[Congressional Record Volume 146, Number 39 (Monday, April 3, 2000)]
[Senate]
[Pages S2032-S2034]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    PRESCRIPTION DRUG AFFORDABILITY

  Mr. WYDEN. Mr. President, I come to the floor today to talk about a 
very encouraging development and solution with respect to prescription 
drugs.
  I have come to the floor on more than 20 separate occasions over the 
last several months to talk particularly about how America can no 
longer afford to deny this critical coverage. Again and again, I cited 
examples on the floor of this Senate about how our country cannot 
afford to deny seniors the opportunity to get prescription drug 
coverage. I have talked, for example, about the exciting anticoagulant 
drugs. These drugs allow a senior citizen, for example, for perhaps 
$1,000 or $1,500, to prevent a stroke which might end up costing more 
than $100,000.
  What is so exciting about these prescription medicines is that they 
don't just help older people when they are very ill, but they are 
absolutely key to keeping older people healthy by lowering blood 
pressure and cholesterol. They will help senior citizens stay in the 
community and will keep them from racking up those much larger health 
care expenses under what is known as Part A of the Medicare Hospital 
Insurance Trust Fund.
  Again and again, we have seen examples of how cholesterol-lowering 
drugs can reduce death and expenses for senior citizens.
  For example, heart disease is the leading cause of death for persons 
65 and older. Beta blockers can reduce long-term mortality by 25 
percent, and they cost about $360 a year, or $30 a month.
  One in five older women has osteoporosis. About 15 percent have 
suffered fractures as a result this disease. This disease is the 
leading risk factor for hip fractures. Estrogen replacement can reduce 
the risk of osteoporosis as well as cardiovascular disease. One 
commonly used drug costs $20 a month. This is an investment that can 
help avoid those hip fractures and help avoid the extraordinary medical 
expenses.
  I must say that my own mother, who will be 80 years of age very 
shortly, had a hip fracture recently, and this drove home to me how 
these prescription medicines can help avoid the kinds of health 
problems that my mother and scores of others seniors have seen, and how 
providing coverage now is an investment this Senate cannot afford to 
pass up.
  What was exciting about the developments in the budget resolution 
was, first, that the Budget Committee committed $40 billion would be 
committed for this important program. For example, on the other side of 
the Capitol, the House of Representatives talked about $40 billion, but 
they could spend it on just about anything in the health care arena. 
The Senate Budget Committee said we are going to make $40 billion 
available for prescription drugs because it is high time we set in 
place this important coverage.
  Second, we provided a date certain to get this job done. Our 
colleague from Louisiana, Senator Breaux, has been correct to say 
repeatedly that the Senate Finance Committee has now held 14 hearings 
on this issue. Clearly there is great interest in that committee in 
moving forward.
  The budget resolution says on this point that if the Senate Finance 
Committee does not come forward with a prescription drug benefit on or 
before September 1st of this year, any Member of the Senate can come to 
the floor of this body and bring this issue before the Senate.
  The Presiding Officer of the Senate, who serves with me on the Senate 
Committee on Aging, could come to the floor if he had a plan to deal 
with prescription drugs. Senator Snowe and I have teamed up on a 
bipartisan basis. We are particularly grateful for the help of Senator 
Gordon Smith last week in the Budget Committee. The resolution allows 
any group of Senators to come forward with legislation if the Senate 
Finance Committee does not report a prescription drug measure on or 
before September 1st of this year.

  I think it is critical to note that many Senators in the leadership 
of both political parties were involved in this effort.
  Senator Daschle has talked to me almost daily about the importance of 
the Senate dealing with this issue, and dealing with it this year. He 
has worked very hard to try to reconcile the various approaches 
Senators have on this issue. He also has been steadfast in saying how 
important it is that the Senate not put this off until after another 
election.
  There may be some colleagues on the Republican side and some on the 
Democratic side who will say: Let's just talk about this in the 
political campaign.
  I believe we can't afford to deny this coverage to the Nation's 
senior citizens.

