[Congressional Record Volume 147, Number 58 (Wednesday, May 2, 2001)]
[House]
[Pages H1835-H1842]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 PRESCRIPTION DRUG COVERAGE FOR SENIORS

  The SPEAKER pro tempore (Mrs. Capito). Under the Speaker's announced 
policy of January 3, 2001, the gentleman from Texas (Mr. Turner) is 
recognized for 60 minutes as the designee of the minority leader.
  Mr. TURNER. Madam Speaker, I would like to talk about a subject this 
evening that has been ignored, I think, for the entire Congress that we 
have been in since the first of the year, an issue that many of us feel 
very strongly about, an issue that many of us campaigned on on both 
sides of the aisle, an issue that I think must be dealt with if we are 
going to have a budget that is honest and realistic, and that is 
dealing honestly with the problem of providing prescription drug 
coverage for our senior citizens.
  Tomorrow, this House will vote on a budget that emerges from a 
conference committee. The details of that budget at this hour, at this 
late hour, are still very murky, but one thing is clear: a

[[Page H1836]]

promise that we all made to our senior citizens this past fall, a 
promise of affordable prescription drugs, is being shoe-horned into 
this budget as an afterthought. There are many of us who believe very 
strongly that prescription drug coverage under Medicare for our senior 
citizens should be our highest priority.
  I am pleased to be joined today in this special order hour by several 
members of the Blue Dog Democrat Coalition. The Blue Dog Democrats have 
worked hard to advocate the inclusion of a meaningful and an honest 
prescription drug benefit for our seniors under Medicare. We all 
understand the skyrocketing prices that we are paying at our 
pharmacies. We understand that as a very stark reality. And instead 
when this House passed its budget, it included prescription drugs as a 
mere contingency item in a contingency fund that is far overloaded with 
items that need to be funded.
  So we are here this evening to urge this Congress and this President 
to include a real prescription drug benefit under Medicare in the 
budget this Congress will pass tomorrow. When we have so many 
constituents out here who are having to choose every day between 
filling their prescription and paying their rent or buying their 
groceries, we cannot afford to ignore this problem. I have received 
many letters in the last few weeks from senior citizens who said, I 
heard a whole lot last Congress about solving this problem of 
prescription drugs. Some of them even write they saw television ads run 
by candidates for Congress, some of whom are reelected and are here in 
this Congress talking about taking care of our seniors. They ask, ``Why 
haven't y'all done anything about it?''
  The answer is very simple. This Congress has not placed a proper 
priority on providing prescription drug coverage for our seniors under 
Medicare. The budget that we will vote on tomorrow is created entirely 
around a tax cut that leaves very little room for anything else. The 
Blue Dogs presented a budget to this House. We lost by a handful of 
votes. Our budget included a meaningful prescription drug benefit under 
Medicare.
  Now, we all favor significant tax relief. I do not find anybody in 
this Congress that does not understand that tax relief is an important 
priority for all the American people. But we have to balance that 
interest and that priority with the other priorities of government. One 
of those should be providing prescription drug coverage for our 
seniors. Everybody is quick to talk about this $5.6 trillion surplus, 
but when we break it all down, we understand that much of that surplus 
has already been committed.
  This Congress uniformly agrees that Medicare and Social Security 
trust funds should not be spent. That means almost half of that surplus 
cannot be spent by this Congress in either tax cuts, new spending 
programs, or anything else. The Blue Dogs have advocated giving a 
substantial portion of that surplus toward paying down our national 
debt, and we believe very strongly in that. But in addition to those 
priorities, we must have a prescription drug plan that will work that 
makes common sense for our senior citizens.

