WASHINGTON, Jan. 18 (UPI) -- With his Senate confirmation to head the Department of Health and Human Services assured, Michael Leavitt followed in the footsteps of other Bush administration Cabinet nominees Tuesday by providing little insight to lawmakers about how he will run the agency, beyond his support for the White House's stated policies.
Leavitt was praised and faced pointed questions from both Republican and Democratic members of the Senate Health, Education and Pensions Committee in the first of two scheduled hearings this week on his nomination to oversee the agency.
HHS has an annual budget of $580 billion and oversight of more than 300 programs, including the Head Start early education program, the Food and Drug Administration, Centers for Disease Control, National Institutes of Health, Medicare and Medicaid.
Sen. Edward Kennedy, D-Mass. and ranking Democratic member of the panel, praised the "impressive skills" of the former Utah governor and outgoing Environmental Protection Agency administrator.
Committee chairman Sen. Michael Enzi, R-Wyo., said that Leavitt, "has the abilities to help keep our healthcare system responsive and out safety net intact to protect the most vulnerable among us."
Nevertheless Leavitt provided significant information about just what his heavily praised skills on social insurance and health issues will bring to bear as head of the agency following his Senate approval.
Although repeatedly asked about his ideas of overhauling the Medicaid program, which provide healthcare to about 39 million poor, Leavitt provided no real answers about his plans for the program, only standard Bush administration boilerplate.
In his testimony Leavitt preached a conservative doctrine about health programs for the poor, noting the responsibility for such programs to "teach self reliance," while helping people.
Leavitt did indicate that the number of people served "with the available resources" under the program could be expanded.
As Utah governor, Leavitt received a federal waiver to expand the state programs coverage to more people, but he acknowledged under questioning from Kennedy about the ability to provide quality care if coverage is expanded without additional funding that his state was unable to provide, "the kind of healthcare we'd want them (the poor) to receive."
Ultimately, he pledged to work to give states more flexibility with how they spend federal Medicaid funding because the program to both hold down federal costs, and "is not meeting its potential to do good in the lives of the poor."
He provided no specifics about how he would accomplish this goal.
When asked by Enzi about the need to control rapidly rising medical costs, Leavitt stuck to the Bush administration policy line, noting that the discussion about such issues should start on, "medical liability, something that badly needs to be improved."
The Bush White House and its allies controlling Congress are expected to push liability legislation -- as early as next month -- that failed to gain Senate approval last year. The measure would limit medical liability payments in civil suits.
In addition, Leavitt pressed the importance of technological innovation -- particularly, electronic record keeping and easy transferability of records between healthcare providers, a Bush campaign theme -- as a means of cost containment. However, he provided no specifics about how the administration, particularly one so attuned to free-market principles, would make such practices industry standard.
"This is not just a matter of better healthcare, but a matter of economic competitiveness," said Leavitt, noting that the medical sector represents 15 percent of the gross domestic product.
In terms of his personal priorities, Leavitt did offer a few specifics, including the "successful implementation" of the Medicare prescription drug and modernization law approved by lawmakers in 2003, calling it the "main event" at the agency in 2005.
In addition, he cited the reauthorization of the 1996 welfare reform law, which is before Congress this year as a priority.
Another area where Leavitt backed administration wishes was on the ability for Medicare to negotiate with drug companies for better prices on prescription drugs, as it done by the Veterans Administration.
When queried about the prospect by lawmakers, he dismissed the idea out of hand, arguing that such negotiations only work for healthcare providers, such as the VA.
"I think that is better left to the market," he said.
Leavitt also pledged to protect the worldwide reputation and integrity of the "brands" the FDA, CDC, and NIH have become, noting that they are a "promise" to the citizenry for protection and innovation.
Little attention was paid to the Medicare program beyond talk about its growing costs in the context of the overall rising cost of healthcare and none to the impending fiscal crisis faced by the program.
This despite the fact that Medicare costs over the next 75 years have been estimated to reach more than seven times the costs of the Social Security program, which the Bush White House has targeted for the addition of personal spending counts at an estimated cost of $2 trillion over 10 years.
With President Bush continuing the hard sell for adding individual investment accounts to Social Security, some critics note that Government Accountability Office has estimated that the fiscal impact of promised benefits under Medicare, which provides health insurance for 41 million disabled and elderly individuals, is $27.7 trillion over the next 75 years.
This is much higher than the $3.7 trillion in expected payouts of promised benefits under Social Security, which the Bush White House has presented as being in fiscal crisis, but yet to offer ways of fixing.
In addition, Medicare is expected to exhaust its financial accounts in 2019, more than two decades before Social Security exhausts its saved funds.
The lack of political importance being placed on the nominee was evident by the fact that Kennedy, the ranking Democrat, was one of two minority party members who attended the hearing.
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