[Congressional Record Volume 145, Number 25 (Thursday, February 11, 1999)]
[House]
[Pages H626-H631]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         THE PRESCRIPTION DRUG FAIRNESS FOR SENIORS ACT OF 1999

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 1999, the gentleman from Arkansas (Mr. Berry) is recognized 
for 45 minutes as the designee of the minority leader.
  Mr. BERRY. Mr. Speaker, I rise today in support of the Prescription 
Drug Fairness for Seniors Act of 1999. I want to thank my colleagues, 
the gentleman from Maine (Mr. Allen), the gentleman from Texas (Mr. 
Turner), and the gentleman from California (Mr. Waxman), for coming up 
with this great idea to help correct a tremendous injustice in America 
today.
  Our senior citizens pay over twice as much as citizens in other 
countries. They pay over twice as much as the preferred customers of 
the prescription drug manufacturers in this country, and it is simply 
not fair.
  This chart demonstrates the way that our seniors are overcharged and 
the amount they are overcharged for their prescription medications. 
They are forced to make a choice between food and medicine, between 
paying their rent and having medicine, between having utilities, having 
heat, and medicine. This is simply not right.
  The First Congressional District of Arkansas, that I am so fortunate 
to represent, contains the most senior citizens of any Congressional 
District in this country that live only on social security. The cost of 
prescription medication is a tremendous burden for them. Yet, we allow 
them to continue to be overcharged by 40 and 50 and 60 and 70 percent.
  They are overcharged by the most profitable companies in the world. 
These companies should be profitable. We are in favor of them being 
profitable. But that profit should not come at the expense of our 
senior citizens being forced to choose between food and the medicine it 
takes to keep them alive. When that happens, it becomes a moral issue. 
It becomes an issue that this Congress should address.
  Our bill, the Prescription Drug Fairness for Seniors Act of 1999, 
will reduce the cost of prescription medication for our seniors 
approximately 40 percent. Our seniors should not be at a disadvantage 
because they are citizens of the United States.
  The average prescription price for Canadians is 72 percent less than 
it is for Americans. For Mexican citizens, it is 103 percent less than 
it is for Americans. This simply does not make any sense. If the 
prescription drug manufacturers that sell product in this country can 
sell it at other countries at much reduced rates, if they can sell it 
to our Federal Government at much reduced rates, these same prices 
should be available to our seniors. That is what this bill does.
  One company last year raised the price of one of their medications 
4,000 percent in one day. The Federal Trade Commission looked at this. 
They decided it was unfair and they filed a $120 million recovery claim 
against this company. This is an outrageous attempt to make a profit.
  The Prescription Drug Fairness for Seniors Act of 1999 will reduce 
those prices, as I have said, by 40 percent to most of our recipients. 
It is something we should do. It is the fair and right thing to do. It 
does not cost the Federal Government any money. This will simply make 
our seniors part of the largest purchasing pool in the world, and it 
will give them the ability to be dealt with fairly through their own 
local pharmacies.
  I urge my colleagues to support this bill. It is a good bill, and it 
is what we should do for our seniors.
  Mr. Speaker, I yield to the gentlewoman from Texas (Ms. Sheila 
Jackson-Lee).
  Ms. JACKSON LEE of Texas. Mr. Speaker, I thank my good friend, the 
gentleman from Arkansas (Mr. Berry), for his leadership on this issue, 
and as well, my colleagues, the gentleman from Maine (Mr. Tom Allen), 
the gentleman from Texas (Mr. Jim Turner),

[[Page H627]]

and the gentleman from California (Mr. Waxman) for their leadership on 
a crucial and devastating fact of life for our seniors in America.
  It is important to note that those of us who have worked on this 
issue believe that this is the Congress to get it through. I am 
delighted that as an original cosponsor of this legislation for this 
Congress, I again stand up to be counted, as I did in the 105th 
Congress. I do that for the many constituents that I represent.
  In fact, Mr. Speaker, allow me to share the story of a husband and 
wife from my district in Houston written to me just a few days ago in 
January. These individuals retired, having worked in our school system 
educating our young people, and now in their retirement they are 
pleading for relief because presently they are spending an average of 
$4,792 annually on drugs, paid by a Texas teacher's retirement income 
and social security. One-fifth of their income is used to pay for 
prescription drugs.