[[Page S2033]]

  Senator Daschle has been resolute in saying we ought to go forward 
and deal with this issue, and deal with it in this session of Congress.
  I also want to commend several of my colleagues on the other side of 
the aisle: Senator Domenici, for example, in the Budget Committee, when 
this issue got to a flash point; it would have been very difficult even 
to go forward. Senator Domenici worked with several of us, particularly 
Senator Snowe and Senator Smith, in order to bring the committee 
together on this point. We had some bipartisan support last week in the 
Budget Committee for taking tangible action on this issue.
  What is really important is that every Senator understands that I and 
others are going to stay at this issue again and again and again so the 
Senate does not miss this historic opportunity.
  Too often, whether dating back to catastrophic health care 
legislation or the failed efforts in 1993 and 1994 to pass 
comprehensive health care reform, we have muffed. The Congress has 
muffed the opportunity to put in place a historic breakthrough in terms 
of health care in our country. I think we have another such opportunity 
as a result of the work that was done in the Budget Committee last 
week.
  Only about one in four of our senior citizens has prescription drug 
coverage. Many of them take up to 20 medicines a year. Something like 
20 percent of the Nation's senior citizens spend over $1,000 out of 
pocket now on their prescription medicines. As a result of these and 
other factors, there is not a single specialist in the health care 
field and not a Democrat or a Republican who would create a Medicare 
program today without including prescription drug coverage.
  That is why the breakthrough we saw in the Budget Committee last week 
is so important. I think it is absolutely critical that we keep what 
was done in the Budget Committee throughout this process. It may be 
challenged on the floor of the Senate this week. My understanding is 
that there will be Senators opposed to it, but I think we can build on 
the work that was done last week in the Budget Committee. Again, I 
commend Chairman Domenici, Senator Snowe, and Senator Gordon Smith, my 
colleague from Oregon, for working with us on it--we can get this done; 
we can ensure that action on prescription drugs is tied to reform of 
the Medicare program.
  Many of my colleagues have stressed this. I think they are right. I, 
too, happen to believe it would be better to have comprehensive 
Medicare reform that includes prescription drug coverage.
  I think it is also clear--and I stress this because it is so 
important to this Senator and many on this side of the aisle--that we 
cannot afford to wait. We want to use competitive purchasing principles 
for prescription drug benefit. We will use the kind of principles that 
make sense in private sector health care. We will ensure the benefit is 
voluntary. No senior would have to choose this particular benefit if 
they preferred their existing coverage. However, we do want to put in 
place a universal coverage program. We want to get it done before this 
Congress adjourns.
  We are going to fight with all our strength to protect what was done 
in the Budget Committee last week on the floor of the Senate this week 
and when it goes to conference and throughout the process so that if 
the Senate Finance Committee does not act to provide this benefit on or 
before September 1 of this year, that any Member of this body will be 
able, without facing points of order, come to the floor of the Senate 
and force the Senate to deal with this critical issue.
  I am sure when my colleagues go home and talk to constituents they 
will find what I have found; that is, the question of prescription drug 
coverage is one of the two or three most pressing issues our 
constituents care about.
  We have families and older people all across this country who are 
walking on an economic tightrope balancing their food bills against 
their fuel bills and their fuel bills against their medical costs.
  I have been bringing to the floor of the Senate cases of older people 
who are supposed to take three pills and they take only two. They are 
breaking their lipid-lowering capsules in half--the drugs that help to 
deal with cholesterol and heart problems--because they cannot afford to 
take the full pill.
  I spoke recently about a case from Hillsboro, OR, my home State. A 
physician actually put an elder person in a hospital for 6 weeks 
because that elderly man could not afford the medicine on an outpatient 
basis. Allowing outpatient coverage of medicine is what we are trying 
to accomplish in the Senate. Seniors could get their medicine without 
going into the hospital. That older gentleman in Hillsboro, OR, had to 
be hospitalized for 6 weeks so he could get his medicine paid for under 
what is known as Part A of the Medicare program. That is a classic 
example of how, under today's health care system, dollars are wasted by 
having a person hospitalized rather than getting help in the community 
and, at the same time, facing the predicament of taking longer to get 
healthy than if these benefits have been available more promptly on an 
outpatient basis for the elderly.
  Last week's developments in the Budget Committee were encouraging. 
Many predicted the Budget Committee would not adopt binding language 
with respect to prescription drugs that would allow the Senate to get 
this program enacted, and get it enacted this year. However, the Budget 
Committee came together. I commend my colleagues, Senator Snowe and 
Senator Gordon Smith. They have worked with me for 15 months. We now 
have funding available in the budget resolution. We have a date certain 
when it can actually come before the Senate. If the Finance Committee 
doesn't act on or before September 1, any Senator could bring this 
issue to the floor of the Senate and it would be tied to the question 
of Medicare reform.
  There is a long way to go. We have to get through the discussion this 
week. Then we will have a conference committee. Then many Members will 
work closely with the Finance Committee where there are many interested 
Senators who have devoted time to this prescription drug issue.
  What was done in the Budget Committee last week was something of a 
breakthrough. It was a very encouraging development for the millions of 
seniors and families who are watching how Congress deals with this 
issue, watching to make sure we do it this year, do it on a bipartisan 
basis, and not just send it out to be another topic and cannon fodder 
for the political campaign this fall.
  As I have made clear, I intend to keep coming back to the floor again 
and again raising examples of why this Nation cannot afford to deny 
prescription drug coverage for the elderly. More than 4,000 seniors 
from Oregon have written me since I have begun this effort. The cases 
illustrate in a dramatic way how important it is that Congress deal 
with this issue now.
  I intend, with my colleagues, to come back again and again and again 
until we get this coverage for the Nation's older people. This country 
can no longer afford to have the Congress deny this coverage. With the 
work done in the Budget Committee, we have an opportunity now to deal 
with this issue promptly. The seniors who come to our town hall 
meetings with their prescription drug bills tell how their private 
insurance doesn't cover their prescriptions. Because they cannot afford 
prescription medicine, very often they get sicker. They are the ones 
who have a right to expect this Congress to act.
  The developments last week for the first time give me a tangible 
sense that we are going to be able to get this done. It was concrete 
evidence that the Congress understands how important this issue is. 
Many of my colleagues have said this is one of their top two priorities 
for this session of Congress. Certainly it is for this Senator. We are 
going to keep coming back to this floor, stressing the need for action 
on their prescriptions until the Senate moves to do what should have 
been done years ago.
  When Medicare was enacted in 1965, it did not cover prescription 
drugs. Now the big buyers, the health maintenance organizations and the 
health plans, are able to negotiate discounts. That means senior 
citizens in Alabama, Oregon, and across the country pay more for their 
medicine because they are not able to get the benefits of the big 
buyers. Seniors are going to have the power of the big buyers if we can 
act this session. A number of the key

