america. we want to show you part of this video. >> my background is a little bit different. i am chinese, jewish, greek, and russian. majority chinese -- the biggest majority is the jewish religion. >> when you talk about culture, i do not think about a color or religious ethnicity. i think about the social structure. the statue of liberty says to send the hungry, and the tired, and the poor. >> people from asia and europe, south america, and all of these places. the wall come together here in america. >> there is not a single american culture.

there is the melting pot of the different american cultures. if this was just one culture, america would be the minority. >> those are some great issues and individual stories out there. what was the criteria when you were judging this year? >> we had factors that we were looking for. . first, we were looking for inclusion of c-span programming, one thing this students needed to do. adherence to the time limit. quality of expression. showing multiple or various sides of their topic. the last thing is also focusing on the thoughtfulness of the actual theme. actual theme. the documentary be just what from our high school winner, that was from a student in oklahoma. she is an 11th grader.

it was a very intimate look through the eyes of four students and one teacher about the influence of diversity and culture in america. we would like to show you a clip from our first prize middle school winner, focusing on a challenge. a great example of the incorporation of c-span from ramming. >> six years ago the kids played outside after school and on weekends -- 46 years ago, the kids play outside after school and on weekends. mom stayed at home. they do a dinner. now kids have about five hours of screen time per day, including the computer, television. kids no longer play outside after school. they take the bus to school or their parents drive them, they do not walk.

we have become a fast-food nation. as a consequence, childhood obesity has more than doubled since 1980. one out of seven children are now obese. this is a challenge that affects us all. host: anything else about that video? talk about production value and how this has evolved. guest: that video was created by matthew from hawaii, a seventh grader. what he did very effectively was intertwining seized and programming so well that he shot his own b-roll. we noticed that middle school documentary's this year in particular, the technical

components of their documentaries and the narration of the documentary's rose to the challenge, which is why our grand prize winners overtook the winner from high school. our grand prize winner grandskype technology -- grand prize winner use thd skype technology for all of their interviews. we noticed that the technology that students are using is fascinating when it comes to putting them together, as well as teaching themselves about the issues they are facing. host: it is so great to look through these videos. where can we watch them? guest: i encourage all of videos -- all viewers to go to studentcam.org. we have a list of all 75 winners. we will be airing all of them

and having a short interview starting april 1 through april 27. tune in to seize and starting on april 1, or you can watch them on our website, to watch all the top ent >> on c-span today, health and human services secretary kathleen sebelius testifies about her department's budget at a senate hearing. 7:00, washington journal. later, live coverage of the u.s. house. an impeachment resolution against a u.s. district court judge will be considered today.

today the senate appropriations subcommittee looks at the annual budget request for the department of housing and urban development. the white house has requested $41 billion for fiscal 2011. hud secretary shaun donovan is scheduled to testify. watch it live beginning at 9:30 a.m. eastern on c-span 3 and c- span.org. >> obama and his socialistic ideas, deciding salaries, this is a life lesson in progress right now for conservatives. >> sunday, the founder and president of the booth policy institute. sunday night on "q&a." >> kathleen sebelius testified yesterday for a budget for the health and human services

department. increased funding for the food and drug administration and other topics. this is a little less than an hour. >> the subcommittee will come to order. madam secretary, welcome back. i want to start by commending you for the outstanding work you are doing to help enact health- care reform. we can see the finish line. it will be tempting for senators on both sides to want to debate the pros and cons of health reform with you today but i would urge the subcommittee members to keep their focus on the subject of our hearing, which is the budget for the 2011 budget for health and human services.

