Congressional Record, Volume 146 Issue 14 (Tuesday, February 15, 2000)

[Congressional Record Volume 146, Number 14 (Tuesday, February 15, 2000)]
[House]
[Pages H418-H425]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

PRESCRIPTION DRUG BENEFITS

The SPEAKER pro tempore (Mr. Ose). Under the Speaker's announced
policy of January 6, 1999, the gentleman from Maine (Mr. Allen) is
recognized for 60 minutes as the designee of the minority leader.
Mr. ALLEN. Mr. Speaker, Congress is back in session; and while we are
resuming our work, we have to attend first to part of the unfinished
business of last year. All across this country, seniors are finding it
harder and harder to take their prescription drugs, because they simply
cannot afford to take the medication that their doctors tell them they
must take. They are not following doctor's orders, simply because they
cannot afford their medication. We have looked at this issue over the
past year, the Democrats have looked at this issue, and are ready to go
again, ready to do some work to relieve the problems that seniors and
others are facing all around this country.
We need to do two things. First, we need to stop price discrimination
against seniors. Second, we need to provide a universal prescription
drug benefit under Medicare.
Let us start with what is going on in the real world. In the real
world, many seniors are not filling their prescriptions or, when they
do, they are taking one pill out of three. However, all across this
country, they are finding they simply cannot afford to take the drugs
that their doctors tell them they have to take.
Starting in my district of Maine, the First District of Maine and
extending all across this country, the democratic staff of the
Committee on Government Reform has done a series of studies. The first
of those studies which I released in July of 1998 show this: on
average, seniors pay twice as much for their medication as the drug
company's best customers. Well, who are the best customers? They are
HMOs, big hospitals, and the Federal Government itself buying
prescription drugs for Medicaid recipients or for the Veterans'
Administration. Twice as much. Seniors pay twice as much as the drug
company's best customers.

[[Page H419]]

Second, a study first done in October of 1998 and now replicated
around the country revealed that citizens in Maine and across the
country pay 72 percent more than Canadians and 102 percent more than
Mexicans for the same drugs in the same quantities by the same
manufacturer.
A third study that I released in November of 1999 showed that when
drugs are manufactured for human use and sold to pharmacists, the
charges are, on average, 151 percent more than when the same drug is
sold to veterinarians for animal use. Any way we look at it, there is
rampant price discrimination in this country against seniors and all of
those other Americans who do not have coverage for their prescription
drugs. The industry has engaged in this widespread price discrimination
because frankly, what they are trying to do is to charge whatever the
market will bear. So seniors, who have no insurance for their
prescription drugs, pay the highest prices in the land because they
have no bargaining power.
Mr. Speaker, as I said, we have to do two things. We have to stop
price discrimination, and we have to provide a universal prescription
drug benefit under Medicare. As one can see from this chart to my
right, seniors are 12 percent of the population, but they buy 33
percent of all prescription drugs. Mr. Speaker, 37 percent of all
seniors have absolutely no coverage at all for prescription
medications. Another 25 to 30 percent have very inadequate coverage for
their medications, so 60 percent or more are really struggling simply
to take the medications that their doctors tell them they have to take.
Now, let us contrast the situation with the pharmaceutical industry.
The pharmaceutical industry is the most profitable industry in the
country. Every year, the Fortune magazine shows which industries are
the most profitable, and every year by every measure it is the
pharmaceutical industry. Just to give my colleagues one example, in
terms of return on revenues, the pharmaceutical industry brings in 18.5
percent, on average. That is an average for those 10 or 12
pharmaceutical companies. The next most profitable industry comes in at
13.2 percent, a 40 percent plus difference.
In short, it comes down to this: the most profitable industry in the
country is charging the highest prices in the world to those least able
to afford it, primarily our seniors who do not have prescription drug
coverage under Medicare. We aim to change that in two ways.
The Democrats tomorrow will begin a discharge petition to bring to
this floor two bills, H.R. 664, the Prescription Drug Fairness for
Seniors Act, and H.R. 1495, which would provide a Medicare prescription
drug benefit. Here is what the Prescription Drug Fairness for Seniors
Act does. This bill is very simple. It would allow pharmacists to buy
drugs for Medicare beneficiaries at the best price given to the Federal
Government. Remember, we were talking about that price discrimination,
and this is the way to end price discrimination. It would give senior
citizens the benefit of the same discount received by hospitals, big
HMOs, and the Federal Government. It does not involve any significant
increase in government spending. It creates no new bureaucracy.

