[Congressional Record Volume 146, Number 5 (Monday, January 31, 2000)]
[Senate]
[Pages S124-S125]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             PRESCRIPTION DRUG COVERAGE FOR SENIOR CITIZENS

  Mr. WYDEN. Mr. President, I intend to take a few minutes this 
afternoon to talk about the prescription drug issue for senior 
citizens. As many of our colleagues know, I have made it clear that I 
am going to come to the floor repeatedly between now and the end of the 
session in the hope we will get a bipartisan piece of legislation 
through this body that will meet the needs of so many vulnerable older 
people.
  In the past, I have come to the floor and have read two or three of 
the cases I have been getting from seniors across the country. A lot of 
these older people, when they are finished paying their prescription 
drug bills, have only a few hundred dollars a month on which to live. 
Picture that: After you have paid your prescription drug bill, you pay 
for your food, your rent and utilities, and you have virtually nothing 
left over.
  I think it is extremely important this Congress pass legislation to 
meet those needs. I have teamed up for more than a year with Senator 
Olympia Snowe from Maine. We have a bill that is market oriented. It 
would avoid some of the cost-shifting problems that we might see with 
other approaches. We want to make sure that as we help senior citizens, 
we do not have to cost shift it over to somebody who is, say, 27 or 28 
and just getting started with a family and having trouble with their 
own medical bills. The Snowe-Wyden legislation avoids that kind of 
approach.
  The reason I am taking a moment to speak this afternoon is because 
the comments made by the President last week at the State of the Union 
Address opened up a very wide berth for the Congress to address this 
issue in a bipartisan way. Prior to the President's comments, I know 
there was widespread concern by a variety of groups as to what he would 
say about the issue and how he would say it.
  What the President of the United States said in the State of the 
Union Address on this issue of prescription drugs seems to me to 
capture our challenge.
  First and foremost, the President made it very clear he is aware that 
in every nook and cranny of this country there are scores of senior 
citizens who cannot afford their medicine. They simply cannot afford 
it. His remarks spoke to the millions of older people in this country 
who walk on an economic tightrope; every month they balance their food 
bill against their fuel bill and their fuel bill against their medical 
costs.
  After the President described this great need, he did not get into 
any of the particulars of writing a bill. He made it clear he wanted to 
work with the Congress to get a bipartisan piece of legislation that 
will meet the needs of older people.
  Yes, he has his approach. His approach--and I am not going to get 
into all of the fairly complicated details--involves a role for what 
are called pharmacy benefit managers, PBMs.
  The Snowe-Wyden legislation that has been proposed takes a slightly 
different approach. We use private entities which, in effect, will have 
to compete for the senior citizens' business.
  We think that makes sense as a way to hold down the costs of medicine 
for older people because it has worked for Members of Congress. The 
Snowe-Wyden legislation is modeled after the health care system to 
which Members of Congress belong.
  I have been asked again and again whether you could reconcile the 
President's approach, in terms of using pharmacy benefit managers, and 
the kind of approach that is taken in the Snowe-Wyden legislation, with 
these private entities that would have to compete for senior citizens' 
businesses. I think it is possible to reconcile these two approaches. I 
think we are making a lot of headway now in terms of addressing this 
issue, in terms of the parties saying the need is urgent.
  We have to come together, in a bipartisan way, to do it. The 
President opened up a real opportunity for the Congress to come 
together on this matter.
  The reason it is so important, of course, is that we cannot afford, 
as a nation, not to cover prescription medicine. I repeat that. People 
ask if we can afford to cover prescription drugs for older people. The 
reality is, our country cannot afford not to cover prescription drugs.
  A lot of these drugs today are preventive in nature. They reduce 
problems related to blood pressure and cholesterol. I have talked a 
number of times on the floor about the anticoagulant drugs which 
prevent strokes. Perhaps it would cost $1,000 a year to meet the needs 
of an older person's prescriptions for these anticoagulant drugs. Sure, 
$1,000 or $1,500 is a lot of money, but if you have a legislative 
opportunity to help an older person in that way, and you save $100,000, 
which you can do because those drugs help to prevent strokes--and 
strokes can be very expensive, even upwards of $100,000--that is 
something our country should not pass up.
  The elderly in this country get hit with a double whammy when it 
comes to pharmaceuticals.
  First, Medicare does not cover prescription drugs. It has been that 
way since the program began in 1965. I do not know a soul who studied 
the Medicare program, who, if they were designing it today, would not 
cover prescription drugs simply for the reasons I have given, that they 
are preventive in nature.
  The other part of the double whammy for older people is that the big 
buyers--the health maintenance organizations, the health plans, a 
variety of these big organizations--are able to get discounts; and then 
when an old person, a low-income older person, walks into a pharmacy, 
in effect, they have to pay a premium because the big buyers get the 
discounts.
  So this is an important issue for the Congress to address.
  As I have done in the past, I want to put into perspective exactly 
what so many of these vulnerable people are facing in our country.
  I see our friend from Michigan. I want to make sure he has time as 
well. Democrats have a few more minutes. I want to make sure my 
colleague can be heard, as well.
  But one of the cases I want to touch on this afternoon follows a 65-
year-old senior from West Linn, OR. He wrote me recently as part of the 
campaign I have organized to have older people send in their bills. He 
wrote me that he used to have prescription drug coverage when he was 
working. Now he has no coverage at all. He is taking medication for 
high blood pressure, for high cholesterol, for heart-related problems. 
He had triple bypass surgery in 1991 and anticipates he is going to be 
taking medications for the rest of his life.

  He found that, as he tried to shop for medicines, the cost was 18 
percent higher than when he had insurance coverage, which illustrates 
the double whammy that I described.
  When he was in the workforce--and the Senator from Michigan knows a 
lot about this as a result of the company-retiree packages that 
autoworkers and others have--the workers were in a position to get a 
bargain. But then that senior retired and lost the opportunity to have 
some leverage in the marketplace. That senior in West Linn found that 
his prescription prices were 18 percent higher.
  This person from West Linn has written, saying he hopes the 
bipartisan Snowe-Wyden legislation is successful.
  We have received scores and scores of other letters. Because my 
friend from Michigan is here, and I want to allow him time to talk, I 
am going to wrap up only by way of saying that the last case I was 
going to go into in more detail is an older woman in eastern Oregon, 
just outside Pendleton, OR, who told me during the last recess that 
when she is done paying her prescription drug bill, she has only $200 a 
month on which to live for the rest of the month.
  Perhaps other people can figure out some sort of financial sleight of 
hand

[[Page S125]]

so they can get by on a couple hundred dollars a month for their food 
and utilities and housing, and the like, but that is not math that I 
think adds up.
  We need to address this issue in a bipartisan way. The Snowe-Wyden 
legislation does that. I was particularly encouraged by the President's 
remarks last week on prescription drugs because I think, through the 
conciliatory approach that he took, making it clear that he wants to 
work with all parties to get this addressed, we now have a window to 
climb through to get the job done and provide a real lifeline to 
millions of older people. That is some good news for our country.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Burns). The Senator from Michigan.
  Mr. LEVIN. First, I congratulate, again, the good Senator from Oregon 
for his leadership in the area of prescription drugs. His effort to 
achieve a bipartisan move in this direction is very critical to the 
Nation. I commend him for it.
  I thank him for truncating his remarks a few minutes so I might have 
a few minutes. I hope I can complete this in 2 or 3 minutes. But if I 
do not, perhaps I could ask my good friend on the other side of the 
aisle to be able to extend it a minute or two beyond the appointed hour 
of 1 o'clock.

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