  Adding a prescription drug benefit under Medicare would require only 
about 6 percent of this $5.6 trillion 10-year surplus that everybody 
hopes will show up around here over the next decade. It is small enough 
to fit within a responsible budget. It deserves more than being listed 
as a possibility under the 10-year budget that the Congress will pass 
tomorrow.
  It just makes plain common sense. We must have a budget that balances 
our priorities, and our budget that we will vote on tomorrow does not 
do that. It neglects a promise that many of us made to our 
constituents, a promise that we would try to bring the high price of 
prescription drugs down and that we would provide a benefit for all 
seniors under Medicare.
  Medicare is the roof that protects our senior citizens. It is 30 
years old but it has dangerous leaks. Thirty-five years ago when 
Medicare was created, it did not include any coverage for prescription 
drugs because prescription drugs were not a big part of our health care 
costs. Since that time, we have had amazing advances, amazing 
discoveries, new prescription drugs that cure our ills.
  We think it is very important to be sure that all of those remedies 
are available to all of the American people. The least we can do with 
this surplus that we are so proud of is to ensure that our senior 
citizens have a prescription drug benefit under Medicare. Many doctors 
and nurses from hospitals in my district have told me stories about the 
massive hospital bills that could have been prevented if the patient 
had merely taken the necessary prescription drugs. There is no question 
that providing prescription drug coverage is the right thing to do for 
our citizens. The only question is whether this Congress is going to 
stand up and face the problem or continue to put it aside and ignore it 
and try to deal with it at a later date.
  There are some in this Congress who have hidden behind the issue of 
Medicare reform. They have said we are going to provide a prescription 
drug benefit in a Medicare reform package. Nobody, to my knowledge, 
knows clearly how this Medicare reform package is going to be put 
together nor what it is going to look like. We cannot wait for Medicare 
reform to deal with the problem of prescription drug coverage for our 
seniors.
  All of us who believe in honoring our commitment to our senior 
citizens to providing the assistance that they need for a meaningful 
prescription drug plan want to do it now, not tomorrow. We have 
advocated a universal prescription drug benefit under Medicare that 
will allow any senior citizen to walk in their local pharmacy and get 
the prescriptions that their doctor prescribes for their ailments and 
to do it at a reasonable cost under a reasonable plan.
  Now, it is not a plan that is without some cost to the senior 
citizen. It has been estimated that it may cost $25 to $30 a month in a 
premium for a senior citizen to have this coverage because the 
government, frankly, cannot afford to pay for the entire plan. But we 
believe that a plan that would require $25 or $30 a month from our 
seniors, that would take care of the first $4 or $5,000 of their 
prescription coverage cost, at least pay half of that and then over the 
$4 or $5,000 pay all of it, is a plan that makes sense for our seniors.
  We can afford to do that if we are willing to commit $300 billion of 
this surplus over the next 10 years to doing that. They had a vote in 
the Senate just a few days ago when they were debating this budget. An 
amendment was offered that would provide $300 billion for a real 
prescription drug plan for seniors under Medicare. When the votes were 
counted, it was 50 for and 50 against with the Vice President casting 
the deciding no vote. Later an amendment was offered that said that we 
will have a prescription drug plan and set aside $300 billion of the 
contingency fund in this budget if we reform Medicare first, and that 
was adopted by one vote, the Vice President again casting the tie vote.
  Those of us who know the reality of this problem for our seniors say 
that is not good enough, that surely in a country as generous and as 
compassionate as we like to claim we are, surely we can provide a 
basic, meaningful prescription drug benefit for our seniors under 
Medicare.
  Now, we are not forcing this plan on anybody. It is an option under 
Medicare, just as your current part B Medicare is an option for your 
doctor coverage. So if you have got a plan that you like and you do not 
want to change, you do not need the coverage, do not sign up. But this 
plan should be available for the hundreds of thousands of seniors all 
across this country who are struggling today to pay for their 
prescription drugs.
  We are fortunate to have on the floor with us tonight a Member of 
Congress, a fellow Blue Dog, the gentleman from Arkansas (Mr. Ross), 
who is a pharmacist, who understands this problem all too well. It 
gives me a great deal of pleasure to yield to the gentleman from 
Arkansas to share his perspective on this very, very important issue.
  Mr. ROSS. Madam Speaker, I might clarify one thing. I am not a 
pharmacist. I never was smart enough to be one. My wife is one. 
Together we do own a family pharmacy. I come from a small town in rural 
south Arkansas. It is a town called Prescott, a town of about 3,500 
people. It is a town I love very much. For those Members who were 
raised in small towns or perhaps

[[Page H1837]]

still live in small towns like I do, they know what I am talking about 
when I say that in small towns, there are always one or two gathering 
places.

