbied for this bill down to the individual 
Member, it is another giant broken promise to the working people and, 
in this case, to our veterans.
  President Trump made improving the healthcare of our veterans a theme 
of his campaign. Just a few weeks ago, he said that ``the veterans have 
poured out their sweat and blood and tears for this country for so long 
and it's time that they are recognized and it's time that we now take 
care of them and take care of them properly.''
  His healthcare bill, TrumpCare, would deny the means of affording 
private insurance to as many as 7 million veterans and maybe more--
another broken promise, saying one thing and doing another. Many of the 
people who support Donald Trump don't want to embrace that idea, but it 
is happening in issue after issue. They will see it--saying one thing 
and doing another. That is another reason for Senate Republicans to 
scrap this bill, scrap repeal, and start working with Democrats on 
bipartisan ways to improve our healthcare system.
  Today, we Democrats will be sending a letter to the Republican 
leadership laying out our position on healthcare. All 48 Democrats and 
the two Independents who caucus with us have signed it. It has been our 
position all along: We are ready to work in a bipartisan, open, and 
transparent way to improve and reform our healthcare system.
  Look, we have made a lot of progress in the last few years. Kids can 
now stay on their parents' plan until they are 26. Women are no longer 
charged more for the same coverage. There are more Americans insured 
than ever before. These are good things. We ought to keep them and then 
build on our progress.
  To our Republican friends we say this. Drop this idea of repeal. Drop 
this nightmare of a bill, TrumpCare, which raises costs on our 
veterans, and come work with us on ways to reduce the cost of premiums, 
the cost of prescription drugs, and other out-of-pocket costs. We can 
find ways to make our healthcare system better if we work together. 
TrumpCare is not the answer.
  I want to thank my friend from Massachusetts for the courtesy.
  I yield the floor back to the Senator.
  The PRESIDING OFFICER. The Senator from Massachusetts.
  Mr. MARKEY. Mr. President, I thank our leader for his great 
leadership on all of these national security and healthcare issues. I 
think he has injected some common sense into how the American people 
should be viewing each and every one of those very important issues. 
His national leadership is greatly appreciated.
  Let me turn now and yield to the great Senator from the State of New 
Hampshire, where this opioid epidemic has hit hardest of all, Senator 
Hassan.
  The PRESIDING OFFICER. The Senator from New Hampshire.
  Ms. HASSAN. I thank Senator Markey.
  Mr. President, I, too, want to thank Leader Schumer for his remarks 
and his work on national security and on healthcare and, in particular, 
on the opioid, heroin, and fentanyl epidemic, which is the greatest 
public health and safety challenge that the State of New Hampshire 
faces and which I know many other States face as well.
  I rise today to oppose the nomination of Dr. Scott Gottlieb to serve 
as the Commissioner of the Food and Drug Administration. It is the 
responsibility of the Food and Drug Administration, starting with its 
Commissioner, to protect consumers and stand up for public health.
  I have serious concerns about Dr. Gottlieb's record. I also have 
additional concerns from his nomination hearing about his stances on 
critical priorities for people in New Hampshire and across the Nation.
  As I mentioned, and as Senator Markey has detailed, as well, the most 
pressing public health and safety challenge facing New Hampshire is the 
heroin, fentanyl, and opioid crisis. I want to thank the Senator from 
Massachusetts for his leadership and work in helping to identify the 
root causes of this terrible epidemic.
  Yesterday, I was in New Hampshire, and I met with the Drug 
Enforcement Agency leaders and personnel there. I heard updates from 
those on the frontlines about the latest developments in the substance 
misuse crisis. We discussed the spread of the dangerous synthetic drug 
carfentanil, which is 100 times stronger than the already deadly drug 
fentanyl.
  A report released this week by New Futures showed the economic impact 
of alcohol and substance misuse costs. It costs New Hampshire's economy 
now over $2 billion a year. It is clear that we need to take stronger 
action to combat this crisis.
  We have to continue partnering together with those on the frontlines 
and at every level of government. We need to be developing new tools 
and leveraging the ones we have to combat this crisis.
  What we cannot afford to do is to institute policies that would take 
us backward. Unfortunately, Dr. Gottlieb has been opposed to the 
creation of one of the key tools that the FDA has at its disposal--risk 
evaluation and mitigation strategies, otherwise known as REMS. The 
agency uses REMS--including, as a strategy, prescriber training--to try 
to stem the risks associated with certain medications.
  The FDA should be making REMS stronger and making sure that all 
opioid medications have REMS. We don't need a Commissioner who opposed 
the very creation of the REMS program, as Dr. Gottlieb did. In the 
midst of a public health challenge as serious as this epidemic, we 
should be taking--and we have to take--an all-hands-on-deck approach. 
The fact that Dr. Gottlieb was opposed to the very creation of REMS 
raises questions about what strategies the FDA would support under his 
leadership.
  There is another issue involved in this nomination of deep concern to 
the people of New Hampshire. I am concerned about Dr. Gottlieb's record 
of putting politics ahead of science when it comes to women's health. 
To compete economically on a level playing field, women must be able to 
make their own decisions about when and if to start a family. To fully 
participate not only in our economy but also in our democracy, women 
must be recognized for their capacity to make their own healthcare 
decisions, just as men are. They must also have the full independence 
to make their own healthcare decisions, just as men do.
  Unfortunately, this administration has made clear that it is focused 
on an agenda that restricts women's access to critical health services, 
including family planning.
  Dr. Gottlieb's record has demonstrated that he supports this backward 
agenda. During his time in the Bush administration, Dr. Gottlieb was 
involved in a controversial and unscientifically based delay in 
approving the emergency contraceptive Plan B for over-the-counter use.
  I am concerned that under his leadership, the FDA will play political 
games with women's health once again. I am afraid that he will 
disregard science-based decisions under pressure from this 
administration. Dr. Gottlieb's nomination raises too many questions 
about whether he will put political interests ahead of science and 
ahead of the safety of consumers.
  I hope that he has learned about the priorities of Senators and the 
constituents they represent throughout the nomination process and that 
he proves to be a stronger Commissioner than his record suggests. But 
in voting today, I cannot overlook that record, so I will vote against 
his nomination, and I urge my colleagues to do the same.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Strange). The Senator from Massachusetts.
  Mr. MARKEY. Thank you, Mr. President.
  I thank Senator Hassan for all of her great leadership as Governor of 
New Hampshire and now the Senator from New Hampshire. The epidemic has 
hit

