[Congressional Record Volume 146, Number 77 (Monday, June 19, 2000)]
[House]
[Pages H4664-H4670]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PRESCRIPTION DRUG COVERAGE
The SPEAKER pro tempore (Mr. Pitts). Under the Speaker's announced
policy of January 6, 1999, the gentleman from Pennsylvania (Mr.
English) is recognized for 60 minutes as the designee of the majority
leader.
Mr. ENGLISH. Mr. Speaker, the House is on the brink of considering a
very important issue, one that matters to people in my district in
northwestern Pennsylvania and to all users of the Medicare program
throughout the United States, whether they are seniors or individuals
with disabilities. We are talking, of course, about the bipartisan
effort to revise the Medicare program and to include prescription
drugs.
My intention tonight, along with a couple of my colleagues, is to
clear away the partisan smoke, to clear away the rhetoric, and to focus
on what is really being proposed and the potential for a true
bipartisan approach to extending prescription drugs under the Medicare
program.
Mr. Speaker, modern medicine is using drug therapies more and more to
prevent and treat chronic health problems. This is the 21st century. A
trip to the pharmacy is far better than a trip to the operating room.
We no longer practice medicine as our grandfathers or even our fathers
once experienced, nor should we continue to offer seniors the limited
Medicare program that our grandfathers and fathers knew. We need to
revise the program and expand it and rethink it.
Medicare is, essentially, a standard benefit program from the 1960s,
and it needs a facelift. We started that process in recent years by
extending Medicare benefits to include a variety of new procedures. But
we need, among other things, fundamentally we must modernize this
benefit to provide prescription drug coverage.
Now, Mr. Speaker, I had the privilege of being appointed by the
Speaker to serve on his Prescription Drug Task Force. We generated a
blueprint and an outline which we thought could form the basis of a
bipartisan prescription drug initiative. And indeed it has.
The House bipartisan prescription drug plan is a billion-dollar
market-oriented approach targeted at updating Medicare and providing
prescription drug coverage. After all, how many of us would give our
employer's health
[[Page H4665]]
plan a second look if it did not include coverage for prescription
drugs. But that is what we have been asking America's seniors to do.
We must take the steps necessary to ensure that seniors have access
to affordable prescription drugs throughout America. What we have done
is create a plan which invests $40 billion of the non-Social Security
surplus to strengthen Medicare and offer prescription coverage to every
beneficiary.
This is, after all, $5.2 billion more than what the President had
proposed, and it was included in a budget resolution that we passed in
this House over fierce resistance from House Democrats.
The bipartisan prescription drug plan that we have created will
provide lower drug prices while expanding access to life-saving drugs
for all seniors. Many of us had carefully examined the President's
proposal and, in doing so, felt that we could improve on it and do
better and provide seniors with a richer benefit and the flexibility to
choose a plan that best meets their needs.
Under this bipartisan plan, seniors and persons with disabilities
will not have to pay the full price for their prescriptions and will
have access to the specific drug, brand name or generic, that their
doctor prescribes.
This plan provides Medicare beneficiaries with real bargaining power
through group purchasing discount and pharmaceutical rebates, meaning
that seniors can lower their drug bills up to 39 percent. These will be
the best prices on the drugs that they need, not some Government
bureaucracy that may not offer the drug that the doctor prescribed.
Studies have shown, Mr. Speaker, that a small portion of the senior
population consume a majority of prescription drugs, making them
extremely difficult to insure and driving up costs for everyone. Under
our prescription drug plan, the Government would share in insuring the
sickest seniors, creating a stop-loss mechanism, making the risk more
manageable for private insurers.
By sharing the risk and the cost associated with caring for the
sickest beneficiaries, premiums would be lowered for every beneficiary.
We address skyrocketing drug costs by providing Medicare beneficiaries
with real bargaining power through private health care plans which can
purchase drugs at discount rates.
Our plan provides options to all seniors, options that allow all
seniors to choose affordable coverage that does not compromise their
financial security. The plan benefits all seniors. Even though it is
not a subsidy for a millionaire's mother, it provides the prospect of
more affordable coverage for every senior. Seniors will have the right
to choose a coverage plan that best suits their needs through a
voluntary and universally offered benefit.
We realize that the left wing of the House Democratic Caucus is
violently opposed to giving seniors that choice, but we disagree with
them. Those that are happy with their current coverage will be able to
keep that plan without any difficulty. Others who need to supplement
existing benefits or State programs or who are without coverage can
also choose from a variety of competing drug plans.