                              {time}  1730

  My wife and I are very fortunate that in our hometown of Prescott, 
the family pharmacy that we own is such a gathering place. It is a 
place where people come to share recent photographs of their children 
and grandchildren, to celebrate the good times together and, yes, to be 
there for one another during the difficult times.
  I must say, I see way too many difficult times. Prior to being 
elected to the United States Congress last year, I worked in that 
pharmacy. This is an issue I do not just talk about. I worked with it. 
I saw seniors that were literally forced to choose between buying their 
medicine, paying their natural gas bill and buying their groceries.
  Living in a small town, I would learn a week later where a senior 
would end up in the hospital running up a $10,000 or $20,000 Medicare 
bill or where a diabetic would lose a leg or spend in excess of half a 
million dollars of Medicare money receiving kidney dialysis before 
eventually dying, simply because they could not afford their medicine 
or could not afford to take it properly.
  I do not just talk about this. I worked with it. I saw it. I can put 
names to the faces.
  This is America, and I believe we can do better than that by our 
seniors. That is why I will continue to fight to modernize Medicare to 
include a voluntary, but guaranteed, prescription drug benefit.
  Now what do I mean by that? When I say voluntary, that means if one 
has a plan, if they are fortunate enough to be one of the few seniors 
on Medicare in America who have medicine coverage from a previous 
employer, and they like it, they ought to be able to keep it. So it 
should be voluntary.
  Just recently, during the spring district work period, I had a 
townhall meeting in conjunction with the National Committee to Preserve 
Social Security and Medicare in one of the more affluent counties in my 
26-county district, Garland County. More than 100 seniors showed up for 
that townhall meeting on Social Security and Medicare, and I asked 
those who had medicine coverage of any kind to raise their hand. Less 
than 10 hands in the room went up. Then when I asked them to keep their 
hand up if they were confident they would be able to keep that coverage 
for the rest of their life, nearly every single hand in the room went 
down.
  I come from a very rural and poor district. The average household 
income in my district is only $19,000 a year. It is where very few 
seniors have any prescription drug coverage. So it should be voluntary, 
but it should be guaranteed. Just like under Medicare one can go to the 
doctor and they can go to the hospital. This is very important to our 
seniors. This is an issue that I ran for the Congress on, an issue that 
I will not stop fighting for until we finally do truly modernize 
Medicare to include a prescription drug benefit that is voluntary but 
guaranteed just like going to the doctor, just like going to the 
hospital.
  One of the problems we have in this country, I think, is created by 
the big drug manufacturers. I have bottles of medicine on the shelf of 
my pharmacy that cost more than I paid for a new car in 1979, and yet 
that same bottle is being sold in Canada and Mexico for ten cents on 
the dollar. We are talking about drugs that are being invented in 
America, oftentimes with government subsidized research. They are being 
made in America, and they are being shipped from America and sold for a 
fraction of the cost to these other countries.
  So what does that mean? That means all of us in America are 
subsidizing the cost of health care for these other countries. I think 
it is time we stood up to the big drug manufacturers and said enough is 
enough. It is time we demanded the kind of rebates to help pay for a 
Medicare drug program from them that they are now dishing out left and 
right to the big HMOs and to our States' Medicaid programs. Now I know 
the debate so far in Congress has been about the budget and tax cuts, 
and I hope we can now move from that very important subject of the 
budget and tax cuts into spending some quality time making something 
happen that will truly modernize Medicare to include medicine for every 
single senior citizen in America who needs it and wants it.
  Now we are hearing a lot of talk about this projected surplus, some 
$5 trillion. Well, it is a projection over 10 years, and it is being 
projected by the same bureaucrats that missed it by the tune of 
hundreds of billions of dollars last year. Seventy-five percent of that 
surplus does not even get here until 2006 through 2011, based on their 
projections, if they are right. Nearly half that surplus is Social 
Security and Medicare Trust Fund money.
  When we talk about the highway trust fund we do not dare talk about 
counting it in the surplus. I am not advocating that we do. The highway 
trust fund money ought to go to improve our roads. What I am 
advocating is that we stop talking about Medicare and Social Security 
when we talk about this Nation's surplus. That is why the first bill I 
filed as a Member of the United States Congress was a bill to tell the 
politicians in Washington to keep their hands off the Social Security 
Trust Fund, to keep their hands off the Medicare Trust Fund.

