Good morning, Chairman Specter, Senator Harkin, and members of the Subcommittee. I am
pleased to appear before you today to discuss the President's FY 2000 budget for the Department
of Health and Human Services.
STANDING AT THE CROSSROADS OF THE NEW MILLENNIUM
What makes my appearance this year before your Subcommittee distinct from all the others is
that we are not only submitting a balanced budget for the second straight year, but we are also
celebrating a landmark bipartisan achievement -- last year's budget surplus, the first on the books
in three decades. In the past, we have spoken at great length about the need to balance the
budget, and thanks to the hard work and cooperation of the Congress and the Administration, we
have been able to achieve that goal.
Mr. Chairman, while we can all take pride in helping to achieve this success, we must now look
ahead together to the challenges that still confront us. These challenges are many: helping
Americans live not only longer but also healthier lives, extending protections to those without
health insurance or who are at-risk, safeguarding our public health, and working to better the
lives of our nation's children. As we stand at the crossroads of the new millennium, the
combination of our fiscal discipline, the expanding economy, and a new age of scientific
breakthroughs provide us with a unique opportunity to meet these challenges.
The budget I present to you today begins to meet these challenges through critical investments in
the health and well being of our citizens. It is a budget that keeps faith with the President's
vision of a 21st Century America where every family can get ahead and no one is left behind.
Mr. Chairman, the total HHS budget request for FY 2000 is $400.3 billion (Outlays). The
amount before this Committee totals $230.7 billion (BA), of which $38.527 billion is
discretionary. This discretionary component represents an increase of $1.352 billion over last
year. Let me now highlight the main components of our FY 2000 budget request.
THE PROMISE OF A RETIREMENT WITH DIGNITY FOR ALL AMERICANS
Thanks to advances in medical science and health care, Americans are now living longer than
ever before. By 2030, the number of Americans over 65 will double, from 34 million to
69 million. This change creates a new set of demands on our health care system, from an
increasing need for long-term care services to preparing Medicare to meet the needs of an
expanding pool of beneficiaries. Meeting these demands will help older Americans live not just
longer lives, but healthier ones.
America's aging population, which continues to increase, needs better long-term care. Our
budget addresses this need with a multi-faceted initiative to help the five million Americans who
require long-term care and to those who care for them.
Studies show that those who need long-term care prefer to remain in their own homes and
communities rather than receive care in nursing homes or other institutional settings. The
majority of caregivers are women, and one-third have full time jobs. Sadly, research shows that
rates of depression among caregivers are significantly higher than those of non-caregivers of the
same age. We must assist these caregivers in their difficult task.
Our budget invests $125 million in FY 2000 for a new National Family Caregiver Support
program in the Administration on Aging to assist approximately 250,000 families nationwide
who are caring for elderly relatives with chronic diseases and disabilities. This investment will
enable states to create comprehensive support systems that provide a range of community-based
services to caregivers, including quality respite care, information about local services,
counseling, and training for complex care needs.
Our budget also provides seniors, as well as younger Medicare beneficiaries, with critical
information to help them better understand their long-term care options. We have requested
$10 million for a national Medicare information campaign to provide Medicare beneficiaries of
all ages with information on the long-term care coverage available under Medicare and
Medicaid, private insurance options, and community-care services. The budget also expands
access to home and community-based care services to people of all ages with significant
disabilities by allowing states to provide Medicaid coverage to people with incomes up to
300 percent of the federal SSI level who need nursing home care but choose to live in the
community. This new Medicaid option will help make eligibility for nursing homes and
community based services more comparable and eliminate one of the sources of Medicaid's
"institutional bias." This long-tem care initiative also includes policies from other Departments,
including a tax credit to compensate for the cost of long-term care services; providing the Federal
government with the authority to offer private long-term care insurance to its employees at group
rates; and an innovative housing initiative to create and integrate assisted living facilities and
Medicaid home and community based care.
Nursing Home Quality Initiative
While we develop the means to support those who receive long term-care in home and
community- based settings, we must also continue to ensure that those in nursing homes and
institutional settings are getting the quality care they deserve. Last summer, the President
announced an initiative to strengthen enforcement and oversight of nursing home quality and to
crack down on those who repeatedly violate program standards. While key provisions of this
initiative are already being implemented, this year's budget will provide the $60.1 million
needed to complete implementation of these provisions. Funds will support increased state
surveys of nursing homes, Federal oversight and development of a national criminal abuse
registry to screen potential employees, as well as the costs of the additional litigation and appeals
that result from stepped-up enforcement efforts.
