[Congressional Record Volume 145, Number 114 (Thursday, August 5, 1999)]
[Senate]
[Page S10441]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

                             By Mr. GRAMS:

  S. 1535. A bill to amend title XVIII of the Social Security Act to 
provide for coverage of outpatient prescription drugs under part B of 
the Medicare program, and for other purposes; to the Committee on 
Finance.


          medicare ensuring prescription drugs for seniors act

 Mr. GRAMS. Mr. President, I rise today to introduce 
legislation I've drafted to provide a prescription drug benefit for 
Medicare beneficiaries.
  While I firmly believe we must deal directly with the structural 
problems facing the Medicare program, I also understand the very real 
need to provide prescription drug coverage now.
  Mr. President, Americans might be surprised to learn there are 
estimates that about half the people who have ever--ever--reached age 
65 are alive today. It's a revealing statistic--one we should be proud 
of because America has had much to do with the success in lengthening 
the life expectancy of nearly everyone in the world. Whether it's 
through government-funded research at the National Institutes of Health 
or private research funded through foundations, it has all contributed 
to this success.
  In 1900, the average American could expect to see their 47th 
birthday. Today, Americans can expect to celebrate 29 more birthdays--
living to the age of 76. Clearly, this increased life expectancy can be 
attributed to many things, but the advances made in pharmaceuticals is, 
perhaps, the most significant contributor.
  When the Medicare program was being discussed by Congress in the 
1960s, no one could foresee the enormous change our health care system 
would experience over the course of thirty years. Of course, we 
couldn't have expected them to know how different things would be 
today.
  In the 1960s, health care was predominately hospital or clinic 
oriented and as a result, Medicare focused on hospital stays. Indeed, 
even months before the final Medicare package was passed there was 
debate over whether physician visits should be included in the program. 
Now, we find ourselves with a program going broke, but in need of 
reform--a program largely successful for the past 30 years, but 
woefully inadequate in meeting the needs of today's seniors.
  Mr. President, one of the first witnesses before the Bipartisan 
Commission on the Future of Medicare, Robert Reischauer, described 
Medicare's problems as the four ``i's:'' insolvency, inadequacy, 
inefficiency and inequity. I couldn't agree more.
  As I alluded to earlier, perhaps the best example of the inadequacy 
of the current Medicare program is the lack of a prescription drug 
benefit. While I continue to believe the best way for us to include a 
prescription drug benefit in Medicare is through overall reform, I also 
believe it is important for us to explore different ways we can meet 
the challenge of adding the benefit without undermining the entire 
program.
  In putting together my plan for providing a prescription benefit, I 
tried to keep in mind the root of our dilemma. Many make the mistake of 
thinking access to needed pharmaceuticals is the problem. It's not--
affording the increasing number and cost of prescriptions is the real 
problem facing seniors today.
  Mr. President, my plan, the ``MEDS Act of 1999,'' would work like 
this:
  Single seniors with incomes of $927 per month or less, will be 
eligible to receive their prescription drugs with a 25 percent co-
payment and no deductible. Married seniors with incomes of $1,244 per 
month or less will be eligible for the same co-payment of 25 percent 
with no deductible.
  The income figures are the equivalent of 135 percent of the federal 
poverty level.
  Seniors above the income limits will be protected through a monthly 
deductible of $150. For amounts over those deductibles, Medicare will 
pay 75 percent of the prescription cost.

  Mr. President, rather than using a yearly deductible, which, in the 
first months, forces many seniors to use more of their monthly income 
on prescription drugs than they can often afford, my plan uses a 
monthly deductible allowing seniors to budget their drug costs every 
month.
  In addition, it ensures that if a senior, such a your parent or 
grandparent, is seriously ill in one month, Medicare will cover 75 
percent of their drug costs with no caps on the benefit. Meaning, they 
get the help they need when they need it.
  While I understand there will be concerns about how we determine when 
a beneficiary has reached their $150 deductible, particularly on a 
monthly basis, I contend that we have the knowledge and technology 
necessary to structure the program nearly any way we wish--we simply 
have to use it.
  Mr. President, America's seniors understand that if their drug costs 
are $50 a month, it doesn't make sense for them to buy a drug insurance 
policy for $100 a month. In this case, prescription drug coverage is 
not the issue. The issue is, can the senior trying to get by an $600 a 
month afford the $50 or $75 a month to pay for their medications? And, 
in the event of a major illness, can a senior bear the entire cost of 
treatment during that particular month?
  My plan would make sure that person gets relief when the costs become 
too much to handle. It is truly a safety net for seniors and especially 
for those who would not otherwise be able to reap the benefits of 
modern medicine.
  I believe this is a responsible, credible plan for America's seniors. 
I hope it will serve as a starting point for an honest, rational and 
responsible discussion about who needs help and how much.
  While I applaud the President for putting forward a plan, I believe 
it falls short in one important way--it doesn't help those who need it 
most.
  President Clinton's plan requires all seniors to pay $288 in monthly 
premiums and a co-payment of 50 percent up to $2,000. Under the 
President's plan, the most benefit any senior could get is $712 and, by 
capping the benefit at $2,000, it abandons seniors when they need help 
most.
  The debate over prescription drug coverage and overall Medicare 
reform may be political for some, but I know seniors in Minnesota who 
have difficulty paying for their prescriptions don't think much of 
political games played by politicians in Washington. They won't care 
who takes credit for this or that. They just want to know they won't go 
broke or hungry to pay for the medicines they need to stay alive. The 
plan I introduce today, the Medicare Ensuring Prescription Drugs for 
Seniors (MEDS) Act, will help ensure that they won't.
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