the president's budget hold the line on non security related spending for fiscal 2011. the president promised to use a scalpel could to achieve that hhs would be one of the agencies to get an increase. 2.5% more than in 2010. i was pleased the president included a major boost our efforts to root out fraud in medicare and medicaid, reducing health-care fraud and abuse has been a priority of mine for many years and will play a key role in bringing our long-term deficits under control. significant increases were also proposed in the national institutes for health, a start, child care, a new character is initiatives that would help families take care of their elderly relatives. other provisions raised cause for concern, however. the president's budget would cut spending to the cdc. the budget also includes a $1.8

billion cut to discretionary funding bin -- program. but it's a good start. i look forward to discussing it with you. i want to add, about like assistant secretary murray to advise you on the issues. i can tell you if you are in good hands. i read that just as she voted for me. [laughter] >> i'm turning to senator carper. >> mr. chairman, thanks for convening the hearing. madam secretary, we appreciate your being here to talk about the budget request and we look for to your testimony. unanimous consent that the balance of my remarks be placed on the record. >> thank you, senator carper.

again, madam secretary, thanks for your leadership. kathleen sebelius became the 21st secretary of the parliament of health and human services on april 29, 2009. in 2003 she was elected as governor of kansas and served in that capacity until her appointment as secretary. she was the kansas state insurance commissioner, a graduate of kansas western university and the university of kansas. >> thank you very much, chairman harkin and senator carper and members of the subcommittee, i am glad to be back to discuss the 2011 budget for the department of health and human services. this budget builds on many of the themes that president obama laid out in his state of the union address this year, strengthening our health-care system, laying the foundation for future growth, rooting out

waste and fraud to make programs even more effective. under this budget we plan to make prudent investments in our nation's health and long-term prosperity, that members of this subcommittee and you, mr. chairman, have pushed for years, in prevention and wellness and attacking health-care fraud, in supporting our children during the formative years, and biomedical research that leads to lifesaving doors, to name just a few areas. today i would like to briefly highlight a few of these priorities and then i look forward to our discussion about the issues in this budget. mr. chairman, as you pointed out many times, what we have today in america is a sick care system. last february under your leader steps we took a big step in the direction to change the focus of that system with the investment in the recovery act. it made the single largest investment of prevention and

wellness in american history, including the almost $373 million in grants for promising local programs that we look forward to releasing in the next couple weeks. our budgets for 2011 builds on his investment with new efforts to reduce the harmful effects and a tremendous cost of chronic disease in the urban population, to create a new health prevention corp. and prevent unintended pregnancies, the programs. senator cochran, the first lady recently traveled to your home state of mississippi as part of her initiative in the let's move campaign to end childhood obesity in a generation, and highlighted some of mississippi's very helpful efforts in this area. these are exactly the kinds of promising approaches and strategies we would like to make sure are in place around the country. a budget makes a historic investment in fighting old care fraud. mr. chairman, your subcommittee

began on this task two years ago with the first discretionary funding. we have built on that. when american families are struggling to make every dollar counts we need to be just as vigilant in how we spend their money. the new fraud-fighting of funfun will help expand proven strategies, like putting roddick -- medicare fraud strike forces in cities that are hubs for fraudulent activity. bela was to invest in promising new approaches, like systems that will help us analyze claims data and suspicious activities in real-time. when the budget takes effect, it will be a lot harder for criminals to get rich stealing from our health care system and our seniors. our budget does continue the senior medicare patrol program, which you helped start many years ago.

it is a great reserves of eyes and ears on the ground. a third. focus that i want to highlight for the subcommittee is our early childhood program. building on the recovery act, our budget includes an increase of $1 billion for headstart. and an extra $1.6 billion for child care. creating room in child care programs for hundred 35,000 additional children. with these increases, we are putting a new focus on quality. through age of 5, those are important as the years children spend in kindergarten through 12th grade, maybe even more important according to scientists. there's no reason we should not insist on the same high standards and same rigorous focus on the -- on results. the budget includes a critical increase of nearly $1 billion for the national institutes of health. i want to thank chairman harkin primogenitor cochrane, senator specter, and others on the subcommittee for their support for nih, and it's critical