[[Page 7644]]

New Hampshire very hard, harder than any other place. Her leadership is 
absolutely outstanding. I thank her for all of her leadership on this 
nomination as well.
  As we look at this issue, we realize that a whole epidemic was being 
created, but that epidemic was being created because of approvals of 
``abuse-deterrent'' opioids since 2010. I put ``abuse-deterrent'' in 
quotes because it was extremely deceptive because too many people felt 
``abuse-deterrent'' meant they could not ultimately become addicted to 
the medicine. The damage has now been done. The prescription painkiller 
abuse became rampant across the country. We had become the United 
States of Oxy, and the opioid issue was well on its way to becoming an 
opioid epidemic because when those who were addicted to Oxy could no 
longer afford $60 for a 60-milligram pill, they opted for low-priced 
heroin, which is why we should not be surprised that of those 
individuals who began abusing heroin in the 2000s, 75 percent reported 
that their first opioid was a prescription drug.
  Taking advantage of the new demand for heroin, an incredibly 
sophisticated network of drug traffickers from Mexico set up franchises 
in the United States, and now they are responsible for nearly half of 
this Nation's heroin supply and are branching out from large urban 
areas into our suburbs. These systems collided in a perfect storm that 
has caused the epidemic we are experiencing today: the overprescription 
of opioid painkillers that were approved by the FDA, the over-the-top 
sales and marketing programs by a deceptive and deep-pocketed 
pharmaceutical giant that went unimpeded for years, and an 
overabundance of heroin flowing into the United States from Mexico and 
South America. All of that has led us here.
  We know that nationally opioid overdoses kill more people than gun 
violence or auto accidents. Every single day in America, we lose more 
than 91 people to an opioid-related overdose. Nationally, nearly half 
of all opioid overdose deaths involve a prescription opioid that was 
approved by the FDA and often prescribed by a physician. In 
Massachusetts, in 2016, 2,000 people died from an opioid overdose.
  Who is the typical victim of an opioid overdose? Who is the typical 
substance abuser? The answer is that there is none. This epidemic does 
not discriminate on the basis of age or gender or race or ethnicity or 
economic status. It does not care if you live in a city or in the 
suburbs. It does not care if you have a white-collar or a blue-collar 
job. The 50-year-old White male attorney is just as likely to become 
addicted to prescription drugs or heroin as the 22-year-old Latina 
waitress. Opioid addiction is an equal opportunity destroyer of lives.
  Those addicted to opiates are too often stealing from their friends, 
their families and neighbors, or complete strangers to fuel their 
addiction. Cars are broken into, and valuable stereo systems are left 
intact, while a few dollars in change are stolen. Homes are broken 
into, and flat-screen television sets remain untouched, while 
children's piggy banks go missing.
  The impacts of opioid addiction are also causing immeasurable harm to 
the families of those in the unbreakable grip of opioids. Too often, I 
hear the stories of parents who have drained their entire life savings 
to provide the treatment and recovery programs necessary to beat this 
addiction. Many times, it results in bankruptcy filings that were 
unimaginable only a few short years ago.
  The opioid crisis is robbing people of their friends and their 
families. It is robbing them of their livelihood. It is robbing them of 
their freedom as they look out from behind prison bars. All too often, 
it is robbing them of their lives.
  If we don't act now, we could lose an entire generation of people. As 
this opioid crisis explodes in my State of Massachusetts and in every 
State in the country, we need an FDA leader who will understand that 
universal healthcare does not mean that every American should have 
access to a bottle of prescription opioids.
