By ROBERT PEAR
ASHINGTON, March 8 — President
Bush's nominee to run Medicare and Medicaid, Dr. Mark B. McClellan, said
Monday that he would work with Congress on bipartisan legislation to assure the
safety of prescription drugs imported from Canada.
The way to do that is by giving the Food and Drug Administration more money,
more personnel and more power to police imports, Dr. McClellan said at his
confirmation hearing before the Senate Finance Committee.
"I absolutely am committed to doing that," so Americans can safely import
lower-cost medicines, he said.
As commissioner of food and drugs for the last 16 months, Dr. McClellan has
led the Bush administration's campaign to stop unauthorized drug imports. He has
said such products endanger American consumers because they are often
counterfeit, mislabeled or contaminated.
Under intense questioning...
by several senators, Dr. McClellan appeared to soften his tone a bit on Monday.
His stance took account of two political realities. Several senators have
threatened to hold up his nomination if he resists drug imports. In addition,
drug prices and proposals to import drugs from Canada are emerging as an issue
in the presidential campaign.
Senator
John Kerry of Massachusetts, the likely Democratic presidential nominee, has
said he wants to "allow individuals, pharmacists, wholesalers and distributors
to import F.D.A.-approved prescription drugs from other countries at lower
prices." He has also said, "The only reason George Bush has opposed this
approach is that the drug industry would lose billions in profits."
On Tuesday, Senator Kerry plans to join Illinois's governor, Rod R.
Blagojevich, in discussing the issue with Medicare beneficiaries in Evanston,
Ill. Mr. Blagojevich, a Democrat, recently encouraged an Illinois couple to file
suit to overturn the federal ban on importing drugs from Canada.
Senate Republican leaders said they hoped the Senate would confirm Dr.
McClellan this week. If confirmed, he would become administrator of the Centers
for Medicare and Medicaid Services, which provides health benefits to more than
70 million people who are elderly or disabled or have low incomes.
Dr. McClellan defended the new law that offers drug coverage to Medicare
beneficiaries and gives private insurers a large new role in the program.
But he had no immediate answer when Senator
Bob Graham, Democrat of Florida, asked why the administration had assumed
that increased enrollment in private plans would drive up Medicare costs rather
than save money.
"There are a lot of steps we can take to bring down costs and increase
competition," said Dr. McClellan, who is a physician and an economist.
President Bush and Congressional Republicans had hoped to reap political
dividends from the law providing drug benefits to the elderly, but many
Republicans find themselves on the defensive. Democrats have kept up a barrage
of criticism, saying the law helps drug and insurance companies more than the
elderly, and polls suggest that many of the elderly are not aware of the new
law.
Senator Olympia J. Snowe, Republican of Maine, told Dr. McClellan she had
grown weary of hearing reasons the federal government could not allow drug
imports from Canada.
"We need to hear a can-do approach," Ms. Snowe said, noting that both houses
of Congress had signaled support for allowing drug wholesalers and pharmacists
to import drugs under strict safety standards. "What is it going to take to move
this forward?" she asked.
One step, Dr. McClellan said, would be to restrict "the scope and type of
drugs that can be imported."
AARP, the lobby for older Americans, called on drug companies on Monday to
limit price increases. In letters to 16 major drug manufacturers, William D.
Novelli, chief executive of AARP, said prices for existing drugs should not rise
faster than the Consumer Price Index, which is the basis for annual increases in
Social Security benefits.
Mr. Novelli said manufacturers should also "constrain the prices of new
drugs" and should use their influence to "curtail greater markups throughout the
distribution chain" to retail pharmacies.
John C. Rother, policy director of AARP, said the organization had begun to
monitor price changes for about 200 commonly prescribed drugs and would
periodically report its findings to the public.
In response to other questions, Dr. McClellan said he would not take any
steps that undermined the False Claims Act, a federal law that rewards people
who report fraud in government programs like Medicare and Medicaid.
He also said that he would not approve any state Medicaid experiments that
imposed firm limits on federal spending or eliminated the guarantee of specific
benefits for poor people.
"Caps on spending are not envisioned as part of the structure" of Medicaid,
Dr. McClellan said, and "the individual entitlement cannot be waived."