  I urge my colleagues to work together. Let us put progress over 
partisanship, and let us give our seniors a Medicare prescription drug 
benefit that means something, one that they can count on.
  Mr. TURNER. Mr. Speaker, I thank my colleague, the gentleman from 
Arkansas (Mr. Ross), for his remarks; and I beg his forgiveness for 
mentioning that he was a pharmacist. I did recall that his wife is a 
pharmacist, but she makes the gentleman work in the pharmacy whenever 
he is at home. We are glad the gentleman has the perspective that he 
does to share with us because it is only by being there. I had the 
opportunity in my district to be in several pharmacies to talk about 
this issue, and just as I was there talking about the issue people 
would come in trying to fill their prescriptions. One lady came to the 
gathering that was just in a local grocery store, not too far from the 
pharmacy counter, and she said I am glad to hear what you are saying. I 
did not know you were going to be here, but I was just in here 
yesterday and left my prescription; and I was just back at the window 
to pick it up, and when the pharmacist told me how much it was, I told 
him he would have to just keep it.
  Those are the kinds of problems that seniors are having today. They 
are very real. They are very serious and ones we must tend to in this 
Congress.
  Mr. Speaker, I am pleased now to yield to a fellow colleague, the 
gentleman from Texas (Mr. Sandlin), another Blue Dog who has worked 
hard to try to provide a meaningful prescription drug benefit for our 
seniors.
  Mr. SANDLIN. Mr. Speaker, we need to ask ourselves, who built this 
country? Who built this country? It was built by people that got up 
every morning and made a sandwich and threw it in the pail, went to 
work, built a product, sent their kids to school, and lived the 
American dream. It was built by men and women, our veterans, who 
traveled the world in the cause of freedom, who took the red, white and 
blue, the symbol of freedom, brilliant with color, signifying the 
American way of life. It is now time for us to honor our senior 
citizens. It is time to honor our veterans. It is time to keep our 
promise and make sure that prescription drugs are available, accessible 
and affordable to the American public and particularly to our senior 
citizens.
  The cost of prescription drugs continues to escalate. I am pleased, 
as are many of my colleagues, to see that the White House has 
recognized that this is a very, very serious problem in the United 
States and we must do something about it. However, we need to move 
toward a real prescription drug benefit.
  Unspecified benefits that have been sent over by the White House are 
not adequate, and I think we need to tell the administration that 
placing the Medicare surplus in jeopardy to pay for these benefits is a 
complete nonstarter. In this time of alleged surpluses, certainly we 
can address issues that are important to our senior citizens, some of 
our most vulnerable citizens in this country. If indeed we have a 
surplus, then certainly we can share that surplus with those that built 
this country.

[[Page H1838]]

If, in fact, we will continue to develop some of the finest 
pharmaceuticals that the world has ever seen, those pharmaceuticals 
have to be available to American citizens.
  Pharmaceutical companies have done an excellent job in developing 
drugs that have increased our life span, have given us a better quality 
of life, have allowed us to be with our families for a longer period of 
time. Most drugs have been developed on the backs of the American 
taxpayers. Research and development dollars are deductible, as they 
should be. It has been shown that as research and development dollars 
increase, the development of beneficial drugs increase and our public 
benefits.
  There are also Federal grants for the development of drugs. That is 
as it should be, and we all share in the benefits. Mr. Speaker, if 
these drugs are developed with American taxpayer dollars, as they are, 
then these drugs have to be available to American taxpayers, 
particularly to our senior citizens. They should not be just available 
to our friends in Canada. They should not be just available to our 
friends in Mexico. They should not be available to everyone except for 
the American taxpayer who helps develop these drugs.
  All of us, as we travel our districts across the country, hear 
stories from our constituents about the availability, accessibility, 
and affordability of prescription drugs.
  Gilmer, Texas, is a small city in my district. I was approached 
recently by a man who had some heart medication. He showed me the 
medication, made in the United States, packaged in the United States, 
FDA approved. That drug can be manufactured in the United States, 
package it, ship it to Mexico and sell it and make a profit, both for 
the seller and for the pharmaceutical company for \1/2\ of what that 
same drug cost in Gilmer, Texas. He could get a prescription for this 
heart medication for 30 days for the same cost as he could get the 
medication for 360 days in Mexico. Now something is just not right 
about that.