Mr. Speaker, I can tell my colleagues that the pharmaceutical
industry does not want this to happen, just as the pharmaceutical
industry does not want a prescription drug benefit under Medicare. They
will run TV ads saying they do, but they have helped to fund a group
called the Citizens for Better Medicare which says seniors need a
benefit, but I can tell my colleagues the pharmaceutical industry is
blocking every effort to improve Medicare, to strengthen Medicare, to
make sure that our seniors get what they need, which is coverage under
Medicare and a prescription drug benefit.
I found that in my district, many seniors are confused when they get
these Citizens for Better Medicare mailings. They think this is a group
trying to improve our health care system, trying to extend coverage,
but it is not. The fact is, it is a group that is funded by the
pharmaceutical industry. They ran all of those ads featuring Flo last
year, and now in some areas Flo is back. But over and over again the
industry is the obstacle. We really can support one of two groups. One
can line up with the pharmaceutical industry, or one can line up with
our seniors.
Mr. Speaker, for H.R. 664 we have over 140 cosponsors in the House.
Unfortunately, not one Republican has stepped forward. Not one
Republican will support this legislation to give a discount to seniors
who are already in a Federal health care plan called Medicare which
does not provide prescription drug coverage, and all we are saying is
give them the same break that hospitals get, that HMOs get, that the
Veterans' Administration gets. That is all we are saying. Seniors
deserve a break on the price of their prescription drug medications.
Mr. Speaker, I am pleased that so many of my colleagues have come
here tonight to speak on this issue. I want to begin by yielding to the
gentlewoman from California (Ms. Woolsey).
Ms. WOOLSEY. Mr. Speaker, I would like to thank the gentleman from
Maine (Mr. Allen) for doing such a great job, in providing leadership
in helping seniors get the medicines they need and to get them at fair
prices. The gentleman is outstanding. Thanks a lot.
Mr. Speaker, prescription drugs are not affordable to the people who
need them the most, and that is our seniors and other people on
Medicare. That is not acceptable, point-blank, unacceptable. For many
seniors, prescription drugs for arthritis, diabetes, high blood
pressure and heart disease are simply a fact of life or death. However,
because of the high cost of prescriptions, many seniors are forced to
choose between buying food and buying medicine. That is not right.
In the case of Ivera and Roy Cob, residents of my district, paying
for the prescriptions that they both need is impossible. So, Roy goes
without some of his medications, medications he also needs, but he does
that because he believes Ivera needs her medications more. They cannot
afford his and hers. Seniors like Roy and Ivera should be deciding how
much time to spend with their grandkids, not deciding who is going to
get the medications they need to survive.
One reason many seniors cannot afford the drugs they need is because
as the gentleman from Maine told us, the Nation's largest drug
companies favor HMOs, insurance conglomerates, and government buyers
with negotiating power, those who pay much less for prescription drugs,
while many, many seniors on Medicare pay much higher prices for the
same drugs.
According to a study I requested of the House Committee on Government
Reform, seniors in my northern California district are being
overcharged for the drugs they need to survive. In Sonoma County,
California, seniors pay, on average, 145 percent more for the commonly
used drugs than the favored customers pay. That is 145 percent more. In
Marin County, California, just south of Sonoma, also my district,
seniors pay 137 more.
Take, for example, Zocor, a drug used to lower cholesterol. Favored
customers pay $35 for a dosage, but Sonoma County seniors pay $119, a
price difference of 242 percent. That is outrageous.
The Republican leadership must stop dragging its feet and enact a
meaningful prescription drug benefit for our seniors, a benefit that
eliminates price discrimination. Our seniors do not have time to wait
for the Republicans to play their political games. They need their
medications and they need them now.
Mr. Speaker, tomorrow I will join my colleagues in signing a
discharge petition to bring prescription drug legislation to the floor.
The longer the leadership stalls, the less time one more child will
have to spend with grandma or grandpa. Providing a prescription drug
benefit and eliminating price gouging is a big job. It is a job that we
must do, because treating our seniors with respect is our
responsibility.
It is time for the majority leadership to step up to the challenge
and give our seniors a break. It is a small measure for them to have
prescription drugs that they can afford, but it is a measure that does
not even compare to what they have done for us.

{time} 1645

I thank the gentleman for making this possible tonight.
Mr. ALLEN. I thank the gentlewoman from California for her leadership
on this issue.

[[Page H420]]

Mr. Speaker, I yield to the other gentlewoman from California (Mrs.
Napolitano).
Mrs. NAPOLITANO. Mr. Speaker, I thank the gentleman from Maine (Mr.
Allen) for yielding time to me.
Mr. Speaker, I stand here today to further address the urgent need
for decent prescription drug coverage for America's elderly citizens.
Prescription drugs help keep our seniors well and they help hold down
the cost of medical care in America. Many of these drugs, such as the
blood pressure and cholesterol medication, serve as the valuable ounce
of prevention, saving lives, cutting medical treatment costs.
The need for prescription drug coverage has always been a major
priority among senior citizens. Now, with the steep increases in
prescription drug costs and the growing importance of these drugs in
preventing and treating diseases, the need for prescription drug
coverage for all Medicare beneficiaries is more important than ever.
Opponents of a Medicare prescription drug plan would say that most
Medicare beneficiaries already get prescription drugs through other
sources, and therefore, they do not need the government's help.
However, we do know that the Medicare program generally does not cover
prescription drug costs. It is estimated that over 13 million Medicare
beneficiaries have no prescription drug coverage.
Opponents of a Medicare prescription plan claim that Medicare
beneficiaries get their prescription drugs from retiree health plans.
However, there is only a very lucky few, about one-quarter of these,
that have access to employee-sponsored retirement plans.
Opponents of the prescription drug benefits state that many seniors
may also purchase drug coverage through a Medigap prescription drug
policy. However, these are very expensive. Depending on the State, the
premium could run from $100 a month up. These costs increase
substantially with age, as drug coverage under this plan becomes priced
out of reach. The burden particularly affects women, who make up 73
percent of those over age 85.
Opponents would say that if seniors want prescription drug benefits,
they should enroll in a Medicare HMO. However, they are not available
in all parts of the country. In addition, the Medicare+Choice plans
limit coverage to $1,000 or less for each beneficiary per year.
Recent studies also show that seniors who buy their own medicine
because they do not belong to HMOs or have additional insurance
coverage are paying twice as much on average than HMOs and insurance
companies, Medicaid, Federal health programs, and other purchasers.
Pharmaceutical companies are charging competitive prices that are
tantamount to price discrimination against our seniors.
These seniors, Mr. Speaker, live on fixed incomes. They either have
to choose between food, oil to warm up, or to medicate themselves to be
able to live. They cannot afford to take the drugs that their doctors
prescribe them, and they stretch, as we have heard, many different
ways, or they do not take them.
We should not force them to choose between paying for food, paying
for heating costs, or paying for medicine. We cannot afford not to
cover drug prescriptions. What we will save as a result of seniors'
access to these medicines is going to exceed the cost that may be
incurred as a result of debilitating illnesses that seniors will suffer
if they cannot get these drugs.
We must stop this price discrimination. We in Congress cannot
continue to stand by and see our elderly, our seniors, mentors, and
family members suffer. Let us enact an effective Medicare prescription
drug benefit and support H.R. 664 offered by the gentleman from Maine
(Mr. Allen).
Mr. ALLEN. Mr. Speaker, I thank the gentlewoman very much for all her
good work on this issue.
I yield to the gentlewoman from Oregon (Ms. Hooley), who has been a
real leader on this particular issue and has felt the efforts, I guess
I would say, of the pharmaceutical industry to stop her from speaking
out. But she is back. We are glad she is here.
Ms. HOOLEY of Oregon. I am back. First of all, Mr. Speaker, I want to
thank my friend and colleague, the gentleman from Maine (Mr. Allen),
for all the work he has done in the leadership. Right now I do not
think there is a bigger issue facing seniors in Oregon and elsewhere in
the United States than prescription drugs.
Two months ago, Mr. Speaker, a massive ad campaign was undertaken in
the Portland media market attacking me for defending senior citizens
who cannot afford the high cost of prescription drugs. The ads were
paid for by Citizens for Better Medicare, a group that looks grass
roots, an organization that claims to be representing interests of
patients and seniors, but as we all know, looks can be deceiving. In
reality, this ad campaign was primarily funded by the pharmaceutical
companies.