                              {time}  1615

  I would simply say, Mr. Speaker, this has got to stop. That means 
that these senior citizens who have worked all of their life, who, in 
fact, have a commitment to being part of the engine of this economy for 
many, many years, are now having to sacrifice the meager income that 
they have and to make choices, as my good colleague indicated, between 
room and board, and health.
  The Prescription Drug Fairness for Seniors Act is not a giveaway. It 
does not interfere with competitiveness, as my pharmaceutical friends 
have said. It does not do damage to the marketplace, as they have 
attacked us so readily.
  What it does is it simply tries to emphasize fairness. Pharmacies 
will now be able to purchase prescription drugs for Medicare 
beneficiaries at the same low prices available to the Federal 
Government such as the Federal supply schedule price or the medicaid 
price.
  Since drug prices presently paid by the Federal Government are 
approximately half the retail prices paid by senior citizens, 
participating pharmacies will be able to pass on large cost savings to 
senior citizens.
  I know that my good friend, the gentleman from Arkansas (Mr. Berry) 
has been in his district and has seen the sincerity expressed by 
seniors who have said they do not want a handout, but after we have 
given them the option of Medicare why shouldn't Medicare have the same 
ability to be able to purchase low priced pharmaceuticals, 
competitively priced equal to that of the HMOs?
  Has anyone ever been in the midst of seniors, maybe those who are a 
little older, in their seventies and eighties, and heard them plead to 
us for clarity about these HMOs? Who am I to pick? What are they giving 
me? The confusion abounds and yet now we have promoted these HMOs over 
Medicare that has been so helpful in providing good health care for our 
seniors, and we have given HMOs the upper edge by providing these 
incentives, and yet sometimes seniors are moved from one HMO to the 
next. It shuts down and they get letters, and it is confusing.
  Oh, yes, I believe that HMOs provide a viable service, but those who 
are on Medicare should not be deprived the ability to get low-priced 
prescription drugs and to have a fairness process in place.
  So I believe that we are, in fact, providing what the Constitution 
says we should have, and that is equality. And we are doing it for a 
population that is now suffering. They suffer because of the way 
pharmacies are doing business, and many Americans whose retirement 
plans rely in part on private pension plans are also struggling. This 
is because many of those plans which were designed decades ago do not 
contain comprehensive medical plans, and even the ones that do include 
medical insurance typically do not pay for medication.
  In fact, I have talked to senior citizens who have said I am going to 
get that mail order program because I have heard that if you do mail 
order, that you can get cheap prescription drugs.
  So I think it is important, Mr. Speaker, that this legislation not 
have one moment of a slow process. It should be expedited. It should go 
through the committees of jurisdiction with flying colors. We should 
respond to the tragedy of senior citizens having to make choices 
between what they will buy, whether they will pay for food for the 
evening meal or which meal they will escape or not be able to have so 
that they can get the necessary prescriptions.
  I will just simply say, as we work together on this legislation, 
tears have come to my eyes when I have met with senior citizens who, 
first of all, are grateful for life, gratified for the medical care 
that many of them have been able to access, but when they give me the 
list of prescriptions that they have to take every single day, they do 
not do it in anger, they just simply say we have got to take it but 
give us a reprieve, help us not to be have to choose one over the 
other. So I want to thank the gentleman.
  As I close, I want to just make a personal note that from my home 
district, in addition to these prescription drugs, I am gratified for 
the medical health system, of which we also need to look at with the 
Patients' Bill of Rights, access to medical care. I am grateful for the 
system that is in my community, the public hospital system, now under 
attack by county government. My commitment to the senior citizens of 
that community, the children of that community, is to say that I am 
going to fight for this legislation, the Prescription Drug Fairness for 
Seniors Act, as well as a patients' bill of rights, as well as fighting 
for Lois Morris, our health care director in Harris County, and fight 
against anybody who would move to shut it down or to deprive our 
citizens of good health care by cutting the budget.
  I want to thank my friend, the gentleman from Arkansas (Mr. Berry). I 
want to thank my good friends, the gentleman from Maine (Mr. Allen), 
the gentleman from Texas (Mr. Turner) and the gentleman from California 
(Mr. Waxman), and I see the gentlewoman from California (Mrs. Capps) 
and I know the gentlewoman from Michigan (Ms. Stabenow), and if I begin 
calling the roll we all can stand up here and be gratified that we are 
working together for what I know can be bipartisan legislation to see 
this legislation passed.
  I thank the gentleman from Arkansas (Mr. Berry) for his kindness. Let 
us roll up our sleeves and get to work.
  Thank you Congressmen Berry, Allen and Turner for giving me the 
opportunity to speak on this bill, and for allowing me to help you 
tackle this tremendous problem.
  This year, many of us have taken up arms to preserve Social Security 
and Medicare, so that we can ensure in the future that our Older-
Americans have at least the bare minimums needed to live in this 
society.
  However, seeing that Social Security and Medicare, are in some 
respects, anti-poverty programs, we must supplement the law to protect 
the interests of senior citizens who rely on them in the later years of 
their life. One of the ways that we can do that is by guaranteeing that 
the senior citizens that rely on those programs are subjected to 
discrimination by the private sector.
  This bill does just that, by allowing pharmacies to purchase 
prescription drugs for Medicare beneficiaries at low prices. The bill 
uses naturally-occurring market forces to consolidate the purchasing 
power of our Medicare recipients. And by doing so, it, in affect, puts 
senior citizens on the same footing as the federal government when it 
purchases medication--which makes sense, because in a way, the 
government is paying for these drugs in an indirect manner.
  This bill also aims to stop the price discrimination that affects 
Older-Americans that are unable to purchase their prescription 
medication through HMOs or other health care providers. As the studies 
underlying this bill demonstrate, it is a fact that our Medicare 
recipients' dollars are being used to subsidize the low drug prices 
that group health care participants are privy to in our current 
economy. I believe that most of you will agree with me when I say, that 
is not what our precious few Medicare dollars should be used for!
  I would like to add that Medicare recipients are not the only ones 
who suffer because of the way pharmacies are forced to do business 
today. Many Americans whose retirement plans rely in part on private 
pension plans, are also struggling. This is because many of those 
plans, which were designed decades ago, do not contain comprehensive 
medical plans. Even the ones that do include medical insurance 
typically do not pay for medication. That means that most must still 
stretch their finances to pay for the medication that is required for 
their continued good health.