  We also did a study in my district recently that showed on average 
senior citizens paying 101 percent more for prescription drugs than the 
preferred purchaser, such as HMOs, the insurance companies. Now that is 
not the result only of bulk purchasing. That is the result of a 
systematic and targeted effort by the pharmaceutical companies to raise 
prices to those people who need these drugs and those people who can 
least afford the increase. So senior citizens in my district, and I 
would assume it is the same across the country, are paying twice what 
the HMOs pay for the same drugs, twice plus a little bit more; and that 
is just not fair.
  One estimate shows that more than one in eight of older Americans 
have been forced to choose between buying food and buying medicine. 
That is outrageous. We have the greatest, most powerful and richest 
country that the world has ever seen; and to have our senior citizens 
choosing between rent and food and pharmaceuticals and clothing is just 
not right. We cannot put up with it in this country. We cannot stand 
idly by while senior citizens take one prescription and not the other, 
while they cut their pills in half, while we have spouses sharing 
medication and say I will take one pill one day, you take a pill the 
next day, or say we are going to have to live on macaroni and cheese 
this week because we have to get the medication.
  Some are having, for example, three to four to five prescriptions; 
and they take two to three and not the others. That is just not right. 
We cannot do this in this country. We cannot ask our senior citizens 
who sacrificed their lives, who built this country up, who gave up 
opportunities to fight in wars, we cannot now ask them to suffer and 
allow citizens in other countries to reap the benefits of the research 
in this country.
  Our seniors deserve better. As I said, we appreciate the fact that it 
has now been recognized as a serious problem by the administration, but 
let us keep our promises that we have already made. Let us keep Social 
Security inviolate and keep it off budget. Let us make sure that we 
keep that Medicare surplus where it is to answer the needs of Medicare. 
While we have a surplus, we can use the surplus money to address the 
needs of senior citizens for prescription drugs. We can do no less in 
this country. We have a moral and a legal obligation to do that.
  As I have talked to my friends across the country from other 
districts, I have seen that this same problem exists district by 
district, State by State, all across this great country that we call 
America. It is our obligation to answer that call and to do something 
now, to do something immediately, to do something definitive that 
covers all Americans, especially all senior Americans; not targeted 
groups of Americans, not just Americans that are below the poverty 
level, not just those involved in some kind of catastrophic illness, 
but we should all share.

                              {time}  1745

  If the stock market is going to continue to have records, everyone 
should share. If we are going to continue to say we have a budget 
surplus in this country, everyone should share in those efforts, 
everyone should share in the benefits of that surplus.
  So, as we move forward, we are asking for a definitive program, not 
just a notation in a budget, not just an indication that there is a 
problem, not just a statement that, well, we think that probably more 
than likely, under most circumstances, it looks possible that we may be 
able to address prescription drugs with some contingency in the budget.
  We need to identify what we can do, how much it is going to cost, put 
it in the budget. And we need to do it. We need to answer it. We need 
to be definitive. Nothing else is adequate. Nothing from the White 
House, nothing from the Congress, nothing else is adequate, but to say, 
here is a need and here is how we are going to address it.
  We can do it. We have 435 people in here working hard. We have 100 
people in the Senate. We have knowledge about these issues. We know 
what the issue is, we know what the need is. Let us not play around. 
Let us not do smoke and mirrors. Let us not say we can do this tax cut 
or that tax cut or give away this money or that money before we meet 
our commitments to the people that made this country great.
  Mr. TURNER. Mr. Speaker, I thank my colleague from Texas. I have no 
doubt that what this group that is on the floor tonight is seeking is a 
definite commitment in the budget to a prescription drug plan for 
seniors.
  Another fellow Member of the Blue Dog Democrat Coalition here on the 
floor with us tonight is our friend, the gentleman from Mississippi 
(Mr. Shows.) He also shares our deep commitment to dealing with this 
very serious problem for our seniors. I am honored to yield to the 
gentleman.
  Mr. SHOWS. Mr. Speaker, it is a pleasure to be here. We appreciate 
the opportunity to speak.
  Mr. Speaker, when I was campaigning in 1998, I had traveled around 
the State of Mississippi a good bit. I was a highway commissioner and 
State senator, and the highway commissioners in Mississippi travel 
thousands of miles across the district. I really was not involved in 
national legislation at that point in time, except for Federal funds.
  But when I decided to run for Congress, I really did not know what 
the issues were going to be out there when we were approaching this 
level of politics. So, as I started out, I told the people in my 
campaign, I said, we are going to find out what this thing is all 
about.
  Well, after about a week and a half out there, going door-to-door, 
driving around every community and talking to all the people, I came 
back to my office and the campaign staff and I said, you know what it 
is about; it is medicine and health care. That is what this campaign is 
going to be about. It was that way in 1998, it was that way in 1999, 
and it was the same topic in the last election we just won.
  I think what happens is, when you think about your traveling across 
your district and the scenario does not change, we are still having 
people, these grandmothers and grandfathers, our parents, aunts and 
uncles, that cannot afford their medicine. It was an issue then and it 
is an issue now, and it does not really make sense.
  We all hear the stories, and the gentleman that spoke before me 
talked about, our office will get calls, ``We have to make the decision 
between paying our electric bill or buying food or buying medicine.'' 
Those stories,

