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Federal Document Clearing House
Congressional Testimony
May 16, 2001, Wednesday
SECTION: CAPITOL HILL HEARING TESTIMONY
LENGTH: 1680 words
COMMITTEE:
SENATE FINANCE
HEADLINE: TESTIMONY
HEALTH TREASURRY,TRADE NOMINEES
TESTIMONY-BY: THOMAS
SCULLY , NOMINEE FOR ADMINISTRATOR
AFFILIATION: HEALTH
CARE FINANCING ADMINISTRATION
BODY: May 16,2001
Statement of Thomas Scully Nominee for Administrator of the Health Care
Financing Administration Department of Health and Human Services Before the
Committee on Finance United States Senate Chairman Grassley, Senator Baucus and
other distinguished Committee Members, it is an honor to appear before you today
as President Bush's nominee to be the Administrator of the Health Care Financing
Administration (HCFA) at the Department of Health and Human Services. HCFA has
the largest budget of any federal agency or Department. And running Medicare,
Medicaid, and the State Children's Health Insurance Program effectively, is one
of the central functions of the federal government -- delivering health care
services to more than 70 million seniors, the disabled, and other needy
citizens. I am proud the President decided that I was best suited for this duty,
and should you concur, I assure you that I will not let you down. HCFA is not
the most popular agency in the government, nor should it be. With a budget of
almost $400 billion, you have to say "no" to a lot of people, including an
occasional Senator or Representative, if you want to keep the annual rate of
health inflation under control. When I was last in the government, Medicare and
Medicaid were both growing at annual rates of almost 15 percent a year, which
was -- and still is -- unsustainable. The economy cannot stomach a return to
those days nor, I suspect, can Congress. So, by design, HCFA --which means me --
will probably again fail to win public popularity awards during my tenure.
However, we can and we will do far better in working with Congress,
beneficiaries, and the physicians, providers, and insurers who serve as HCFA's
partners in delivering care and providing coverage. That is my commitment to you
as Administrator. One of my top priorities will be greatly enhanced education
for beneficiaries, physicians, and providers. I hope to expand our educational
efforts to seniors on a number of fronts to further improve their understanding
of their options and opportunities under the Medicare program. I will also push
the agency to be far more aggressive in its work with physicians, nurses,
hospitals, nursing homes, home health agencies, dialysis facilities, and every
other provider partner to explain what we are doing in our regulatory efforts.
Likewise, I will quickly push to develop a more direct and accountable
relationship between HCFA's Medicaid staff and the States they partner with in
th6 Medicaid program. As I mentioned, I do not expect everyone to always like
our decisions, but everyone has a right to expect clear, prompt, and thoughtful
answers from HCFA. I have worked with HCFA throughout my career in the Office of
Management and Budget (OMB), on the White House staff, and in the private
sector. I believe that HCFA is stocked with an exceptionally smart and talented
staff. In fact, my regulatoryexperience with HCFA over the last 15 years has
generally been good. However, I have some understanding of the maze that is the
HCFA process. This is a skill most taxpayers, seniors, doctors, nurses, and
other providers -- not to mention Governors and Members of Congress -- do not
have, and probably do not want to have. My first goal is to fix this process, to
untangle the web, and to clarify the regulatory mystery that HCFA has become to
many of its constituents. My other primary interest in taking on this job is
legislative and I look forward to working with Congress on reforming Medicare.
In my most recent years in government service, during the "first" Bush
Administration, I worked on a number of very successful bipartisan legislative
projects -- most involving the Senate Finance Committee. From physician payment
reform in 1989 to child care and the Earned Income Tax Credit (EITC)
restructuring in 1990 to Medicaid Disproportionate Share Hospital (DSH) reform
and hospital capital reform in 1991 and 1992, a number of significant and
important programmatic improvements were made. Enough improvements to make me
believe that you really can make a difference in public service. On the other
hand, working for the last 15 years on health care issues, both inside and
outside of government, has occasionally made me feel like I am watching the
movie "Groundhog Day." Every day I get up and the issues are the same as they
were a decade ago. For example, I spent the first half of 1989 trying to "save"
the Medicare Catastrophic Coverage Act, which was primarily a
Medicare
prescription drug and catastrophic benefit. Today, twelve years later,
we are only now beginning to refocus on that issue. Medicare reform, as well as
Medicaid DSH, and upper payment limit reforms were enormous issues in 1991 and
1992. Little has changed today and, arguably, the situation may be even worse.
In addition, we still have over 40 million uninsured, with little national
consensus about how we should address the problem. Clearly, there is a
tremendous amount of work to do for anyone, in either party, with a strong
interest in fixing health care in America -- both at HCFA and in our nation's
health insurance and delivery mechanisms. I enjoy public service, and I am
determined to make a difference. I have tremendous respect for the Finance
Committee and I have been fortunate enough to make good friends on both sides of
the aisle during my many years in Washington. If confirmed, I sincerely hope to
work with each of you on this Committee and with the Congress over the next four
years to make HCFA work better, but more importantly, to significantly improve
our health care system. Again, thank you for your consideration of my
nomination, and for the honor of appearing before you today.
LOAD-DATE: May 23, 2001, Wednesday