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00:02:317 min.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Good morning, ladies and gentlemen. The

hearing for the Appropriations Subcommittee on Labor, Health

and Human Services, Education, and...

00:09:553 min.
Murray, Patty - U.S. Senator, [D] Washington

Well, thank you very much, Mr. Chairman. I

am managing the floor for the Democrats in the supplemental and

need to get back to the floor,...

00:13:0324 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you, Senator Murray. Before yielding

to Senator Craig, let me call upon our current distinguished

ranking member for an opening statement....

00:13:271 min.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Well, that's kind of you, Mr. Chairman, but

I just follow your lead--that's all. If some of the reflective

glory comes up, I am--that's...

00:14:31
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Okay. Thank you very much, Senator Harkin.

Senator Craig?

STATEMENT OF SENATOR LARRY CRAIG

00:14:312 min.
Craig, Larry E. - U.S. Senator, [R] Idaho

Well, Mr. Chairman, I want to welcome the

Secretary, and I must say that these two gentlemen struggle

mightily with a very tough budget...

00:17:12
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you very much, Senator Craig.

Senator Durbin, would you care to make an opening statement?

STATEMENT OF SENATOR RICHARD DURBIN

MEDICARE...

00:17:124 min.
Durbin, Richard "Dick" J. - U.S. Senator, [D] Illinois

Mr. Chairman, thank you very much. I would

just say briefly thank you, Mr. Secretary, for being here. I

think you have an awesome responsibility...

00:21:5348 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Well, thank you, Senator Durbin. Well, we

welcome you here, Secretary Leavitt, notwithstanding the

opening statements of the Senators. You...

00:22:418 sec.
Leavitt, Michael O. - Secretary, Utah

Thank you, Senator. I will submit a

formal statement for the record.

00:22:49
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Your statement will be made a part of the

record and any other prepared statement.

FISCAL YEAR 2007 HHS BUDGET

00:22:496 min.
Leavitt, Michael O. - Secretary, Utah

You acknowledged in a very kind way my

service--previously as Governor. I will tell you that I value

every day I had that opportunity. However,...

00:29:371 min.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you very much, Mr. Secretary. We'll

now go to the questioning by the Senators with 5-minute rounds.

In the second round, Mr. Secretary,...

00:31:2230 sec.
Leavitt, Michael O. - Secretary, Utah

Mr. Chairman, pandemics happen. They

have happened through all-time. You can date back to ancient

Athens--25 percent of that city was wiped...

00:31:52
Specter, Arlen - U.S. Senator, [R] Pennsylvania

How many people died in the pandemic in

the United States not long into the 20th century?

00:31:5246 sec.
Leavitt, Michael O. - Secretary, Utah

Your point is a very good one. We have

had 10 pandemics in the last 300 years. We have had three

pandemics in the last 100 years. In 1968...

00:32:3815 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Well, those are pretty stark figures--90

million, about one-third--almost one-third of the population,

and you say millions would die. What...

00:32:5318 sec.
Leavitt, Michael O. - Secretary, Utah

Well, for that reason, the President has

asked that we mobilize the country. I have committed that we

would hold pandemic summits in all...

00:33:1110 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

What should individual citizens do? Should

individual citizens stock up on water? Should individual

citizens stock up on food?

00:33:2150 sec.
Leavitt, Michael O. - Secretary, Utah

Mr. Chairman, the preparation for a

pandemic is essentially the same preparation that needs to

occur in any disaster. It's a good idea to...

00:34:1113 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

The red light went on in the middle of

your answer, and I intend to observe the red light meticulously

because I ask all the members of...

00:34:242 min.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Thank you very much, Mr. Chairman. Again,

welcome Mr. Secretary. Again, I just want to point out that

this committee--the Senate went on...

00:37:07
Leavitt, Michael O. - Secretary, Utah

No State has made that statement to us

at this point.

00:37:0711 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Okay. What is your plan if States don't

order these treatments by July?

