[Congressional Record Volume 145, Number 148 (Wednesday, October 27, 1999)]
[Senate]
[Pages S13328-S13329]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                MEDICARE COVERAGE FOR PRESCRIPTION DRUGS

  Mr. WYDEN. Mr. President, and colleagues, this is the seventh time I 
have come to the floor of the Senate in recent days to talk about the 
issue of Medicare coverage for prescription drugs. The reason I do so 
is I think it is so important that before we wrap up our work in this 
session of Congress, we take action on this matter, given how many 
vulnerable senior citizens there are in this country who simply cannot 
afford their prescriptions.
  There is just one bipartisan bill with respect to prescription drug 
coverage now before the Senate. It is a piece of legislation known as 
the SPICE Act, the Senior Prescription Insurance Coverage Equity Act.
  It is a bipartisan bill on which I have teamed with Senator Olympia 
Snowe of Maine; and it is one that the two of us are very hopeful this 
Congress will act on before we conclude our work.
  There are some who think this issue is too controversial and too 
difficult to tackle before the next election. I would note that it is 
going to be more than a year until the next election. We are going to 
have a lot of senior citizens who are walking on an economic tightrope, 
every week balancing their food costs against their fuel costs, and 
their fuel costs against their medical bills, who are not going to be 
able to pay for their prescriptions and their necessities if the Senate 
decides to duck this issue and put it off until after the next 
election. I think the reason we are sent here is to tackle issues and 
not just put them off until after the election.
  Over the last few months, Senator Snowe and I have worked with senior 
citizen groups; we have worked with people in the pharmaceutical 
sector, in the insurance sector, various public- and private-sector 
organizations; and we believe the SPICE legislation that we have 
crafted is the kind of bill that Members of the Senate can support.
  In fact, as part of the budget, Senator Snowe and I teamed up, and we 
offered a specific funding plan. And 54 Members of the Senate are now 
on record--they are now specifically on record--with respect to the 
Snowe-Wyden funding plan for paying for prescription drug benefits. So 
we are now in a position, it seems to me, colleagues, to take specific 
action.
  One of the reasons I have come to the floor tonight is my hope that 
we can really show how urgent this need is.
  What I have done, as the poster next to me says, is urge senior 
citizens to send in copies of their prescription drug bills, directly 
to their Senator, U.S. Senate, Washington, DC. I have decided I am 
going to, in my discussions on the floor each evening, read a portion 
of the letters I am receiving from seniors at home in Oregon.
  I read about one group in the newspaper the other day who said it is 
not really that urgent a need. More than 20 percent of the Nation's 
senior citizens are spending over $1,000 a year out of pocket for their 
prescription medicine.
  I read a couple of nights ago about an elderly woman from southern 
Oregon whose income is just over $1,000 a month in Social Security. She 
spends more than half of it on her prescriptions.
  Those are the kinds of accounts we are hearing again and again and 
again. The fact is, our senior citizens are getting shellacked twice. 
First, Medicare doesn't cover prescriptions. That is the way the 
program began in 1965. I was director of the Gray Panthers at home for 
about 7 years before I was elected to Congress. The need was very acute 
back then for prescription drug coverage. But today it is even more 
important, for two reasons.
  First, the senior citizen, who not only gets no Medicare coverage for 
their prescriptions, is now subsidizing the big buyers such as the 
health maintenance organizations that are in a position to negotiate 
big discounts. These big buyers, the health maintenance organizations, 
have real bargaining power and clout. They go out and negotiate a 
discount; they get a break. If you are a senior citizen, for example, 
in Myrtle Creek, OR, or Philomath--I will read from those letters in a 
moment--you end up subsidizing those big buyers. I don't think that is 
right.
  In addition, since the days when we began to push, with the Gray 
Panthers, for prescription drug coverage, a lot of the new, important 
prescriptions are preventive in nature. I described several days ago an 
important anticoagulant drug that can help with a variety of ailments 
relating to strokes. The cost of that anticoagulant drug is in the 
vicinity of about $1,000 a year. You have a full-scale stroke that can 
come about if you don't get the medicine, and the cost can be $100,000 
a year.
  When people ask me, can this country afford to cover prescription 
drugs under Medicare, my view is, our country cannot afford not to do 
it. As part of this campaign we have launched in the Senate to have 
seniors send in, as this poster says, copies of their prescription drug 
bills, Senator Snowe and I have teamed up on a bipartisan kind of plan. 
I am going to read from these letters. I will take just a couple of 
minutes for that tonight.
  Just a couple of days ago, I heard from a woman in Philomath, OR, who 
wrote me about her mother. Her mother had recently spent more than 
$2,220 on prescription drugs. The daughter said--this was particularly 
poignant, in my view--the only way her mother was able to, in effect, 
cover her prescription needs was that her mother was getting samples 
from the doctor. The fact that she spent more than $2,220 on 
prescription drugs and the year isn't even over yet is dramatized by 
the fact that the cost would be much greater were it not for the fact 
that she was getting samples to supplement what she was paying for. 
That is the kind of account we are hearing from seniors in Oregon, as 
they, as this poster says, send in copies of their prescription drug 
bills. I hope we will get more of that.