work in discovering the cures of the future. this budget will help get your to american families faster. these are just a few areas in which our budget will employ new resources and new approaches to improve the lives of american families. i look forward to discussing some of the other priorities with you in a few minutes. first i want to clarify one point. the budget is intended to be a complement and not a substitute for health insurance reform. the only way to increase health security and stability, bring down health-care costs, and give americans better insurance choices is to pass comprehensive health insurance reform. combined with the reform effort, the budget is a major step toward building a stronger healthier america. even then, we will need your help improving the health, safety, and well-being of the american people. but the goal we can only achieve by working together. no one has a more important

goal and congress. i appreciate the opportunity to be with you today. i look for to the discussion. >> thank you very much, madame secretary. we will start with 5 minute rounds. where is keeping the clot going. there we go. again, thank you, madam secretary. i applaud you for your continued efforts in the waste, fraud, and the use area. we have figures that show how much money we save when we invest in that. but for about every dollar we spend, we save about $6. that is real money. the largest portion, the medicare integrity program, if we get $14 for every dollar we spend. both from the standpoint of just economics, it is important, but also to get more integrity to the programs. i applaud you for that. something i want to cover with you was the emergency

supplemental funding that we appropriated last year. we appropriated 7.6 $5 billion to address critical needs relating to the emerging h1n1 influenza virus. in the 2011 budget request i have noticed you are using $555 million from his emergency supplemental for things we usually funds in our annual appropriations bill. these are the annual costs for flute appeared as activities at the d.c. and in the office of the secretary. -- flu preparedness. it also includes staff salaries, i understand. can you tell me how you have justified these emergency supplemental funding for these types of ongoing costs? >> mr. chairman, i think our goal in seeking 2011 funding was to be mindful of the budget

situation and the president's desire not to increase discretionary funding for three years, starting this year. recognizing that, first of all, the appropriations made by this committee over time and certainly supplemental funding helped us be very well prepared to face the pandemic that arrived in april with the new vaccine, a very robust outreach efforts. as you know, when we requested supplemental funding, it was still anticipated that we might need two doses per person. we were not certain how legal the disease would be. we were building for a contingency plan based on the best possible activities. -- we were not sure how lethal disease would be. we were still working with state and local efforts to have people

vaccinated, but we have additional funding that we thought rather than seeking new funds from the committee process, that it would be more appropriately used for ongoing flu efforts, the pandemic efforts underway year in and year out whether we are in a pandemic or not. i am sure the cdc activities will continue on, our work with state and local partners will continue on, as part of appearing as efforts underway year in and year out. but we decided not to bank that money and then seek additional funds from the committee, but used the funds that were available in an effort to be as prudent as possible. >> madam secretary, another. , i've been a longtime supporter of early childhood programs. on the education side, i have talked a great deal with your

counterpart, secretary duncan. many studies have shown that children receive high-quality early chou to a service are less likely to commit crimes, more likely to graduate from high school, more likely to hold a job. the key seems to be whether the services are of high quality. the national headstart impact study released last month shows most of the gains that children show after participating tend to wear off after the first grade. this is troubling. we have to make sure that the quality of early childhood programs is consistently high. could you talk for a minute about how you plan to address the quality issue in the 2011 budget request? >> absolutely. mr. chairman, i share your concern that it is always a key issue for parents to have their children in safe child care situations. more importantly, or as important is to make sure that

they are actually developing the skills so they are ready to learn once they get to kindergarten. often that does not happen in many child care settings. the study that you mentioned is a snapshot of some years ago of what the results were at its start programs. i can assure you that there have been a number of investments in quality since the snapshot was taken. even more importantly, this year we share the notion that we have to greatly enhance quality. too often there are somewhat erratic standards at the state level. some states have set very high quality standards and others have not. we have actually applied some of the funding this year for the additional that start monday -- headstart money for quality standards to it be implemented across the country, to make sure that whether you are in arkansas or rhode island or iowa

or mississippi in a headstart program, that you would anticipate the same high quality standards and that would be part of the funding going forward. >> $118 million? >> yes. we did not apply its all. we think quality enhancements nationwide are critical part of the effort. >> senator cochran. >> madam secretary, thank you for being here to discuss the budget request before the subcommittee. we appreciate some of the highlights of your intentions as secretary in terms of leadership and trying to move to solve some of the problems that face many of us in our states. i noticed right away you are putting an emphasis on obesity -- you called attention to the fact that the first lady came to mississippi to talk about the