Mr. Speaker, let me set the record straight, I do not want to get in
a shoving match with the pharmaceutical industry. These companies spend
tens of millions of dollars to develop cures for diseases, and we
should take great care to work with them and help them make these
essential medicines more affordable for our seniors and working
families.
But in that same light, I am not going to let multi-million dollar ad
campaigns prevent me from doing something in this Congress to act on
this issue.
As Members can see, I have heard from a lot of people in my district.
This is just part of it. I could not carry it all over. Some of it is
in my Oregon office. People have sent me letters. They have sent me
copies of their drugs. I want to tell the Members something, in many
cases they are paying 50 percent of their take-home income that is
being spent on prescription drugs. They are demanding some kind of
relief in Washington, D.C.
This is just a month's worth of receipts from Harry Percy, a
constituent of mine in Salem, Oregon. He had to pay over $200 this
month for prescription drugs, even though he is enrolled in a health
maintenance organization. The sad thing is, Mr. Percy is not any
different from the thousands of other seniors I have talked to, or from
the hundreds of letters that we see here.
At my request, the staff of the Committee on Government Reform
recently conducted a study to determine how much more people like Harry
Percy in the Fifth Congressional District in Oregon are paying for
their medication than customers are paying in countries like Mexico and
Canada.
I requested this study because I found out that a lot of my seniors
were going to Canada to buy their drugs. I was surprised to learn that
in the Fifth Congressional District of Oregon, they pay 83 percent more
for the same drugs than consumers in Canada, and they pay 82 percent
more, on average, for prescription drugs than Mexican consumers. These
are the same drugs, the same amount, sold by the same pharmaceutical
companies.
For example, an uninsured senior in my district who had to take
Prilosec to treat an ulcer must pay over $80 more than in Mexico or $86
more than in Canada for that same drug. I also did a study, a
comparison of how much those uninsured seniors paid compared to the
most favored customers that the drug companies sell to. In that case,
they paid almost twice as much than their favored customers.
We have to change this. Congress is having a hard time agreeing on
how to make such an effort work. We need to work together, but lately
the big drug companies have been getting into the mix. What they are
trying to do is scare seniors into thinking that prescription drug
costs will rise if the government tries to help those seniors in the
middle. Yet, we know that over one-third of seniors have no
prescription drug coverage, so they must pay for their medication with
their own limited resources.
As I stated earlier, they have made remarkable progress in finding
new drugs, in helping people live a better life, but it does not do any
good if they cannot afford to take those drugs. Seniors I know that do
not take the drugs that have been prescribed to them live in pain and
discomfort. Many times, if they do not take them they end up in a
nursing home, or the worst case, a hospital, or they die prematurely.
They also suffer anxiety and depression over the fact that they have a
hard time paying for their medication.
American seniors should not pay the highest prices in the world for
their

[[Page H421]]

prescription drugs. Frankly, it is unfair, it is wrong, and it is time
for this Congress to act.
For any of my constituents that happen to be watching this, they can
rest assured that I will remain committed to making prescription drugs
more affordable and accessible. Tomorrow I will also sign the discharge
petition to try to get this bill on the floor of the House.
I know we can reach a solution through reasoned debate and bipartisan
compromise, but it is time for Congress to act to assure that no older
American anywhere has to choose between buying medicine or food,
between paying their heating bill or their drugstore account, or
between taking their medicine or living in pain and anxiety.
Again, I thank the gentleman for his effort. He has been a great
leader.
Mr. ALLEN. Mr. Speaker, I thank the gentlewoman from Oregon (Ms.
Hooley) very much. I appreciate all she has done.

Mr. Speaker, I yield to the gentlewoman from the great State of
Nevada (Ms. Berkley), a short way down.
Ms. BERKLEY. Mr. Speaker, I thank the gentleman from Maine for
helping us highlight this issue, which is very important to me.
As the gentlewoman from Oregon (Ms. Hooley) alluded to, I was also
unmercifully attacked by the pharmaceutical companies. It has only made
me more resolute in my desire to provide relief for my older Americans
who simply cannot afford the high cost of prescription medication. I
quite agree with the gentlewoman when she states, what is the point of
being able to create these wonderful miracle drugs if we cannot afford
to take them? That is a serious problem in my district.
I rise today in strong support of including a prescription drug
benefit in Medicare. I am also in favor of lowering the high cost of
prescription drugs for older Americans. As a cosponsor of both H.R.
664, the Prescription Drug Fairness for Seniors Act, and H.R. 1495, the
Access to Prescription Medications in Medicare Act, I believe Congress
must act now to ensure that our Nation's seniors have access to
affordable prescription drugs.
Why is this issue so important to me? Because I have the fastest
growing senior population in the United States in southern Nevada. Each
week when I return to southern Nevada, I hear story after story from
seniors experiencing great difficulty paying for their prescription
medications. They are asking for relief. They are begging for relief.
In particular, one constituent's story resonates in my mind. I would
like to share that with the gentleman. Sister Rosemary Lynch is an 83-
year-old Franciscan nun in my hometown of Las Vegas who is currently
taking multiple prescription drugs to treat glaucoma, high blood
pressure, and severe allergies. Every month she struggles to pay for
these costly medications.
Sadly, she is not alone. Unfortunately, there are 14 million other
Medicare beneficiaries in our Nation with no prescription drug
insurance. Last spring, I asked the Committee on Government Reform to
investigate prescription drug price discrimination in the congressional
district that I represent, which is the First Congressional District in
Nevada.
I was appalled, I was appalled, to discover that the evidence showed
that seniors are charged 126 percent more for their prescription drugs
than are drug companies' most-favored customers. Who are those? The
HMOs and the Federal government.
In addition, a second study showed that Nevada seniors pay more than
90 percent more for prescription medication, the exact same medication,
mind you, that seniors pay for in Canada and Mexico. The result of this
is that I have many, many senior citizens who live in Las Vegas,
Nevada, live in southern Nevada, live in Henderson or north Las Vegas,
that travel all the way to Mexico in order to be able to afford the
prescription medication that their doctors in southern Nevada are
prescribing.
I have made a firm commitment to the seniors in my district, the
seniors in the United States, and now Congress must make a firm
commitment to our seniors, as well, and pass a comprehensive
prescription medication benefit for all Medicare beneficiaries.
Tomorrow I will be standing here proudly signing the discharge
petitions to urge consideration of the prescription drug bills of which
I have spoken. It is my hope, it is my fervent hope, that the
leadership in Congress will bring these proposals to the floor so that
all seniors can have access to affordable prescription medication.
Mr. ALLEN. Mr. Speaker, I thank the gentlewoman from Nevada very
much.
I yield to the gentleman from Texas (Mr. Turner), who with the
gentleman from Arkansas (Mr. Berry) and me is a co-chair of the
Prescription Drug Task Force. No one has worked longer or harder on
this issue to try to get some fairness for seniors, trying to stop
price discrimination and get to a Medicare benefit. I thank the
gentleman for being here tonight.