  We need to deal with this issue on a bipartisan basis. Senator Snowe 
and I have chosen to model our program after the Federal Employees 
Health Benefit Plan. The SPICE proposal we introduced is sort of a 
senior citizens version of the Federal Employees Health Benefit Plan. 
The elderly population, of course, is different from that of the 
Federal workforce, but the model of trying to offer choices and options 
and alternatives to make sure there is competition in health care of 
the kind Senator Graham has advocated in the past is very sensible. If 
it is good enough for Members of Congress, it certainly ought to be the 
kind of thing we look at to cover older people. It is especially 
important because it can be a model that prevents cost shifting on to 
other groups of citizens.
  There are other proposals, for example, that in effect have Medicare 
sort of buying up all the prescription drugs and taking the lead as the 
purchaser. What concerns me about that approach is, I think you will 
have massive cost shifting on to other groups of individuals. Nobody in 
the Congress intentionally would want to see a proposal developed that 
would, in effect, give a discount to folks on Medicare and then just 
have the cost shifted over to somebody who was 27 years old and had a 
couple of kids and was working hard and doing their best to get ahead 
in life. We have to use marketplace forces to develop and implement 
this benefit.
  The proposal I have introduced with Senator Snowe is one that uses 
those marketplace forces. It would give seniors the kind of bargaining 
power a health maintenance organization and a big buying group would 
have, but it wouldn't involve a lot of price controls. It wouldn't 
involve a lot of micromanagement. It wouldn't be sort of one-size-fits-
all health care.
  As we go ahead with this bipartisan campaign, the bill on which 
Senator Snowe and I have teamed up is, in fact, the only bipartisan 
measure now before the Senate. I am going to come to this floor as 
often as I can and urge seniors to send in copies of their prescription 
drug bills directly to their Senator and just keep bringing to our 
colleagues' attention the need for action on this issue.

[[Page S13329]]

  The second letter I want to describe tonight comes from an elderly 
couple from my hometown in Portland who said they have already spent 
$1,750-plus on their prescription drug costs so far this year. They 
wrote: We have saved all our life, never knowing what health problems 
would befall us. We are glad to pay our fair share, but the cost of 
prescription drugs is eating up our savings.
  Finally, a constituent from Myrtle Creek has written that recently 
they spent $700 on prescription medicines. This exceeds the so-called 
average many of the experts in the beltway are talking about as not 
being that big a deal for senior citizens. This is a bill incurred by 
an older person from Myrtle Creek. We hear the same thing from 
Portland, OR. We hear the same thing from Philomath, OR. This is what 
we are hearing all across this country.
  It would be a terrible shame, in my view, for the Senate to say we 
are not going to act, we are going to let this become a big campaign 
issue in the 2000 election, and Democrats and Republicans can engage in 
a lot of finger pointing and, in effect, sort of put out that the other 
side doesn't care, the other side isn't interested. We will end up 
seeing this issue drag on well into the next century.
  I believe the Snowe-Wyden legislation, the only bipartisan bill now 
before the Senate on prescription drugs, may not be the last word on 
this issue. It is not going to be enacted into law with every I dotted 
and every T crossed, as it has been proposed thus far, but I do believe 
it can serve as a model.
  It is bipartisan. Fifty-four Members in the Senate are already on 
record as having cast a vote for the specific plan we have to fund this 
program. And so the opportunity to make the lives of older people in 
this country better, to help those who are scrimping and not taking 
their drugs the way they ought to, to be able to do it in a way that 
uses marketplace kinds of forces and provides choices and options, just 
the way our families get, seems to be an opportunity we cannot afford 
to pass up.

  I know Senator Graham, who has done good work on the health care 
issue and the prescription issue as a member of the Finance Committee, 
is here to talk. The hour is late. But I intend to keep coming to the 
floor of the U.S. Senate and pushing for action on this issue. There is 
a bipartisan bill before the Senate now. This would be the kind of 
issue that could be a legacy for this session of the Congress. I intend 
to keep coming to the floor of the U.S. Senate, reading from the 
letters I am getting from home, urging seniors to do as this poster 
says: Send in copies of your prescription drug bills.
  I intend to come back to this floor again and again and again, until 
we get action on this matter. For years, since the days when I was 
director of the Oregon Gray Panthers at home, I have had a dream that 
the U.S. Congress would make sure that older people who aren't taking 
their medicines because they can't afford it would be able to get this 
coverage.
  The opportunity to team up with Senator Snowe has been a real 
pleasure for me. She has been speaking out on this issue. I will 
continue to speak out on it, and we are going to do everything we can 
to make sure the U.S. Senate acts on this question and does it in this 
session of the Congress.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Florida is recognized.

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