Keeping rural seniors in mind, our plan guarantees at least two drug
plans that will be available in every area of the country with the
Government serving as the insurer of last resort. Clearly, we do not
depend exclusively on HMOs or on private insurance, as has been
alleged. The plan also requires convenient access to pharmacies
allowing beneficiaries to use their local pharmacy or have their
prescriptions filled by mail.
This plan protects seniors at 135 percent below the poverty level,
matching the eligibility contained in the President's plan. That means
a single senior making less than $11,272 or a couple making less than
$15,187 a year will receive 100 percent Federal assistance for low-
income seniors, including 100 percent full reimbursement for premiums.
Like the President's proposal, this bipartisan plan also includes
reimbursement phase-outs exceeding the poverty line. For those between
135 percent and 150 percent of poverty, Medicare will pay part of their
premiums and their co-payments would be covered under Medicare. Yet,
the President's plan shoe-horns seniors, many of them who have already
private drug coverage which they are happy with, into what I would call
a one-size-fits-few plan, with Washington bureaucrats in control of
their benefits.
Our plan, our bipartisan plan, gives all seniors the right to choose
an affordable prescription drug benefit that best fits their own health
care needs. By making it available to everyone, we are making sure that
no senior citizen or disabled American falls through the cracks.
The plan also provides coverage and security against out-of-pocket
drug costs for every Medicare beneficiary. Any senior spending $6,000 a
year or more will have 100 percent of their drug costs covered by
Medicare. No longer will seniors be forced to drain their savings in
order to pay for the prescriptions on which their lives depend.
The President's plan does not reflect any coverage for those seniors
who pay high drug costs. Although we now understand that belatedly the
President has leaped forward, panicked, and is now offering a
catastrophic benefit as an add-on, but that was not his original
proposal.
The Congressional Budget Office has estimated that if the President
were to add such coverage, it will double the cost of the plan and/or
double the premiums seniors would pay. The President leaves those who
face the highest drug costs out in the cold in his original plan,
choosing between paying the bills or buying life-saving medicines.
In addition, private employers under our plan would be given the
option to buy into the Federal program in order to enhance their
current plans or to begin offering a drug benefit to their employees.
States would be allowed to choose to enhance their existing plans with
the Federal coverage while not jeopardizing the existing coverage that
their residents have. This includes programs such as the Pace Program
in Pennsylvania.
But in adding a prescription drug benefit, we also modernize Medicare
to ensure its long-term solvency. The plan ensures that seniors and
disabled Americans will continue to have access to life-saving drug
therapies.
In recent years, scientific and medical research has resulted in 400
new medications to treat the top killers of seniors: heart disease,
cancer, and stroke. A market-oriented approach ensures that the quality
of care that beneficiaries receive will continue to be second to none.
The plan takes vital steps toward improving Medicare as a whole. It
expedites the appeals process by mandating that appeals that used to
take an average of 400 days now take less than a quarter of that time.
After all, to some seniors every minute counts.
But on top of that, the plan removes this part of Medicare from the
Washington bureaucracy that has haunted and nearly bankrupted the
system. The Health Care Financing Administration, which the last
speaker had quoted extensively in his comments, will not control the
prescription drug benefit under our plan. We create a Medicare benefit
administration within the Department of Health and Human Services to
manage prescription drug plans autonomously.
This reform is fundamental to safeguard the new program and to allow
it to realize its potential free from interference from the
bureaucracy.
We would also remove Medicare+Choice plans from under HCFA and put
under the control of this agency giving it more flexibility and
stability.
{time} 2245
President Clinton has attacked the bipartisan plan primarily because
he knows it offers richer, more encompassing benefits and greater
flexibility than the plan he has proposed while dealing with the needs
of people with diverse circumstances. The President's plan would force
as many as 9 million seniors out of their existing programs for drug
coverage because the employers would be dropping or limiting their
prescription drug coverage instead of allowing the Government to take
over.
As baby-boomers retire, 40 million Medicare beneficiaries could lose
their current drug coverage under the President's plan. As time goes
on, the coverage offered by the President dwindles as the cost of the
program for seniors skyrockets. Under his plan, seniors see as little
as a 12 percent savings on drug
[[Page H4666]]
costs. Under his plan, seniors would pay more for premiums, more fees
for services, all while the President spends more than was ever
budgeted for the program.