"let's move campaign." more activity, more healthy eating practices. we surely need that in our state. so i was pleased to see that the emphasis is being placed by your department and at the white house on doing something about this really big problem. in mississippi we win the prize. we are number one in childhood and adult obesity. we welcome these efforts and we hope that we can work with the department to put money where the problem is and let you show us what can be done. we need your leadership and we welcome that. do you have any specific things to tell us about what the elements of this program might be? >> senator cochran, in the "let's move campa" campaign, the

first lady has outlined goals. more tools and information to . -- for parents to make good choices. that is everything from the fda looking at new, easier to read, easier to find food labels, to the cdc updating and clarifying nutrition standards, so parents wanting to shops smarter, by healthy blue will be able to find it on the grocery shelf and not have to read a dense bar code on the back of a package. we think that pediatricians have stepped up, saying that they are in agreement that every child getting a check of should have a body mass index. more than just having the body mass index on a regular basis, have a conversation with parents about what it means. literally write prescriptions for more exercise and/or healthy eating habits, helping parents

make choices that matter. the second pillar is focus on schools where kids spend a lot of their time. the department of agriculture is working to upgrade what is said to children in school breakfast and school lunch programs and make it healthier and more nutritious. working with the cdc on nutrition guidelines. the physical education component at schools has fallen off the radar screen in many cases. what we know from the secretary of education studies is that not only our children healthier, but they are better lerner's if they move around some during the course of a school day. reinstituting physical education will be part of this goal. working with soft drink manufacturers on marketing sugary beverages inside schools and a lot of activity has been done so far in terms of voluntarily removing high-sugar

content drinks from schools and substituting water and juices. the third component is we have 23 million americans living in a so-called food deserts' where they don't access to threats -- fresh fruits and vegetables. they may want to eat healthy, but they don't have any place within two miles of their house to buy a piece of fruit or fresh vegetable. the department of agriculture is not only doing mapping of those food deserts', but looking at initiatives with local farmers and local grocers to establish a different protocol. we have some dollars available in our budget for helping to subsidize some of those healthier choices and figure out if it is a price strategy or an access strategy. the fourth component of the

program is -- >> health centers. one thing to do is to use the health centers as a place for the children going to head start programs there, the parents can come in and visit with health care professionals at those centers. we found in our state that bringing all these programs together in one location certainly helps a lot, particularly for the very young, those who have not started elementary school. you cannot start too early. one area of our state, mississippi delta, has had great success in developing adult the health alliance. i hope that we can see funding directed to programs like that -- developing the delta health

alliance. the the university of mississippi and mississippi state univ. all have roles to play in our state in that effort. thank you for getting off to such a good start and mapping out a plan of action. >> senator, i look for to learning the lessons that are already being enacted in mississippi. your governor and the first lady of mississippi have taken a real interest and effort in this area. i absolutely agree that community health centers can play an enormous important role. thank you. >> thank you. >> senator reid. >> senator from was your first. >> thank you. madam secretary, thank you very much. the chairman already alluded to the issue of funding in my state and practically every other state. the cold states and the warm

states. the chairman over the last few years has insured we've gotten very robust funding. if the $2 billion reduction will translate in rhode island into a $13.6 million cut. which is a sizable number for us. also, it undercuts the certainty of planning in terms of what money they might have. i know you are creating a mandatory stream with a trigger. all that will be discounted because it will be so difficult to calculate. essentially, they will be planning for and allocating and getting a waiting list for the figure which is much less. the other issue is this trigger is going, i think, to be difficult to estimate when it precisely kicks in. and it's unclear to me what the form of distribution is, if the trigger kicks in and.