[[Page H1839]]

they have got to get to you. They get to us, and I know it gets to my 
staff, and it really breaks your heart.
  I will tell you the other people it gets to. You go to the little 
pharmacists in little towns in rural Mississippi and rural America, and 
you have to listen to them. Some of them actually give them to some of 
them to help them out.
  Well, when we came to Washington we said we wanted to make a 
difference, and we did want to make a difference, and we did cosponsor 
the bill last year that the gentleman from Maine (Mr. Allen) introduced 
and cosponsored the bill he has now.
  But you start comparing, why in the world should American citizens or 
the American people pay the highest prices in the world for their 
medicine? Certainly some of these medicines that are being discovered 
by the pharmaceutical companies are getting research dollars from the 
Federal Government, a certain percentage of them, heart medicines and 
some of the major medicines we need.
  Yet the American citizens, for the rewarding of offering a free 
country, and these older folks that have a generation that helped make 
this country free, all of a sudden are put at a real big disadvantage, 
because they do not live in Mexico or Canada or Europe where they pay 
half-price for it.
  But let us look at the price for what they are having to pay. In 
Mississippi, we did the survey, we surveyed 10 drugstores in my 
Congressional District, over the 15 counties, and I think everybody has 
got these same figures. Even the people who do not support our bill or 
our move to try to do something about prescription medicine have these 
same figures.
  But in Mississippi, you pay $110 for Zocor; in Canada, you pay $46. 
Prilosec is $117, which is for ulcers, which I take, in Mississippi; it 
is $55 in Canada. Procardia, a heart medicine, in Mississippi, $138; in 
Canada, $74. Despite all the rhetoric and talk last year, we still have 
not got anything for the drug benefit program.
  Let us think about the people that made this country free, the World 
War II veterans and these same parents and grandparents that went 
through the Depression, went through World War II and fought other 
major battles to make this country free, are now fighting for their own 
survival, their own war, and that is to buy their medicine.
  I am proud of the drug companies and American pharmaceutical 
companies that have made this technology so available to our parents 
for medicine. But still what good does it do them to have the medicine 
if they cannot afford to buy it?
  I have joined my colleagues in reintroducing the Prescription Drug 
Fairness for Seniors Act. It is a little different this time in the 
structure. They said they could not afford the other one, it would not 
work. So they are taking the average foreign price of our medicines 
from Canada, France, Germany, Italy, Japan and the United Kingdom, and 
we are going to average our prices by what they are selling to them 
for.
  Let us look at one thing. If they are making a profit in the United 
States, and we know they are making a tremendous profit, what kind of 
profit are they making in these other countries and getting half-price 
for what we are paying for in the United States? So let us take the 
average foreign price. If we do this, we could save those seniors 40 
percent on their medicine. It is just like cutting taxes. That is a 
real tax cut. It may be survival for those folks that really need it. 
Let us quit price discrimination on our seniors.
  They say, if you do this--and this is always the argument, they say, 
if you do this, we will not have the money for research. Well, you 
know, last year when I looked these numbers up, they spent $17 billion 
on research, and I am glad they do, but they spent $11 billion on 
entertainment. They say, this is why we cannot do it. Well, if you have 
got to raise prices, raise prices in Mexico or raise prices in Canada.
  We must also have a prescription plan under Medicare, because this 
could be done separately.
  We must guarantee our parents, the people and grandparents who made 
this country free, the availability of prescription medicine. It is our 
duty and our obligation. I think not to let that happen would be a 
