Nomination of Michael Leavitt

NOMINATION OF MICHAEL LEAVITT -- (Senate - January 26, 2005)

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Mr. WYDEN. Madam President, I note that the chairman of the Senate Finance Committee and the ranking minority member will be here shortly to speak on the Leavitt nomination. Until they get here, I thought I would summarize my thoughts concerning this nomination.

I come to the Chamber to speak in favor of Mike Leavitt to head the Department of Health and Human Services.

I want to begin my brief remarks by talking about the importance of bipartisanship in the health care field and to note that at the end of the last session of the Congress, there was a bipartisan failure in the health care area, in my view, of enormous ramifications. At the end of the last session of the Congress, the Congress failed to provide the funding necessary for the office of Dr. David Brailer, who is, in effect, the national health care technology point man, to try to modernize decision making, record keeping, telemedicine, and other crucial matters in the health care field. His office, as a result of this bipartisan failure by the Congress, was essentially defunded. So what you have is a situation where both political parties talk a big game about health information technology, or IT. You hear senators of both political parties saluting the promise of this exciting field and talk about how committed they are, but the response of the Congress was to essentially defund it. So rhetoric has been in abundance; concrete support has been lacking.

I come to the Senate floor to say I very much hope--and Mike Leavitt has a great interest in health information technology--that this deficiency is corrected in this upcoming Congress because otherwise there will be great consequences.

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First, I am concerned that as we see the move towards electronic medical records, these records and the placement of them is not being done in a fashion that will promote interoperability so that they are best in a position to be coordinated and maximize their value. They simply are not interoperable. It is a very significant concern. If we are going to see this trend toward electronic medical records and not take the steps to promote interoperability, that will be a very serious deficiency as we set up the new system and will cause a great deal of confusion.

Second, I am very concerned that in the information technology area, the big and powerful figures, be they high-tech companies or medical clinics, will be able to do this work, but it is not going to be done by the small physician offices and clinics. Dr. Brailer's office was the office that was in a position to give incentives to help those small offices go forward. That work is not being done.

Third, the very promising aspect of health technology has been in the area of regional offices, and now we are not seeing the funds that are necessary for those regional offices as well.

The Congress essentially zeroed out the money that Dr. Brailer needed. It was a modest amount, $50 million. My sense is to really promote health information technology, it is going to take much more significant sums, but to have this body on a bipartisan basis constantly talking about the value of health information technology and then taking the one program that would make a difference and zeroing it out is just unconscionable. Both political parties have let down what needs to be done in this critical area.

I see the chairman of the committee. I know he is very interested in health information technology, as is Senator Baucus. I hope to lead a bipartisan effort in this session of the Congress to ensure that Dr. Brailer's office gets the funds that are necessary.

The last couple of points I would make in support of the Leavitt nomination: First, on the question of Medicaid, Mike Leavitt told me, in response to a question I asked, that there was no plan to send a block grant proposal to the Congress. That was welcome news. But he left an awful lot of wiggle room in terms of the details, and so bipartisan concerns remain, concerns by the governors as well, about what is to come.

As one Senator who specializes in this field, I send a message that I am very supportive of the concept of health care waivers. I think that kind of flexibility is certainly a plus. We in Oregon have used them in a humanitarian way, to get better quality care to people for services that are medically effective. But there is a big difference between waivers that are borne out of a desire to use flexibility to serve people and a block grant proposal which just sets an arbitrary cap and cuts people off.

Finally, I want to talk about the importance of working in a bipartisan way to contain costs for prescription drugs under the new Medicare law. As one who voted for that law, believing it was important to get started, I said then that the next step has to be to put in place a real cost containment effort that looks particularly to the private sector. Senator OLYMPIA SNOWE, who serves with great distinction on the Finance Committee, will be introducing legislation with me next week that will say we are going to use private sector forces, marketplace forces, to hold down the costs of prescription drugs in our country. For the life of me, I cannot figure out why Weyerhauser, a big timber company, or an auto company, or a steel company, or any other big concern, has marketplace power to hold down the cost of medicine but the Medicare Program does not. In fact, I don't know of a single buyer in the private sector who, after they purchased a certain volume of a particular commodity, looks to buying another commodity and then doesn't ask for a discount, doesn't ask for some kind of benefit as a result of using their marketplace power.

So I am very hopeful. Mike Leavitt indicated last week he was open to discussions in this area. Certainly, again, there were no details discussed, but he showed a flexibility that I found welcome.

I see the chair and the ranking minority member here. I don't want to detain them. I urge the Senate to approve the nomination of Mike Leavitt when he comes up for a vote. I thank the chairman of the committee, Senator Grassley, and the ranking minority member for their indulgence so I could make these comments.

I yield the floor.

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