Reforming HCFA Management and Combating Medicare Fraud, Waste, and Abuse
As steward for some of the most important programs for our elders, the Health Care Financing
Administration faces the daunting challenge of reorganizing and modernizing while at the same
time meeting pressing statutory deadlines for program changes mandated in the Balanced Budget
Act (BBA) and the Health Insurance Portability and Accountability Act (HIPAA). HCFA must
be highly sensitive to the needs of its customers as it undertakes these reforms. While HCFA's
recent reorganization has made some progress in achieving the necessary changes, more needs to
be done. The President's budget outlines a five-part reform plan that will increase HCFA's
administrative flexibility while also enhancing accountability, thereby enabling HCFA to be
responsive to its customers and serve as a more prudent purchaser of health care. As HCFA
begins to accomplish the basic objectives of these reforms, we will also begin reviewing
legislative proposals to increase the stability of HCFA's funding in the future.
While we pursue our efforts to strengthen HCFA management, we also will continue our fight
against fraud, waste, and abuse in the Medicare program. Since 1993, the government has
increased prosecutions for health care fraud by over 60 percent and increased convictions by 40
percent, and I would like to thank the Subcommittee for supporting these efforts so strongly.
This budget continues the fight by providing $864 million for the Medicare Integrity Program
and the Health Care Fraud and Abuse Control Account, which support the efforts of both HHS
and the Department of Justice in fighting fraud and abuse. It also includes proposals to spend
Medicare dollars more wisely by eliminating the overpayment for Epogen and excessive mark-ups for outpatient drugs, requiring private insurance companies to provide secondary payer
information, reducing the misuse of partial hospitalization services, and making "Centers of
Excellence" a permanent part of the Medicare program. In total, these programs will save an
estimated $240 million in FY 2000 and $2.9 billion over the next five years.
QUALITY, AFFORDABLE HEALTH CARE FOR AMERICA'S WORKING FAMILIES
Today, too many people are denied the benefits of health breakthroughs because they lack
insurance or access to care. We must take steps to ensure that in the new millennium our health
care delivery system keeps pace with advances in medical science and provides high quality and
affordable health care to every American family. To do so, our budget expands access to health
care and health insurance, particularly for our most vulnerable populations.
Increasing Access to Health Care for Uninsured Individuals
Nearly 43 million Americans lack health insurance. Many of these individuals receive care only
sporadically in hospital emergency rooms. To help these people get the primary care and other
services they need, the President is proposing a five year, $1 billion initiative to help
communities and health care providers to develop integrated systems that can deliver a more
coordinated array of health care services more efficiently to uninsured workers. This program
would provide $25 million in grants this year, and $250 million a year from 2001 to 2004, to
assist over 100 communities in establishing the infrastructure necessary to develop and
participate in coordinated care arrangements and finance additional core health services for
uninsured workers within integrated systems of care.
Improving Mental Health Services
Every year approximately 44 million American adults experience some form of mental disorder,
including 10 million who suffer serious mental illness. In addition, up to 4 million children ages
9 to 17 experience a serious emotional disturbance. Yet estimates show that less than one quarter
of these people are treated for their disorders. Our budget includes $359 million for the Mental
Health Block Grant, an increase of $70 million, to provide additional funds for states to create
comprehensive, community based systems of care for both adults and children. It also provides
$31 million for the Projects for Assistance in Transition from Homelessness (PATH) grant
program, an increase of $5 million, which will increase by approximately 13,000 the number of
individuals served and increase the number of services provided to those already enrolled.
Ensuring Access to AIDS Therapies (Ryan White)
We have made significant progress in the fight against HIV and AIDS. Due to the widespread
use of combination anti-retro viral therapy, the AIDS death rate in 1997 was its lowest in nearly a
decade. But the news is not all good. While the overall AIDS death rate is declining, the disease
an excruciating toll in minority communities. In 1997, 47 percent of those newly
diagnosed with HIV were African American and 20 percent were Hispanic. We must continue
our efforts to expand access to drug therapies and improve the quality of care, particularly in
minority communities. The President's budget continues the fight against HIV and AIDS by
providing $1.5 billion for the Ryan White Program, an increase of $100 million. Included in this
amount is an increase targeted to communities to provide state of the art clinical care to an
additional 10,000 people living with AIDS. In addition, the AIDS Drug Assistance Program
(ADAP) will receive a $35 million increase to help individuals gain access to combination drug
therapy. The budget also continues to build on the effort initiated by the President and this
Committee to address the AIDS crisis in minority communities. The budget for FY 2000
includes $171 million for special initiatives that will be specifically targeted to HIV/AIDS
prevention, treatment, and capacity development needs within the African-American and other
racial and ethnic minority communities.