{time} 1700

Mr. TURNER. Mr. Speaker, it is a pleasure to be here with all of the
Members who have spoken on this issue. I really do appreciate the fact
that we have this hour to talk about this very important issue. It has
been almost 2 years since we first addressed the problem of
discriminatory pricing in drugs, the problems of lack of access to
prescription drugs at affordable prices. I appreciate the leadership
the gentleman has given, as well as the leadership of the gentleman
from Arkansas (Mr. Berry) here tonight on the floor next to me from
Arkansas, and on my left the gentleman from Mississippi (Mr. Shows),
who has filed a discharge petition. That is why we are here tonight
talking about this issue, because tomorrow we are going to have for the
first time an opportunity to get a chance to bring this issue to the
floor of the House of Representatives.
After these many months of collecting support, of cosponsors, I
believe we have close now, with over 140 Democrats who have joined
wanting to do something about the high price of prescription drugs.
Tomorrow we will have that chance by joining and signing the discharge
petition that will bring the bill that the gentleman from Maine (Mr.
Allen), the gentleman from Arkansas (Mr. Berry), and I introduced back
almost a year ago, as well as the other bill to provide a prescription
drug benefit under Medicare.
This issue hits very close to home for all of us. I know in my
district, I have 84,000 senior citizens, the highest number of seniors
in any congressional district in Texas. I hear from them. We saw the
gentlewoman from Oregon (Ms. Hooley) bring to the floor a stack of
letters. I have a similar stack. Seniors are concerned about the
problem of the high price of their prescription medications.
Just to give an example, I visited with a lady over a year ago in a
pharmacy in Orange when we were going around talking about this issue
initially, Ms. Frances Staley. She is 85 years old. Mrs. Staly is
blind. She is a beautiful lady. She spends about half of her $700
Social Security check every month just on her prescriptions. That is
her sole source of income, Social Security.
I had a letter from Billy and Joe O'Leary. I have met them and know
them well and they wrote, they live down in Silsbee, they spend $400 a
month for eight prescription medicines.
I want to read just a little section from the letter that they sent
to me. It really makes a whole lot of sense. We hear this cry from the
big drug manufacturers that, oh, well, we cannot do anything about drug
prices or we will not have any money for research. Well, none of us
want to cut off funds for research in the pharmaceutical industry. We
have a lot of new drugs that have come on the market, done a lot of
wonderful things but here is what Mr. and Mrs. O'Leary had to say about
it in their letter to me. They said, what good is research and finding
cures for disease if a large part of our population cannot afford the
medicine for the cure?
That is the bottom line. We have to be sure that our seniors have
access to affordable prescription drugs.
Archie and Linda Davidson of Vidor, Texas, have spent more than
$3,500 in the last 6 months just for their prescription medicines.
I had a nice visit with a gentleman down in Hull in Liberty County,
Texas, a few months ago; and he came up to me, and this is hard to
believe, but he has told me, he said, my wife and I both have a lot of
prescription medicines we have to take every month. He

[[Page H422]]