  Last year, more than 33,000 mothers, fathers, children, and loved 
ones were robbed of their potential when they died of an opioid 
overdose, but Dr. Scott Gottlieb has openly questioned the value of the 
Drug Enforcement Administration's enforcement against doctors and 
pharmacists to prevent prescription opioids from entering the illicit 
market. The DEA is our prescription drug cop on the beat, but Dr. 
Gottlieb wants to give that role to bureaucrats at the Department of 
Health and Human Services, an agency that has consistently failed at 
any kind of enforcement.
  At the same time, Dr. Gottlieb has also publicly stated his 
opposition to the FDA's risk plans, so called REMS--meaning risk 
evaluation and mitigation strategies--for the use of these opioids. 
That is what is used to address the safety of opioid painkillers. These 
vital tools that the FDA has to manage the risk should be made 
stronger, but Dr. Gottlieb argues that they should not exist at all. 
Risk evaluation and mitigation strategies--he says they should not 
exist at all. With the overwhelming majority of heroin users reporting 
that their addiction began with prescription opioids, Dr. Gottlieb 
believes drug safety does not need strong oversight. That is simply 
irresponsible.
  We are suffering this public health epidemic because Big Pharma 
pushed pills they knew were dangerous and addictive. The FDA approved 
them, often without expert counsel, and doctors, because they do not 
have mandatory education on these drugs, prescribed them to innocent 
families all across our country. It is a vicious and deadly cycle that 
has turned this Nation into the United States of Oxy, and it must stop.
  Dr. Gottlieb's Big Pharma formula is simple: Take away the DEA 
oversight over prescription opioids and give that authority to the FDA. 
Then, at the same time, limit the FDA's ability to utilize its full 
oversight authority over these addictive products. That would leave a 
mostly unregulated marketplace for big pharmaceutical companies and 
their opioid painkillers to thrive, while American families pay the 
highest price they can: the life of someone in their family.
  Perhaps most alarming is Dr. Gottlieb's connection to a specific 
pharmaceutical company called Cephalon. Last month, a Washington Post 
story was published that detailed Dr. Gottlieb's work on behalf of one 
company, Cephalon, to raise the amount of the addictive opioid fentanyl 
that the company could market at the same time the prescription 
painkiller epidemic was exploding. The Washington Post story detailed 
how Dr. Gottlieb advocated for the DEA--the Drug Enforcement 
Administration--to raise the quota of fentanyl that Cephalon could 
manufacture and put on the market, even while the company was under 
investigation for pushing doctors to prescribe the addictive painkiller 
for headaches and back pain when it was meant for late-stage cancer 
patients.
  These aggressive and off-label promotion tactics were out of the 
Perdue Pharma playbook that got us into this opioid crisis in the first 
place.
  Cephalon ultimately pleaded guilty in 2008 to illegally promoting the 
fentanyl drug and paid a $425 million fine. This relationship is deeply 
disturbing.
  Dr. Gottlieb seems to believe that pharmaceutical profits are more 
important than the public's health. When the prescription opioid 
epidemic was taking deadly hold, Dr. Gottlieb advocated to put even 
more addictive fentanyl onto the market when it was not appropriate or 
necessary.
  Dr. Gottlieb said during his confirmation hearing that the FDA 
unwittingly fueled the opioid epidemic, but he is guilty of 
intentionally pushing an addictive prescription opioid onto the 
American public just to benefit one company instead of working to 
prevent this massive public health crisis. Dr. Gottlieb's actions could 
have made the opioid crisis worse.
  Serious questions remain about Dr. Gottlieb's association with 
Cephalon, which was fined hundreds of millions of dollars for violating 
FDA rules.
  After his tenure at the FDA, Scott Gottlieb was then hired by a law 
firm