Reducing Racial Health Disparities
Unfortunately, members of minority groups are often less healthy than Americans as a whole.
Despite improvements in overall health outcomes, minorities continue to bear a disproportionate
burden of the nation's disease and illness. For example, the infant mortality rate for African-Americans is more than twice that of Caucasians, and American Indian and Alaska Natives are
about three times as likely to die from diabetes compared to other Americans. The President is
committed to ending these racial disparities in health status, and the budget provides $145
million to target many other Department resources in the effort to provide health education,
prevention, and treatment services targeted to minority populations.
Medicare, Medicaid, and the Children's Health Insurance Program
Our budget also includes a variety of legislative proposals to expand access to Medicare and
Medicaid for groups that would otherwise be denied health insurance for any number of reasons.
It allows Americans ages 62 to 65 to buy into Medicare by paying a premium, provides a buy-in
option for displaced workers ages 55 to 62 who have lost employer-provided health coverage,
and allows retirees between the ages of 55 and 65 whose companies have reneged on their health
benefits to buy into their company's health plan. Another proposal would give states the option
of providing Medicaid coverage to legal immigrant children, pregnant women, and certain
groups of immigrants with disabilities who have entered the United States
after the enactment of
the welfare reform legislation in 1996.
The Children's Health Insurance and Medicaid programs represent a valuable means of
providing health insurance to poor children who might otherwise go without care. But many
families are unaware that their children are eligible to receive care under these programs. Our
budget will allow states to increase spending by $1.2 billion over the next five years on benefits
and outreach and give them additional flexibility to expand outreach efforts through development
of new and innovative approaches.
Making Work Pay for People with Disabilities
Our Budget also promotes opportunities for Americans with disabilities. All too often, disabled
Americans are prevented from working by their legitimate fears of losing access to Medicaid and
Medicare coverage once they go to work. To enable these Americans to work and earn a living
wage, our FY 2000 budget extends Medicare coverage, and at the option of states, Medicaid
coverage, to working people with disabilities. This proposal also includes new incentives for
states to help them start their programs and to link workers to necessary support services..Since President Clinton and Vice President Gore took office, the American economy has added
17.7 million new jobs. However, the unemployment rate among working age adults with
disabilities is still nearly 75 percent. People with disabilities can bring tremendous energy and
talent to the American workforce, yet institutional barriers often limit their ability to work. The
President's budget proposes a historic new $2 billion initiative that removes significant barriers
to work for people with disabilities. It includes the Work Incentives Improvement Act, which
invests $1.2 billion in providing options for workers with disabilities to buy into Medicaid and
Medicare; a new $700 million investment in a $1,000 tax credit for workers with disabilities; and
more than double the government's current investment, an increase of $35 million, in assistive
technologies that make it possible for individuals with disabilities to work.
MAKING AMERICA A HEALTHIER AND A SAFER PLACE TO LIVE
As we enter the 21st century, new threats to our public health are continually emerging. From the
challenge of confronting infectious diseases, to the possibility of a bioterrorist attack and the
ongoing problems of foodborne illness, we must constantly be vigilant. The only way to
successfully combat the public health problems of tomorrow is by investing today in the
necessary medical research and public health and disaster response infrastructure.
The International Challenge of Infectious Diseases
If you will permit me, Mr. Chairman, I would also like to speak briefly to the importance of
fulfilling our commitment to support the World Health Organization and the work it does to
improve the health of people throughout the world, including our own citizens.
I recognize that funds for the WHO are appropriated to the Department of State through another
Subcommittee. But those of us responsible for the health of the American people need to
understand that the WHO's ability to fulfill its mission and responsibilities can make a real
difference in fulfilling our own public health goals. Key areas include the WHO's work in the
surveillance and outbreak control of infectious diseases, headed by a distinguished American
(David Heymann), the Tobacco Free Initiative, Roll-back Malaria, the elimination of polio, and
the Stop TB initiative.