00:37:18
Leavitt, Michael O. - Secretary, Utah

We intend to acquire 50 million courses

of antivirals.

00:37:1810 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

You mean 50 million over the 20 you have?

00:37:2817 sec.
Leavitt, Michael O. - Secretary, Utah

Let me reconcile the entire amount and

then give you the timeframes. We will have by the end of 2006

the 26 million that you have spoken...

00:37:45
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Okay.

PANDEMIC INFLUENZA VACCINE DISTRIBUTION

00:37:4551 sec.
Leavitt, Michael O. - Secretary, Utah

We will make a distribution of that 50

million among the States on essentially a proportionate basis.

So they will have that available to...

00:38:3616 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

My time is running out. Mr. Secretary, in

the case of a pandemic, State, and local health departments

will have to distribute the vaccines....

00:38:52
Leavitt, Michael O. - Secretary, Utah

We are.

00:38:5210 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

If so, will you allow the States to use a

portion of the $350 million that we allocated for that to

purchase annual flu vaccine?

00:39:0213 sec.
Leavitt, Michael O. - Secretary, Utah

Actually, we would prefer that they

utilize the $350 million to build up the public health

infrastructure and to reach deep into the community...

00:39:15
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

But isn't one way to do that is to purchase

annual flu vaccine and put in place an infrastructure----

00:39:15
Leavitt, Michael O. - Secretary, Utah

Oh.

00:39:1511 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

To distribute it? That's what

I am saying.

That's what I am talking about.

00:39:26
Leavitt, Michael O. - Secretary, Utah

I misunderstood your question.

00:39:26
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Yeah.

00:39:2616 sec.
Leavitt, Michael O. - Secretary, Utah

At this point, we have not begun to

distribute the stockpile of vaccine that we have. It is

relatively small, but we will not release it...

00:39:427 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

No, now we're--my time is running out, and

that's not what I am talking about. What I am talking about is

the annual flu vaccine.

00:39:49
Leavitt, Michael O. - Secretary, Utah

Oh.

00:39:4919 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Is we put $350 million for--to build up

State and local structures in case of a pandemic. One of the

ways to test that to see if it works,...

00:40:08
Leavitt, Michael O. - Secretary, Utah

Third time is the charm, Senator. You

got it.

00:40:08
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Okay.

00:40:086 sec.
Leavitt, Michael O. - Secretary, Utah

I think you finally reached me.

00:40:1411 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

So, my question--would they be allowed to

use some of that $350 million to purchase the annual flu

vaccine to test modalities out there...

00:40:25
Leavitt, Michael O. - Secretary, Utah

I hadn't thought of that.

00:40:25
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Oh.

00:40:25
Leavitt, Michael O. - Secretary, Utah

It's a really interesting idea----

00:40:25
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Okay.

00:40:25
Leavitt, Michael O. - Secretary, Utah

I'd be happy to give it

some thought and respond back to you.

00:40:2516 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

I appreciate that. Thanks, Mr. Secretary.

All right.

[The information follows:]

Pandemic Influenza Infrastructure

A major component...

00:40:41
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you, Senator Harkin. Senator Craig?

COMMUNITY HEALTH CENTERS

00:40:411 min.
Craig, Larry E. - U.S. Senator, [R] Idaho

Thank you very much, Mr. Chairman. Mr.

Secretary, during the Easter recess when I was back in Idaho, I

visited a community health center,...

00:41:5630 sec.
Leavitt, Michael O. - Secretary, Utah

Mr. Senator, as I indicated earlier,

this is one of the President's high priorities, and this budget

includes funds to continue forward...

00:42:2613 sec.
Craig, Larry E. - U.S. Senator, [R] Idaho

Okay. So as I said, funds as it relates to

the training of personnel, we don't--you don't see that as a

problem in relation to standing...

00:42:397 sec.
Leavitt, Michael O. - Secretary, Utah

As I speak with those who run and

operate these in the same way that you have, there are always

needs there.

00:42:46
Craig, Larry E. - U.S. Senator, [R] Idaho

Yeah.