[[Page H628]]

  This is illustrated by a letter I recently received from a 
constituent in my district, in support of this bill, that reads: ``My 
wife and myself have supplemental insurance which does not include 
prescription drug reimbursement. Presently, we are spending an average 
of $4,792 annually on drugs . . . (which is) one-fifth of our income.'' 
One-fifth of their income is a staggering amount Undoubtedly, something 
must be done to alleviate their problem, and the least we could do is 
protect them from price discrimination.
  This bill is tremendous because it relies on tried and true 
principles of capitalism, purchasing power and competition, to craft a 
remedy that will save the federal government, and my constituents from 
inflated prices--and I will be glad to support it as it makes its way 
through the House of Representatives.
  Mr. BERRY. I thank the gentlewoman from Texas (Ms. Jackson-Lee) for 
her comments.
  Mr. Speaker, I yield to the gentleman from Maine (Mr. Allen), the 
author of this bill.
  Mr. ALLEN. Mr. Speaker, I thank the gentleman from Arkansas (Mr. 
Berry) for yielding.
  We should all know that the gentleman from Arkansas (Mr. Berry) is a 
registered pharmacist. He is, with the gentleman from Texas (Mr. 
Turner) and myself, a co-chair of our prescription drug task force. 
Really, no one has done more than he has to bring these issues out so 
the American people can understand that we in Congress are trying to do 
something about it.
  I thought what I would do is take a little time and talk first about 
our seniors, then review the current status of some of the 
pharmaceutical companies and then talk about H.R. 664, the Prescription 
Drug Fairness for Seniors Act that I introduced yesterday with 66 
cosponsors.
  Let us talk first about our seniors. All across this country, as we 
speak, seniors are not following their doctors' orders. Some of them 
have been given prescriptions which they cannot afford to fill. Others 
have filled prescriptions which they cannot afford to take as directed.
  What happens is, because they cannot pay the rent, pay the electrical 
bills, buy food and take very expensive prescription drugs, they are 
out there taking one pill out of three, mixing and matching. They are 
doing things that in the long run really are detrimental to their 
health.
  I know for the gentleman from Arkansas (Mr. Berry), the gentleman 
from Texas (Mr. Turner) and others, we get letters in our Congressional 
offices, and I want to share some of those letters.
  I received a letter last July, and I have had others like this since 
then, from a woman who said here is a list of the prescription drugs 
that my husband and I are expected to take, and when you added up the 
cost it came to $600 a month. Then she said, here is a copy of our two 
Social Security statements, and when you added up their two Social 
Security statements, which is all they had on a monthly basis, it was 
$1,350.
  One cannot get there from here. The math does not work. There is no 
way that couple could afford to take the prescription drugs that their 
doctors tell them they have to take.
  Perhaps the most poignant letters come to me from people who write 
and say, I do not want my husband to know but I am not taking my drug 
medication because we cannot afford both his and mine and it is more 
important that he take his medication than I take mine. So we have 
women out there, or men, not taking their own drugs so that their 
spouse can take his or hers. It is not right in this country and it 
should not continue.
  The reason is, the study that we did in my district in Maine, back in 
July of 1998, which has since been replicated in 19 districts across 
the country, including the gentleman from Arkansas (Mr. Berry), the 
gentleman from Texas (Mr. Turner) and a variety of other people, and 
the findings are always the same. The findings show that seniors who 
have no coverage for prescription drugs walk into their local pharmacy 
and pay a price for their drugs that is, on average, twice what the 
drug companies' best customers are paying.
  The best customers are big HMOs, the Federal Government, and others, 