says, it costs us $1,400 a month. Now, I do not know how long the
gentleman from Hull can pay that kind of cost; but the truth is,
everyone that has had to buy prescription medications knows that the
prices are higher and higher and higher every month that passes.
This is, indeed, a national problem, and I think that it is time that
we do something about it.
Let us look at the big picture. Senior citizens spend three times as
much of their income on health care as compared to that which is spent
by the average American. The elderly, who are 12 percent of our entire
Nation's population, purchase one-third of all prescription drugs and
yet nearly 40 percent of all senior citizens have no prescription drug
coverage.
One in five of our elderly citizens takes at least five prescription
drugs a day, and more than 2.2 million seniors spend more than $100 a
month for medication and many pay much more.
The bottom line is, senior citizens in our country today are paying
the highest prices for prescription drugs of anyone in our society. The
studies which the gentleman from Maine (Mr. Allen) did, the gentleman
from Arkansas (Mr. Berry) did, the gentleman from Mississippi (Mr.
Shows) did, and many of the others that are here, show indisputably
that senior citizens pay on average twice as much as the favored
customers of the big drug manufacturers.
The favored customers are the big hospital chains, the big HMOs.
Those are the folks who are getting the good deals and our senior
citizens, without prescription drug coverage, who walk into their local
pharmacy, are paying twice as much as those favored customers. That is
just not right.
When we did the international study, we found that folks in the
United States are paying over twice what the folks in other
industrialized countries around the world are paying. We have to do
something about this problem. We have to do something about it soon,
and tomorrow is our first opportunity to sign the discharge petition,
which is a procedure that we use around here to force an issue to the
floor that we feel strongly about.
I thank the gentleman for the leadership he has given, the gentleman
from Maine (Mr. Allen), on this critical issue.
Mr. ALLEN. Mr. Speaker, I thank the gentleman from Texas (Mr.
Turner). He summarized this issue very, very well.
If I could just add one other point. The situation gets worse year by
year. If we think the situation is bad now, spending on prescription
drugs is going up 15 to 18 percent year after year after year. The
problem on average will be 15 to 18 percent more a year from now than
it is today. Think about those seniors that the gentleman from Texas
(Mr. Turner) was talking about. They are a part of the biggest health
care plan in the country. It is called Medicare. The way the law works
now, it is okay for the Veterans Administration to get a discount. It
is okay for the medicaid program to get a discount. It is okay for big
HMOs and hospitals to get a discount, but it is not okay for people who
are Medicare beneficiaries, who have worked hard all their lives,
played by the rules, now they are in a Federal health care plan called
Medicare and they cannot get a discount under existing law.
That is what we are trying to do, trying to stop price discrimination
and provide a prescription drug benefit under Medicare that will cover
all Medicare beneficiaries.
I want now to turn to the gentleman from Colorado (Mr. Udall). He,
too, has been the object of attack from the pharmaceutical companies. I
have to say that I hope that conveys to the constituents in his
district how hard he has been working on this issue that they would
single him out for attack.
We are very pleased to have the gentleman here tonight and I yield
some time to him.
Mr. UDALL of Colorado. Mr. Speaker, I thank my colleague, the
gentleman from Maine (Mr. Allen), for yielding to me. I thank him for
his leadership on this very important issue.
Mr. Speaker, Juanita Johns is one of my constituents back in the
Second District in Colorado, and she told me she used to keep her
thermostat at 60 degrees so she could pay her drug bills. In addition
to that, a few times a week she would visit the food bank so she could
eat, and eventually she sold her house and moved in with her son so she
could afford her medicines.
Now this is intolerable. Seniors should not be forced to make that
kind of decision between buying food or buying their medicine or paying
their utility bills. Her story, Juanita's story, is one of many that I
have heard from seniors in my district.
I, too, had a study done by the House Committee on Government Reform
that found that seniors in my district who pay for their own
prescription drugs pay more than twice what the drug companies' most-
favored customer, such as HMOs and the Federal Government, pay.
It is clear that rising prescription drug prices and eroding coverage
are squeezing seniors' incomes. My colleague, the gentleman from Texas
(Mr. Turner), mentioned that seniors make up 12 percent of the
population, but they use one-third of all prescription drugs. They have
the greatest need for these drugs, but they often do not have adequate
insurance coverage to pay for them. That adds up to more than 15
million seniors in our Nation who do not have any sort of drug benefit.
As the gentleman from Maine (Mr. Allen) mentioned, Medicare's basic
package does not include it. Employers are scaling back or dropping
retiree health coverage, and premiums for supplemental medigap policies
and drug coverage has in many cases reached unaffordable levels. That
is why I am a strong supporter of H.R. 664, the Prescription Drug
Fairness for Seniors Act.
This simple and important piece of legislation would end unfair drug
pricing discrimination and could save seniors up to 40 percent of their
drug bills.
It is hard to understand why anyone would be against making
prescription drugs more affordable, but during the winter recess, as
the gentleman referenced, a group called the Citizens for Better
Medicare ran attack radio and TV ads against me because of my efforts
to help seniors fill their medicine cabinets with affordable,
lifesaving medications. It struck me that it was an Astroturf campaign
that was designed to look like a grass-roots initiative; but it was
really intended, in my opinion, to protect the profits of the
pharmaceutical companies, scare seniors, and spread misinformation.
As the gentleman remembers, these ads confused H.R. 664 with
President Clinton's proposal to have Medicare directly cover seniors'
drug costs. The ads had a toll-free number for seniors; and when the
seniors called the phone bank, then the operator asked them if they
would like to be connected to my office, and then they were directly
connected to my office.
Oftentimes when the seniors reached my office, they did not know who
they were talking to or really what was going on. It also served the
purpose of tying my office up for an entire week. I received thousands
of telegrams in addition to these phone calls.
To summarize, it was really a classic bait and switch kind of
campaign, where the ads attacked me for being on the bill of the
gentleman from Maine (Mr. Allen), but all of the communication my
office received was about the President's proposal.
Now I have not expressed a position on the President's proposal; but,
however I, do support a Medicare prescription drug benefit that is
fiscally responsible and fair.
Needless to say, this ad campaign did not wash with Coloradans.
I want to quote from a couple of newspapers. An editorial in the
Denver Post described the ads as ``vicious and outrageous untruths.''
The Boulder Daily Camera called these ads ``a vaguely worded and
deceptive advertising campaign.'' Thankfully, many people saw through
this well-organized campaign and called my office to offer their
support.
I looked with interest last month at the news that the drug companies
are dropping their opposition to creating this drug benefit under
Medicare. The change in their rhetoric is significant. It shows they
realize there is a problem and they are willing to work with the
Congress on a solution. As I think many of the previous speakers
mentioned, we all here have been supportive of the research and
development tax credit so the pharmaceutical companies can find these
lifesaving

[[Page H423]]

medications, but we also feel that there ought to be fair pricing.
There will be plenty of time for politics later this year. I am not
interested in playing politics with this issue, and I do not think the
15 million seniors who do not have prescription drug benefits want to
play politics, either. I am looking for solutions. Let us end this
price discrimination. Let us provide universal prescription drug
coverage for seniors. People like Juanita Johns in my district and
people all over the country are counting on us.
I again thank the gentleman from Maine (Mr. Allen) for his leadership
on this issue.
Mr. ALLEN. Mr. Speaker, I want to thank the gentleman from Colorado
(Mr. Udall) for all his good work on this issue.
I would like now to turn to the gentleman from Mississippi (Mr.
Shows). The gentleman from Mississippi (Mr. Shows) may be a freshman,
but he has been an early and enthusiastic supporter and is now the
author of the discharge petition on H.R. 664, which all of us have been
working on so hard. I am just very pleased that the gentleman is going
to be the sponsor of this discharge petition on the bill; and I trust
that a very large group from this caucus, the Democratic Caucus, will
come in tomorrow and sign that discharge petition and try to get this
bill to the floor over the opposition of the Republican leadership;
because the fact remains, as urgent as this problem is, we do not have
one single Republican as a cosponsor of H.R. 664, and there is
absolutely no indication that the leadership would bring this bill to
the floor or bring to the floor a bill that would provide a Medicare
prescription drug benefit for all Medicare beneficiaries.
Mr. SHOWS. Mr. Speaker, I want to thank my friend, the gentleman from
Maine (Mr. Allen), for yielding.
Mr. Speaker, I am hoping they are going to have a vision when this
discharge petition comes to the floor because I think when their
seniors start calling them about whose side are they on, are they on
our side or the pharmaceutical side, I believe they are going to have a
vision that they need to get on our side and sign this discharge
petition, because I guess so many of us, in my district, and I live in
Jeff Davis County in the Fourth Congressional District in Mississippi,
and we have so many people that they do not have the means to buy their
medication.
One of the problems we have, we have a lot of high unemployment in
Mississippi right now. In my congressional district, and I am putting
this in perspective in the cost of these prescription drugs, we have
lost somewhere around 4,000 jobs because of NAFTA. They are in Mexico
right now. Our problem, we have a lot of people who do not have the
money to buy these drugs. I can give an instance from around every
corner. We have a Ms. Bruce who used to live by herself in Clinton,
Mississippi. She enjoyed all the freedoms of being a senior, except
when it came time to buy her prescription medicine, which absolutely
forced her from living by herself independently to moving in with her
daughter.

