[Congressional Record Volume 146, Number 1 (Monday, January 24, 2000)]
[Senate]
[Pages S7-S8]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             PRESCRIPTION DRUG COVERAGE FOR SENIOR CITIZENS

  Mr. WYDEN. Mr. President, I will be brief this afternoon. I note 
Senator Hollings is here and also Senator Grams.
  I come to the floor because last fall I indicated that I would come 
to the floor of the Senate again and again until this body passed 
bipartisan legislation to make sure the Nation's older people secure 
prescription drug coverage under Medicare. We have had some very 
exciting developments on this issue in recent days. I think all the 
work that has been put in by so many parties is beginning to pay off.
  I think the reason there is such intense interest in this issue is 
that while Medicare provides important health insurance coverage for 
older people, its coverage still today has many gaps. In particular, it 
doesn't cover prescription medicine.
  There is not anyone I know today--Democrat or Republican--who would 
argue that if we are going to redesign Medicare now, we would leave 
prescription drugs out. Quite the contrary. Virtually everyone who has 
studied this issue believes prescription drug coverage is absolutely 
critical because today's medicines are key to keeping older people 
well. The drugs of the future are going to help lower blood pressure 
and cholesterol.
  I cited on the floor of the Senate the important anticoagulant 
medicines. If you spend perhaps $1,000 or $1,500 in a year, you can 
prevent stroke. If an older person suffers a stroke as a result of not 
having access to those medicines, they could incur expenses of $100,000 
or more. So the need is intense.
  This is an issue that must be addressed in a bipartisan way. For many 
months now, there has been a bipartisan effort in the Senate. Senator 
Snowe and I have teamed up on legislation which we believe, using 
marketplace principles, addresses many of the concerns Senators on both 
sides of the aisle have had. It doesn't contain price controls or a 
sort of one-size-fits-all approach.
  We would allow for a tobacco tax to finance the program. We don't 
require one. We say that it would be possible to finance the program 
using the general fund. But 54 Members of the Senate, a majority of the 
Senate, voted for the Snowe-Wyden funding plan for prescription drug 
coverage for older people. We now have a majority of the Senate in a 
recorded vote saying they would be willing to pay the dollars needed 
for a good prescription drug benefit for older people.
  Our approach in the Snowe-Wyden legislation focuses on making these 
drugs accessible and affordable. Right now Medicare, of course, doesn't 
cover prescriptions. But just as importantly, older people, when they 
can afford their medicine, and go to a drugstore are, in effect, having 
to subsidize the big buyers--the HMOs and the health plans that can 
negotiate discounts.
  In effect, the older people are getting shellacked twice when it 
comes to this issue of prescription drugs. They get no coverage. They 
have to subsidize the benefits, in effect, of those who have real 
bargaining power--those who are on the health plans.

[[Page S8]]

  I would like to wrap up with a couple of minutes on an issue that I 
know is important to South Carolina and in Minnesota, as well as my 
home State of Oregon. That is the plight of rural older people. There 
has been some discussion of this prescription drug issue, of course, on 
the floor of the Senate, but never before has there been a focus on the 
special needs of older people in rural communities.

  In my State--and I know in the States of Senator Hollings and Senator 
Grams as well--if you live in a rural community, you have fewer 
physicians available to write medications. You have fewer pharmacies so 
that medication is not accessible. You have to drive longer distances 
in order to get your medicine.
  We found, according to the Oregon Health Sciences University's Office 
of Rural Health, that a conservative number of seniors in rural Oregon 
who live in poverty is 16,500. I can tell you, having gone through many 
of those rural communities during the break, that there is a special 
need for coverage for prescription drugs for older people in rural 
communities.
  I will wrap up by reading a few of the accounts older people from 
rural Oregon have sent me about the problems they are having in 
affording their medicine. An elderly couple, for example, in Baker City 
depending solely on Social Security takes prescription drugs for 
chronic back ailments. After they purchase their monthly medication, 
they have only $200 for that month left over to pay for their 
necessities.
  They wrote me, and I am going to quote: ``. . .  that is not living, 
that is existing.''
  I think all of us know you cannot live on $200 a month. Yet that is 
what an older couple in Baker City, OR, are faced with after they 
finish paying for their prescription medicine.
  In Clatsop County, after an older couple paid for their supplemental 
coverage, they had to spent $450 a month on their prescription 
medicine. They fear their supplemental insurance premium is going to go 
up again this year. That is always the case. They are then going to 
have to stop taking their medication altogether.
  In Coos County, a 75-year-old female resident is getting by on a 
fixed income of about $800 a month. Every single month she is spending 
more than 25 percent of her monthly income on prescription medicine.
  One older woman in that county lives on Social Security and doesn't 
have any prescription drug coverage at all. She is now at the point 
where she cannot afford spending the necessary $200 a month for her 
medications.
  Before I came to Congress, I tried to specialize in the gerontology 
field. As sure as night follows day, when we have a vulnerable older 
woman who cannot, in a cold Oregon winter, afford to take her 
medications, she is going to get much sicker. Very often she will end 
up in the hospital needing extensive medical services that are 
available under what is called Part A of the Medicare program, the 
institutional program.
  We ask: Can we afford to cover prescription drug medicine? That 
example I just gave of the older woman in Coos County makes it very 
clear this country cannot afford not to cover prescription drugs for 
older people under Medicare. If older folks do not get these 
medications, they are going to get sick and the medical bills will be 
far higher.
  I ask unanimous consent to have printed in the Record many other 
cases from rural Oregon.
  There being no objection, the material ordered to be printed in the 
Record, as follows:

                           Rural Case Studies

       A 75-year-old hearing impaired woman from Coquille living 
     on Social Security does not have any prescription drug 
     coverage. She cannot afford spending the necessary $200 a 
     month for her medications.
       Deschutes County: An 83-year-old woman from Sisters and her 
     79-year-old husband are currently taking 12 prescription 
     drugs to treat diabetes, osteoarthritis and hypertension. 
     Their sole source of income is Social Security, and they 
     incur a cost of $400 a month for these medications, which 
     represents 25% of their income.
       Lincoln County: An 81-year-old widow from Toledo currently 
     takes eight prescription drugs daily for glaucoma, angina and 
     high blood pressure. Social Security is her only income, and 
     her Medicare supplemental insurance policy does not cover the 
     medication. If she doesn't use her eye drops she will go 
     blind, and if she cuts down the dosage on her other 
     medication, due to expense, she is in danger of having a 
     stroke or a heart attack.
       Linn County: A 78-year-old woman living in Lebanon suffers 
     from hypertension. She is presently taking six prescription 
     drugs: Atenolol, Ziac, Zestril, Cimetidine, Quinidine and 
     Xanax. She spends an average of $236.92 a month on these 
     drugs. This figure does not count her considerable expense on 
     over-the-counter medication and vitamins.
       A retired couple from Lebanon live on a combined Social 
     Security income of $990 a month. They suffer from arthritis, 
     high blood pressure and osteoporosis. Because of the 
     increasing financial strain, they can no longer afford their 
     medications.
       Umatilla County: An elderly couple from Pendleton lives on 
     a combined fixed income of $1,269 a month from Social 
     Security and relies solely on Medicare for their health 
     insurance. The 76-year-old husband has Parkinson's disease 
     and glaucoma, while his 73-year-old wife, who suffers from 
     heart problems, has skipped her medication at times when she 
     couldn't afford it. Without any drug coverage, they 
     collectively spend $800 a month--63% of their income--on 
     their 14 prescriptions.
       A 74-year-old man who takes six prescription drugs a month 
     cannot survive on his Social Security and Medicare benefits. 
     His niece must help him pay the $500 month for his 
     prescriptions.
       A retired teacher from Pendleton is taking eight 
     medications for chronic back pain. She spends $200 a month on 
     her prescription drugs.
       Wasco County: An elderly couple from The Dalles depends on 
     their combined monthly Social Security income of $1,263 and 
     profits from the sale of their family farm to survive. Even 
     though they have supplemental insurance, health care costs 
     are still high. In addition to considerable medical expenses 
     for eyeglasses, hearing aids and other health care needs, 
     they spend over $250 a month on prescription drugs to treat 
     asthma and high blood pressure.

  Mr. WYDEN. Mr. President, I will come to the floor of this Senate 
again and again and again these next few months to urge bipartisan 
action on this issue. The Snowe-Wyden legislation is one approach. 
Certainly, our colleagues will have other good ideas. There are a 
variety of ways this issue can be addressed in a bipartisan way. I am 
pleased our approach garnered 54 votes when it came to actually paying 
for it.
  I intend, with Senator Snowe, to continue to urge older people to 
send in copies of their prescription drug bills to each Member in the 
Senate in Washington, DC, so we can read their personal accounts into 
the Record.
  The PRESIDING OFFICER (Mr. Fitzgerald). The Senator from South 
Carolina.

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