[[Page 7645]]

as an expert witness used to defend the actions of Cephalon in court.
  In advance of this floor vote, I and a group of other Senators 
questioned Dr. Gottlieb on this work and the extent of his historical 
and financial relationship with Cephalon, but we received nothing that 
shed any light on his relationship with the company.
  We cannot have a leader at the FDA who has worked on behalf of a 
company that aided and abetted the prescription drug and heroin 
epidemic.
  Sadly, Dr. Gottlieb is yet another example of President Trump's lack 
of commitment to address the opioid crisis. President Trump believes 
that if we just build a border wall, well, we will end this opioid 
crisis.
  We don't need a wall, President Trump, we need treatment.
  President Trump's support for the repeal of the Affordable Care Act 
and the legislation the House passed just last week means coverage for 
opioid-use disorders for 2.8 million people could be ripped away. 
President Trump has proposed slashing the research budget of the 
National Institutes of Health by 18 percent, undercutting our ability 
to better understand addiction and come up with alternative, less 
addictive pain medication.
  If President Trump and his Republican allies are committed to 
combating the opioid crisis, they should release their plan for 
addressing this crisis, including committing to quickly release the 
remaining $500 million authorized last year in the 21st Century Cures 
Act, and plan for investing more Federal dollars into understanding, 
preventing, and treating this debilitating disease of addiction. The 
crisis is wearing families down to the bone and we need to give them 
hope. That is what a comprehensive strategy to address this crisis is 
all about, and strong leadership at the FDA is a critical component of 
any plan.
  We need the FDA to be a tough cop on the beat, not a rubberstamp 
approving the latest big pharma painkillers that are the cause of this 
deadly scourge of addiction in overdoses. We need to stop the 
overprescription of pain medication that is leading to heroin addiction 
and fueling this crisis. The United States has less than 5 percent of 
the world population, but we consume 80 percent of the global opioid 
painkillers and 99 percent of the global supply of hydrocodone and the 
active ingredients inside of Vicodin.
  We also need to ensure that prescribers are subject to mandatory 
education responsible for prescribing practices. Anyone who prescribes 
opioid pain medication and other controlled substances must undergo 
mandatory medical education so we are sure these physicians know what 
they are doing. The FDA would be in a position to be the primary 
enforcer of this critical education.
  We also shouldn't allow companies to continue to promote their 
opioids as abuse deterrents. It is misleading. Fifty percent of all 
physicians believe the ``abuse deterrent'' that is on the label means 
the drug is not addictive. Physicians don't even know this is 
addictive, and we know through Purdue Pharma that this is just not the 
case.
  The FDA is in a prime position to ensure the terminology used for 
promoting a drug is not confusing or misleading. At this time of 
crisis, we need a leader at the FDA who recognizes the dangers of 
prescription painkillers, who will stand up to big pharma and reform 
the FDA to prevent addiction before it takes hold. Dr. Scott Gottlieb 
is not that individual.
  Dr. Gottlieb's nomination signals a continuation of FDA policy that 
has cultivated and fueled the opioid epidemic. I strongly oppose Dr. 
Gottlieb's nomination and call on my colleagues to join me in voting 
no.
  Mr. President, I yield back the floor.
  The PRESIDING OFFICER. The Senator from Maryland is recognized.


