[Congressional Record Volume 145, Number 155 (Friday, November 5, 1999)]
[Senate]
[Pages S14228-S14229]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                MEDICARE COVERAGE OF PRESCRIPTION DRUGS

  Mr. WYDEN. Mr. President, I have been coming to the floor now on a 
number of occasions, as we move toward the end of our work for this 
year, in an effort to try to build bipartisan support for ensuring that 
senior citizens can get prescription drugs under their Medicare.
  There is one bipartisan bill now before the Senate. It is the 
legislation that Senator Snowe and I have introduced together. Fifty-
four Members of the Senate have voted for this bill. It seems so sad 
that the Senate cannot come together on an issue such as this and 
provide some real relief for the Nation's older people.
  So as part of this effort to get bipartisan support for legislation 
to cover seniors for their prescription drug bills, I have come to the 
floor and urged seniors to send in copies of their prescription drug 
bills, to send in copies of their bills to all of us here in the Senate 
in Washington, DC. I hope that in doing that, it will help generate 
some awareness about how serious a problem this really is for the 
Nation's older people.

  As I have done on previous occasions, I come to the floor to discuss 
some of these letters. This afternoon, I want to take a couple of 
minutes to talk about a handful of the letters I have received from 
senior citizens in my hometown of Portland. We have read from letters 
from seniors across the State of Oregon in the past. Today, I thought I 
would look to my hometown and describe a little bit about what the 
seniors are faced with in terms of trying to pay these prescription 
bills.
  One elderly widow wrote me in the last couple of days from Portland 
to describe her situation as one where she has a monthly income of 
$806. She spends about $150 of that monthly income on her 
prescriptions. She indicates she is having problems paying for these 
very large prescription drug bills. When asked by our staff what she 
does in a situation such as this, she just said: I do without and pray. 
That was her response to the question of making sure she could get help 
with her prescriptions. She goes on to say, when we asked her about 
choosing between food and fuel and health care--we have literally 
millions of our Nation's seniors today walking on an economic 
tightrope, balancing these costs, medical bills against their fuel 
bills. When we asked her how she handled the situation with respect to 
her medicine, she said: I just wait. I always pay the utilities first.
  Now, this isn't some kind of statistic or abstract kind of matter 
that the think tanks are debating here in the beltway. This is a senior 
citizen back home in Portland, my hometown. She has a monthly income of 
$806. She spends $150 of it on her prescription medicines. When she 
can't afford her prescriptions, she writes me: I just do without and 
pray.
  How is it that a country as rich and strong and powerful as ours 
can't provide some relief to an elderly widow with an income of $806 a 
month, spending more than $150 of it on her prescriptions and literally 
having to pray she will get some help with her medical bills? How is it 
that our country, so strong and so good, can't come up with a plan to 
help an elderly widow such as this?
  Senator Snowe and I are part of a bipartisan team trying to address 
it. The Snowe-Wyden legislation has garnered 54 votes on the floor of 
the Senate in terms of its funding plan. Already a majority of the 
Senate is on record as saying this is an appropriate way to try to fund 
a prescription drug benefit for older people. I am concerned--this is 
right at the heart of the philosophy behind the Snowe-Wyden 
legislation--that if we don't act, and act in a bipartisan way, in this 
session of the Congress before we wrap up our business next year, it 
will be years before older people get some help with their prescription 
drugs.
  I am very often asked at town hall meetings and other gatherings 