crime and an injustice.
  Mr. TURNER. Mr. Speaker, I appreciate the gentleman joining with us 
this evening and advocating a meaningful, universal prescription drug 
benefit under Medicare. I know that the gentleman has studied this 
issue a long time and sees it firsthand in his Mississippi district.
  I do think it is hard for the American people to understand why they 
are paying so much higher prices for prescription medicines than any 
other people around the world. The answer to that is really quite 
simple, because every other country around the world has some kind of 
restriction on the price of prescription medicine. So, compared to what 
they pay, we are footing the entire bill.
  A lot of the drug manufacturers have weighed in on this issue of 
prescription drug coverage under Medicare because they fear that what 
may result is the American people might end up paying the same lower 
prices as the people all around the world are paying. Of course, that 
would significantly cut into their profits. But the American people 
deserve to know why it is that when you walk into your local pharmacy, 
you have to pay over twice as much for prescription drugs as you do any 
other place in the world.
  There was a group of seniors down in Texas several months ago, and a 
lot of folks in Texas, a lot of them go across the border into Mexico 
and fill their prescriptions. We are not talking about prescription 
drugs that are second class. They go down there and buy the same 
medicine by the same manufacturer and in the same bottle they can buy 
it in their local pharmacy. They just get it a whole lot cheaper.
  So all these seniors in Houston decided to lease a bus, and they all 
got in this Greyhound bus and went down to Mexico and they filled their 
prescriptions. When they came back, they got to calculating how much 
they had saved, and they figured that they could save $10,000 on a 
year's worth of prescriptions just by making that trip to Mexico to 
fill their prescriptions.
  I talked to a fellow not too many months back who had a friend, who 
had a little single-engine plane, and he had some expensive heart 
medication, and his friend flew him down into interior Mexico to fill 
his heart medication. He saved literally thousands of dollars by making 
this trip, and he said if you go into the interior of Mexico, you can 
get an even better deal than you can at some of these pharmacies along 
the border.
  So it is really time to do something about this problem and to be 
sure that our seniors get some prescription drug coverage under the 
Medicare program, and to be sure that all Americans are treated fairly 
on their prescription drug costs.
  Mr. SHOWS. Well, think about the communities that have been impacted 
by NAFTA. They have lost jobs. The community I live in, Jeff Davis 
County, unemployment is 11 percent.
  Now, you look at the parts of this country that are doing well, and 
financially these people may be making it all right; but you take these 
poorer communities and rural districts that have been devastated by 
loss of jobs, and how much revenue is lost out of these areas and how 
much harder it is for these people to be able to buy this expensive 
medicine.
  And there is just something wrong with a country that has a budget 
surplus, and the tax cuts are fine, and some we like better than 
others, but what could be a truer, better tax cut, because we know the 
families, the children, the wage earners, are having to supplement 
their parents and grandparents or aunts and uncles, so it is taking 
money away from them.
  So it is just really compounding itself when you have a married 
couple, or a couple that has their parents or grandparent living in the 
same county, and they were to get in on the job so they could help 
their parents or grandparents with their expenses of medicine, and now 
they are hurting because their job is gone. Now what is going to happen 
to those people?
  There are so many people in this country today who, without the 
family's support, would absolutely die without it, would absolutely not 
survive. Then, to be compounded even worse, the loss of jobs in my area 
that have gone to other parts of the country, to Mexico, it is kind of 
like our berets are going to China, and now our

