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Excerpt from 1994 Nomination for the Department of Veterans Affairs: Hearings Before the Committee on Veterans' Affairs, United States Senate, One Hundred Third Congress, Second Session; January 26 and September 13, 1994 Senator murkowski. Good luck to you, Dr Kizer. Nice to meet your family. Chairman rockefeller. Of course, when you're trying to lower cost, you're not just dealing with pharmaceuticals. I resonate very much with what you said because Henry Waxman and David Pryor and myself and John Chafee did just exactly what you all did with using Medicaid, which is, after all, the largest purchaser of pharmaceuticals in the country. So I thank you for that example. But we also deal with providers, we deal with academic health centers. You come more from an academic background to some extent, than had you been a career VA person. I am a very strong supporter of academic health centers and, in fact, my family has been for many, many years. I also understand that they are going to have to make some adjustments, one of which is they are going to have to start training more generalists and, in a ratio of some parity, generalists to specialists. In fact, under a proposal which is in one of the bills out there now, the number of specialists in real terms continues to go up. But specialists consider that to be an assault. But there are a variety of adjustments that academic health centers are going to have to make, just as everything in health care is going to have to make adjustments. So I need to know that not having come up through va, that you are willing to be tough on providers and academic health centers and others in the same way that you are on pharmaceuticals. I mean appropriately so - not inappropriately so, just appropriately so. Dr. Kizer. No, I understand and I appreciate the opportunity to comment on that. I think, again, my experience in California where I did have to deal directly with the California hospital association, medical association, and a whole long list of other groups representing different sectors of the health care industry in addition to pharmaceuticals, I believe the reputation that I carried away from that was that I was a fair but tough person to bargain with and that most people went away feeling that the deals were hard won. So I think that I have a track record in that regard. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.