April 02,2009

Grassley Outlines Challenges Facing Next Health, Human Services Secretary

Gov. Sebelius Nomination Hearing
Opening Statement of Sen. Chuck Grassley
Thursday, April 2, 2009

Thank you, Senator Baucus, and thank you, Governor Sebelius, for your willingness to serve
your country. If confirmed, you will be leading over 64,000 employees and in charge of an
annual budget of about 700 billion dollars. The Department of Health and Human Services and
its operating divisions serve many vital functions to promote the health and well-being of all
Americans. For example, the Centers for Medicare and Medicaid Services provides health care
to about 100 million Americans through the Medicare, Medicaid and the Children's Health
Insurance Program, sometimes better known as CHIP. Americans also rely on the Food and
Drug Administration to ensure the safety of food, drugs and devices that are consumed and used
every day. And the National Institutes of Health is the principal driver of basic and applied
biomedical research.

In addition to being at the helm of the Department, you will be the policy leader in the
Administration when it comes to health issues. As a cabinet member, you will have a significant
role in shaping Administration policy. It is good that you will be bringing your extensive public
service and your Midwest sensibility and know-how to the job. These will serve you well in the
difficult challenges that will lie ahead for you as Health and Human Services Secretary.

You come at a time when we face many significant challenges in the health care arena. First and
foremost of these challenges is health care reform. I think we all know by now why we need to
take on health care reform now instead of later. Skyrocketing health care costs affect everyone
including the federal government, states, business and households. Despite all this spending,
about 47 million are uninsured at some point during the year. Being uninsured poses a significant
barrier to health care access. And despite all this spending, it is clear that we are not always
getting our money’s worth when it comes to health care quality.

Governor Sebelius, these are indeed serious challenges. But you also come at a time when there
is a strong desire and commitment to work together to reform our health care system. Doing
nothing should not be not an option. But as with most significant undertakings, the devil is in the
details. If we work together, we can reform our health care system to solve the problems we face
with cost, quality and access. And we can do it without some proposals that have been
circulating lately. First, health care reform should not be legislated through reconciliation.
Everyone agrees that health reform must be done on a bipartisan basis. Reconciliation is instead
a partisan exercise that is not an appropriate vehicle for “real” health care reform.

The next important issue is the public plan option. We can reform our health care system to
achieve our goals without having a public plan option that is run by the government. We do not
need a public plan option where the government sets the rates it pays doctors and hospitals and
decides what treatments it would cover. Instead, we need a system where people who like the
coverage they have today can keep it; where stronger rules on the health care market mean that
health insurers have to cover people with pre-existing medical conditions and stop charging
higher premiums to sick people. A new government-run health insurance plan would result in
rationing of our health care to control costs. It would take us down the road toward a government
run system.

These are a few examples of the tough issues we need to roll up our sleeves and work out on a
bipartisan basis. I would like to discuss with you a number of issues that I have working on in
Congress. First is the need for transparency in health care. All the stakeholders need to have
adequate information to make choices in order for the health care system to work. This
information includes price and quality data for patients and providers. It also includes knowing
if the manufacturer of a drug or medical device your doctor prescribes for you also has been
funneling him or her a lot of money at the same time. So l look forward to hearing your thoughts
on the role of transparency in the health care system.

Combating waste, fraud and abuse has also been a longstanding priority of mine. We have much
work to do in this regard. I would like to know if curbing waste, fraud and abuse is a priority for
you and what you have done in this regard as Governor.

Another area that Senator Baucus and I and other members of the Committee have worked
tirelessly on is health care for rural America. Since you come from a largely rural state, I am
sure you share our commitment to ensuring that we have a viable and high quality health care
system in rural America. These are but a few of the issues that I hope we will be facing together.

Mr. Chairman, I would also like to ask unanimous consent to place two letters into the record.

These letters are from a group of nine scientists at the FDA. They are writing for a second time
to President Obama today regarding their grave concerns about the FDA. Governor Sebelius, I
want to be sure that you aware of these concerns from whistleblowers inside the agency. I also
want to note that I am providing copies for the record that do not identify the whistleblowers by
name. They are afraid of retaliation particularly in light of the former acting FDA
Commissioner’s recent statements and the President’s recent signing statement that seems to
limit whistleblower protections.

Also, as has been reported already, you’ve addressed some tax irregularities before we began our
review in the Committee of your tax returns. I take tax matters very seriously and I am eager for
you to address those matters today so they may be taken into consideration as your nomination
moves forward.

With that, I want to thank you again for your willingness to serve and express again, and that if you are confirmed, I look forward to working with you in the days and months ahead.