Mr. Speaker, about 69 percent of America's seniors have some
prescription drug coverage currently. Many of them need more help, but
it is the remaining 31 percent that worry me the most. A stronger
Medicare program with prescription drug coverage is a promise of health
security and financial security for older Americans, and we are working
to ensure that promise is kept. America's seniors deserve no less.
House Republicans believe that Americans should be spending their
golden years concerned about what time the grandchildren are coming to
visit or is the rain ruining their walk in the park. They should not be
concerned with how they are going to pay for the medicines that allow
them to enjoy life.
I am joined in this sentiment by a number of members from my task
force that I served on and also fellow members of the Committee on Ways
and Means.
I would like first to recognize a colleague of mine, the gentleman
from Pennsylvania (Mr. Greenwood), who served with me on the task force
and a distinguished member of the House Committee on Commerce who has
specialized in health care issues and has been a strong voice for
seniors.
Mr. GREENWOOD. I thank the gentleman for yielding, and I thank my
colleague from the other side of the State of Pennsylvania, from Erie,
Pennsylvania, for organizing this Special Order.
Mr. Speaker, we come here to Washington and we talk about the issue
of Medicare prescription drugs, as we have for months and months; and
sometimes the discussion, the dialogue, gets fairly arcane and
complicated and seems to go far from the flesh and blood of the people
we are trying to represent; and the gentleman from Erie just talked
about the fact that seniors should not have to at that stage of their
lives be worrying about whether or not they can afford their
prescription benefit.
I want to read a letter that I received recently from just such a
senior in my district, who certainly is worrying. She is from Holland,
Pennsylvania, which is the little town that my family moved into in
1955. She wrote this letter to me just a few weeks ago, a couple of
weeks ago.
``Dear Congressman Greenwood, I never thought that I would come to
this time in my life and find myself neglecting my health out of sheer
necessity. I am a widow, 70 years of age. My medical problems require
drugs that amount to over $1,000 per month. I am enrolled in Aetna U.S.
Health Care which has a cap on prescription drugs of $500 a year. After
filling out the prescriptions, my cap was met.
``I am in pain daily and I cannot correct this problem because of
financial difficulty. I have stopped taking Prilosec,'' which costs her
$285 each month, ``Zoloft, approximately $100 a month; Losomax, another
$100 a month; Xanax, approximately $100 a month; and Zocor, $100 or
more. I need these drugs filled monthly, and I simply cannot afford
them. I am also in need of pain pill, Vioxx, which costs $89; and I
have not been able to purchase it.
``I have cried myself to sleep over this dilemma. I had to visit my
pulmonary doctor, who diagnosed me with full-blown asthma and chronic
bronchitis. My doctor told me that I cannot miss a day taking my
medication for my lungs. I take Zevent, two puffs twice a day; Flovent,
two puffs twice a day; and Albuterol, 2 puffs every 4 hours.
``The prescription for each is $98 times three, lasts 2 weeks.'' So
$98 every 2 weeks for each of these three medications. That is $600 per
month right there. ``I cannot stop taking this. I tried and ran into
breathing problems again.
``I also must take Zithomax for chronic infection, $89. I must keep
this on hand always.
``Also my ophthalmologist prescribed Xalton for glaucoma, which I
must take faithfully, nightly, another $89.
``The drugs I must take average about $800 per month. The other drugs
I need for osteoporosis, reflux and hiatal hernia, anxiety and
depression, high cholesterol and nerves, I had to eliminate them; and I
can feel my health declining each day.
``I tried a generic brand drug for my lung infection, and I had to
end up taking three Zithromax, as the generic did not help me.
``My problem is that I make $200 too much per month to qualify for
assistance. You figure this out. I have two friends who make $200 and
$250 less than I do per month. They are paying $6 for all their
prescriptions because they qualify for the program. They are getting
help with their electric bill, they are being well taken care of, they
are able to go out to dinner weekly and on a bus trip now and then. I
can do none of this. My money is going to prescription drugs.
``I just pray that some good Congressman like you could make the guys
in Washington see what this drug problem for the aged is doing to us.
We worked hard all of our lives and then have to come to this.''
Mr. Speaker, that is a pretty persuasive argument, I think, a pretty
poignant letter from a real woman who lives in my district, a 70-year-
old widow who is only able to use every penny of her income simply for
the drugs that she has to have to stay alive, and then she neglects her
other needs; and so her cholesterol problem, her anxiety, her
depression, her pain, her osteoporosis, all of those conditions go
unchecked because she does not have this benefit. That is why all of us
in Washington who care about this issue are trying so hard to get this
done, and that is why we have come here tonight to talk about the
bipartisan bill.