by way of that, this january there is contingency money being released to the states in rhode island -- and in rhode island they got $4 million less when our unemployment is second or third in the nation, sadly. the sensitivity of this funding will contribute, i think. my question, i think, is can we do better? in terms of the? baseline the se -- in terms of the base line number? and second, how about the trigger? >> i appreciate the interest in leadership in the program in the past.

i recognize, as a recognizewho distributed funds, how important it is to people not able to pay their bills in the winter and some in the summer. so i know what a critical safety net that is. in terms of the distribution methodology this year which was the subject of some concern, particularly in the northeast, look that two factors for the money that was distributed in january. one of them was the cost of heating oil, which had come down to some degree over where it had been in the previous year. in addition to that, the number of states who were experiencing unusually cold winters and there were states that were far more scattered than some patterns we have seen in the past, and added to that the adamec index as an indicator of states in real

economic hardship, that combination, so that the patterns of colds -- and, as you know, 14 states were deemed to be, not by our count but by the weather assessments, degrees colder during the winter months than had been experienced in the past. we then distributed the money -- some additional money to those 14 states as well as a formula grant to the other states on what we were seeing. there still is a pot of money for the funding this year that is still being held, anticipating further distributions this winter or in the summer months having spikes in temperature that require additional distribution. in terms of the proposition for

2011 and the trigger proposal, there is a $3.3 billion discretionary fund but then a $2 billion mandatory pfund that would activate with a trigger which would result in an increase in the funding for 2011 and not a decrease in funding. the combination trigger would be based on the cause -- on an analysis of the cost of winter fuel and an assessment of the poverty population in a state, based on who is eligible for the snap program. not are subjective look at it, but it will look at eligibility for the food and nutrition program combined with the heating oil prices for the

winter. we anticipate if oil prices are high and people are struggling to pay their bills, the trigger would be met. again, having the poverty sensitivity in it would help enhance that ability in the formula -- and the formula would be divided according to the population. so i know that there was some discussion last year in our budget about a formula that just looked at the price of winter fuel. we thought that an additional looking at the fact that this is an economic downturn and people try to pay their bills, you need to look at who is in economic difficulty, may trigger a lot more sensitive. >> let us go over the numbers. i have an indication that, if you look at the formula money in addition to the trigger money,

it will not be as much as previous years, but that might be my calculation, miscalculation. even in the best of times, when the economy is doing very well and the temperature is relatively mild, there are long waiting lists in my state and other states. this notion of needing a trigger because the demand only comes up in economic crises i don't think is substantiated by the facts, but i thank the chairman for his indulgence. >> senator, i volunteer that we would love to work with you on this. for getting you the numbers and make sure we on the same page and then talking to you. i think we share the same goals. we don't want people struggling to pay their heating bills or having to turn off the lead when they cannot pay them. >> thank you, madam secretary. >> thank you very much. i want to thank you, senator reed, for your leadership.

you have been stallworth on that. i look forward to making sure you get this worked out for us. senator pryor. >> thank you, mr. chairman. madam secretary, welcome once again to the subcommittee. always good to see you. i believe the administration has made a commendable effort to reduce waste, fraud, and abuse in health care programs, both as budget requests and in its health-care reform proposal. what support do you need from this committee in the appropriations process as we move forward, to take the necessary steps to reduce waste, fraud, and abuse? >> i'm glad you asked that question, senator. let me reiterate that i think the president takes his effort to very seriously. it is one of the reason he asked the attorney general and me as cabinet officers to convene in a