International trade, commerce, and tourism have truly created a global village. Because
infectious diseases do not recognize borders, it is increasingly necessary to protect the health and
safety of American citizens by investing in a global public health strategy.
Tuberculosis provides a striking example. In this decade, we have had to aggressively combat a
resurgence of TB in the United States
. We have made extraordinary progress, with the number
of cases declining dramatically.
New York City was among the hardest hit. Now, the only new cases are found among the City's
immigrant population among people who were exposed elsewhere.
Working in partnership with the WHO, and providing the necessary resources, we can develop
the global strategy that is critical to protecting our citizens and people around the world.
Responding to the New Threat of Bioterrorism
Terrorism represents a serious threat to the peace and prosperity of our nation. While terrorist
attacks can take numerous forms, the threat posed by bioterrorism is particularly deadly, because
it can affect a large population, remain undetected for some time, and cause secondary illness or
death if the agent is communicable. As the lead federal agency responsible for preparing for and
responding to the medical and public health consequences of a bioterrorist event, we are
mounting a comprehensive public health effort to combat this deadly threat.
The President's Budget includes $230 million for the Department to undertake a coordinated,
four-pronged initiative to prepare for the medical needs and health consequences resulting from a
potential terrorist use of biological weapons. First, our budget invests in the infectious disease
surveillance infrastructure needed to detect the occurrence of a bioterrorist attack and to
determine its cause, including improvements in case reporting, epidemiological and laboratory
capacity, and the development of information technology to allow coordination among Federal,
State and local public health officials. Second, it funds the purchase of a stockpile of the
vaccines needed to treat the most likely biological agents. Third, the budget invests in
developing the medical response capability at the local level to respond to an outbreak by
training local health providers and supporting the creation of 25 Metropolitan Medical Response
Systems. Finally, it provides funds for research and development activities to develop and
expedite review of new vaccines and therapeutics and new rapid screens for diagnosing chemical
Creating Superior Public Health Surveillance and Food Safety
Our nation needs a high quality surveillance system to collect and analyze epidemiologic
information if we are to be able to respond effectively to a future outbreak of disease. The
President's budget proposes to strengthen our surveillance system by providing a total of
$65 million to support the implementation of a National Electronic Disease Surveillance
Network Initiative (NEDSNI) at the Centers for Disease Control. This Initiative would integrate
electronic communications related to surveillance for the Emerging Infectious Diseases ($15
million), Bioterrorism ($40 million), and Food Safety ($10 million) programs and will establish
communication links with the public health and medical communities to enable them to furnish
timely information on outbreaks of communicable diseases to State and local public health
departments and assure better communications among public health entities.
Surveillance is just one of the keys to fighting outbreaks of foodborne illness. Food-related
hazards are responsible for as many as 33 million illnesses and up to 9,000 deaths each year. To
combat these outbreaks, the budget seeks $29.5 million for the CDC, a $10 million increase, to
expand the PulseNet network of health labs which preform DNA "fingerprinting" of disease
causing bacteria. In addition, FDA is seeking $79 million to support its food safety efforts.
Expanding Medical and Health Care Quality Research
Biomedical research has been the foundation of the unprecedented gains we have made in
improving the health of both Americans and the world. Last year, the President made a
commitment to increase the budget for the National Institutes of Health, the world's largest and
most distinguished organization for biomedical research, by nearly 50 percent over five years,
and this Committee responded by passing an increase of almost $2 billion. This year's budget
continues the President's commitment and keeps us on the path set last year with an investment
of $15.9 billion, an increase of $320 million. The FY 2000 request, combined with last year's
14.6 percent increase, represents a 17 percent increase over two years. This year's request will
enable NIH to fund nearly 30,000 research projects grants, the highest total in history.
Along with his commitment to increase funding for biomedical research, the President last year
also made a commitment to ensuring that scientific advances are translated into better health care
for the American people. The President's budget honors this commitment as well, providing an
increase of $35 million for the Agency for Health Care Policy and Research. These funds will be
spent on health care research that will enhance knowledge about how to improve outcomes and
quality of medical treatment and how to best translate research results into daily practice to
improve health care for all Americans.
THE RIGHT TO A SAFE AND HEALTHY CHILDHOOD
Mr. Chairman, the health investments that I have outlined are critical to meeting the challenges
that will confront us in the next century. But we must also invest now in what will undoubtedly
be our greatest natural resource in the new century, our children.