who can buy in bulk and control market share.
  It is not right. This degree of cost shifting has a result. This 
price structure in the pharmaceutical industry right now means that the 
pharmaceutical industry, in effect, is charging its highest prices to 
those who are least able to pay; and those least able to pay are a big 
group. They are 37 percent of all seniors in this country.
  When Medicare was created in 1965, there was no prescription drug 
benefit because, frankly, it was not a big deal then. The drug 
companies have made enormous progress in developing new drugs. They 
have helped millions of Americans, old and young, live more productive 
lives. What we have got now is a degree of cost shifting in the 
industry that is imposing the highest costs on those seniors who do not 
have any coverage for their prescription drugs.
  Medicare does not cover prescription drugs. Most medigap policies, 
when they cover prescription drugs, and often they do cover only a 
portion of the cost, and the result is that, as I said, 37 percent of 
all seniors have no coverage and others are uninsured.
  The drug industry, pharmaceutical industry, is the single most 
profitable industry in the country. Last year, Fortune Magazine 
indicated they had the highest return on equity, the highest return on 
assets of any industry in the country. They are making their profits on 
the back of uninsured seniors who simply cannot take all the 
medications that their doctors tell them they have to take.
  If I can talk about the bill just for a moment and then defer to 
others, the bill we introduced yesterday, H.R. 664, the Prescription 
Drug Fairness for Seniors Act, is probably one of the simplest pieces 
of legislation we could possibly introduce in this area. We are not 
creating a big new government program. We are making a suggestion that 
would involve very little expense to the Federal Government. All we are 
saying is that the Federal Government should, in effect, be the 
negotiating agent for Medicare beneficiaries so that they can get the 
best price that is given to the Federal Government through the Veterans 
Administration, off the Federal Supply Schedule or through medicaid. 
That is all we are saying.
  They ought to have advantage, those people, Medicare beneficiaries, 
all of whom are now on a Federal health care program, Medicare, which 
is saying they ought to be able to get the best price from the drug 
companies that the Federal Government gets now, and the way that would 
work is through the Department of Health and Human Services. 
Participating pharmacists would be able to buy drugs for resale to 
Medicare beneficiaries at the best price the Federal Government buys 
those drugs. Simple bill, very simple, as close to a free market 
solution as you can get. The pharmaceutical industry objects.
  I would thank the gentleman from Arkansas (Mr. Berry) for yielding me 
this time and would ask to come back later, after others have spoken, 
to address a few of the arguments that I expect we will see as this 
debate moves along.
  Mr. BERRY. I thank the gentleman from Maine (Mr. Allen) and again 
appreciate his leadership in this effort.
  Mr. Speaker, I now yield to the gentlewoman from Michigan (Ms. 
Stabenow).
  Ms. STABENOW. Mr. Speaker, I thank the gentleman from Arkansas (Mr. 
Berry) for yielding.
  I want first to thank the gentleman from Arkansas (Mr. Berry) for his 
leadership in the last Congress and as we begin this Congress; also the 
gentleman from Maine (Mr. Allen), the gentleman from Texas (Mr. 
Turner), who has also worked so hard, and the gentlewoman from 
California (Mrs. Capps), who is here today.
  This is such an important issue for all of us, and as we make a 
commitment, and I know on our side of the aisle we have made a 
commitment, that the majority of the surplus that we have been reaping 
as a result of a strong, vibrant economy, will go back into paying off 
the Social Security Trust Fund and keeping Medicare strong, an 
important part of that is this bill that we are talking about today, 
the Prescription Drug Fairness for Seniors Act.

