[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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