00:42:4610 sec.
Leavitt, Michael O. - Secretary, Utah

I would not want to say that we will

have quenched that, but we do recognize that training is a

component of it and want to meet those needs.

WELLNESS...

00:42:5656 sec.
Craig, Larry E. - U.S. Senator, [R] Idaho

Okay. Mr. Secretary, myself and other

Senators consistently over time have introduced legislation to

authorize Medicare to cover medical...

00:43:5257 sec.
Leavitt, Michael O. - Secretary, Utah

I believe, Senator, it should become our

entire focus. When I say entire focus--until we begin to view

wellness with the same passion we...

00:44:4922 sec.
Craig, Larry E. - U.S. Senator, [R] Idaho

Well, my time is up, but you segued nicely

from my request for a response as it relates to medical

nutritional therapy and to prescription...

00:45:111 min.
Leavitt, Michael O. - Secretary, Utah

We anticipated that in the first year,

we would see 28 to 30 million people enroll. We have now

exceeded 30 million. We anticipate between...

00:46:17
Craig, Larry E. - U.S. Senator, [R] Idaho

Thank you. It is a success story. We

appreciate it.

00:46:1710 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you very much, Senator Craig. Under

the early bird rule, we turn to Senator Durbin.

MEDICARE PART D ENROLLMENT DEADLINE

00:46:271 min.
Durbin, Richard "Dick" J. - U.S. Senator, [D] Illinois

So, Mr. Secretary, there is more to the

story, and here is the rest of the story. The Bush

administration says that 35.8 million Medicare...

00:47:4430 sec.
Leavitt, Michael O. - Secretary, Utah

Senator, millions of people--tens of

millions of people--have prescription drug coverage who did not

have it before. That is a great step...

00:48:14
Durbin, Richard "Dick" J. - U.S. Senator, [D] Illinois

But----

00:48:1418 sec.
Leavitt, Michael O. - Secretary, Utah

We have had that problem--I want to

answer your question. About half of them are in a low-income

status, and we have granted them the ability...

00:48:32
Durbin, Richard "Dick" J. - U.S. Senator, [D] Illinois

So increasing monthly premiums of 1 percent

for every month past the deadline--are you going to waive that?

00:48:3218 sec.
Leavitt, Michael O. - Secretary, Utah

If you are in fact a low-income eligible

person, you will not have a penalty, and you will not be

required to wait until the next enrollment...

00:48:50
Durbin, Richard "Dick" J. - U.S. Senator, [D] Illinois

Will the administration support extending

the deadline beyond May 15?

00:48:5058 sec.
Leavitt, Michael O. - Secretary, Utah

We believe that a deadline is necessary

and that it is working. The Government actuary told us if we

did not have a deadline, we would have...

00:49:481 min.
Durbin, Richard "Dick" J. - U.S. Senator, [D] Illinois

I think that we are missing the point here.

Of the universe of people who did not have prescription drug

coverage on January 1, some 25--let...

00:51:001 min.
Leavitt, Michael O. - Secretary, Utah

Senator, we do have an epidemic of

obesity, particularly among our young people, and the Centers

for Disease Control and Prevention does...

00:52:31
Durbin, Richard "Dick" J. - U.S. Senator, [D] Illinois

Thank you.

00:52:317 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you, Senator Durbin. Senator Kohl?

FDA GENERIC DRUG APPLICATIONS

00:52:3852 sec.
Kohl, Herbert "Herb" H. - U.S. Senator, [D] Wisconsin

Thank you, Mr. Chairman. Mr. Secretary, the

FDA currently has a backlog of more than 800 generic drug

applications, which is an all-time...

00:53:3023 sec.
Leavitt, Michael O. - Secretary, Utah

Senator Kohl, I concur with you that

there is a need to speed generic drugs to market. It is a good

thing for consumers. It's a good thing...

00:53:53
Kohl, Herbert "Herb" H. - U.S. Senator, [D] Wisconsin

So you are not proposing any increase in the

budget to help reduce this backlog?