                              {time}  1630

  I think of my own family, where I have had my aunt, who is having 
back problems and finding herself now needing to pay $200 to $300 a 
month for prescriptions; other friends of my mother's who are looking 
at $500 or $600 a

[[Page H629]]

month in prescription drugs in order to be able to live at home and be 
able to continue to be able to live in the community and be able to 
move around and be independent, and when I look at those kinds of 
numbers, it is very clear to see that for too many seniors we are 
talking about the difference between food for the month and getting 
their prescription drugs so that they are healthy and pain free and 
able to stay well, or we are talking about the difference between 
paying the rent or paying the electric bill. This is basic survival for 
too many seniors.
  When we look at the costs that continue to go up and up, as I know 
the gentleman from Arkansas (Mr. Berry) has talked about, the fact that 
we are seeing these costs go up, and that we have not yet addressed 
this through the Medicare system or in some other way, I think this is 
really a tragedy, and that is why I am so excited to be a cosponsor of 
this legislation.
  This legislation, in a very cost effective way, as the gentleman from 
Maine (Mr. Allen) said, has a very simple approach: Let us get the best 
price; let us let the Federal Government negotiate on behalf of all 
uninsured seniors that need prescription drug help; let us let them 
negotiate the best price for our seniors who are on Medicare; and then 
let the pharmacists be able to receive that best price and pass it 
along to the seniors. So it makes sense.
  It does not involve a lot of new dollars being spent and it addresses 
one of the critical issues for our seniors as they are growing older: 
Living longer and wanting to benefit from all these wonderful new 
discoveries that allow them to live independently; to be able to leave 
a hospital sooner rather than later after an operation; to be able to 
avoid a nursing home as long as possible. There are wonderful new 
opportunities for them through prescription drugs. What a shame, what a 
shame if they are not able to afford these new opportunities because of 
the spiraling costs.
  So I once again celebrate and really commend the leadership of the 
people who are here today, who are really fighting on the front lines 
for our seniors, and I am hopeful that by the end of the year we will 
see this in place so that we can really lower the costs for seniors and 
help them to be able to balance that budget of theirs just a little 
better.
  Mr. BERRY. Mr. Speaker, I thank the gentlewoman from Michigan, and I 
yield 5 minutes to the gentlewoman from California (Mrs. Capps).
  Mr. CAPPS. Mr. Speaker, I want to thank the gentleman from Arkansas 
(Mr. Berry) for organizing this important time for us to speak today, 
and I am so honored to join my colleagues and the others really who are 
speaking around the country who are trying to give voice to our seniors 
as we bring to the attention of the House of Representatives a 
veritable scandal, I believe, which is occurring in our country today.
  I know that seniors on the central coast of California, where I live, 
and I believe that we are seeing evidence that seniors throughout the 
country, are paying outrageously high prices for their prescription 
drugs. Even worse, these inflated costs subsidize the discounts that 
high-profit HMOs get for these very same drugs. These inflated costs 
are rising every day, so they are rising at a faster rate even than the 
cost of living. Seniors are paying more this month than they paid a few 
months ago for their prescription medications. And this unfair practice 
has caused many of our older Americans to cut back on their 
medications, leading some to choose between buying food or filling 
their prescriptions.
  Last September I conducted the first comprehensive study of the 
impact that these big drug companies' high prices are having on the 
central coast of California's senior citizens. My office then released 
a report on the cost of prescription drugs for seniors and, more 
importantly, a major reason why these costs are so high, and the 
findings are startling.
  Seniors in my district pay, on average, 113 percent more for the 10 
most widely prescribed drugs than do the HMOs buying the same drugs. 
These are critical medications, like Zocor, for reducing cholesterol; 
Norvase, for reducing high blood pressure; and Relafen, for relief from 
arthritis. Prescription drug companies give huge discounts to managed 
care companies for these and other drugs. Other buyers, such as 
pharmacists, pay substantially more for the same drugs and must pass 
those higher costs on to their customers, many of whom are seniors.
  The average senior fills between 9 and 12 prescriptions a year. This 
is a far greater number than any other segment of our population. It is 
estimated that the elderly, who make up approximately 12 percent of the 
population, use one-third of all the prescription drugs.
  Today, in Santa Barbara, in the News-Press, our local newspaper, it 
was reported that Ticlid, one of the most widely prescribed medications 
for persons who have had strokes, sells to HMOs for around $34 for 60 
tablets. In my district, the average price seniors, who have to pay 
out-of-pocket for this drug, are being charged an overwhelming $131, 
nearly a 300 percent markup over the price the HMOs are paying.
  This huge difference in prices is not going to the retail pharmacists 
in Santa Barbara or Santa Maria or Arroyo Grande. According to my 
study, the local pharmacists on the central coast are paying an average 
of $100 to $110 for Ticlid.
  The final price seniors pay includes only a reasonable markup to the 
outrageous price that pharmacists are being forced to pay to the drug 
companies. No, the extra money the seniors are paying goes to the drug 
company so it can continue giving big discounts to HMOs and managed 
care companies.
  It is a very sad story that seniors are paying more in money for 
drugs than they should while HMOs are reaping a huge profit based 
partly on the huge discounts they get from drug companies. But there is 
an even sadder element. Many seniors simply cannot afford these high 
prices. They live on fixed incomes, especially as they keep on rising. 
So, instead, they take half the prescribed dose or they do not buy 
these lifesaving drugs because they cost too much.
  For example, Harriet MacGregor, in Santa Barbara, told my staff that 
because of the high cost of her five prescriptions she must sometimes 
skip or reduce her dosage. As a nurse, I am particularly appalled when 
I hear these stories. This is an intolerable situation. Seniors should 
not have to be subsidizing the profits of the HMOs, and they should not 
have to choose between filling their prescriptions or buying food or 
paying rent.
  I want to give credit to the pharmaceutical houses for developing the 
medications that save seniors' lives and enable them to live quality 
lives longer. These drugs are keeping our older Americans out of 
hospitals and out of nursing homes. We want them to take the 
medications. We have to find a way for them to be able to do this.
  Yesterday, I was a proud cosponsor of legislation to address this 
issue. This Prescription Drug Fairness Act for Seniors, introduced by 
my good friends and colleagues, the gentleman from Texas (Mr. Jim 
Turner), the gentleman from Maine (Mr. Tom Allen), and the gentleman 
from Arkansas (Mr. Marion Berry), will allow pharmacists an opportunity 
to receive the same big discounts that HMOs get for the drugs that they 
dispense to seniors. This cost saving will be passed on to the seniors. 
This legislation is long overdue and will ensure that seniors pay 
reasonable prices for the lifesaving drugs they so desperately need. I 
urge my colleagues to support this legislation.

