[Congressional Record Volume 141, Number 189 (Wednesday, November 29, 1995)]
[Extensions of Remarks]
[Page E2253]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


[[Page E 2253]]


        CHANGES IN THE MEDICARE PART B PROGRAM FOR FEHBP MEMBERS

                                 ______


                         HON. ROBERT A. BORSKI

                            of pennsylvania

                    in the house of representatives

                      Wednesday, November 29, 1995

  Mr. BORSKI. I rise today to express my concern about the proposed 
changes in the Medicare part B prescription drug benefit program for 
our Federal employees and retirees.
  Effective January 1, 1996, many Federal retirees receiving medical 
benefits through Blue Cross/Blue Shield will be forced to obtain their 
prescription drugs from mail-order drug companies or be required to pay 
an additional 20 percent copayment for their prescription drugs 
acquired from their neighborhood druggist. As a result, over 1 million 
of our Nation's seniors may no longer be able to afford to have the 
convenience and security of receiving their prescription drugs from 
their neighborhood, preferred-network pharmacies.
  On January 1, Federal employees and retirees who receive retail 
pharmacy benefits from the Medicare part B program of the Federal 
Employee Health Benefits Program [FEHBP] Blue Cross/Blue Shield 
standard option will no longer have their 20-percent coinsurance drug 
deductible waived if they choose to receive their drugs from their 
local pharmacy. Only those members who receive their prescription drugs 
through mail-order drug companies will be entitled to retain the waiver 
available under current law. As a result, many of our Nation's retired 
Federal employees will no longer be able to afford the safety and 
convenience of receiving their prescription drugs from their 
neighborhood druggists.
  Mr. Speaker, by raising the cost of prescription drugs by 20 percent, 
Blue Cross/Blue Shield is economically forcing many of our Nation's 
seniors into receiving their prescription drugs from anonymous mail-
order drug companies. By removing trusted, local druggists from the 
picture, Blue Cross/Blue Shield is creating a potentially dangerous 
situation for many of our retired Federal employees.
  First, Federal retirees, like most senior citizens, use prescription 
drugs more frequently than any other age group. Many of the drugs taken 
by the elderly are so dramatically important that should a senior 
citizen mistakenly forget to reorder his or her medication, or 
accidentally spill the medication in the sink, the consequences of not 
being able to acquire or afford immediate replacement of the 
prescription would be life threatening.
  In addition, senior citizens are more likely to be taking multiple 
drugs at the same time. Many seniors require the face-to-face attention 
and recordkeeping provided by pharmacists to ensure that their 
medications are being properly administered and that there are no 
adverse reactions among their prescriptions. However, unlike community 
pharmacies, many mail-order firms do not maintain complete patient 
medication records, which means that they cannot check for or prevent 
any potential serious medication problems.
  A recent study by the U.S. General Accounting Office [GAO] entitled 
``Prescription Drugs and the Elderly'' noted that health practitioners 
are in agreement that in order for our Nation's elderly to receive safe 
and effective care, physicians, pharmacists, and patients should all 
participate in the drug therapy decisionmaking process through 
increased communication. However, mail-order prescriptions do not allow 
this type of face-to-face communication and accurate recordkeeping 
which is essential to prevent dangerous mistakes with prescription 
drugs.
  Finally, Blue Cross/Blue Shield has stated the proposed elimination 
of the prescription drug waiver for Federal retirees was a result of 
``working hard to create a balance between providing an overall 
comprehensive benefits package for [its FEHBP] members and keeping 
[its] premiums competitive.''
  However, this decision seemingly ignores the fact that increasing the 
medicinal risk to many seniors by removing local druggists could have a 
drastic effect on the health care costs for everyone. According to the 
GAO study, nearly one of four ambulatory elderly patients were taking 
prescription medication in an inappropriate manner which led to 
unnecessary adverse reactions and higher medical costs amounting to $20 
billion a year. By further increasing the risk of medicinal accident to 
the elderly, there is no estimate as to the likely increase in medical 
costs.
  Therefore, Mr. Speaker, considering the unnecessary risk that would 
be imposed on many of our Nation's retired Federal employees as a 
result of a simple cost-cutting measure, it is unwise and inappropriate 
to place the protection of the neighborhood pharmacist out of the 
economic range for many of our Nation's retired Federal employees.

                          ____________________