Senate Confirms Nominees To Head HHS, VA

The Senate on Wednesday confirmed Mike Leavitt, former administrator for the Environmental Protection Agency and former Utah governor, as the new secretary of HHS, the Los Angeles Times reports. Leavitt, who is replacing Tommy Thompson at the department, said during confirmation hearings that the "main event" of 2005 would be implementing the new Medicare prescription drug benefit, which begins Jan. 1, 2006 (Alonso-Zaldivar, Los Angeles Times, 1/27).

"Expectations are very high, and time is very short. There will inevitably be flaws, but we will not fail," Leavitt said of the benefit. According to CQ Today, legislators have "made it clear" that they would closely monitor implementation of the prescription drug benefit, particularly costs (Schuler, CQ Today, 1/26). Regarding proposed changes to the Medicare law that would allow HHS to negotiate bulk prices for prescription drugs with pharmaceutical firms, Leavitt said, "My instinct tells me that it is an open and rigorous market that ultimately produces the best outcome." He added that the federal government "should be quite cautious as to not become the setter of prices as opposed to a player in a market."

In addition, Leavitt told the Senate Finance Committee that the debate about legalizing reimportation "is a discussion that we should be having" if the practice can be done safely.

During confirmation hearings, Leavitt said he would work to improve the reputation of FDA as "a brand" and a "name of trust" following recent allegations that the agency did not adequately monitor the safety of some medications. Protecting the integrity of FDA is "vital and important," he said. In addition, Leavitt said one of his first priorities would be appointing a new, permanent FDA director, adding that he would respect the rights of whistleblowers.

During conformational hearings, Leavitt "sidestepped specific questions" about Medicaid and "expressed reluctance when prodded about whether Medicare should negotiate bulk discounts" for prescription drugs, the Times reports.

Leavitt also said he favors changes to Medicaid that would give states more flexibility in determining Medicaid benefits and maintain coverage for specific populations (Los Angeles Times, 1/27). He said several times that populations states are required to cover under Medicaid "should remain mandatory, and optional populations should remain optional" (CQ Today, 1/26).

Also on Wednesday, the Senate confirmed Jim Nicholson as secretary of the Department of Veterans Affairs (Los Angeles Times, 1/27). Nicholson, who succeeds Anthony Principi, said during confirmational hearings that regional differences in veterans' benefits are a "real issue" and that determining why state-to-state compensation rates differ is a "high priority" (American Health Line, 1/25). Nicholson was serving as the nation's ambassador to the Vatican (Los Angeles Times, 1/27).

No HHS secretary "ever feels the job is finished when his or her time is up," columnist David Broder writes in a Washington Post opinion piece, adding that outgoing HHS Secretary Tommy Thompson "is no different from his predecessors." Thompson, who called health care the "nation's No. 1 problem, aside from terrorism," recommends greater use of preventive medicine and encouraged medical and hospital groups to adopt information technology applications that could reduce medical errors and health care costs, Broder writes.

In addition, Broder writes that Thompson recommended that the federal government work to reduce the number of uninsured U.S. residents, including allowing states to subsidize health insurance purchasing pools among the uninsured. According to Broder, "you can expect to hear more" from Thompson on the subject of "medical diplomacy," or providing medical assistance to other nations. Broder concludes that Thompson "will continue to do what he has done for well over 20 years in public office: fight the status quo" (Broder, Washington Post, 1/27).