  This important bill brings to mind another related problem: 35 
percent of American seniors have no prescription drug coverage. 
Medicare, this health safety net for millions of elderly and disabled 
Americans, does not cover outpatient prescription drugs. So many 
seniors are forced to pay for these spiraling costs with absolutely no 
assistance.
  Mr. Speaker, we must examine ways to improve Medicare. As we do that, 
I believe we must seriously consider extending prescription drug 
benefits to the elderly and to the disabled. We should also ensure that 
seniors are not subject to pharmaceutical price discrimination.
  In closing, we can and should do everything we can to safeguard 
access to these life-extending and life-enhancing prescription 
medications for our seniors. I thank the gentleman for the opportunity 
to speak.
  Mr. BERRY. Mr. Speaker, I thank the gentlewoman from California, and 
I

[[Page H630]]

yield 5 minutes now to the gentleman from Texas (Mr. Turner) and 
congratulate him on his leadership in this matter.
  Mr. TURNER. Mr. Speaker, I thank the gentleman from Arkansas (Mr. 
Berry) for the leadership that he has given to this issue. And as a 
pharmacist, the gentleman knows better than any of us the difficulties 
that the cost of high drug prices are having on our senior citizens.
  It is a privilege to have joined the gentleman from Arkansas, and the 
gentleman from Maine (Mr. Allen), the gentlewoman from California (Mrs. 
Capps), and the gentlewoman from Michigan (Ms. Stabenow) yesterday to 
introduce once again into this Congress the Prescription drug Fairness 
For Seniors Act, a bill that we introduced at the end of the last 
session of Congress and that we are reintroducing now, early in this 
session, because we believe that we will now have the opportunity to 
see this legislation become law.
  When I first became acquainted with this issue it was because of my 
membership on the Committee on Government Reform and Oversight, where 
our staff prepared a study of prescription drug costs in my district, 
as well as in the district of the gentleman from Arkansas (Mr. Berry) 
and many others who are with us here today. That study revealed that 
the big drug companies are heavily discounting prices to their most 
favored customers and passing on much higher prices to local retail 
pharmacists, which means that our senior citizens, who have to buy 
their prescription drugs in their own communities, are paying the 
highest prices of anyone.
  This is not a new phenomenon. Local pharmacists, I understand, have 
known this for years. In fact, as I traveled across my district talking 
about this bill, I found that many of our local pharmacists, who have 
gone out of business in recent years, have done so because they have 
been unable to compete because of the discriminatory pricing practices 
that have been carried on for these many years by the big drug 
companies. And most citizens, for years, have known that if they just 
fly or drive into Mexico, or across into Canada, they can buy their 
prescription drugs much cheaper than they can in their local pharmacies 
here in the United States.
  We all understand the big drug companies have made great progress in 
their research and in providing the best pharmaceutical products the 
world has ever known. And yet, in the course of the pursuit of that 
practice and that good research, they have engaged in a discriminatory 
pricing practice that has resulted in our senior citizens, those who 
are least able to afford to buy prescription medications, having to pay 
the highest prices.
  One individual that particularly impressed me was a lady that I met 
in Orange, Texas, when I held a brief press conference talking about 
this bill toward the end of last year. Her name is Miss Frances Staley, 
and a story about Miss Staley was recounted in the Houston Chronicle 
back on November 22nd of last year.
  Miss Staley is 84 years old. She has a Social Security check that she 
has to live off of that totals about $700 every month. She spends over 
half of that $700 just to pay for the 14 prescription medications she 
has to take every day. Miss Staley in this article said this: By the 
time I get through paying for my medicines, I have very little to live 
off of. She goes on to recount that at one point she began to take a 
pill and split it in half to stretch out her supply of her 
prescription, but she was stopped after a stern rebuke from her doctor.
  No senior citizen in this country today should have to struggle to be 
able to pay for their prescription medications. Retirees, such as Miss 
Staley, who must pay the full cost of their prescription drugs, are the 
