107th Congress

FY 2002 Budget Testimony By the Secretary of HHS, Tommy G. Thompson -- House Appropriations Subcommittee on Labor, Health and Human Services and Education -- May 2, 2001

Members Present

Representatives Bill Young, Chairman, House Committee on Appropriations (R-FL); Ralph Regula (R-OH), Chairman; David Obey (D-WI), Ranking Minority Member; Randy "Duke" Cunningham (R-CA); Rosa DeLauro (D-CT); Kay Granger (R-TX); Steny Hoyer (D-MD); Ernest Istook (R-OK); Jesse Jackson, Jr. (D-IL); Patrick Kennedy (D-RI); Nita Lowey (D-NY); Dan Miller (R-FL); Anne Northup (R-KY); Nancy Pelosi (D-CA); John Peterson (R-PA); Don Sherwood (R-PA); and Roger Wicker (R-MS).

Chairman Regula and the other members welcomed Secretary Thompson for his first visit in front of this Subcommittee and expressed their enthusiasm and confidence in his leadership abilities.

Secretary's Testimony

Secretary Thompson discussed the President's FY 2002 budget for the Department of Health and Human Services (DHHS), which totals $498.8 billion (outlays) for FY 2002. The Secretary addressed highlights of the budget: 1) nearly $3 billion in increased spending for children's programs; 2) support for working families with an increase in child care funding and block grants; 3) promotion of safe and stable families and independent living; 4) the Center for Faith-Based and Community Initiatives; 5) increased funding for the National Institutes of Health (NIH); 6) modernization of Medicare and expansion of Community Health Centers; 7) reforming management, particularly the Health Care Financing Administration (HCFA) and investing in infrastructure for the Centers for Disease Control (CDC) and NIH. Secretary Thompson also stated that the President's budget included a 12 percent increase in funding for asthma research and an 11 percent increase in funding for diabetes research.

Testimony of Interest to NIH

Chairman Young asked Secretary Thompson to speak about his current efforts on organ donation, an issue that Chairman Young is very interested in. Secretary Thompson described four new organ donation initiatives: 1) the Workplace Partnership for Life; 2) an annual recognition of families of donors by a National Give of Life medal; 3) an effort to make sure that people talk to their families and let them know their wishes, once they have signed a donor card; and 4) a mandatory course in organ donation upon obtaining a driver's license.

Chairman Regula stated that he would submit his questions to the Secretary.

Representative Hoyer stated that he was pleased to hear the Secretary speak about doing things in new ways and deploying resources in new areas. Representative Hoyer stated his belief that Federal agencies need to work together better coordinating similar resources for the public and even co-locating them in one location. He cited his bill, the Full Service School Improvement Act, as an example of this type of coordination.

Representative Miller discussed his support for stem cell research and urged the Secretary not "to tie the hands of scientists," but to support scientists doing research using stem cells. The Secretary stated that stem cell research is a very contentious issue, but he is a passionate supporter of NIH. He said that the legal impediment to stem cell research is being reviewed and those reviews should be completed by the first week in June. Representative Miller also asked the Secretary to justify the total budget for CDC. The Secretary discussed the infrastructure plans for CDC. He stated that the decision was made to invest in NIH, because NIH could do a better job in areas, such as contagious disease.

Representative Kennedy discussed his support for mental health issues and asked the Secretary to utilize his leadership, as he has done on the organ donation issue, to make mental health a priority.

Representative Wicker expressed his concern for the budget cuts to CDC's Chronic Disease and Prevention program. He stated his support for NIH, but felt that since we now know how to prevent several major health risks, such as heart disease, diabetes and obesity, we should focus on spreading these prevention messages to the public and changing behaviors that would lead to better health.

Representative Obey expressed his concern over the President's Budget for DHHS. He stated that the 14 percent increase for NIH, supported eagerly by both parties, could be known as the "holy picture item in the budget". Representative Obey stated that increasing funding for NIH could lead to more expensive treatment options. He asked that the Secretary ensure that this increased funding would not lead to treatments that would not be affORDable to poor people in rural areas. Representative Obey also expressed his concern that NIH's increased funding is at the expense of other HHS agencies and programs. He also discussed the stem cell research decision-making process, noting his envy at the certitude on both sides of the issue and stating that this is an issue of mercy and ethics. He noted that he doesn't know "where the right place to cut the line" is, but hopes that the Secretary is allowed to make a decision on merit rather than the political issue.

Representative Northup discussed her support for a focus on prevention of diseases. She referenced a NICHD study on teen smoking, presented during a recent hearing, as an example of how studies examine an issue, find a behavior change and later a follow-up study finds that the changed behavior is no longer in place. She encouraged the Secretary not to throw money at a problem, but rather utilize research to find ways to ensure long-lasting behavior changes.

Although Representative Lowey stated her support for NIH, she expressed concerns about the budget cuts to CDC and stated her desire to work with the Chairman and the Secretary to "fine tune the budget with regards to CDC".

Representative Cunningham encouraged the Secretary to make the Office of Women's Health a permanent office, instead of an administrative office, and asked for his support for an Office of Men's Health. He invited the Secretary to attend an upcoming town hall meeting on prostate cancer, which will be held in the District of Columbia (DC). Rick Klausner, Director, National Cancer Institute, and Anthony Williams, Mayor of DC, also will participate in this town hall meeting. Representative Cunningham also expressed his support for stem cell research, noting that he is a pro-life supporter.

Representative Peterson noted his support for preventive healthcare. He asked the Secretary to raise the podium of the Surgeon General, David Satcher. He stated that "no one has equaled C. Everett Koop" and that we need a strong voice to spread health messages to the public on morning talk shows, etc. He also discussed rural health care needs and support for long-term care insurance.

Representative DeLauro asked the Secretary to speed the implementation of rules regarding restraints used in mental health facilities, which should be in place by May 2001. She also expressed concern for preventive care and cuts in funding for light/heating programs.

Representative Istook echoed Representative Obey's concerns about the effects of increased funding for NIH. He cited a Blue Cross report stating that the current medical cost inflation is being driven by medical research. He asked the Secretary to ensure that affORDable treatments are outcomes of research. Representative Istook also stated that the benefits of medical research are not disseminated to every state and that half of NIH's research grants go to five states (California, Maryland, Massachusetts, Pennsylvania, New York). He asked the Secretary to ensure that research centers are spread out among the states, so that local physicians can receive the benefits of those research centers. Chairman Regula asked if NIH works with universities to tell them how to better help them get grants. The Secretary stated "yes, but maybe not as good as they should." The Secretary noted that the Health Resources and Services Administration and the Agency for Healthcare Research and Quality also work with universities on this issue. Representative Istook noted that Dr. Kirschstein, Acting Director, NIH, is "very positively disposed to this area".

Continuing Representative Istook's discussion about the distribution of NIH grants, Representative Pelosi stated her support, but stated that the grants must remain competitive awards. Representative Pelosi also discussed her support for increased funding for HIV/AIDS, noting that currently the increase is largely in NIH research. She stated that domestically, HIV/AIDS prevention and education, also need to be a priority.

Prepared by Jennie Titsworth Kirby/OLPA