April 26, 2001

 
I welcome the new Secretary of Health and Human Services, Tommy Thompson, to the Committee on Energy and Commerce. I know that Members look forward to hearing more about the Bush Administration’s proposals for the health care programs that affect millions of Americans from the youngest to the oldest. Because the Subcommittee on Telecommunications and the Internet is marking up a major bill that I have cosponsored with Chairman Tauzin, I will not be able to participate here this morning. But I have some concerns about the choices in this budget.

First, we know that lack of access to affordable prescription drug coverage through Medicare is the most pressing problem that seniors and the disabled face today. Yet, there is not enough money in the Bush budget to provide even a minimal Medicare drug benefit, and the funding allocated for a stopgap measure is woefully inadequate for the need. Moreover, a Medicare drug benefit needs to be adequately financed with new revenues, not through raids on Medicare’s Hospital Insurance surplus to provide drugs.

Second, I am troubled by the way the Bush budget addresses the uninsured. Given that two-thirds of the uninsured are below 200 percent of poverty ($28,300), we need to provide this group with affordable insurance. A $2,000 credit to buy a $6,000 insurance policy will not make insurance affordable to them, and it may not even provide needed benefits. Instead of building on programs like Medicaid and the Children’s Health Insurance Program (CHIP) that are effective in covering the uninsured, the budget suggests using tax credits which provide no guarantee of meaningful coverage.

Third, the Bush Administration’s new policies on section 1115 waivers may even go so far as to undermine the very insurance programs which serve working families and low-income children so well. The new administration has expressed an eagerness to give states more "flexibility," but I am worried that this flexibility may mean giving states more money that is not required to be spent to provide health care, while giving poor children fewer benefits, and broadly circumventing Congressional intent.

Fourth, the public health "safety net" takes major hits. The budget haphazardly cuts, freezes, or inadequately increases the resources that support programs that collectively serve millions of American’s most vulnerable. The Centers for Disease Control’s (CDC) chronic disease prevention programs are cut and its youth media campaign is eliminated. Funding for health care programs administered by the Health Resources and Services Administration is inadequate to meet the needs of those they serve. While community health centers would receive an increase, it is not enough. Allied programs such as the National Health Service Corps are essentially frozen, while others such as health professions and facility construction are cut. The highly acclaimed Community Access Program is eliminated. The vitally important drug and mental health treatment and prevention programs of the Substance Abuse and Mental Health Services Administration are frozen.

Fifth, the Food and Drug Administration (FDA) remains woefully underfunded. This agency oversees the safety of our food, drugs, dietary supplements, medical devices, animal drugs, among many others. It is responsible for domestic sources as well as imports of these products. FDA lacks the resources to meet the challenges it faces today, and those it will face in the future. Giving credit where credit is due, this budget does move in the correct direction in some areas, but it is still inadequate.

We currently inspect just seven tenths of one percent of imports under FDA's jurisdiction. The budget may improve this number a little, but not enough for you or anyone working for you to be able to go before the American public and say much more than "we're doing the best we can" with available resources. The advent of resistant strains of microbial contaminants, genetically altered products, and undetectable pathogens like BSE, require that we work harder to strengthen programs that protect Americans from dangers that they can neither evaluate or avoid for themselves.

Also, generic drug approvals are lagging. It takes an average of 18 months for generic drugs to be approved, while new drug approvals take less than a year. Given the enormous economic benefits to consumers of generic competition, it would seem that generic "parity" in approval times would represent a worthwhile investment in FDA's resources.

I look forward to working with you on these matters, as well as on other issues. For example, I applaud your decision to let the regulation providing for the confidentiality of medical records take effect. This is an important consumer protection measure and your approach to this matter gives us hope that all Americans will have the assurance that their medical records will be kept from unauthorized prying eyes. Many of my colleagues and I, of course, have a continuing concern with the possibility of changes to the regulation and with guidance that you may issue in the future. We stand ready to help make the regulation work well.

Mr. Secretary, today marks the beginning of what I hope will be a productive partnership with this Committee to improve health care for all Americans. Secretary Shalala had an extraordinarily successful and long tenure. Her remarkable cooperation with the Congress played a major part in this success. I hope your tenure is similarly successful, although perhaps not quite as long.