whether our Nation can afford to cover prescription drugs. My view is, 
we cannot afford not to cover these prescription drugs. Not only are we 
hearing about the suffering in these letters I keep bringing to the 
floor of the Senate, but we are seeing in so many instances that if 
older people could get just a little bit of help with their 
prescription drug costs, that would help our country save much more 
expensive medical bills down the road.
  I have repeatedly cited on this floor the anticoagulant drugs. That 
seems to me a particularly good example. The evidence shows that if 
older people can get help with some of these anticoagulant medicines--
the cost might be $1,000 a year for help with anticoagulant medicines--
they could save the cost they might incur if they suffer a stroke as a 
result of not getting their medicines. Those costs can be upwards of 
$100,000 a year. That is, in effect, the kind of challenge with which 
we are faced. Either we address this issue on a bipartisan basis--that 
is what the Snowe-Wyden legislation is all about--or we continue to 
have our senior citizens suffering, whether it is in Alabama, Oregon, 
or any other State. This is an area where we can work in a bipartisan 
way.
  In the Snowe-Wyden legislation, we reject price controls. This isn't 
a run from Washington, one-size-fits-all Federal approach. We try to 
use marketplace forces, the ingenuity of the marketplace to give senior 
citizens some clout. It is a model we all know something about. Federal 
employees in Alabama and Oregon use the Federal Employees Health 
Benefits Plan. It is marketplace oriented. It gives folks choices and 
options and alternatives. That is the model behind the Snowe-Wyden 
legislation.
  Our bill is called SPICE, the Senior Prescription Insurance Coverage 
Equity Act. With a majority of the Senate already having voted for a 
funding plan for the program, we think that is the way to proceed.
  As seniors hear us on the floor of the Senate talking about this 
issue and urging that folks send us copies of their prescription drug 
bills to the Senate in Washington, DC, they may have other ideas than 
the Snowe-Wyden legislation. The important thing is, there is no reason 
this Senate cannot come together in a bipartisan fashion and act in a 
way to provide real and meaningful relief to the Nation's older people.
  I will cite another couple of examples of older people who have been 
writing us in recent days. An elderly gentleman from Portland, again, 
describes taking five drugs, a lot of them very familiar--Minocin, 
nitroglycerin for blood pressure, for heart ailments connected with 
diabetes. This gentleman has a monthly income of about $900. He is 
spending about $170 from his monthly income on prescriptions.
  We talked to him about what it means for him to be in this kind of 
financial crunch where, out of a monthly income of $900, $170 of it 
goes for prescriptions. He reports that if he could have a little bit 
of help with his prescriptions, he would have money for other things he 
describes as clothing.
  So we are not talking about seniors getting help with their 
prescriptions and then suddenly using it for some sort of luxury or 
something that might be considered nonessential. These seniors are 
talking about not having enough money to pay for essentials. When they 
can't get help for their prescription drugs, such as this elderly 
gentleman in Portland, this gentleman said, in effect, he can't afford 
his clothing. He cannot afford clothing.
  Of course, that, to some extent, is a health-related kind of matter 
because older people are susceptible to illness. This is getting to be 
the colder part of the year. These are folks who, if they can't get 
adequate clothing, may pick up illnesses as a result of not being able 
to afford warm clothes.
  What we are talking about may not be of great importance to some of 
these think tanks in Washington. I have seen they are putting out all 
kinds of reports that this is not all that important to seniors. I talk 
to senior citizens at home in Oregon. The seniors we are