00:53:5315 sec.
Leavitt, Michael O. - Secretary, Utah

We are putting substantial focus on it,

however, I will tell you, at FDA.

00:54:0812 sec.
Kohl, Herbert "Herb" H. - U.S. Senator, [D] Wisconsin

I'd like to hope that's going to happen, that

in fact we will get the kinds of numbers--increases that we

need, that I think you believe...

00:54:2037 sec.
Leavitt, Michael O. - Secretary, Utah

Let me suggest one piece of information

that might at least give you some insight into this. Of the 800

applications, some of them are essentially...

00:54:571 min.
Kohl, Herbert "Herb" H. - U.S. Senator, [D] Wisconsin

Mr. Secretary, some of the most painful cuts

in the budget are programs under the Administration on Aging,

which takes a $28 million hit...

00:56:0756 sec.
Leavitt, Michael O. - Secretary, Utah

Senator, you have listed a number of

different areas, so let me do my best to respond to them and to

give you a sense of what was going...

00:57:03
Kohl, Herbert "Herb" H. - U.S. Senator, [D] Wisconsin

I would like some more information on those

particular programs.

00:57:03
Leavitt, Michael O. - Secretary, Utah

We'll be happy to respond to that.

[The information follows:]

Alzheimer's Demonstration Grants

For 14 years under the Alzheimer's...

00:57:0343 sec.
Kohl, Herbert "Herb" H. - U.S. Senator, [D] Wisconsin

There are a number of programs in your

Department aimed at bolstering rural health. Wisconsin, one of

the biggest beneficiaries in the country,...

00:57:4637 sec.
Leavitt, Michael O. - Secretary, Utah

I, like you, come from a State where

rural medicine is a very important part of the social fabric of

our State, and so I have become quite...

00:58:23
Kohl, Herbert "Herb" H. - U.S. Senator, [D] Wisconsin

Thank you, Mr. Chairman.

CDC BUDGET CUTS

00:58:232 min.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you very much, Senator Kohl. On

round two, we begin now with Mr. Secretary. With respect to the

budget cuts, the Centers for Disease...

01:00:2535 sec.
Leavitt, Michael O. - Secretary, Utah

Senator, may I acknowledge that the work

that this committee has done to be supportive of CDC is not

just noticeable, but revered, and I...

01:01:00
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Should we stop the rebuilding?

01:01:0026 sec.
Leavitt, Michael O. - Secretary, Utah

Well, we believe that we are capable of

pausing on what will be a long-term strategy to continue to

improve the facilities. We have made...

01:01:2644 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Let me ask you to submit the balance of

your answer in writing so I can go onto NIH.

[The information follows:]

CDC Physical Plant

CDC...

01:02:1043 sec.
Leavitt, Michael O. - Secretary, Utah

Senator, I want to tell you again I

agree with you that funding new research ideas is a vital,

important priority and that the fiscal year...

01:02:5349 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Well, there will be a lot of grant

applications denied and a lot of existing grant applications

denied. I get lots of letters, and one illustrates...

01:03:4247 sec.
Leavitt, Michael O. - Secretary, Utah

I'd like to acknowledge that we are

working to find opportunities for new investigators and for new

innovations, and one of the things we...

01:04:2913 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Well, I turn now to the second round for

Senator Harkin, and I am anxious to see if he follows his

customary pattern of having really tough...

01:04:42
Leavitt, Michael O. - Secretary, Utah

I am going to watch that too.

NIH FUNDING LEVELS

01:04:422 min.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

You're putting me on the spot here. Just to

follow up on the distinguished chairman's line of questioning

on NIH--when we worked hard in...

01:07:3714 sec.
Leavitt, Michael O. - Secretary, Utah

I'd love to respond just briefly. I

believe one of the side benefits of our pandemic preparedness

is the ability to take the annual flu...

01:07:51
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Yeah.