If this issue is not handled in a bipartisan fashion, my constituent,
this 70-year-old woman, will not get relief. It is absolutely the case.
The people of the United States have elected a Republican House and a
Republican Senate, and they have a Democratic President in the White
House. For us to get this done this year, we have to exercise
bipartisanship, and that is why this bill that we are supporting is
bipartisan.
Now, unfortunately, in the Special Order that came before us, my
friend, the gentleman from New Jersey (Mr. Pallone), and I will give
him credit for this, he comes to the floor every night just about and
makes a speech about prescription drugs; but what is so discouraging to
me is the level of partisanship. There are reasons for there to be
differences between the President's plan, the Democrat's plan, and the
Republican plan, because this is a hard problem to solve; and it takes
different kinds of thinking from different perspectives.
There are reasons why the Republican plan is different. This is a
complex issue. One of those differences between the two plans is that
we think that you need catastrophic coverage. We think that it is
important that when some of these drugs that can cost $10,000 to
$20,000 per year, you cannot stop the coverage at $2,000 and let the
individual be on their own, because that is not going to help my
constituent. My constituent will not be helped by that, because she
will run out of money; and not only will her insurance coverage not be
sufficient, but now the Medicare coverage will not be sufficient, and
that is not good enough.
When you look at the President's plan and when you look at the
Republican plan, there are differences. I happen to prefer the
Republican plan, but the fact of the matter is they are more alike than
they are different. What we have got to do this year is we have to be
bipartisan and make sure that the bipartisan bill is adopted by the
House, that we take ideas from other Members, we negotiate this with
the President and get it done.
When you see Members of Congress come to the well of this House or
sit in committee hearings and meetings, and when you hear them looking
for common ground and looking for a bipartisan approach, when you have
Republicans and Democrats supporting the same kind of legislation, then
you know these are serious Members who care about 70-year-old widows
from Holland, Pennsylvania, who cry themselves to sleep at night.
Conversely, when you see Members of Congress come to the well of the
House and you listen to them in the hearings and they spend most of
their time emphasizing the differences, contrasting
[[Page H4667]]
the Republicans and the Democrats, this lady does not care whether the
bill is a Republican bill or a Democratic bill. She wants a bipartisan
approach that gets the job done. When you see Members constantly
emphasizing partisan differences, then you have to conclude that these
are Members who are not interested in solving the problem. They are
interested in winning elections, they are interested in political gain
and leverage, and I think that is what is shameful.
We need to get this done in a bipartisan fashion. The bipartisan bill
we are here to talk about tonight will do that. I urge my colleagues in
the Congress to support that.
Mr. Speaker, I would again thank my colleague from Erie for
organizing this event tonight.
Mr. ENGLISH. Mr. Speaker, I yield to the gentleman from Arizona (Mr.
Hayworth), a very distinguished member of the Committee on Ways and
Means and a gentleman who has been a leader on most of the issues
before our committee, but who particularly has come forward to be a
strong advocate today on prescription drugs; and I might add, it is a
great service to serve with him.
Mr. HAYWORTH. Mr. Speaker, I thank the gentleman from Pennsylvania,
and I thank the gentleman from Pennsylvania who preceded me in the
well. So we have not only eastern and western Pennsylvania, but the
east and the west united in this bipartisan effort to find a solution
that helps America's seniors with prescription drug bills.
I thought it was very instructive to hear the comments of the lady
from Pennsylvania in the letter to our friend, the gentleman from
Pennsylvania (Mr. Greenwood); and I thought it was equally instructive
to hear our friends on the left precede us this evening on the floor,
focusing on process and politics instead of on problem solving,
because, Mr. Speaker, make no mistake: we are committed to forging a
bipartisan plan. Indeed, sponsors of both political parties have
stepped forward and said, even though this is an even numbered year on
the calendar, even though it is the nature in this institution to
realize that about 5 months remain before an election, some issues are
too important even in an election year to simply preen and posture and,
yes, politic.
Mr. Speaker, not only was that letter from the lady in Pennsylvania
very poignant, it was also very practical. I think, Mr. Speaker,
another difference that we see in terms of approach is a question of
trust. Our bipartisan plan trusts America's seniors with an aspect of
freedom that has been their birthright. My folks are now in their late
sixties; my grandfather is 96. Choice has been a part of their life in
a variety of settings. Why then take away choice when it comes to
prescription drug coverage?
