As former majority leaders of the United States Senate, we understand the difficulty of arriving at consensus in our country’s often contentious political environment. Nowhere is this truer than with health care, perhaps the most polarizing domestic policy issue of our time. Health care costs continue to rise, straining the budgets of the American people, along with those of and federal and state governments. And our fragmented health care system fails to deliver the kind of coordinated and interconnected care that both patients and providers want.
Despite significant policy differences, we believe that Republicans and Democrats agree more than they disagree when it comes to health care. We all want a high-performance, high-value health care system with greater access, better quality, and lower cost. In order to achieve this goal, we need a person of integrity and competence at the helm of the Department of Health and Human Services. The good news is that President Trump has nominated just such a person, Alex Azar, who we both have come to know.
The secretary of HHS is one of the most important Cabinet positions in the federal government. The department has a budget of over $1 trillion and 70,000 employees, and its programs touch nearly every American:
- Medicare provides coverage for more than 40 million seniors and persons with disabilities;
- The Affordable Care Act, through marketplace plans and Medicaid expansion, provides another 22 million Americans with health insurance, many for the first time;
- Medicaid and the Children’s Health Insurance Program provide coverage to more than 65 million low-income women and children as well as families and fathers;
- Temporary Assistance for Needy Families provides financial help to low-income qualified persons and families who are unemployed;
- The National Institutes of Health is a key engine for research and medical discovery;
- The Centers for Disease Control and Prevention helps protect us against public health emergencies, man-made and natural;
- The Health Resources and Services Administration, through its grantees, is the principal source of primary care for millions, provides primary care workforce training, and oversees organ and bone marrow donations;
- The Food and Drug Administration regulates our food and drug supply, ensuring our health and safety; and
- The Indian Health Service provides health care to Native Americans across the country.
With such an extensive reach, the HHS secretary must be experienced managing complex and large organizations; possess broad knowledge across an array of issues; and demonstrate a record of solving difficult problems. A person like this is hard to find, and the search is made even more difficult by the hyper-partisan nature of today’s politics, in which both parties too often view the other with deep suspicion.
Alex Azar’s nomination as the next HHS secretary meets this high bar.
We know Alex to have the temperament, judgment, and necessary focus on practicality that is important to being a successful HHS secretary, even if we do not agree with him on every issue. He has pledged to follow the law and abide by its restraints. And just as essential, he has promised to listen to stakeholders and work with Democrats as well as Republicans.
Alex’s history testifies to his ability to fulfill these promises. From 2001-2007, Alex was general counsel and then deputy secretary of HHS — both vital positions in the department. In these roles, Alex demonstrated leadership and an ability to tackle challenges during one of the most consequential times in America after the 9/11 and anthrax attacks. Alex helped create the Office of Public Health Preparedness and Response so HHS could respond to the existing crisis and prepare for the next. He also played a lead role in stopping the gaming of the patent system by pharmaceutical companies in a policy that the Office of Management and Budget estimated would save consumers almost $36 billion.
Alex has shown a willingness to confront major obstacles. At HHS, he made difficult decisions even when opposed by powerful industries, and he did this all while working with career staff and within the constraints of the law. This is the kind of leadership we need at HHS.
One the harshest criticisms leveled at Alex is that he worked for 10 years in senior management for a large pharmaceutical company, and therefore is too closely tied to an industry he would ultimately be responsible for overseeing. We agree that he should be questioned carefully and closely on his industry connections. However, Alex’s history suggests that he is not afraid to take on tough issues and be fair, impartial, and focused on patients. We are hopeful that Alex’s in-depth knowledge of the pharmaceutical industry will be a positive attribute when addressing the complicated issue of drug pricing.
Make no mistake: Alex is a conservative. His work for Justice Antonin Scalia and President George W. Bush has informed the person he is today. But our collective experience with Alex is that he is also not an ideologue. He carefully considers all sides to an argument, and is most interested in finding solutions through direct engagement with the stakeholders and patients impacted by HHS’ policies.
As Alex said at his hearing before the Senate Committee on Health, Education, Labor, and Pensions, “This is the most important job I will ever have in my lifetime.” We hope he is right.
Bill Frist is a former Senate majority leader, a heart and lung transplant surgeon, and chairman of the executive board of Cressey & Company. Tom Daschle is a former Senate majority leader, co-founder of the Bi-Partisan Policy Center, and founder of the Daschle Group.