Curtailing Youth Smoking
Last year's settlement of the State tobacco lawsuits affirmed the responsibility of the tobacco
industry to pay for health care costs associated with smoking. While this agreement was a step in
the right direction, there is more that needs to be done to preserve the public health -- and to
protect our children from the dangers of smoking. It is horrifying to think that over 400,000
deaths each year are due to cancer, respiratory illness, heart disease and other smoking-related
illness. It is even more horrifying that three thousand young people will begin smoking each
day, and one thousand of them will die earlier than they should as a result of smoking.
Our budget reaffirms our commitment to combat smoking among the nation's youth. First, the
President has proposed raising the price of a pack of cigarettes by 55 cents to reduce teen
smoking. The budget also includes $101 million, an increase of $27 million, to expand the
Center for Disease Control's support for State tobacco control programs. The budget also
provides $68 million for the Food and Drug Administration to support outreach and enforcement
activities to curtail youth smoking, an increase of $34 million.
Last year, after extensive negotiations, the states' Attorneys General reached a settlement with
the tobacco companies that was based in part on recovering the medical costs of those with
tobacco-related diseases. Since U.S. taxpayers paid a substantial portion of the Medicaid costs
that were the basis for much of the state settlement with the tobacco companies, federal law
requires that the federal government recoup its share. However, the Administration will work
with the states and the Congress to enact legislation that, among other things, resolves these
Federal claims in exchange for a commitment by the states to use tobacco money to support
shared national and state priorities which reduce youth smoking, promote public health and
children's programs, and assist affected rural communities.
Promoting Childhood Immunizations
The most cost-effective way to prevent infectious disease among young people is to immunize
every child. As a result of the Administration's Childhood Immunization Initiative, the nation
exceeded its childhood vaccination coverage goals, with over 90 percent of America's toddlers
receiving each basic childhood vaccine. Thanks to these efforts, the incidence of vaccine-preventable diseases such as diphtheria, tetanus, measles, and polio are at all-time lows.
The President's budget provides a total of $1.1 billion for childhood immunization, including
$526 million in discretionary funding, an increase of $77 million over last year. These funds will
allow the program to provide all the vaccines recommended by the Advisory Committee on
Immunization Practices, including vaccines for rotavirus and catch-up vaccinations for
hepatitis B. The budget also includes $99 million for global polio and measles eradication, an
increase of $17 million, to support the efforts of the World Health Organization to eliminate
polio throughout the world by the year 2000.
Advancing Innovative Treatments for Asthma
Over the past 15 years, the number of Americans afflicted with asthma has doubled to
approximately 15 million, with the sharpest increase in rates among children under age 5.
Asthma is one of the leading causes of school absenteeism, and often results in limitations in
activity and disruption of family routines. To begin to arrest this growing epidemic, our budget
proposes $50 million in demonstration grants to states to test innovative asthma disease
management techniques, derived in large part from NIH-funded research, for children enrolled in
Medicaid and CHIP. Participating States will measure success in reducing asthma related
incidents such as emergency room visits and length of hospital stays.
Ensuring Continued Educational Excellence in the Nation's Children's Hospitals
Expertly trained pediatricians are a critical ingredient to keeping children healthy. Children's
hospitals play an essential role in the education of the nation's physicians, training 25 percent of
all pediatricians and more than half of many pediatric sub-specialties. To support the vital efforts
that children's hospitals play in training physicians, our budget includes $40 million to provide
financial assistance to support graduate medical education at free standing children's hospitals.
Making Child Care Safe, Reliable, and Affordable
In millions of American families, both parents must work to support their children. In millions
of others, single parents must work doubly hard to maintain family income. This
Administration, working together with the Congress, has taken numerous steps to support
families of all types, ranging from the Earned Income and Child Tax Credits to the Family and
Medical Leave Act and the Children's Health Insurance Program. The next step we must take is
to help all parents find child care that is safe, reliable, and affordable. This is not only important
as a way to support the needs of working families. Safe, quality child care is essential to the
healthy development of our children. Study after study provides evidence that investments in
quality care can have major benefits for children, their families, and our society.