                         Healthcare Legislation

  Mr. VAN HOLLEN. Mr. President, I join my colleague in opposing the 
nomination of Dr. Gottlieb and thank him for laying out the case.
  The FDA, of course, is an important part of our healthcare system, 
and just last week we saw the House of Representatives jam through a 
piece of legislation that would wreak havoc on the healthcare system. 
In fact, many people are appropriately calling what they did 
``wealthcare'' because it represents a huge transfer of wealth away 
from caring for patients to the very wealthiest in our country, 
including many powerful special interests.
  I think everybody understands--Republicans, Democrats, Independents 
alike--the Affordable Care Act is not perfect and specifically that we 
need to address the issues within the Affordable Care Act exchanges. We 
need to address those issues to lower the deductibles, lower the 
copays, and make it more affordable. There are some very 
straightforward ways of doing that.
  One good idea is to create a public option within the Affordable Care 
Act exchanges, a Medicare-for-all-type choice. What will that do? It 
will create more competition. That will drive down the price of 
insurance within the Affordable Care Act exchanges, and it will ensure 
that you have a provider everywhere in the United States in every 
community of this country. Even better, the Congressional Budget 
Office, the last time they looked at it, concluded that it would save 
taxpayers $160 billion over 10 years, so it would reduce our deficit.
  The House Republican wealthcare bill doesn't try to fix the 
exchanges. What it does is blow up the Affordable Care Act and in the 
process wreaks havoc on our entire healthcare system. You don't have to 
take my word for it. Just take a look at the long list of groups that 
have come out strongly opposed to the House bill, starting with patient 
advocacy groups, such as the American Lung Association, the American 
Diabetes Association, the American Heart Association, the American 
Cancer Society, and the list goes on. These aren't Democratic groups. 
They don't have only Democratic patients. They have patients who are 
Democrats, Republicans, Independents, and people who aren't 
participating in the political process. These are groups that care 
about patients, they don't care about politics, and they are strongly 
opposed.
  How about those who are providing care to those patients? Well, here 
is a partial list of the groups that are strongly opposed: the American 
Academy of Family Physicians; the American Medical Association, the 
doctors; the American Academy of Pediatrics, the folks who look after 
the care of our kids; the American Nurses' Association.
  Let's look at the hospital groups. The American Hospital Association 
strongly opposes this; the Children's Hospital Association opposes 
this, and the list goes on. It is opposed by those who are spending all 
their time advocating for patients and opposed by those who provide 
care to patients.
  Then you have a long list of senior groups, including AARP, that 
strongly oppose this because the House bill discriminates against older 
Americans--people over 50 years old--because it allows insurance 
companies to charge them a whole lot more for their healthcare than 
they currently have to pay.
  These groups don't care about party. They don't care about politics. 
They care about patients in our healthcare system, and it should tell 
us all a lot that they are opposed and strongly opposed to this bill. 
Now, why is that?
  This House bill is rotten at its core. Its foundation was rotten when 
the Congressional Budget Office first looked at it, and then they made 
it even worse. Let's look at the foundation of this, which the 
Congressional Budget Office did have a chance to look at. I do want to 
remind the Presiding Officer that the head of the Congressional Budget 
Office was selected by the chairman of the House Republican Budget 
Committee, the House Budget Committee, the Republican chairman, and the 
chairman of the Senate Budget Committee, a Republican chairman. They 
took a look at that first foundation of the House bill, and here is 
what they concluded. This is right in their report; that 24 million 
Americans would lose their access to affordable healthcare. That is on 
page 2 of the nonpartisan Congressional Budget Office report.
  Why is that? It is because they take a wrecking ball to Medicaid and 
a

[[Page 7646]]