hardest hit of anyone due to the discriminatory pricing practices that 
have been pursued by the big drug manufacturers.
  Let us look at what that discrimination really is. I have here a 
chart that shows three different prescription drugs that are used by 
our senior citizens. One of them, right here in the middle, is 
synthroid. That is a hormone treatment. The big drug companies sell 
synthroid, a month's supply, to their most favored companies, the big 
insurance companies, the HMOs, and even the government, for $1.78. 
People like Miss Staley, in my district in Texas, they would have to 
pay $25 for that same prescription. That is just not right.
  Another drug, micronase, which is a medication for diabetics, the 
most favored customers, the big insurance companies can buy that from 
the drug companies for $6.89 for a month's supply. Miss Staley would 
have to pay a price of $45.60.
  Now, those high prices to Miss Staley are not the result of the local 
pharmacy marking up that drug. The local pharmacies in this country 
today have a very small margin. In fact, that margin has decreased in 
recent years. That is why I was mentioning a minute ago that many of 
them are having to close their doors.
  We want to solve this problem, and the way we try to solve it in this 
legislation is we simply provide that local pharmacies may purchase 
their prescription drugs that they resell to Medicare eligible 
beneficiaries directly from the drug manufacturers at the same prices 
that they are currently selling to the government, to the big HMOs, and 
to the hospital chains.

                              {time}  1645

  We think that is only fair, that is only right. Our senior citizens 
deserve to be treated better. I am proud to join with the gentleman 
from Arkansas (Mr. Berry) and the gentleman from Maine (Mr. Allen) and 
the others here today in trying to enact this into law.
  Mr. BERRY. Mr. Speaker, I thank the gentleman from Texas for his 
leadership in this matter.
  Mr. Speaker, I now yield to the gentlewoman from Connecticut (Ms. 
DeLauro).
  Ms. DeLAURO. Mr. Speaker, I thank my colleague, the gentleman from 
Arkansas (Mr. Berry), and I want to say I offer my congratulations to 
him and to the gentleman from Texas (Mr. Turner) and the gentleman from 
Maine (Mr. Allen) for introducing this legislation. It really is so 
critical to what seniors in this country are facing today.
  To bring this to the Nation's attention, I think we can really create 
no better opportunity than to provide some relief to people who we have 
all heard from, all of us. There are 435 Members of this body; 435 
Members have heard that their seniors that they represent are in a 
difficult spot. Many are just deciding, as has been said on this floor 
today, between whether or not they are going to have a decent meal or 
whether or not in fact they are going to be able to take care of their 
health concerns.
  Let me just talk a little bit about my own district, which is the 3rd 
District of Connecticut. I conducted a study and discovered that 
seniors in Connecticut's 3rd District pay an average of twice what the 
pharmaceutical companies' preferred customers pay. And by ``preferred 
customers,'' so it is clear, and I am sure others have made that clear 
here today, these are large corporate institutional customers with 
market power for which they can buy drugs at a discount price. And that 
is a good thing. That is a good thing.
  While HMOs and others get the drugs at a discount, the cost is 
shifted to seniors and others who shop at their local store or their 
pharmacy. The bottom line is that we have seniors winding up 
subsidizing the corporate discounts out of their own pockets, and they 
live on fixed incomes. It is very difficult for them to make ends meet 
and to be able to afford prescription drugs.
  I will give my colleagues an example. Prilosec, a drug commonly 
prescribed to seniors, HMOs are able to buy an average dosage for 
$56.38. Seniors in my district would pay $108.63, almost double. It 
really is no wonder that some of the seniors that I have talked to 
spend nearly half of their income each month just on prescription 
drugs.
  On a personal note and a sad note for our family, my father-in-law, 
Sam Greenberg, passed away about two weeks ago. And something I did not 
realize when I talked with my mother-in-law is that they were paying up 
to $800 a month for prescription drugs. I do not know how they did it. 
I do not know how they did it. And I did not know that. My husband did 
not know that. But they were trying the best they could to pay $800 a 
month for prescription drugs.
  When I released the study that I did last year, I met with the local 
pharmacists and I met with seniors in my