I hold a number of senior coffees in my district to sit down with
constituents who are articulate, informed, and very interested in a
multitude of topics. When this first appeared on the radar screen of
the body politic, a lady from my district summed it up very nicely when
she said to, ``J.D., whatever you do, please don't increase my Medicare
premium so that I have the honor of paying Ross Perot's prescription
bill.''
Now, think about that. Despite all the sophisticated talk that comes
out of Washington, D.C., my constituent really defined the issue. She
says, ``Number one, keep Medicare affordable. Don't needlessly raise my
premiums. Number two, don't force me into a plan that Washington
sometimes seems to gravitate toward, which in intent is one size fits
all, which in reality,'' as my colleague from Pennsylvania pointed out,
``is one size fits very few, and yet everyone is compelled, indeed,
coerced by law, to be involved in the plan.''
{time} 2300
That is not what we want to do. We want to champion choice and the
marketplace, and we want to make sure that the nearly two-thirds of
America's seniors who have existing prescription drug coverage can keep
that current coverage if they so desire.
The letter read by the gentleman from Pennsylvania from his
constituent reminds me of another real-life story involving one of my
constituents from Apache Junction, Arizona. Like the lady from
Pennsylvania, she too faced tough choices for herself and for her
husband. She told me that the prescription bills had become so
cumbersome that she was not able to qualify for a plan with
prescription drug coverage; that she, in her 70s, was employed at the
drive-through window of a prominent fast food chain, one of their
outlets in Apache Junction and, at that time, paying a penalty for
working, because of the earnings limit for seniors. But she was doing
so out of necessity, to deal with the prescription bills that she and
her husband were facing.
So let us state a broad objective and observation that most Americans
can agree with, Mr. Speaker and my colleagues, and it is this: no
senior should be forced to choose between buying food and buying
medicine. That is fundamentally wrong.
It is our intent to make sure that those who heretofore have not had
coverage, the one-third of current seniors without a health insurance
plan, without a prescription insurance plan, should have that type of
coverage. We want to take action to strengthen Medicare by prescribing
prescription drug coverage that is available to all seniors, but
undergirded with the principles of freedom and choice, that no one in
this country, I believe, wants to abandon.
Even though it was disturbing to hear earlier tonight the chief
administrator for the Health Care Financing Administration basically
say that seniors could not make up their own minds, I find that nothing
could be further from the truth in my district. As I said earlier, at
town hall meetings, at senior coffees, at the grocery store, at church,
at the softball and T-ball games when grandparents come to watch their
grandchildren play and visit with me, I find that our Nation's seniors
are among the most engaged, the best informed.
Now, at the dawn of the new century, there is unparalleled health and
prosperity for today's seniors, and indeed, this is a blessing, and it
is an opportunity. Yes, problems exist, as I pointed out, the situation
for the lady in Apache Junction and as the gentleman from Pennsylvania
read the letter from his constituent and the tough decision she has
been forced to make without prescription drug coverage. But we want to
make sure that we embrace and bring to the floor a plan that gives
seniors the right to choose an affordable prescription drug benefit
that best fits their own health care needs.
Mr. Speaker, this bulletin just in: we are all unique. We all have
different health challenges, different problems, different prescription
bills, different treatments. Why would we choose a plan that would
allow Washington bureaucrats to bring their red tape and regulation to
America's medicine chests? That is not what we want to see. We want,
again, to embrace the notion of freedom and opportunity and choice for
our honored citizens, for our senior citizens, for people who take the
time, as every senior in my district has, to intimately understand
their own challenges, their own health needs, their own prescription
needs, and to deal with it. We do not want to force the two-thirds of
seniors already covered out of coverage if it works for them.
The real challenge with the one-size-fits-some approach is that in an
effort to have the heavy hand of government and the Washington
bureaucrats take the role of the corner druggist, that when government
inserts itself into that dynamic, we have very serious problems, and we
would hate to see those plans abandoned. Let us make sure that good
coverage is maintained for those who want the private coverage that
they currently enjoy; let us have a variety of plans based on the free
markets that are there; and yes, in those circumstances, in some rural
areas, in some areas that have been deprived of coverage, yes, there is
a role for government to play, not a game of ``gotcha'' or bureaucratic
intent, but by focusing on what works. That is what we are about in
this bipartisan plan.
Again, our mission is clear here, defined by my constituent and her
very simple and direct statement: please do not increase my Medicare
premiums so that I have the honor of paying Ross Perot's drug bill.
