[Congressional Record Volume 146, Number 38 (Thursday, March 30, 2000)]
[Senate]
[Pages S1947-S1948]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                            MEDICARE REFORM

  Mr. WYDEN. Mr. President, over the last 3 months I have come to the 
floor of the Senate on more than 20 occasions to talk about the need to 
assist the Nation's senior citizens and families under Medicare with 
help with the extraordinary costs so many of them are experiencing for 
prescription medicine. I am very pleased to report some very exciting, 
positive developments that have taken place in the last few hours on 
this issue as a result of the bipartisan effort in the Budget 
Committee.
  I particularly want to commend my colleagues Senators Snowe and 
Smith. Senators Snowe and Smith have teamed up with me on a bipartisan 
basis for more than 15 months to address this enormous need of the 
Nation's older people.
  Today in the Budget Committee we took a concrete, tangible step to 
set in place the kind of program that really will provide meaningful 
relief for the Nation's older people. We did it in a way that will be 
consistent with long-term Medicare reform, a view that is a view shared 
by Members on both sides of the aisle. It allows for universal coverage 
and a program that is voluntary. That is to ensure that older people 
can make the choices that are good for them.
  Specifically, what the Budget Committee did is provide legislation 
that would allocate $20 billion during the next 3 years to put in place 
a prescription drug program, and then make it possible to add another 
$20 billion in the next fiscal year, which would be fiscal year 2004-
2005, as part of an effort to ensure solvency, long-term Medicare 
reform, and to do it in a way that would not cause an on-budget deficit 
in those later years.
  I have believed for a long time that at a time when more than 20 
percent of our Nation's older people are spending over $1,000 a year 
out of pocket on their prescription medicine, when we have millions of 
seniors with an average of 18 prescriptions a year, that it is 
important we put in place, on a bipartisan basis, meaningful relief for 
the Nation's older people.
  Today, on a bipartisan basis, the Budget Committee said the Finance 
Committee should report a plan on or before September 1 of this year to 
help older people with their prescription drug medicine to ensure that 
$20 billion would be available for fiscal years 2001, 2002, and 2003, 
and, accompanied by real reform of the Medicare Program, there could be 
$20 billion for fiscal years 2004 and 2005.
  This required, frankly, compromise on both sides. For example, one of 
the stipulations in what was done by the Budget Committee today was a 
stipulation that there could not be transfers of new subsidies from the 
general fund to extend solvency. Frankly, some of my colleagues on the 
Democratic side of the aisle had supported those kinds of transfers in 
the past.
  I think after many months of debate, and certainly a lot of 
prognosticators saying it was not possible in this session of Congress 
to make real headway on the prescription drug issue, and, in fact, to 
get the job done, what the Senate Budget Committee showed this morning 
in a very significant breakthrough is that we are now on our way to 
address the needs of older people. In fact, this language would be 
binding. The language adopted by the Budget Committee, setting out the 
parameters for the adoption of a prescription drug program for the 
Nation's elderly under Medicare, would be binding.
  In addition to my two colleagues Senators Snowe and Smith, I would 
like to single out a number of others on a bipartisan basis who helped 
us. Chairman Domenici, for example, was one who, in many conversations 
with me on this issue, talked about the need to make this program 
consistent with long-term Medicare reform and to make Medicare more 
solvent in the future. That is an issue that has been highlighted by 
Senators Daschle, Lautenberg, and Conrad as well. But the fact that 
Senator Domenici emphasized that in the last couple of days helped us 
find common ground this morning.

  This is a vast improvement on what the House has thus far been able 
to accomplish on this issue of prescription drugs. Specifically, the 
Senate made it clear we could launch a prescription drug program that 
would offer $40 billion of assistance to the Nation's older people, a 
program that would assist all senior citizens. So the Senate was able, 
this morning, in the Budget Committee, on a bipartisan basis, to add a 
significant amount of additional relief. That was important.
  The House did not address the solvency issue and that is what, in 
fact, the Senate did. In that sense it is a dramatic improvement. What 
we did, in terms of the dollars on a bipartisan basis, is today we 
raised the amount the Senate would make available for the program to 
$40 billion. Originally that amount was $20 billion.
  The fundamental point remains. We addressed this issue by adding more 
money than was originally envisaged in the mark that came out from the 
Senate. We were able to do it in a way that addressed the Medicare 
solvency question. The House did not really touch the Medicare solvency 
question, and we think, on a bipartisan basis in the Senate this 
morning, that was important.
  Finally, we know the revolution in American health care has 
essentially bypassed the Medicare Program. A lot of these medicines 
today help older people to stay well. They help to lower blood 
pressure. They help to lower cholesterol. They are medicines that 
promote wellness. They do not just take care of folks when they are 
sick. As a result of the work done today, we made a major step forward 
in modernizing this program and bringing it in line with the rest of 
the American health care system.
  I reported on the floor of the Senate recently a case of an older 
person in Hillsboro, OR, who had to be hospitalized for 6 weeks because 
Part A of Medicare would pay his prescription drug bill and he could 
not afford his medicine on an outpatient basis. Today, as a result of 
what the Senate Budget Committee did, that person will be in a position 
to get his medicine on an outpatient basis.
  They will be able to get help because the Senate improved on what the 
House has been talking about by putting more of a focus on solvency, 
and