joint effort. we are working very well with the justice the promised. the strike forces that are in seven cities now are really paying off big results. the budget has a couple of requests. one is an additional $250 million in discretionary funding, which would allow us to expand the strike forces. we know that every dollar invested returns multiple dollars. that is just dollars we get back in the door for prosecutions and are able to return to the fund and make the medicare fund more solvent. there's an additional impact that is impossible to measure, which is that we discourage people from committing crimes in the first place, by making it very clear that we intend to prosecute vigorously and come after them. that is one piece of the puzzle. another big piece of the puzzle is our data system request that is in for about $110 million to begin a two-year process to

upgrade our system. what we missed right now is the ability to look at datasets in one system. medicare is the biggest health insurance program, i think, in the world. we pay out 1 billion providers over the course of the plan, $800 billion every year. we still have those datasets in multiple places. so it is impossible to check errant behavior unless you check for six or seven systems. we have a plan that has been developed that by the end of 2011 we would be at a real time 1 datasets flexible ability to share that data with law enforcement officers. to do the same thing that a major credit-card companies can do, which is what what is happening and immediately go after folks. if we need more boots on the ground. >> i think that is great.

i am glad to know that you are on top of that. when i was the state's attorney general, we did the medicare fraud the spirit on all those cases, we would do this extensive investigations and all this, but it was always after the fact. p ay an-- you never get the moneyk or whatever the case may be. you mentioned credit card companies. also, the health insurance companies do that. they are able to look. they get a prompt when they are doing the claim, the insurance company says, no, we need to check on this right now permit it is out there. we can do this. we can do this a lot smarter. we can save tens of billions of dollars each year by doing that.

we have a concern in arkansas on what we call geographic variance. that's in medicare reimbursement. in your home state you may have some of this as well. if health care reform is enacted, will you work to ensure that any geographic variation in reimbursement is fairly calculated and that you do not discriminate against rural america? >> senator, i am very familiar with the difficulty of providing quality health services in rural areas and the cost estimations have to be calculated about what it requires to do that. so i would love to work with you and other members. as you know, i like to refer to your state as ar-kansas.

we are sister states. >> the last question i have, i know we have been through the h1n1 flu pandemic. i am sure different people would agree or disagree about how well that was managed by the federal government. what is the administration's budget to put us in an even better position this coming flu season and the years to come to handle h1n1 or some other pandemic? >> the ongoing efforts of pandemic planning continue. the budget, through the centers for disease control, through our hospital. as grants, through our partnership efforts with state and local governments continues to ramp that up. i don't think there's any question -- and this committee was instrumental in helping those years of preparation so that this year when something hits wheat were far more

prepared than we would have been if we were facing it for the first time. we are in the process -- and i look forward to coming back to this committee and others in an entire system wide review, not just h1n1, but our whole countermeasures effort, we think it is appropriate to use this most recent situation as a way to say how prepared we are for whatever comes at us next. whether it's a pandemic warning that we get or hear about a vaccine or a dirty bomb on a subway, what have we learned, where are the gaps in the system, where are the efforts to move into? we know we need more manufacturing capacity for vaccine. we know we need a different technology for a vaccine production. the timetable of growing virus in eggs is slow. that needs to increase. we need to look at the whole

system. that is under way. as we anticipate a one-year return from break in a couple of weeks we will have the ability to report back on a range of lessons learned from h1n1. >> great. thank you, mr. chairman. >> thank you, senator. following up a little bit on that, because the pandemic did not happen, i am somewhat concerned that we -- i have read something about this recently, that the scare was not going to happen, and we fall into a lethargic mode now of saying we can kick that can down the road. we have to build structures that can respond more rapidly to cell-based systems so we can grow the virus is or rna-based

systems that can be even more rapidly utilized. we only have one new one online. >> we cut the ribbon at a plant in north carolina just this year. and there is planning underway for the second plant. >> that is going to be on track, online and all that, we have the? funds the? >> i think you have the funds for one additional plant, the way of funding looks now. instead of i think it was anticipated five or six years ago that the funds war for four plants. the cost of the north carolina plant, it turns out it exceeded what it was estimated to be a number of years ago. >> madam secretary, one of the problems for having these kinds of plants is what do they do every year? if we don't have something that is confronting you, how do they keep a viable?