Let me thank you for having made a down-payment towards the President's child care initiative
with $173 million in quality funds and $10 million for child care related research. The
President's FY 2000 budget again includes a requested increase of $10.5 billion in mandatory
funding over five years for child care programs in HHS, as well as critical increases in the
Departments of Treasury and Education. These additional funds will dramatically expand the
availability of safe and affordable child care for working families, as well as improve early
learning and the quality and safety of child care. The Child Care and Development Block Grant
was used to serve 1.25 million children in 1997. With these additional funds, we are committed
to increasing the number of children served by more than one million by 2004.
Enhancing Head Start
Head Start has been and will continue to be one of the Administration's top priorities. This
program has been successful in ensuring that low-income children start school ready to learn.
Since 1993, enrollment in Head Start has grown by 17 percent. The President's budget invests
$5.3 billion, an increase of $607 million, to allow Head Start to serve an additional 42,000
children, bringing the total number of children served to 877,000 and moving forward on our
commitment to enroll one million children by 2002. Consistent with last year's Head Start
reauthorization, our budget provides funds to improve program quality, enhance staff
development, and reduce staff turnover. This request includes over $420 million for the Early
Head Start program, which will provide almost 45,000 infants and toddlers and their families
with early, continuous, intensive, and comprehensive child development and family support
Curtailing Violence against Women
Each year an estimated 2.1 million women are raped or physically assaulted in this country. The
President's budget provides $218 million, an increase of $28 million, to combat this serious
problem that affects families across our nation. This includes $102 million for the Grants for
Battered Women Shelters program, which will provide approximately 40,000 survivors of
domestic violence and sexual assault with counseling, shelter, and other services. Funds will
also be targeted to activities designed to change the social norms that condone violence against
MANAGEMENT IMPROVEMENTS AND INNOVATIONS
Managing the complex problems that will confront us in the 21st century requires the
development of innovative management strategies that enhance productivity while promoting
accountability. We have and will continue to work closely with the Congress and this
Subcommittee to develop management reforms that allow us to put every dollar to efficient and
As this Committee is well aware, I have taken the Year 2000 millennium problem (Y2K) very
seriously. In fact, in September 1998, I informed all of the HHS Operating Division heads that
Y2K was this Department's "Job #1". With your agreement, I redirected $42 million from other
HHS activities to ensure that HCFA had the funds it needed for Medicare contractor renovations.
As a Department we have engaged in a series of strong administrative actions, undertaken a
comprehensive review of our funding needs to ensure millennium compliance, and encouraged
staff throughout the Department to work diligently to see that our equipment, facilities and
systems are all Y2K OK. Although I cannot declare total victory today, I can assure you that
85 percent of our mission critical systems are now Year 2000 compliant and I expect the
remainder to be fully compliant within the next couple of months. While this part of the work
will be completed prior to FY 2000, we must not relax our efforts, and we must continue our
work on other Y2K activities including outreach to communities, infrastructure and biomedical
equipment remediation, and business continuity and contingency planning. It will take
continued, intense efforts, working together with our colleagues in State and local governments
and our public and private partners, to overcome this daunting challenge. We cannot allow the
millennium bug to impair our mission or disrupt our services to the American people. Therefore,
as part of the FY 2000 budget, I am requesting $165 million to ensure that all of our systems are
Our budget submission also includes HHS' FY 2000 GPRA performance plans. We have been
working hard to improve our performance plans and our GPRA process within the Department.
Our plans are much better than the first set of GPRA plans we submitted last year. They reflect
increased involvement of senior staff, increased consultation with our partners, clearer linkages
with the Strategic Plan, and the refinement of measures, baselines and targets. Still, there are
several significant challenges facing HHS in GPRA performance measurement. We continue to
work toward the increased use of outcome measures, to confront complex data issues, and to
work closely with our partners and stakeholders in the development of performance goals and
measures. We are confident that our GPRA performance plans for FY 2000 are sound ones and
we look forward to continued discussions with the Congress on our plans.
THE MOMENT IS NOW
Mr. Chairman, I have put before you today a blueprint for preparing our health and social service
systems to meet the challenges of the new millennium. The goals of making health and happiness
the defining characteristic of our senior's retirement, of providing a better future for our children,
and of enabling all Americans to live a longer and healthier lives are ones that we all share. And
like you, I am committed to achieving these goals while maintaining the balanced budget
discipline we have all worked so hard to create.
Chairman Specter, Senator Harkin, and members of the Subcommittee: I appreciate the support
you have provided us in the past and I look forward to working with all of you to meet the
challenges before us in this budget. We have much to accomplish, and no time to waste. I would
be happy to address any questions you may have.