[[Page H631]]

district who were affected by the problem, and I met the daughter of a 
woman who had a stroke because she could not afford to take her 
medications but she was embarrassed to tell anyone about the problem. I 
met a pharmacist who does all that he can to help his customers afford 
the prescriptions that they need, sometimes giving them credit until 
they find money to pay him. I saw people who are struggling to make 
ends meet on a limited income while buying the medicine they need to 
stay healthy.
  One of those seniors, Irma Yoxall, is a 72-year-old resident of West 
Haven, Connecticut. Ms. Yoxall suffers from diabetes and high blood 
pressure and she takes six prescription drugs. Her monthly income is 
$750. She spends between $300 and $400 a month, almost half of her 
income, on her prescription drugs.
  Until she became eligible for Medicaid, Ms. Yoxall had no insurance 
coverage at all for her prescription drug needs and at times was forced 
to skip medications because of the high cost. In fact, she recently 
suffered a stroke which her daughter believes was brought on because of 
the skipped medications.
  Let me just say, and let me conclude, I want to say thank you to my 
colleagues. This is such an important piece of legislation. It simply 
says, let seniors purchase their medications at the same cost that our 
large corporations, HMOs, can make that purchase, and keep them healthy 
and keep them in a sense of security that in fact they can weather, 
weather the storm of a serious illness.
  I thank my colleague again for letting me participate with all of my 
colleagues tonight.
  Mr. BERRY. Mr. Speaker, I thank the gentlewoman from Connecticut (Ms. 
DeLauro) not only for her support in this matter but for her great 
leadership in the House.
  Mr. Speaker, I yield to the gentleman from Maine.
  Mr. ALLEN. Mr. Speaker, I thank the gentleman for yielding, and I 
thank the gentlewoman from Connecticut for her support. It means a lot 
to us to have her come down and be with us in this debate.
  I just wanted to say, in closing, one thing. I said earlier that what 
is happening out there is that the pharmaceutical companies are 
charging their highest prices to those least able to pay. And by those 
least able to pay, I mean those Medicare beneficiaries, those seniors 
who do not qualify for Medicaid but are not wealthy enough to buy and 
use prescription drug insurance coverage. So they are left on their 
own, paying out of their own pocket.
  The industry is going to say that this bill involves price controls, 
and my final point is that that is flat out wrong. This bill will allow 
the Federal Government to act as a negotiating agent to make sure that 
it gets the best prices for our seniors across the country. It does not 
involve price controls. It simply puts a big negotiator, a big buyer, 
into a market where right now seniors or, more accurately, those 
wholesalers who sell to retail pharmacies really do not control market 
share and really do not buy in the kind of bulk that is necessary to 
get big discounts.
  H.R. 664, the Prescription Drug Fairness For Seniors Act, is the 
right bill at the right time at a low cost, a bill that would be 
effective in lowering the prices for seniors all across this country.
  I just want to say in conclusion how much I appreciate the work of 
the gentleman from Arkansas (Mr. Berry) on this issue, the work of the 
gentleman from Texas (Mr. Turner) on this issue. We are going to make a 
difference in this Congress and pass this legislation.
  Mr. BERRY. Mr. Speaker, I will just conclude by mentioning what a 
heroic effort our local pharmacies have made in the last few years to 
try to take care of our seniors and see that they got the medicine they 
needed at the best possible prices, and the heroic effort that our 
seniors have made to deal with this very difficult situation.
  The drug companies will say, ``We need this much profit.'' What we 
are saying is, we want them to make a profit but they should not make 
it all off of our senior citizens. We must level the playing field. We 
must treat our seniors the way that other preferred customers get 
treated. And this is the right thing to do. It is the fair thing to do.
  I urge my colleagues on both sides of the aisle to support H.R. 664.

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