[[Page S2034]]

bills before the Senate give older people bargaining power in the 
marketplace in order to be able to afford their medicine. That is key--
affordability--the ability of senior citizens to afford their 
prescription medicine so they don't have to give up food, rent, and 
heat.
  Making drugs affordable for seniors has been important to all Members 
who have focused on this issue. Yet there are many seniors who struggle 
to make ends meet because they cannot get medicine in an affordable 
way. The budget resolution provides the opportunity now for those 
seniors to get relief. I will do everything in my power, and there are 
many of my colleagues who will, as well, to defend what was done in the 
Budget Committee last week on prescription drugs throughout this 
process. If we have a floor fight on this measure, those who try to 
knock out what the Budget Committee did ought to understand how strong 
Members feel who worked to get that prescription drug coverage in the 
budget resolution. I hope we will not see that kind of fight.
  I hope the work done by Senator Snowe and Senator Smith, along with 
Senator Daschle, Senator Conrad, and myself, the group of Members who 
worked with the Budget Committee, can be preserved.
  It ought to be preserved for the Nation's senior citizens. Those are 
the people who are counting on us to deliver on this critical issue. I 
intend to keep coming back to this floor again and again and again 
until we have achieved this major health care reform that the older 
people of this country richly deserve.
  Mr. President, I yield the floor and I suggest the absence of a 
quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. CRAIG. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Sessions). Without objection, it is so 
ordered.
  The Senator from Idaho is recognized.
  Mr. CRAIG. I inquire of the Chair, what is the business on the floor 
at this moment?
  The PRESIDING OFFICER. Morning business.
  Mr. CRAIG. Mr. President, I will then proceed for the next few 
moments in morning business.
  I believe that when I am done, I will also conclude the Senate for 
the day and take us out, as others who had been planning morning 
business comments for the day are not going to be with us.

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