[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

[[Page H4669]]

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

[[Page H4670]]

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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