The Biden administration nominees for surgeon general and assistant secretary for health had a mostly positive reception from senators during their first and only confirmation hearing.
Over several hours on Thursday, the Senate Health, Education, Labor and Pensions (HELP) committee questioned the two nominees — Vivek Murthy, MD, for surgeon general, and Rachel Levine, MD, for assistant secretary for health, an office within the Department of Health and Human Services (HHS) that oversees a number of key offices, including the Surgeon General, the Office of Minority Health, the Office of Infectious Disease and HIV/AIDS Policy, and the Office for Human Research Protections.
Murthy, 43, previously served as the 19th surgeon general from December 2014 to April 2017.
HELP Committee Chairperson Patty Murray (D-Washington) said Murthy was the right pick because "he's already done the job and done it well." Aside from attacking the opioid epidemic, he "shined a light on how stress, isolation, and other mental health issues threaten America's well-being," Murray said.
The committee's highest-ranking republican, Richard Burr of North Carolina, however, said he wondered why Murthy would want the job again, noting that a colleague often said, "there's not much education in the second kick of a mule." Burr also questioned whether Murthy would be able to "separate
political influence from your ability to communicate healthcare decisions," noting that the nominee had spoken at the Democratic National Convention.
Burr also had doubts about Levine, who stepped down as the secretary of health for Pennsylvania when she was nominated in January. He questioned her handling of the COVID-19 pandemic, saying that "Pennsylvania ranks as one of the most dangerous states for long-term care residents battling COVID-19." The North Carolina senator said she should not hide behind the notion that she was following federal guidance.
Levine, who previously served as president of the Association of Territorial and State Health Officials, told Burr that like other states in the mid-Atlantic and Northeast, Pennsylvania experienced huge challenges early in the pandemic — with testing and getting enough personal protective equipment, among other issues. She said she aimed to improve federal collaborations with state and local officials if she is confirmed.
The former state health official later noted that COVID-19 is the biggest health crisis the nation has experienced in more than a century — adding that it has exposed many fissures. "This pandemic has shown the importance of public health like nothing else possibly could," Levine said.
If confirmed, Levine, 63, would be the highest-ranking openly transgender official.
Sen. Rand Paul (R-Kentucky) used Levine's transgender status to express his concerns about minors being given puberty-blocking hormones, likened that to genital mutilation, and cited statistics from the American College of Pediatricians (not the American Academy of Pediatrics) that "80%-95% of pre-pubertal children with gender dysphoria will experience resolution by late adolescence if not exposed to medical intervention." He repeatedly asked Levine to say whether she thought minors should be allowed to take puberty blockers.
Levine responded that "transgender medicine is a very complex and nuanced field," and said if she was confirmed that she would be happy to discuss with Paul and his staff "the standards of care and the complexity of this field."
Murray later thanked Levine for her "thoughtfully and medically informed response" to Paul. "It is really critical to me that our nominees be treated with respect and that our questions focus on their qualifications and the work ahead of us rather than ideological and harmful misrepresentations like those we heard from Senator Paul earlier," added Murray.
Zeroing In On Mental Health
Senators from both sides of the aisle homed in on what Levine and Murthy would do to address the mental health aspects of the pandemic, including how to address rising overdose deaths, how to help those living in rural areas, and children and adolescents who are experiencing high rates of anxiety, depression, and suicidality.
Levine, a child and adolescent health specialist, said, "Clearly, mental health issues among our youth remains a significant public health problem."
Murthy was also eager to talk about mental health, noting that he released the first-ever surgeon general's report on addiction, and that he'd also issued a letter that called on physicians to help end the opioid crisis. The COVID-19 pandemic has only worsened these crises, said Murthy, saying that the "impact in rural communities in particular has been heartbreaking."
He said he'd work to expand telehealth and the mental health workforce, and invest more in community health centers.
Murthy said he had personally witnessed COVID-19's impact, with a son at home learning remotely, and noting that he had lost seven family members in the US and India to the disease. "My priority first and foremost is to address COVID and turn this pandemic around," he said.
The committee still needs to vote on the two nominations, which will then be sent on to the full Senate for a final vote.
Alicia Ault is a Lutherville, Maryland-based freelance journalist whose work has appeared in publications including Smithsonian.com, the New York Times, and the Washington Post. You can find her on Twitter @aliciaault.
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Cite this: Murthy for SG, Levine for HHS Get Mostly Positive Senate Reception - Medscape - Feb 25, 2021.