wrecking ball to the exchanges. They don't make the exchanges better. 
They don't drive down the prices. They make the exchanges worse, and 
they take a big whack at Medicaid. In fact, they also take a cut at 
Medicare. In fact, if you go to the table in this CBO chart, I will 
just refer people to table 3. Sometimes you just have to dig deep in 
these reports to get to the bottom line. There is an $883 billion cut 
that consists of about $840 billion cuts to the Medicaid Program, $48 
billion cut to the Medicare Program, and I should emphasize that will 
actually make the Medicare Program somewhat more insolvent. You add it 
up, you have $880 billion in cuts to Medicare and Medicaid combined.
  I remind people that the Medicaid funding not only went to provide 
more access to people for healthcare through expanding Medicaid, which 
many States have talked about and Governor Kasich has been talking 
about recently, but this bill also cuts the core Medicaid Program to 
the States, and two-thirds of that money goes to care for seniors in 
nursing homes and people with disabilities. So it puts all of them at 
risk. That is $880 billion in cuts to Medicaid and Medicare and people 
who need healthcare.
  What is the other big number in the House bill? Well, $900 billion is 
the amount of the tax cuts in what is being described as a healthcare 
bill. That is why people are calling this a wealthcare bill because you 
are cutting $880 billion out of Medicaid and Medicare and transferring 
those dollars that are currently being spent to provide healthcare to 
tens of millions of Americans, transferring that money back primarily 
to the wealthiest people in this country and corporate special 
interests.
  Under this $900 billion tax cut, if you are earning over $1 million a 
year, you are getting an average tax cut of $50,000 a year. If you are 
in the top one-tenth of 1 percent of income earners--we are talking 
about the wealthiest people in this country--you are getting an average 
annual tax cut of $200,000.
  Do you know what they did for insurance companies? They used to say 
the bonuses that were paid to the CEOs of insurance companies would be 
taxed, but they took that away. So now insurance companies can 
essentially pay bonuses and deduct those. They can deduct those now 
from their bottom line, which drives up the profits of insurance 
companies by allowing the deduction of CEO bonuses. So we have $900 
billion in tax cuts that primarily go to the wealthiest, and $880 
billion in cuts to the Medicaid Program and Medicare that goes to care 
for people. That is why this bill is rotten at its core, because it is 
going to hurt our healthcare system, according to all those patient 
advocacy groups and all those patient provider groups, and for what? To 
give this windfall tax break to the wealthy and powerful interests.
  That is why it is probably no surprise that when the American people 
were asked about that original House bill, only 17 percent said: Yes, 
that is a good idea. Everybody else said: Uh-uh, we don't like what we 
are seeing. That is the bill I was just describing.
  Then the House took that rotten foundation and put even worse stuff 
on top of it. They added a provision that would eliminate the essential 
benefits package. These are the provisions that ensure that when you 
are buying an insurance policy, you are getting something that will be 
there when you need it rather than a junk policy--the policies people 
used to get, where they found out after they got sick, ``Uh-uh, we are 
not paying for that,'' said the insurance companies ``because look here 
at the back of page 100, last paragraph, fine print, you are not 
covered for that.'' That is why we had an essential benefits package 
for things like maternity care, mental health care, coverage for 
substance abuse.
  I hear a lot of talk about the problems with the opioid epidemic. 
Those are real problems that are hurting families around the country. 
That was part of the essential health benefits--not there in the House 
bill.
  Then, to add insult to injury, they took out the requirement that you 
have coverage for preexisting conditions in an affordable way. You 
know, people can play word games all they want. You can say that you 
have to provide coverage for someone with preexisting conditions, but 
if the policy you propose is $200,000 a year, $300,000 a year, we all 
know that is a false promise. That is a hoax. That is playing games 
with the American people. So you can write in any kind of requirement 
you want that preexisting conditions be covered, but if they are 
unaffordable, it is not real. That is why the Affordable Care Act put 
everybody into a pool together, to help reduce the costs so we could 
make sure we protected people with preexisting conditions--asthma, 
diabetes or whatever it may be. The House bill pulls the plug on that. 
Maybe that is why the House didn't want to wait for the next 
Congressional Budget Office report to tell them what their bill would 
do to the American people.
  I have already read a little from the original Congressional Budget 
Office report that was based on the foundation of this House bill. That 
hasn't changed. That bill is rotten at its core, and as the 
Congressional Budget Office says, it is going to knock 24 million 
people off of affordable healthcare, going to apply big tax breaks to 
wealthy people, but then they added other provisions as well--getting 
rid of the essential health benefits, getting rid of protections for 
preexisting conditions. Then it was let's see no evil, let's hear no 
evil. We are not even going to wait for the next Congressional Budget 
Office report. I am looking forward to hearing what they have to say.
  For the American people, I think the greatest danger is that here in 
the Senate we are going to hear from a lot of Senators that they don't 
like the House bill just as it is; yes, we are going to have to make 
some changes. What I would say to the American people is to beware of 
people who say they are going to make a change that is meaningful to 
the Affordable Care Act that the House bill passed--their version of 
the bill. Beware of people who say they are making a change that is 
meaningful when it is really only a cosmetic change, when it is really 
only a small change that then provides some kind of rationale or excuse 
for supporting a House bill that is rotten at its core.
  For example, someone may say: Well, let's do a little more by way of 
covering opioid addiction. That would be a good idea. But that doesn't 
salvage a bill that is fundamentally flawed. That doesn't salvage a 
bill that at its core cuts $880 billion from Medicaid and Medicare to 
provide a tax cut of over $900 billion, most of which goes to wealthy 
people and corporate special interests.
  I would say to all the other people who are on employer-provided 
healthcare, which are the majority of Americans: Beware, because that 
House bill will affect you too.
  I just want to read a portion from something that appeared in 
TheUpshot public health section of the New York Times--``G.O.P. Bill 
Could Affect Employer Health Coverage, Too.'' They write:

       About half of all Americans get health coverage through 
     work. The bill would make it easier for employers to increase 
     the amount that employees could be asked to pay in premiums, 
     or to stop offering coverage entirely. It also has the 
     potential to weaken rules against capping worker's benefits 
     or limiting how much employees can be asked to pay in 
     deductibles or co-payments.

  So for someone who is getting coverage through their employer, beware 
because this is going to have harmful effects on you.
  I want to close with one of the many stories that I have received--
and I know many of us have received from our constituents--about how 
that House bill would wreak havoc in their lives. Here is one that I 
received:

       I'm 29 years old and was just diagnosed Feb. 24th with 
     breast cancer. . . . I buy insurance myself, and did so with 
     the assistance from the ACA. Without that program in place, I 
     might not have gone in when I felt this lump. I might have 
     waited much longer, just to be told that it was too late. 
     Without this program, I would be bankrupted by the screenings 
     alone just to find out I am dying. . . . Someone told me not 
     to make this political--but this is my life. It will 
     literally be life or death for so many of us.

  This is a life-or-death issue for tens of millions of our fellow 
Americans. I

[[Page 7647]]

urge the Senate to flatly reject the House healthcare-wealthcare bill, 
which is rotten to its core.
  Let's focus on fixing the issues in the exchanges. We can do that if 
people of good faith want to work from scratch to address that issue, 
but let's not blow up the Affordable Care Act and hurt our constituents 
and tens of millions of other Americans in the process.
  I yield the remainder of my time.
  The PRESIDING OFFICER. The Senator from Ohio.
  Mr. BROWN. Mr. President, I particularly appreciate the comments of 
my colleague from Maryland about the Affordable Care Act. The fact is, 
they are taking insurance from 200,000 Ohioans right now who are 
getting opioid treatment because of the Affordable Care Act, and the 
vote in the House of Representatives would turn those 200,000 families 
upside down. They should be ashamed of themselves. Then to go to the 
White House and celebrate--that is just the ultimate despicable, 
political act. I just can't imagine that in the 21st century people 
would actually do that.
  The FDA has incredible influence over Americans' lives, and the 
Commissioner of the Federal Food and Drug Administration will lead the 
agency dedicated to ensuring that our medicine and food supplies are 
safe.
  It is the job of the FDA Commissioner, and has been for decades, to 
be an independent check on big pharmaceutical companies, to crack down 
on Big Tobacco, and to oversee the safety and efficacy of new 
prescription drugs, including, most essentially in the last few years, 
opioid painkillers. Unfortunately, Dr. Scott Gottlieb's record gives me 
serious concern, as Senator Markey has pointed out so well, that this 
Commissioner will fall short on all of these measures.
  We know the havoc that opioid painkillers have wreaked on communities 
across the country. My State of Ohio has had more overdose deaths from 
heroin, OxyContin, oxycodone, Percocet, opioids, morphine-based 
opioids; we have had more deaths than any other State in the United 
States of America. In my State and across this country, people die 
because of the opioid epidemic; 91 Americans, including 12 Ohioans, 
will die today--91 Americans, 12 Ohioans will die today--from opioid 
overdoses.
  The Commissioner will have a lot of tools to fight this epidemic that 
is ravaging our families and our communities. We need all hands on deck 
to fight this crisis. We need the FDA.
  Unfortunately, Dr. Gottlieb's record indicates he would not take the 
epidemic and the FDA's authority to rein in prescription painkillers 
and other drugs seriously, which is why I cannot support his 
nomination.
  I don't want to point fingers, but there are a whole host of reasons 
for this epidemic. One of them clearly is the proliferation of 
prescriptions and the manufacture of so many of these opioids. They are 
getting to market, and doctors are prescribing them, and pharmacists 
are filling them.
  I don't point fingers at individual people and even individual 
industries; we are all at fault and not doing this right. But Dr. 
Gottlieb has had a cozy relationship with big drug companies for 
decades as an investor, as an adviser, and as a member of the board for 
