[Congressional Record Volume 145, Number 145 (Friday, October 22, 1999)]
[Senate]
[Pages S13045-S13046]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HEALTH CARE POLICY

  Mr. WYDEN. Mr. President, rare is it to have an opportunity to talk 
about health care policy when the chairman of the Health Care 
Subcommittee is on the floor with Mr. Moynihan, a long time expert, and 
Dr. Frist is in the chair. So you have three of the most influential 
people in the health care policy field before you.
  I will not abuse this opportunity. But I wanted to take just a few 
minutes to talk about this prescription drug issue and its importance, 
in terms of coverage under Medicare. There is now one bipartisan bill 
before the Senate on this issue, and that is the legislation that 
Senator Olympia Snowe and I have proposed.
  What I have said--this is the fifth time I have come to the floor in 
recent weeks--is I am actually going to, as this poster says, ``Urge 
Senior Citizens To Send In Copies Of Their Prescription Drug Bills,'' 
so we can show just how critical this issue is and come together on a 
bipartisan basis before the end of this session and get prescription 
drug coverage added to Medicare.
  What Senator Snowe and I have proposed, on a bipartisan basis, uses 
marketplace forces to hold down the cost of these prescriptions. We 
have an ``ability to pay'' feature in the program. That is something I 
have heard Senator Moynihan and Dr. Frist talk about. My sense is, it 
is critically important that we get this coverage, not just because 
senior citizens suffer so, but because this is the next breakthrough in 
preventive health care. The drugs we are seeing today help to lower 
blood pressure; they help to lower the cholesterol level.
  I have heard Senator Moynihan and Chairman Roth talk, for example, 
about how costs are exploding in Medicare, particularly under Part A, 
the hospital portion of Medicare. It seems to me if we can come 
together on a bipartisan basis and address this prescription drug 
issue, a lot of these new drugs, these preventive drugs, will help us 
save money and hold down some of the costs in Part A of Medicare, the 
hospital and institutional portion of the program.

  The Wall Street Journal pointed out yesterday, again, how staggering 
some of these costs are and how we might prevent them with thoughtful 
policy work in the health care area. For example, yesterday in the Wall 
Street Journal they noted that one-third of all stroke survivors are 
permanently disabled. But doctors can now prescribe anticoagulants to 
protect the high-risk patients from stroke. The Journal goes on to say:

       The lifetime cost of a severe stroke is $100,000, while 
     treatment with anticoagulants costs $1,095. This is a chance 
     to get good coverage for vulnerable people in our country and 
     save taxpayers' money at the same time.

  I am just very hopeful; Senator Roth's staff and Senator Moynihan's 
staff have spent a lot of time with us already. Senator Snowe and I 
want to do this in a bipartisan way. We want to act in this session of 
Congress, not put it off until after yet another round of 
electioneering and more slugging back and forth between Democrats and 
Republicans. I am hopeful seniors, by sending in copies of their 
prescription drug bills, as Senator Snowe and I advocate, will help us 
come together in a bipartisan way.
  In wrapping up, as I have indicated to the Senate before, I am going 
to bring to the floor each time I come three cases of what I am hearing 
from seniors at home in Oregon, to dramatize how important it is we act 
on this matter.
  I just heard yesterday from a 75-year-old widow from Salem, OR. She 
wrote me that her income is $8,218 a year; her prescription drug bill 
is $2,289.
  She spent that on three drugs--Fosamax, Relafen, and Paxil. Three 
drugs, $2,289 from her $8,118 income. That is an elderly woman in 
Salem.
  A woman in Portland wrote me:

       My mother is 97 years old and will soon be required to file 
     for Medicaid because the ever-increasing cost of her care and 
     medications have depleted her savings. Currently, her 
     expenses exceed income by over $1,000 per month. In some 
     months, her medication costs over $300. Last year, her 
     prescription drug bill was $2,746.

  As we saw in a recent study, more than 20 percent of the Nation's 
elderly are spending over $1,000 a year out of pocket on their 
prescription medicines. This story was not at all something we found to 
be rare or out of the ordinary.
  Finally, the third case I want to mention this morning comes from a 
woman in Seaside, OR. She has an income of just over $1,000 a month. 
She wrote me yesterday:

       I am supposed to take 20 milligrams of Lipitor, but I do 
     not have enough money to buy it.

  These are the kinds of cases I know we are going to hear when seniors 
send in copies of their prescription drug bills. The question is, Can 
we come together in a bipartisan way to address this issue?
  Senator Snowe and I used the Federal Employee Health Benefits Plan as

[[Page S13046]]

our model. There are other good ideas out there. Our bill is called 
SPICE, the Senior Prescription Insurance Coverage Equity Act. We are 
not saying this is the last word on how to address this issue, but I 
would like to see the Senate look at an approach that utilizes 
marketplace forces, along the lines of what we do in the Federal 
Employee Health Benefits Plan and one that will not produce a lot of 
cost shifting on to other groups of vulnerable people.
  For example, there is one proposal going around, certainly well-
meaning, which has Medicare buying up all the drugs for the Nation's 
senior citizens. I am very fearful what will happen under that approach 
is we may control prices for the elderly, but you could have a divorced 
woman, a 27-year-old, say, African American women in my State or the 
Presiding Officer's State. She could see her drug bill go through the 
roof because prices would be controlled in just one segment of the 
pharmaceutical area, the Medicare area, and the costs would be shifted 
on to somebody else's back.
  I know the Senate has a lot of important business. By the way, I am 
with Senator Moynihan and Chairman Roth on this great bill as well. I 
know they want to go on to that important matter. I intend to keep 
coming to the floor. Senator Snowe had to be in Maine today and could 
not be here. We have already done this together. We urge seniors to 
send in copies of their prescription drug bills.
  We hope they will back the bipartisan Snowe-Wyden bill. Frankly, I 
would rather hear from them so as to bring this Senate together in a 
bipartisan way and deal with this issue. Let's not let it become fodder 
for the 2000 election. Let's make this issue a legacy of this Congress 
where we really came together to do something important, something that 
is the wave of the future in American health care, which is to give 
good preventive approaches, wellness-oriented approaches as part of our 
American health system.
  I thank Chairman Roth and Senator Moynihan and my friend, Senator 
Akaka, for indulging me this morning. I yield the floor.

  The PRESIDING OFFICER. The Senator from New York.
  Mr. MOYNIHAN. Mr. President, before the Senator from Oregon leaves, I 
express my own personal gratitude to him and to Senator Snowe for 
bringing this issue in the congenial, collegial way they do. It must be 
addressed. I feel presumptuous to speak on such matters in the presence 
of the Presiding Officer, the Senator from Tennessee, but since the 
advent of sulfa and penicillin, the great medical revolution has been 
the development of the array of prescription drugs that prevent disease 
as against cured, in the case of penicillin. We will one day go this 
way, and we will have Senator Wyden and Senator Snowe to thank and the 
Senator from Tennessee.
  The PRESIDING OFFICER (Mr. Roberts). The distinguished Senator from 
Hawaii is recognized.
  Mr. AKAKA. Mr. President, I ask unanimous consent to speak as in 
morning business for 15 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. AKAKA. Thank you, Mr. President.

                          ____________________