{time} 1715

She pays hundreds of dollars each month for prescription medicine
while living on a fixed income. She told me that if it was not for her
daughter, she did not know exactly what she would do. And what she
worries about and what she is concerned about, I say to the gentleman
from Maine (Mr. Allen), is what about some of these seniors who do not
have family to help take care of them? It is a crying shame.
My own mother-in-law who, if it was not for my wife and my brother-
in-law's helping to take care of her, would be in the same situation.
Mr. Speaker, she feels a burden on her daughter for having to do this.
She should not have to be doing this.
The bad thing about it, she is having more visits to the hospital, so
her costs may increase because of more medication she may have to take.
I can think of no other issue that needs to be addressed more than the
costs of medicine to our seniors.
Because of Ms. Bruce and millions of others like her not only in
Mississippi but the seniors across this country, that is the reason we
are going to file this discharge petition February the 16. Because of
the job that you have done, I say to the gentleman from Maine (Mr.
Allen), we would not have the opportunity to do that.
I thank you personally for that, not only for myself, but for the
millions of Americans in this country.
Mr. Speaker, I filed a discharge petition to force a vote on H.R.
664, the Prescription Drug Fairness for Seniors Act. I do not think we
can wait. I do not think our seniors can wait any longer for this to
happen.
I am like a lot of other Congressmen in my district. We went back and
we did a survey of all of our drug stores and I know this may be
repetitive and a lot of other people might have talked about it, but I
am finding the same numbers that the other Members on the Democratic
side are finding. We are finding disproportionate costs for people in
America, in Mississippi, in buying prescription medicine. It is more
expensive than purchasing them in Mexico, Canada, or Europe or even the
HMOs.
Mr. Speaker, I can give you a for instance. In Collins, Mississippi,
when we were doing our bus tour, we had an audience, a lot of people, a
lot of them were seniors, and this elderly man and woman came in, the
gentleman had a cane and his wife was there helping him in the room. He
got in there and I referred him to Annette, who handles some of our
Social Security cases and so on.
I noticed, I looked at him, within a few minutes, he was crying, I
say to the gentleman from Maine (Mr. Allen). The man was crying. His
wife, she was trying to support him. He went to the hospital.
Here is a man that probably fought in World War II and probably lived
through the Depression, went through the hardest time this century has
ever seen to make sure our country is free. Now he is having another
war, and that war is trying to pay for his prescription medication and
his health care.
What had happened when he went to the hospital, he lost his
insurance. He was late on paying the insurance bill. He could not pay.
Then after they were given the bill 3 times, they had to turn them over
to the credit bureau, the collection agency.
And to add insult to injury, he cannot even afford his prescription
medication. This gentleman does not know what to do. I mean, he is
depressed. He does not really know where to go. Where can he go?
He ought to be able to come to us and try to get some help trying to
make sure these affordable costs should be affordable.
We can go to Ellisville, Mississippi, there is a Don Skoggins of
Skoggins Drug Store there in Ellisville, Mississippi. And I had a lady
come in there, she was on Medicare. And her problem was she has been
totally disabled. She heard what we are talking about. She said her
medication costs her $700 a month, $700 a month, her income is $399 a
month.
She told me if it was not for her sons and daughters taking care of
her, there was no way she could even buy her food. And this can go on.
I know we have all our stories, but this is the reason we are trying to
do this.
Everybody says this is not the way to do it. This is the way to do
it. The way I look at it, we are using 39 million people in Medicare as
a leverage to negotiate a better price for the prescription medicine,
just like the Wal-Marts do, just like the Rite-Aids do, just like the
Federal Government does with the veterans.
What is the difference? They are all made up of people. They are all
made up of people. Medicare, yes, that is not 39 million people. Why
not use that as a leverage to negotiate a fair price for your
prescription medicine? It does not make sense not to do that. Any good
businessman would do that.
Mr. Speaker, this is what we are trying to do with H.R. 664. I am
sure they might have to raise the price. But let us let them raise
their price in Mexico. Let us let them raise their price in Canada. Let
us let them raise their price in Europe. Why should the American
citizen, the senior pay the highest price for prescription drugs in the
world? It does not make sense.
I am going to tell you when this thing comes down and I have got to
choose on my right hand pharmaceutical companies, on my left hand the
seniors, I will tell you who I am going to pick; I am going to pick
those

[[Page H424]]

