Senate Voices Approval for Bush Nominees

The Senate on Wednesday overwhelmingly confirmed Michael Leavitt as the new secretary of Health and Human Services, setting aside partisan divisions that have roiled debate over some of President Bush’s other nominees.

Leavitt, who turns 54 next month, most recently headed the Environmental Protection Agency and served three terms as governor of Utah. He will assume the leadership of a department whose budget exceeds the Pentagon’s and whose health, retirement and social welfare programs intersect with the basic needs of virtually every U.S. household.

The Senate also confirmed Jim Nicholson, 67, a former GOP chairman and U.S. ambassador to the Vatican, as secretary of the Department of Veterans Affairs. Both his and Leavitt’s confirmations came on voice votes.

Considered a solid manager who is open to innovation, Leavitt has a record of working with lawmakers of both parties. He also maintains extensive contacts with the nation’s governors, who are among the major players in healthcare.

During confirmation hearings before two Senate panels, Leavitt said the “main event” for him this year would be putting into place the new Medicare prescription drug benefit, which takes effect in 2006. The benefit is intended to provide hundreds of dollars of assistance to the typical recipient, but surveys have shown that many elderly people are skeptical that they will be helped. To receive the benefit, they must enroll.

Leavitt, who is succeeding former Wisconsin governor Tommy G. Thompson as the department’s secretary, faces other significant challenges.

The reputation of the Food and Drug Administration has been damaged by a succession of problems with drugs that the agency had approved as “safe and effective” for patient use.

First, several antidepressants were shown to increase the risk of suicidal behavior in teenagers. Then, late last year, the widely used painkiller Vioxx was pulled from the market after a study confirmed that it could cause strokes and heart attacks. An FDA whistle-blower said the agency ignored warning signs on Vioxx and several other medications.

Leavitt said one of his first priorities would be to appoint a new permanent head of the FDA. The administration has had trouble finding candidates of high stature within the scientific community who are willing to take the job. He also pledged to respect the rights of whistle-blowers.

He called the FDA “a brand” and a “name of trust,” and said protecting its integrity would be a “vital and important” part of his job. Lawmakers are pressing for changes that would increase the clout of the agency’s drug safety reviewers.

Leavitt could find himself at odds with his former colleagues in the nation’s statehouses if the administration follows through on plans to seek cuts in the range of $100 billion over five years in the Medicaid health program for the poor, disabled and many elderly in nursing homes.

In his confirmation hearings, Leavitt sidestepped specific questions about the future of Medicaid, a federal-state partnership. He called for changes that would give states more leeway in setting benefits, while guaranteeing coverage for people facing the greatest hardships.

The new secretary will also face pressure from lawmakers of both parties in Congress to take a more active role in trying to stem the rise in prescription drug prices. Some lawmakers are pursuing legislation that would allow drug imports from other industrialized nations, where prices are lower.

Leavitt said he was open to considering the idea. If it could be done safely, “then it is a discussion that we should be having,” he told the Senate Finance Committee.

But he expressed reluctance when prodded about whether Medicare should negotiate bulk discounts for its 42 million beneficiaries, much as the Veterans Administration does.

“My instinct tells me that it is an open and rigorous market that ultimately produces the best outcome,” he said. Government “should be quite cautious as to not become the setter of prices as opposed to a player in a market.”