01:07:5111 sec.
Leavitt, Michael O. - Secretary, Utah

We will have to have new capacity

developed and have it operating continually to keep our

capacity warm----

01:08:02
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

That's right.

01:08:02
Leavitt, Michael O. - Secretary, Utah

The best thing to develop--

01:08:02
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

That's right.

01:08:02
Leavitt, Michael O. - Secretary, Utah

Would be new annual flu

vaccine.

01:08:02
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

That's right.

01:08:0216 sec.
Leavitt, Michael O. - Secretary, Utah

So, I fully believe that we will see

substantial increases in the availability of annual flu

vaccine. How we distribute it, what the cost...

01:08:182 min.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Well, I appreciate that. I will continue to

push that idea that we ought to just provide a free flu shot.

It's about--I estimated about--well,...

01:10:41
Leavitt, Michael O. - Secretary, Utah

I think I best respond to you----

01:10:41
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Respond to me.

01:10:4111 sec.
Leavitt, Michael O. - Secretary, Utah

In writing. I have read

about your concern about this, and I have begun to make

inquiries as to what the current status is.

[The information...

01:10:52
Leavitt, Michael O. - Secretary, Utah

Senator, could I just make one other

quick statement on a previous matter?

01:10:52
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Sure.

NIH RESEARCH

01:10:521 min.
Leavitt, Michael O. - Secretary, Utah

I'd just like to acknowledge that--the

commitment that I feel to maintain the momentum of the research

we have going at NIH. I'll probably...

01:12:25
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

I appreciate that. That's good.

COMPASSION CAPITAL FUND

01:12:251 min.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you very much, Senator Harkin. Just

one final question before we conclude the hearing--Mr.

Secretary, I note that you and First Lady...

01:14:0426 sec.
Leavitt, Michael O. - Secretary, Utah

We are nearing the point in our process

of soliciting proposals. We have an obligation to come up and

review it with the committee, and...

01:14:3011 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Well, the announcement was sometime ago--

March 7, 2005. Have any grants been made under the program in

the intervening 15 months?

01:14:4121 sec.
Leavitt, Michael O. - Secretary, Utah

We have not yet received proposals. We

have an obligation to come to the committee to review them with

you before we do that, and we will...

01:15:0219 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Well, we have put up a fair amount of

money last year, and you are asking for $35 million more this

year in a budget where there are cuts...

01:15:21
Leavitt, Michael O. - Secretary, Utah

Thank you.

01:15:2116 sec.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

But if the money is not going to be

awarded so that we can see some positive results from those

funds, we want to use them elsewhere. Mr....

01:15:371 min.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

There was one thing I just--thank you, Mr.

Chairman--that I wanted to bring up before you left, Mr.

Secretary.

When we first met when...

01:17:0418 sec.
Leavitt, Michael O. - Secretary, Utah

Our purpose is to continue a portion of

it in the Administration on Aging. We do believe, as you have

stated, the need for us to deinstitutionalize...

01:17:2235 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Well, provide me with more details because

it's not just aging. I mean, these are people with--a lot of

the time physical disabilities,...

01:17:57
Leavitt, Michael O. - Secretary, Utah

Something we'd like to change.

01:17:5731 sec.
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

Well, I would like to change that too.

That's why we had this program. So I wish you would really look

at that. We are mandated--Supreme...

01:18:28
Leavitt, Michael O. - Secretary, Utah

I have asked my staff to respond as

quickly as possible.

01:18:28
Harkin, Thomas "Tom" - U.S. Senator, [D] Iowa

I'd appreciate that. Thank you very much,

Mr. Secretary.

01:18:289 sec.
Leavitt, Michael O. - Secretary, Utah

Thank you.

[The information follows:]

Aging Services Programs

Thank you for this opportunity to clarify my remarks at the recent

hearing....

01:18:372 min.
Specter, Arlen - U.S. Senator, [R] Pennsylvania

Thank you very much, Secretary Leavitt.

Thank you for what you are doing on the pandemic problem, and I

urge you to do more on acquainting...

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