seniors, just like I believe the majority of this Congress will.
It is almost like the Patient's Bill of Rights. We could not get the
bill passed. When that discharge petition was filed and the
constituents back home started seeing who was not supporting them and
they found out who their real friends were, guess what, that bill
passed.
I have to believe that is going to happen right here. And I thank the
gentleman from Maine (Mr. Allen) for doing this.
Mr. ALLEN. Mr. Speaker, those stories are legend. I have these
letters from women who say I do not want my husband to know, but I am
not taking my medication, because he is sicker than I am, and we cannot
both afford to take the medications that our doctors tell us we have to
take. It is a national scandal. We need to do something about it.
One of the people who has been working on this now steadily for the
last couple of years is the gentleman from Arkansas (Mr. Berry), who is
a cochair with the gentleman from Texas (Mr. Turner) and myself of the
Prescription Drug Task Force in the Congress. And the gentleman from
Arkansas (Mr. Berry) has been terrific.
I thank the gentleman for his leadership on all of this.
Mr. BERRY. Mr. Speaker, I thank the gentleman from Maine (Mr. Allen).
I want to also acknowledge his great leadership, not only for the
United States Congress, but for the State of Maine. Of course, the
gentleman from Texas (Mr. Turner) and the gentleman from Mississippi
(Mr. Shows) have done a great job also in moving this issue forward.
We have heard a lot of stories here this afternoon. Who we are
talking about is the greatest generation that Tom Brokaw wrote so
eloquently about, the people that were born and grew up during the
Depression fought World War II and then built this country into the
greatest Nation it has ever been.
They thought they were working hard, playing by the rules and going
to be able to retire in a decent situation, but because of the
incredible costs of prescription medicine only in the United States,
they have been forced to deal with untenable situations in their own
personal economics.
Each day in our congressional office, we hear from more and more
seniors that have to choose between food and medicine. I think we
should make the point that the retail pharmacies are not making this
money. The retail pharmacies have done heroic work in trying to provide
this product to our senior citizens and to other Americans at a fair
price. They have kept their margins down. Many times they have
sacrificed not only their own profit but their own economic well-being
trying to provide this medicine to the people that need it.
Mr. Speaker, the prescription drug manufacturers are the people that
are making this money. They are the most profitable companies in the
world. They pay less taxes than any other business in this country. The
American taxpayer pays for much of the research and development of the
new products that we hear so much about.
The drug companies will tell you if we lose these massive profits, we
will not be able to develop new products. We have heard that story
before. When generic drugs were made legal in this country, they said
you are going to destroy us. They have more than doubled their
investment in research and development, because they get a patent on
their product. They have an exclusive right to sell it for 20 years.
We know that that just simply is not true. The point that has already
been made, and I thought made well, what good does it do to have a new
product if you cannot afford to buy it? I think that is a very good
point.
Our seniors are put in that position every day where they cannot
afford to buy the product that they need to keep them alive. Then the
manufacturers chooses to sell these same products all over the world.
You go anyplace else in the world, it does not matter, you can buy it
for half as much as you pay here, or a third as much, sometimes a tenth
as much.
It is unbelievable to me that we would allow that to happen, that we
just let that go on and on and on. Mr. Speaker, I am not against the
drug companies making profits. I think we all want them to be
successful. We want them to do very well. We want them to keep doing
research and development.
They do a great job of it. We want them to make money, but not by
taking the food from the mouths of a senior citizen that has worked
hard, played by the rules and deserves a whole lot better, and we
promised them a lot better.
It is time for us to do something about it. Seniors spend more on
prescriptions than they do for hospital and doctor bills now. When
Medicare was first brought into being, that was not the case, the great
fear in health care was that you have a big hospital or doctor bill.
But in the day of the world marketplace and in the Internet, it is
unbelievable that we have laws in place in this country to give the
prescription drug manufacturers a captive market. Only in this country
do they charge these outrageous prices.
Another point I would make is that inflation for prescription
medicines is about 15 to 18 percent a year, 3 to 4 times as much as for
the rest of the economy. And many of these prices that go up every year
15 to 18 percent are on products that were brought on to the market 50
years ago. They have been around almost as long as I have, some of them
longer.
We still keep raising the price and raising the price for no good
reason, except that they can get by with it, except that we allow it to
happen, because we do not have a competitive marketplace.
Mr. Speaker, the seniors in the First Congressional District of
Arkansas over and over ask me when are we going to get some relief. It
is a heart-breaking thing, as my colleague from Maine can attest to, to
have to face these seniors and say I do not know, we are working on it.
That does not help these folks much when their drug bills are from $200
to $300 a month to over $1,000 a month, and maybe their Social Security
check is $500; that does not do much for them.
I do not blame them when they look at me, like what are you talking
about? I need some help right now. It is time to do something. I am so
pleased that the Democratic Caucus decided it is time to do something.
We are going to sign those discharge petitions. We are going to do
something about this.
It is time for the United States Congress to do what is right, to
move this issue forward and to treat our senior citizens with the
respect and dignity and fairness that they have absolutely earned.
Mr. ALLEN. Mr. Speaker, very well said, I say to the gentleman from
Arkansas (Mr. Berry), very well said.
I turn now to the gentlewoman from Florida (Mrs. Thurman) who has
been working so hard on this issue working in the Committee on Ways and
Means and in her own district to try to lower the costs of prescription
drugs for seniors.
Mrs. THURMAN. Mr. Speaker, I want to thank the gentleman from Maine
(Mr. Allen) for yielding. I would also like to have the gentleman from
New York (Mr. Crowley) join in this because I know our time is very
limited.
Mr. CROWLEY. I thank the gentlewoman.
Mrs. THURMAN. I do just want to say, we had a hearing in the
Committee on Ways and Means on prescription drugs, and I will tell you
if people are watching this tonight, maybe they will turn on C-SPAN
when this hearing is replayed, because it gave us some very interesting
new information or at least information that has been around that was
kind of reiterated.
I think one of the big issues that I heard today is just on the whole
issue of the R&D and what is happening. One of the things that they
pointed out, if I can find it here, was something done by Merrill Lynch
who actually said that, and under your bill, basically said the
toughest proposal on the table in Washington, because it is the best
benefit, because it gives seniors about a 40 percent break in their
costs, said assumed would provide a 40 percent price break for all
Medicare beneficiaries, would reduce drug industry sales revenue by 3.3
percent, because of the volume prices.
I think what the gentleman from New York (Mr. Crowley) will tell you,
if he will just give me some time back and forth, I will yield, you are
going to

[[Page H425]]

hear why from our constituents. These are such compelling stories. This
is not a partisan debate.
We went to our constituents and said, please tell us what is
happening to you. And I say to the gentleman from New York (Mr.
Crowley), I would love to hear what some of his folks are saying.
Mr. CROWLEY. Mr. Speaker, I would like to thank the gentlewoman from
Florida (Mrs. Thurman). I call now the main man on this issue, the
gentleman from Maine (Mr. Allen), he is the main man as we say back in
New York on this issue.