Make sure the plan focuses first on those seniors and disabled
Americans who have fallen
[[Page H4668]]
through the cracks, who do not have the prescription coverage, who find
themselves working a couple of jobs in their senior years to make ends
meet, who find themselves currently making a difficult choice between
food and medicine. It is those seniors to whom we should turn first.
But also, in the spirit of competition and choice and option, we should
allow folks to take a look at their plan to determine which is best for
them and find the plan that is right, rather than one-size-fits-some.
We should not force seniors into a Washington bureaucrat-run, one-size-
fits-all prescription drug plan that has too many rules, regulations,
restrictions, and allows politicians and Washington bureaucrats to make
medical decisions.
Indeed, this is something that I believe every Member of this House,
Mr. Speaker, ought to be able to agree on, as we debate the many facets
of health care, the many different challenges we face. The last thing
on earth we should do under the guise of helping the American people is
to decide on a course of treatment or action that violates the sanctity
of the doctor-patient relationship that prompts bureaucrats, whether
Washington bureaucrats or insurance company bureaucrats, to try and
make health care decisions. The principles we embrace, the plan that we
will bring to the floor in short order will make sure that there is
choice, will make sure that the two-thirds of seniors with current
coverage can continue to enjoy that coverage if that is their want, but
also provide other plans and other availabilities, and that is what we
need to do.
Again I would call on my colleagues to make sure that even in this
even-numbered year, that even with that great exercise, unique in our
constitutional republic where we, as constitutional officers, stand at
the bar of public opinion, the first Tuesday following the first Monday
in November, even with the temptation of some to turn this into a
bumper sticker issue, to come to the floor and impugn the motives of
others. Mr. Speaker, we understand that oftentimes free discussion in
our constitutional republic and in this chamber can bring out both the
best and, sadly, the worst in people.
{time} 2310
So tonight, Mr. Speaker, our call is to every Member of this
institution and, Mr. Speaker, to every American to put aside the
partisanship, to embrace the principles of freedom and choice, and to
focus on what works, making sure that seniors have choice in
prescription drug plans, that the one-third of seniors currently not
covered by a plan have options available to them, options that will
also exist for those currently covered by insurance, but that we do not
throw away or get rid of that coverage as a Washington-run compulsory,
coercive plan would do.
So I would challenge my friends on the left to put aside the venom,
the vitriol, and the predictable political speeches in search of a
bumper sticker solution, and join with us in a plan that is already
bipartisan, that already has the support of Republicans and Democrats
from across the country, folks who have listened to their constituents
and heard loud and clear.
Put aside partisanship, focus on what works. That is our challenge.
Mr. Speaker, I believe we will meet that. I would simply say to my
friends in Arizona to keep those cards and letters coming. We
appreciate their insight. We understand that they are on the front
lines in this battle and their initiative, their input, their wisdom
will help us solve this problem.
Mr. ENGLISH. Mr. Speaker, I thank the gentleman for his generous
efforts in helping us clear away the rhetorical smokescreen that hides
the fact that we have heard advocated on the floor an alternative to
the bipartisan plan which is actually less flexible and less generous
in terms of the benefits it offers. We think we have a better product.
Mr. Speaker, I yield to the distinguished gentleman from Tennessee
(Mr. Bryant), a gentleman who played a critical role in developing this
bipartisan product. He was part of the task force that I served on, and
he is a member of the Committee on Commerce.
Mr. BRYANT. Mr. Speaker, I thank my friend from Pennsylvania for
hosting this special order tonight obviously on a very important
subject that we have already spent 1 hour before we came into the
Chamber hearing one side of this debate, so to speak, and now we are
talking about what we think is probably not the other side, but rather
the one side, the bipartisan side of the solution to this very
important problem.
As we discuss this addition of prescription drugs to senior citizens,
we cannot talk about it in isolation. I think we have to place it in
the context of Medicare as we talk about this.
One of the first things that comes to my mind and I hear about from
my constituents in Tennessee is what I think is the doctors' maxim,
First, do no harm. As we examine these prescription drug proposals, we
should make sure that whatever plan we adopt does no harm. That is, it
should not jeopardize any of the current coverage of Medicare in what
they receive, beneficiaries receive, nor should it jeopardize the
retirement security of any American.
I think, secondly, as we talk about this issue we have to remember
the dignity and rights of Medicare beneficiaries as we protect them.
Just because an American reaches the age of 65 does not mean that they
should be treated like second-class citizens, and any effort that we
make to add this prescription drug benefit should ensure that seniors
gain the right to all the benefits that they are entitled to before
they reach 65, as well as after 65.