that has been the big problem with vaccine production. that is why i suggested, modestly a year or two ago that perhaps what we ought to do on the federal level is provide a free flu shot to every person in the country every year. i forget what the cost was on that. then you balance it again with how many people get sick just from annual flu and get hospitalized, how many people die from that, and add that cost. if you do great outreach programs with a free flu shot, you keep the plants going, because they have to meet that demand every year. if we have a pandemic residents and strain, they can shift to that immediately. second, you build up the infrastructure. if you do have a pandemic that hits us, one of the problems is getting it out. shopping centers and churches

and schools and wherever, drug stores, every other place. if you do that on an annual basis, you build up a good infrastructure that is ongoing and i think you also will build up more of a public support for these vaccinations. a lot of people don't get flu shots because -- i don't know why -- maybe they have heard you should not to get them or they are afraid of getting them, that type of thing. a lot of people in this country are allergic to eggs, who cannot get the shots because of the egg-based production of them. i have revisited that for some time. again, thinking about having a couple of plants that are cell- based, how do we keep them going? we cannot keep them sitting there waiting for the next pandemic. i would be interested in

discussing that with you later on. >> i think that would be very helpful. dr. nik udrih, assistant secretary for prepared this and response -- dr. ninki luri. one of the issues is how we prepare for things we don't even know are coming. what sort of stockpiles we need against anthrax or unknown viruses that may come our way, what markets are there for that. we would love to continue that conversation with you. one of the lessons learned is the kind of distribution system that you just mentioned. this year the h1n1 was a much younger target population, so we were trying to encourage vaccination of people who typically do not get a seasonal flu shot, but they are too young or don't typically get a clue. we had about 90 million people

vaccinated, 90 million doses delivered. people are still being vaccinated. we used a lot of non-traditional sources. school based clinics, which had not been used for years, and turned out to be very successful with kids. a lot of outreach with race- based groups. we went from a 40,000 site distribution system for the children's vaccine up to 150,000 sites. we have a more robust distribution system, a more robust outreach systems than has been in place in a very long time in america. i think that is very good news for whatever comes at us next. >> we have to keep that activated in some way. that is what i'm concerned about. it's faded out and i'm concerned we may not do it next year and a couple of years past. that is why i am focused on the annual flu. >> 36,000 people a year are

dying from flu. 200,000 hospitalized. that is our annual flu data. that is pretty serious. >> that is serious. i just [inaudible] i did have one more question. not to make a far leap from vaccinations to prevention, but we put it -- the subcommittee put a billion dollars in the stimulus bill for prevention activities at hhs. the cornerstone of that is a $373 million grant system to communities, as you mentioned, which i assume will be awarded sometime soon. you might inform me of when. in the stand that state and communities that are awarded this aid or funding will be asked to implement their choice of a list of evidence-based

programs that your department determined are the most likely to be effective. i asked my staff -- i have not seen that list. if you have that, would you share that with us and where did you go to come up with this list of evidence based programs that could be effective? >> mr. chairman, we would be glad to share that data with you. to the community grants, i think, are about to go out the door in the next two-week period of time. the awards will be made. the focus, looking at not only -- we had a multi disciplined team, scientists from nih, surveillance folks from public- health folks from cdc, office of public health and science all looking at what not only the most serious cost drivers were

for underlying these these codisease conditions, but what were effective strategies, and the two focus areas for community grants were determined to be a smoking cessation efforts and to efforts aimed at obesity as the two drivers for a large number of the chronic conditions that caused health care spending to rise and caused quality of life to go down. so the so-called list looked at measures that had existed across states and communities that were effective strategies, had been measured, had been proven effective. we would be delighted to share those with you. but the community grants were available to either look at smoking cessation and/or obesity or both. one or the other or both. those were the two targets as