{time} 1730

I have a letter here from two constituents of mine, Don and Gert
Schwartz from Long Island City. I will not go into their ages, but they
are considerably older than I am. And he talks about the fact that he
had to purchase for his wife Prilosec, a hundred tablets, $394 dollars
for just one prescription of Prilosec.
Somebody had a study done thanks to the help and aid of the office of
the gentleman from California (Mr. Waxman). When you compare the prices
between what people in New York and Queens and the Bronx are paying for
prescription drugs and what they are paying just over the border in
Canada, it is amazing. For the same drug in Canada, $184; $394 in New
York. It is ridiculous. It is simply ridiculous.
Mrs. THURMAN. Mr. Speaker, it is ridiculous. Let me just give my
colleagues some ideas of what happens when they get into the situation.
This is a letter, and I have not been able to ask them for permission
to use this, so I am just going to kind of read an outset. ``My father
has threatened to give up his medications just so my mother can
continue taking hers. This would mean he would die in a very short
time.'' That is another kind of compelling thing.
I have another one from a woman who has taken her mother, who had a
stroke, in her house. So not only is she having to care for her and
having to have somebody come in and care for her, she is also having to
pick up her prescription drug because she has no benefit; and she says
it is absolutely crippling them.
Mr. CROWLEY. Mr. Speaker, I have another example here from a
gentleman in Middle Village in Queens, New York, another constituent.
He has to purchase efudex. He paid $104 in New York, which is the going
rate. He did a lot of shopping around. His daughter brought back the
same prescription for him when she was visiting Ireland, and she paid
only $13 for the two; and that is without any insurance whatsoever. The
price of $13 and go over to the other side of the Atlantic and it is
$104.
Again, just the constituents alone. We are grateful to do the
studies. We do not have to do these studies to find out. We just listen
to our constituents, and they will tell us exactly what these findings
are saying. There is something wrong here in this country.
And the work that the gentleman from Maine (Mr. Allen) and the
gentlewoman from Florida (Mrs. Thurman) are doing to pass this bill,
which is so important to the people of this country, I really do
applaud them all and all those people in this Congress who are
supporting this measure. It is really what the American people want to
see happen right now.
Mrs. THURMAN. Mr. Speaker, another thing that is happening, and the
gentleman from Maine (Mr. Allen) can tell us, too, and certainly from
the area that he is from, I mean, I have been absolutely envious of
what New England is looking at doing and I think probably precipitated
by the work my colleague has done here in Congress, all of a sudden
they are starting to get a lot of heat in the State legislatures to try
to do something about this and pooling, which really goes back to what
we are doing here.
Mr. CROWLEY. The New Yorkers are doing the same thing, as well.
Mrs. THURMAN. Right, you are doing it with them because of the amount
of people you can bring together. But it is because this issue has been
raised by people like the gentleman from Maine (Mr. Allen), who have
said, enough is enough, and there just comes a saturation.
But do my colleagues know what is even harder in all of this? It is a
moving target on the costs. The target keeps moving for these people.
Their incomes are not going up. And all of a sudden one month they go
to the pharmacist and the pharmacist says this medicine, and here is a
woman who is actually taking something to treat both advanced and early
stage breast cancer, that is what the medicine is for, in May it was
$132.22. In December it was $156.59. It is outrageous.
I do not know what is going on out there, but I tell you what, we are
going to find out. I applaud the efforts, and I look forward to signing
this petition tomorrow.
Mr. ALLEN. Mr. Speaker, I thank my colleagues and I thank all of the
Members who have been here. Our mission is simple. We are trying to
stop price discrimination and provide a Medicare prescription drug
benefit, and we can do this. The Democratic Caucus is committed to
those goals. If we can just get some Republicans on board, we can
achieve it in this Congress.
Some seniors struggle monthly to buy medicine for themselves. Social
Security payments rise with inflation, but drug prices have risen even
more. Lanoxin, the most prescribed drug for older people, increased 15
percent from 1998 to 1999. More than 87 percent over 5 years.
I read conflicting statistics about drug prices. One editorial may
say that prescription drugs Americans can already afford. They say the
average cost of drugs is $350 per American per year. But they do not
tell that this price included the entire population, old and young
alike.
Seniors at the low end of the income scale, transplant patients, and
the disabled need drugs continually to stay alive. By bringing the
Stark-Dingell and Allen-Turner-Shows bills to the floor we can begin
the dialogue needed to move forward.
Nearly half of those on Medicare have incomes less than $15,000 a
year. A prescription drug benefit is what seniors on the low-income
scale want and these two bills address those needs. We know we need to
move forward in our discussions, and get these prescription drug bills
on the House floor to discuss. We need to protect our elderly, Mr.
Speaker.
Medicare should guarantee access to a voluntary prescription drug
benefit and provide comprehensive coverage for seniors. Also, Medicare
prescription drug benefit must not reduce access to other Medicare
benefits.
I request that these two bills come to the floor so that we can all
take part in a discussion on how to improve Medicare coverage,
affordability, administration, and the quality of prescription drug
access. Prescription drugs can prevent, treat, and cure more diseases
than ever before. Prolonging and improving the quality of life. No one
would design Medicare today without including coverage for prescription
drugs.
For example, there is the case of a 70-year-old Durham, NC, widow
with emphysema, high blood pressure, and arthritis whose monthly bills
for Prilosec, Norvase, two inhalers, and nitroglycerin which has forced
her daughter to take out a second mortgage on her home. (Testimony of
Michael Hash, Deputy Administrator, Health Care Financing before the
House Commerce Committee, Subcommittee on Health & Environment, Sept.
28, 1999.)
Only one in four Medicare beneficiaries or 24 percent has private
sector coverage provided by former employers to retirees. I might point
out, that the number of firms offering retiree health coverage dropped
by 25 percent from 1994 to 1998 (Foster-Higgins research firm).
Currently, less than 1 in 10 Medicare beneficiaries has drug coverage
from a supplemental Medigap plan. Costs for these policies are rising
rapidly, by 35 percent between 1994 and 1998 according to Consumer
Reports.
We need to talk about these two drug bills on the House floor today.
The ranks of people of the age 65 will double to 70 million by the year
2030. On average, people over 65 fill between nine and a dozen
prescriptions a year, compared with two or three for people between the
ages of 25 and 44. These numbers are not hidden from the general
population. They are in the Wall Street Journal. However, if the
elderly do read and must make a choice between reading the Wall Street
Journal and obtaining drugs to maintain daily life, perhaps, they are
hidden from the population that is currently on Medicare.
I could go on, Mr. Speaker, but I feel that it is time to bring these
bills to the floor. Therefore, I request the discharge of these two
bills.

____________________