| 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... |