Mr. Speaker, I would agree with everyone who has spoken tonight on
both sides of the aisle, that something has got to happen. Something
needs to happen with regard to adding prescription drugs to our senior
citizens. Had we drawn up Medicare in this day and age, we would have
surely brought in prescription drug benefits because of the importance
to everyone, particularly to senior citizens, of drug therapy. This was
not done, though, in 1965, so we have to go back now and find the most
appropriate way to bring this in.
I think the best thing this body can do is to work together in a
bipartisan fashion. We have heard that word ``bipartisan'' mentioned a
lot. What that means is simply we are talking about both Republicans
and Democrats come together. Already on this bill that we are talking
about in this hour, we are in that bipartisan situation where we have
both Democrat Members and Republican Members cosponsoring this bill.
That is why I am proud of this legislation. It is something that our
task force worked hard to produce, and we have now people on both sides
of the aisle who can support it. I think our seniors and our disabled
people who will be eligible for prescription drugs deserve this type of
treatment, and I hope that we can rise above the partisan rhetoric and
the political ploys and get this job done.
As my friend, the gentleman from Arizona, mentioned, so often in
these even-numbered years, which means that we are all up for election
in the House, people play politics with issues like this. They like to
try to go out and scare our senior citizens and turn them for or
against, however they might try to use an issue. That is shameful.
I have hope that we do not do this this year, but last week I saw in
a paper, a newspaper, a paper that is distributed on the Hill with all
the news, where, in the other body, on the other side of the Capitol,
one of the Democrat Senators, the headline mentions his name and says
he is landing in hot water. What he did to put himself in hot water
with his own Democrat leadership was to agree to cosponsor this
bipartisan bill.
It goes on to say in here how he has dashed any hope of landing one
of three coveted seats on a powerful committee in the Senate. My
optimism sunk, because when we have people who are willing to play
politics and threaten their fellow Members and try to intimidate them
from joining a bipartisan bill in an election year, I think it is
shameful, too.
I hope in the House we can move forward, work together as we have
started on this bipartisan bill, and get something done. My friend, the
gentleman from Pennsylvania, mentioned that we have worked on this task
force together, something that our Speaker of the House put together to
study and to come up with recommendations. He charged our task force
with development of a fair and responsible plan to
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help seniors and disabled Americans with their drug expenses.
As we started, we began with a set of principles, and used those
principles to guide our efforts, I think resulting in this bill that we
are talking about tonight.
First, we wanted a plan that was voluntary. Everybody understands
what voluntary means. It means we can get in it or we do not have to,
we have a choice to get in and stay out; that it is universal,
available to everybody; and affordable to all beneficiaries. It would
be voluntary, universal, and affordable.
We also wanted to give seniors meaningful protection and bargaining
power to lower their prescription drug prices. I will talk just a
little more about that in a couple of minutes.
We also wanted to make sure that we preserved and protected Medicare
benefits seniors currently receive. That is what I meant when I said,
First, do no harm.
Finally, we wanted an insurance base, a public-private partnership
that sets us on a path towards a stronger more modern Medicare and
would extend the life of this Medicare program for the baby boom
generation and even beyond.
Coming up with a good plan that fit all of these principles was a
tall order, but the bipartisan Medicare prescription 2000 legislation
does follow these guidelines, and I believe it is the right approach.
Our plan provides prescription drug coverage that is affordable.
Seniors in my district and across Tennessee have been writing and
asking me for help, just like other Members have talked about tonight,
with the high cost of drugs.
In this bill, we will help more people get prescription drug coverage
at lower cost by creating group buying power, without price-fixing or
government control, something that has been referenced tonight already,
something that is totally unworkable. For the first time, Medicare
beneficiaries will no longer have to pay the highest prices for
prescription drugs. Under this proposal, they will have access to the
same discount the rest of the insured population enjoys.
An analysis by the Lewin Group recently concluded that private
market-based insurance policies that we are talking about here can
reduce the consumer's prescription drug costs by as much as 39 percent.
Also, our plan strengthens Medicare so we can protect seniors against
the high out-of-pocket drug costs that threaten beneficiaries' health
and financial security. This plan sets a monetary ceiling, what is
called a stop loss, beyond which Medicare would pay 100 percent of the
beneficiary's drug expenses.
{time} 2320
This is one of the things I found most challenging about what we were
trying to do is somehow protecting people against catastrophic drug
costs where we hear about people having to exhaust their life savings
or sell their home to pay their drug bills. We do that in our bill, and
I think that is one of the best components of what we have done is have
that protection out there, that stop loss, that once one gets to a
certain level, then the beneficiary, the senior citizen does not have
to go beyond that.