[[Page S1948]]

we were able to take the amount of the program up to $40 billion beyond 
what the original discussion had been in the Senate, just $20 billion.
  Finally, we need to understand there is a long way to go from here. 
We are going to have to defend what was done by the Senate Budget 
Committee this morning on the floor of the Senate. Then we will have a 
conference with the House. I hope we will come out of that discussion 
with the House ensuring there is $40 billion for the prescription drug 
program, that it is possible to have universal coverage, that it is 
voluntary, that it is consistent with Medicare reform, and that it 
gives older people bargaining power in the private sector to get more 
affordable medicine.
  There is a long way to go in the process. This morning's breakthrough 
was just one step in the process. It was a chance to go forward in a 
way that is fiscally responsible--$20 billion for the first 3 years to 
as the first downpayment, as Senator Snowe has characterized it, on 
prescription drug relief, but then also to say there will be another 
$20 billion available in 2004 and 2005 when it is accompanied by 
reform.
  We also work to ensure solvency, and for the first time, we put real 
time constraints on getting a prescription drug benefit done .
  As was pointed out yesterday in the Senate Finance Committee by 
Senator Breaux, there have been 14 hearings on the issue of Medicare 
reform and prescription drug coverage for older people. Senator Breaux, 
along with Senator Frist, has a bipartisan bill supported by a number 
of Members of the Senate.
  What we said this morning in the Budget Committee is that we want the 
Finance Committee, on or before September 1 of this year, to bring us 
legislation in line with the binding language offered in the Senate 
Budget Committee under the Snowe-Wyden-Smith amendment.
  Having come to the floor of the Senate on more than 20 occasions, as 
I related those stories about older people who had been put in 
hospitals because they could not afford their medicine on an outpatient 
basis, older people who were taking two pills a day when they should 
have been taking three, or breaking their Lipitor capsules--which deals 
with cholesterol and heart problems--in half, I often thought as I left 
the floor that we might not be able to make the kind of progress we 
made today in the Budget Committee.
  Today, the Budget Committee came together on a bipartisan basis to 
ensure there would be sufficient funds to jump-start Medicare reform, 
provide meaningful relief for the Nation's older people and their 
families, while addressing the solvency question and the need for an 
approach to be consistent with long-term Medicare reform.
  We have improved on what is being discussed in the House because they 
do not have the same focus on solvency. I am very much looking 
forward--as we bring that legislation to the floor of the Senate and it 
goes to conference and the work in the Finance Committee--to continue 
the progress we saw this morning.
  Suffice it to say, there were a number of moments today when it was 
likely that it was all going to break down. Had the Budget Committee 
reported a significantly smaller sum than was finally agreed on, had we 
not made the kind of changes in the Snowe-Wyden-Smith amendment, we 
might not have been able to reach a bipartisan agreement on 
prescription drugs this year in the Congress. As a result of what 
happened today in the Budget Committee and the important work that was 
done on a bipartisan basis, we have laid the foundation for making sure 
that before this Congress adjourns and goes home for the year, we have 
acted to help the Nation's older people.
  For all of those seniors and for all the families who are walking an 
economic tightrope, balancing their food costs against their fuel bills 
and their fuel bills against their medical bills, my admonition this 
afternoon is that we have a long way to go, but today we really made 
progress.
  Today, as a result of bipartisan work, we have an opportunity to 
ensure that by fall, on or before September 1, as the amendment adopted 
in the Budget Committee requires, we have a proposal that is 
bipartisan, that is one which provides meaningful relief for older 
people, that is voluntary, offers universal coverage, and is consistent 
with long-term Medicare reform. We can have that kind of proposal on 
the floor of the Senate this fall.
  For the millions of seniors and families who are watching the 
Congress and looking to see if we can deliver on this issue, progress 
was made today. I particularly commend Senator Snowe and Senator Smith. 
Senator Smith made a very constructive suggestion towards the end of 
the markup when we had a debate about when the Budget Committee was 
seeking a product from the Finance Committee. Senator Smith offered a 
very constructive suggestion. If we can continue to build on that 
bipartisan progress, we can get this job done.
  I believe--and I will wrap up with this--this country can no longer 
afford to deny coverage for senior citizens' prescription needs under 
Medicare. I use those words deliberately. People ask if we can afford 
to offer the coverage. I am of the view that we cannot afford not to 
offer this coverage because the revolution in American health care is 
about these new medicines that help people stay well.
  I have pointed out repeatedly that one can spend $1,000 or $1,500 on 
anticoagulant medicines that help prevent strokes and can stop a stroke 
that costs more than $100,000.
  Today, we made very significant progress in ensuring that no longer 
does the revolution in American health care bypass the Medicare 
program. I look forward to defending what was done in the Budget 
Committee on prescription drugs on the floor of the Senate when we get 
to the budget and working with the Finance Committee. Senators Moynihan 
and Roth have been very gracious in assuring there will be an 
opportunity for colleagues in both parties to contribute and offer 
their ideas and suggestions.
  If we can continue to build on the progress that was made today in 
the Budget Committee, we will get this done, and we will get it done 
before the end of this session. In my view, this will revolutionize 
American health care and provide meaningful relief to older people and 
their families.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER (Mr. Bennett). The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. STEVENS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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