[[Page S14229]]

talking to know these are real problems. What they want to see is the 
Senate deal with them in a bipartisan kind of fashion. They want to see 
us get beyond some of the bickering and the finger pointing.
  The Snowe-Wyden legislation is built on that principle. We don't want 
to see the U.S. Senate duck this issue, have it go out on the campaign 
trail where Democrats will attack the Republicans and Republicans will 
attack back. That is really easy. It is easy to take issues like this, 
using the campaign fodder for advertisements. What is tough is crafting 
bipartisan legislation.
  So I am very hopeful that seniors, as this poster says, will send in 
copies of their prescription drug bills to us here in the Senate in 
Washington, DC. Instead of having to come to the floor of the Senate 
day after day, as I have, I can come to the floor of the Senate and 
talk about being proud of working with my colleagues on a bipartisan 
basis to address this issue.
  Before I wrap this up for this afternoon, I wanted to mention one 
other account that came to Tualatin just outside Portland at home in 
Oregon. This was an elderly couple, they spend about $300 a month on 
their prescription drugs. They are taking 11 prescriptions. They report 
that they are retired but are trying to work to pay for prescriptions. 
The husband is over 65 and he is trying to work now in order to pay 
their prescription drug bills of $300 a month. This is an elderly 
couple in Tualatin, OR. None of it is covered by health insurance. They 
report to us that they are cutting down on other essentials that are 
important to them, but they are going to keep working. The husband is 
going to keep working simply to pay the couple's prescription drug 
bills.
  Think about that for a moment, the three cases I have read from 
today: An elderly widow who can't pay her prescription drug bills 
without great hardship with an income of $806 a month, with $150 for 
prescriptions. She says, ``I just do without and pray.'' Next is an 
elderly gentlemen from Portland, with a monthly income of $900 a month, 
and he is spending about $170 of it on prescription drugs. He says he 
hopes to be able to get some coverage so he would be able to afford 
some clothing --an essential, especially as we move into the cold 
weather season. And then, finally, is the couple I just mentioned with 
$300 a month in prescription drug bills, with the husband not in good 
health but continuing to work solely to pay for their prescriptions.
  I think it is so sad that when we have had a majority in the Senate 
go on record as voting for a plan to fund this important benefit for 
the elderly, when I know there are Senators of good will on both sides 
of the aisle who would like to work on a marketplace solution to 
covering prescription drugs for seniors, the Senate can't come together 
and deal with it. The fact is, our senior citizens are getting creamed 
with respect to their prescription drug bills, and it happens two ways. 
First, Medicare never covered prescriptions when the program began in 
1965. I guess the architects didn't think it would be all that 
important.
  As I have said on the floor of the Senate, it is more important today 
than it used to be because many of these drugs help to lower bills 
because they are preventive in nature. In addition to Medicare not 
covering prescriptions, what is happening today is if you are a senior 
citizen in Alabama, or in Oregon, and you walk into a drugstore in a 
small town in Oregon or in the State of the Presiding Officer, that 
senior citizen who walks into the drugstore, in effect, subsidizes the 
big buyers of medicine. If you are a health maintenance organization in 
Oregon, or in any other State, you can go out and negotiate a discount. 
You can go out and negotiate a good price on your medicine. You have 
clout in the marketplace. But if you are a senior citizen who just 
walks into a drugstore, you don't have any bargaining power, you don't 
have any clout. So, in effect, that senior citizen who walks into a 
pharmacy is subsidizing the big buyers in the community, the health 
maintenance organizations that can negotiate a discount. Those seniors 
are getting creamed twice. Medicare doesn't cover it, and then they 
have to subsidize the big buyers.

  So I intend to keep coming to the floor of the Senate, continuing to 
bring to light these various kinds of real-life examples from home in 
Oregon. I hope seniors, as this poster indicates, will send us copies 
of their prescription drug bills. I want to hear from them. I want 
folks who are listening to the work of the Senate and are following 
this to send me and my colleagues copies of your prescription drug 
bills. Send it to us, each of us here, as the poster says, in 
Washington, DC.
  I want you to do it for just one reason: I think this is the kind of 
problem that we are sent here to deal with. This is not some trifling, 
inconsequential matter. This is a question of whether we are going to 
respond to the more than 20 percent of the Nation's senior citizens who 
are walking on an economic tightrope every year, spending more than 
$1,000 a year out-of-pocket on prescriptions, balancing food costs 
against fuel costs, and fuel costs against their medical costs. As I 
have said again and again, they are giving up medicines that are 
essential to their health.
  I mentioned yesterday older people with diabetes who can't afford the 
Glucophage, an essential diabetes drug. This is not something that is 
inconsequential; this is something that, for older people, can 
literally mean the difference between decent health or incurring a 
very, very serious illness and, often, even death.
  Let us not be indifferent to the plight of those older people. They 
are asking the Senate for action. The bipartisan Snowe-Wyden 
legislation is one approach that I happen to favor. But I am sure our 
colleagues have other ideas. What is unacceptable to me, though, is to 
just say that this Senate won't take it up, we will save it for the 
campaign trail of 2000, we will tackle it another day. We ought to 
tackle it now. This has been an issue and a concern of the Nation's 
older people since back in the days when I was director of the Gray 
Panthers at home in Oregon. But it is getting to be an even bigger 
concern because more and more older people can't afford their medicine, 
and with more seniors interested in wellness and trying to stay 
healthy, this is the time for the United States Senate to act.
  So I intend to keep coming back again and again to the floor of the 
Senate, and I hope seniors will send in copies of their prescription 
drug bills. I am proud there is a bipartisan bill now before the Senate 
to deal with this issue, the Snowe-Wyden legislation. I hope that 
seniors will be in contact with us, give us their ideas on whether they 
think our bill is the way to go, or if they prefer another route. What 
is unacceptable to me is for the Senate to duck this issue. We have an 
opportunity to work in a bipartisan fashion on it. I intend to keep 
coming back to the floor of the Senate again and again until we get 
that action.
  With that, I yield the floor.

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