a number of these companies. He supported allowing those same companies 
to rush their drugs, including potentially addictive opioid 
painkillers, onto the market before we were sure they were safe--more 
on that in a moment.
  He has called into question the Drug Enforcement Administration's 
authority to police opioids, despite the fact that these drugs are 
often sold on the black market. He has defended industry's efforts to 
market new drugs and devices with minimal safety oversight. He has 
refused to answer questions about his previous work for pharmaceutical 
companies that make the opioid fentanyl. We know he participated in a 
meeting on their behalf at the time that the company was under FDA 
investigation for pushing off-label uses of fentanyl.
  Anyone who thinks we need more fentanyl on the market in many of 
Ohio's 88 counties should visit the coroner's office. Imagine this: In 
some counties, the coroner's office has had to bring in refrigerated 
semitrailers to keep up with the growing body count from the lives lost 
to overdoses. Think of that; just think of that picture bringing in 
refrigerated semitrailers to keep up with the growing body count from 
opioid deaths.
  Let Mr. Gottlieb explain himself to the parents, the children, and 
the friends who have lost loved ones to this deadly drug. A friend of 
my wife's, a woman she knew growing up, lost her son to fentanyl. He 
had a 2-year-old child. He was starting to come clean. My understanding 
is that he relapsed, and he passed away just a few days ago.
  We need a leader at the FDA who will step up the agency's efforts to 
fight this addiction epidemic, which is tearing families upside down. 
It rips up communities. We need a Commissioner who will fight the 
addiction epidemic, not one who will roll over for his Big Pharma 
friends. We need a strong public health advocate to address probably 
the worst public health crisis of my lifetime, a public health advocate 
who will continue to stand up to Big Tobacco with strong rules for all 
tobacco products, including newer products like e-cigarettes, which are 
particularly appealing to kids.
  The opioid crisis is certainly a bigger health crisis that we face 
right now, and tobacco is an ongoing public health crisis. We have made 
huge victories; we have made huge strides and have had huge victories 
in this country. Young people smoke in significantly lower numbers than 
they used to. Tobacco companies don't much like that, so they have 
introduced e-cigarettes. Tobacco companies are buying more and more of 
the manufacturing capabilities of these e-cigarettes. The FDA hasn't 
stepped up the way it should. I implore Dr. Gottlieb to do that, but 
there is no evidence so far that he cares enough to.
  Once again, his extensive business dealings call into doubt whether 
he can seriously serve as the people's cop on the beat when it comes to 
policing Big Tobacco. Dr. Gottlieb himself invested in an e-cigarette 
company--the new FDA Commissioner. He probably will be confirmed today. 
I accept that because for every Trump nominee, no matter their ethics, 
no matter their background, no matter their inability to serve well, no 
matter their lack of qualifications for a whole host of their 
responsibilities, almost every Republican--it is sort of like when one 
bird flies off a telephone wire, they all do, and they have voted for 
almost every one of these nominees.
  But think of this: Dr. Gottlieb's job is public health, his job is to 
police Big Tobacco. His job is to stand between these multimillion-
dollar marketing executives and the 15-year-old who is attracted to 
these e-cigarettes with the flavors and the colors and the marketing, 
and he has invested in the past in e-cigarette companies. What does 
that tell you? Can we really trust him to impose tough rules on these 
potentially dangerous products? Can we trust him to protect our 
children?
  Whoever is in charge of the FDA--whoever is in charge--must put the 
people's safety over drug company profits, whether it is addictive 
painkillers or e-cigarettes.
  I don't think Dr. Gottlieb is the right person for this. I hope I am 
wrong. I plan to vote no. I hope he proves me wrong. If he does, I will 
come back to the floor and applaud him. But from his background, from 
his statements, from his qualifications, from his investments, from his 
business background, I don't think he fits the bill.
  Mr. President, I suggest the absence of a quorum.
  Mr. President, I withdraw the suggestion.
  The PRESIDING OFFICER. So noted.

                          ____________________