opposed to spreading them out across the horizon, to focus on those two areas. the the hope is that -- with the funding, to have measurable results. at the end of two years the goal is to have some strategies which really do either encourage young people from not smoking in the first place, decrease smoking dramatically, and/or make a real dent in obesity, and been able to come back and hopefully work with members of congress to take some of those programs to scale. if we can find effective ways, effective strategies to deal with those two underlying conditions, we can dramatically change health outcomes and dramatically lower health costs. >> very good. thank you. >> mr. chairman, i think the secretary has done a great job in presenting the budget request. and in answering our questions. it is a pleasure working with

you and helping make sure that what we decide to appropriate is in the national interest and serve the public interest. >> thank you. i just had one other thing i would bring up. that is a waste, fraud, and abuse. you mentioned the senior patrol and all the things we have done. i have a list, a partial list in front of me that adds up to literally billions of dollars fines and settlements paid by pharmaceutical companies. that have been ripping off medicare and medicaid. a lot of times we think about fraud, waste, and abuse and you think there's some person out there that is putting in for something they should not get. what about pfizer? pfizer just paid $2.3 billion, the largest settlement in u.s. history.

attorneys know that when you settle, you settle because you are afraid of what may happen if you actually go to court. that is why you settle. $2.3 billion. $668 million to medicare. and the rest to medicaid. that was just this year. four other possible companies. mylan, astrazeneca, and another just paid $124 million to medicaid this year. another was fined $23.4 million. all these were done by the attorney general's office. that is just this year. i can go back six, seven, eight years, attorneys general in the bush administration and others that went after these companies and got all these fines and settlements. hundreds of millions of big dollars. that is good. i applaud the attorneys general for doing that. both the present attorney

general and his predecessors. but what can we put in place so they don't do that in the first place? i hope your department will look at that. how was it that these pharmaceutical companies got by with this? some of them got by with it -- this did not just happen a couple months. they had been doing it for years. all of a sudden someone catches them. the problem of justice said it takes a long time, a couple of years, and they finally build a case to get the evidence. then they either get fined or settled. so i hope -- i don't know if you want to respond to this or not, but i look forward to working with you on how you can build systems up that do not allow these kinds of big bucks to be taken out of the system over long periods of time. >> i cannot agree with you more, mr. chairman. in the case of the pfizer

settlement, it was a situation where they were improperly marketing and prescribing a drug, specifically in violation of the authority that they had been given by the food and drug administration. it not only was a case of driving profits for their company, but putting patients in jeopardy. there's no question that the patients were being improperly prescribed a drug that they knew was not going to work for the situation that they had. so it is kind of a double -- it's not only involved dollars but patient safety. the new food and drug administration leadership take that very seriously and is enhancing efforts to make sure that off market products are not allowed, that we follow up much more vigorously, but, also, having a settlement like this

puts a number of manufacturers on notice that we are taking this very seriously and intend to make sure that they are appropriately using the authority they have been given. >> is there a good relationship between you and fda on issues like this? >> absolutely. the drug safety and the drug protocol is something i think they take very seriously. we are very involved in this effort as were car inspector general. this was a collaborative effor. it took -- we are very involved in this effort as are the inspector general. these cases help make us more solvent for the future. >> madam secretary, thank you. >> thank you, mr. chairman. i join you in thanking the secretary for your cooperation

with our committee. if we look forward to working with you as we go through this fiscal year. thank you very much. >> thank you. >> thank you, senator cochran, thank you, madam secretary. >> mr. chairman, we look forward to working with you. >> the subcommittee will stand adjourned. thank you. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2010] >> sunday, your chance to speak with karl rove live. starting at 10:00 eastern. the former senior adviser to president bush and current fox news contributor will take your phone calls, e-mails, and tweak

on his new memoir. then bill cohen and his wife janet on race relations in america, there interview by congressman john lewis. and live coverage of the tucson festival of books. find the entire weekend schedule on the website and get the latest updates on twitter. .