Our plan is available to all Medicare beneficiaries, and our public-
private partnership ensures that drug coverage is available to all who
need it by managing the risk and lowering the premiums. The plan calls
for the government to share in insuring the sickest seniors, thereby
making the risk more manageable, more affordable for insurers, and
lower premiums for every beneficiary.
As I mentioned before, we protect the most vulnerable of our seniors
and low-income beneficiaries. I could go on and on and talk about this.
I would just urge those in the House and those that might be viewing
the proceedings otherwise to look at this bill carefully, study it, and
see if we did not follow those principles that we talked about that we
wanted choice, we wanted it to be universal, we wanted it to be
voluntary, we wanted it to be affordable. We think we have done that.
We were very pleased to bring this bill to the House floor. As we
move this process, I trust that we can do it in a Republican-Democrat
fashion, do what is best for the American citizens. As again my
colleague from Arizona says, even though it is an even number year, an
election year, let us do the right thing.
Mr. ENGLISH. Mr. Speaker, let me say I appreciate the remarks of the
gentleman from Tennessee (Mr. Bryant). Judging from his remarks, he
would concede that we have managed to build a bipartisan product based
on a Republican budget that set aside $40 billion to modernize Medicare
and to improve benefits, and we have offered here the American people a
bipartisan plan that would provide benefits that are universal,
affordable, flexible and voluntary and allow them to get prescription
drugs based on a model of choice, something lacking in the other plan.
I appreciate the gentleman's remarks because he has clearly
elucidated the strength of our plan and the fact that we are offering
something that the American people, hopefully, can unite behind.
Mr. Speaker, I yield the balance of my time to the gentleman from
Arizona (Mr. Hayworth).
Mr. HAYWORTH. Mr. Speaker, I thank the gentleman from Pennsylvania
(Mr. English) for yielding to me, and I thank the gentleman from
Tennessee (Mr. Bryant).
Mr. Speaker, I think it is important just to summarize where it is we
believe this bipartisan plan is headed and what it is we are trying to
do.
Mr. Speaker, as we pointed out earlier, it is a sad fact that too
many senior citizens and disabled Americans are forced to choose
between putting food on the table and being able to afford the
prescription drugs they need to stay alive. That is morally wrong.
So we want to take action in a bipartisan way to strengthen Medicare
by providing prescription drug coverage for seniors and disabled
Americans so that no one is left behind.
While ensuring that all Medicare recipients have access to
prescription drug coverage, we must make sure our senior citizens and
disabled Americans also maintain control over their health care
choices.
It is fundamental that we cannot force folks into a government-run
one-size-fits-all prescription drug plan because, in reality, that
becomes one-size-fits-some. That type of approach would be too
restrictive, too confusing, and would allow Washington bureaucrats to
control what medicines one's doctor can and cannot prescribe.
It is our intent with our plan to give all seniors and disabled
Americans the right to choose an affordable prescription drug benefit
that best fits their own health care needs.
Our plan will help the sickest and the neediest on Medicare who
currently have no prescription drug coverage while offering all others
a number of affordable options to best meet their needs and to protect
them from financial ruin.
By making it available to everyone, Mr. Speaker, we are ensuring that
no senior citizen or disabled American falls through the cracks.
Because our plan is voluntary, we protect seniors already satisfied
with their current prescription drug benefit by allowing them to keep
what they have while expanding coverage to those who need it. We will
not, Mr. Speaker, we will not force senior citizens or disabled
Americans out of the good private coverage they currently enjoy.
I would point out, again, nearly two-thirds of today's seniors have
some form of prescription drug coverage. Again, our plan emphasizes
individual freedom, giving individuals the power to decide what is best
for them, not to rely on Washington bureaucrats.
The task is daunting. The details, we are in the process of hammering
out as we move to markup in the Committee on Ways and Means shortly,
but it is our intent to reach across the aisle as we have already done
with sponsorship of this plan on a bipartisan basis because the
stronger Medicare with prescription drug coverage is a promise of
health security and financial security for older Americans. And it is
our intent to work on a bipartisan basis to ensure that promise is
kept.
Our parents and grandparents sacrificed much for this country. As we
have been given charge by the people to come to this floor to do the
people's
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business, to be about the work of preparing for a new century, we
understand that America's seniors and disabled deserve no less.
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