[[Page H1840]]

jobs have gone to Mexico, and now the loss of revenue; and it is just 
hard for these people to supplement their parents now.
  Mr. TURNER. I like what you said there about a prescription drug 
benefit for our seniors and fair pricing for all of us would be as good 
as a tax cut. It is not unusual for us to run into people who are 
paying $400 and $500 or more a month just to fill all their 
prescription drugs, and when you know that we are paying twice as much 
as anybody else in the world for our medicines, if you had fairness in 
pricing, they would save $200 or $250 a month.
  Goodness, I do not know any of these tax proposals that everybody is 
talking about that are going to give an average family $2,400 a year. 
So if we could provide fairness in drug pricing and a prescription drug 
benefit for our seniors, we would help many of them many times over 
what they can expect under any of our tax-cut proposals.
  I am pleased that we have tonight another member of the Blue Dog 
Coalition with us, the gentleman from Arkansas (Mr. Berry).
  Mr. Berry is trained as a pharmacist. He understands this problem 
full well, and he cochairs the Blue Dog Democrat's Task Force on Health 
Care. I am very pleased to have him join us on the floor tonight and to 
yield to him.

                              {time}  1800

  Mr. BERRY. Mr. Speaker, I thank my distinguished colleague, the 
gentleman from Texas, for yielding to me.
  I also want to thank him for his leadership in this matter, and for 
his continued effort to see that not only the senior citizens in this 
country but also the American people are treated fairly when they go to 
the drugstore to buy their medicine that they have to have to stay 
healthy and stay alive and have a decent life.
  It is an amazing thing to me that here we are, the richest, most 
powerful nation in the history of the world, and yet our senior 
citizens do not have the medicine that they need to stay healthy and 
stay alive, and those that are able to buy it are thrown into abject 
poverty many times, and forced to make a decision between food and 
medicine.
  How many times have we come to this floor in the last 4 years, I say 
to my colleague from Texas, how many times have we come to this floor 
to talk about this?
  In the last election, Republicans and Democrats, every candidate we 
saw, said, ``Boy, we are for it. We are going to take care of it. We 
are going to do everything. We are going to provide you with your 
medicine, and everything is going to be wonderful.''
  Merle Haggard, the great country and western singer, has this 
wonderful song he sings called Rainbow Stew. He says, ``When a man is 
elected and goes through the White House doors and does what he says he 
will do, we will all be drinking that free bubble-up and eating that 
rainbow stew.'' I think it is rainbow stew time.
  In Arkansas, in our folklore there, we have something called a 
buckeye. It looks like a nut. As far as I know, it is not good to eat 
and nobody eats it, and animals do not eat it.
  According to the folklore, if you get a buckeye and put it in your 
pocket, it will ward off evil spirits and give good luck, and keep 
rheumatism from attacking you. I have been carrying a buckeye, but I 
have been giving them away, because that is the only prescription drug 
plan it looks like we are going to get from the Bush administration. I 
am giving it to as many of my senior friends as I can, and I am out of 
buckeyes now. I wish I had one to show it to the Members. It looks like 
that is going to be the prescription drug plan.
  The President has already said he does not want to do anything about 
price. It is all right for the American people to get robbed day after 
day after day. Whether one is a senior or not, one is getting robbed.
  Here we are, we are going to be asked tomorrow to vote for a budget 
that nobody has seen. The most we are going to know about it is what 
speculation we can get and what little bit of information we can get 
from the committee staff in some way or other. I do not even think some 
of them have seen much of it.
  We are going to be asked to vote for a lot of things, particularly 
for some major tax cuts. Like my colleague, the gentleman from 
Mississippi, said a while ago, I am in favor of some of those tax cuts. 
But what could be a better tax cut than to see that our senior citizens 
are not thrown into abject poverty, or create a situation where their 
family has to lend great support to them to see them stay healthy, stay 
alive, and have what they need to have a decent life?
  These are the very people that built this country into the great 
nation it is today. They worked hard, played by the rules. Now we are 
telling them, ``Well, we just really do not think we can afford to take 
care of you. We do not know you anymore. We gave you Medicare in 
1965.''
  A health care plan for seniors today without a prescription drug 
benefit is the equivalent of not having Medicare in 1965. It does not 
make any sense. It certainly does not seem like the right thing to do.
  I think it is absolutely irresponsible to bring a budget to the floor 
tomorrow that does not provide a good, honest, straightforward 
prescription drug benefit for our senior citizens, and the mechanism 
where Americans do not have to pay twice as much or three times as much 
for their medicine as any other country in the world.
  I would urge the majority party to think about these things before 
they bring that budget to the floor. Think about the commitments they 
made in the last election. How can they go home and face their 
constituents and tell them, ``Well, we are going to take care of that 
next year,'' or, ``We are going to figure out some way to make people 
think we are going to take care of it,'' knowing that these seniors 
created this country we have today, and yet they are being ignored by 
their own government.
  Not only are we not providing prescription drug benefits for these 
seniors, we are allowing the prescription drug manufacturers of this 
country to rob them at the same time. It is not right, it is not fair, 
and every Member of this Congress should be working day and night to 
try to do something about it.
  We should not allow this to go past Memorial Day and not do something 
about the fact that the American people are being terribly mistreated 
by the prescription drug manufacturers.

  Again, I cannot begin to thank my colleague, the gentleman from 
Texas, for the leadership he has provided on this matter. I think we 
are very fortunate to have such leaders, and I consider myself 
privileged to work with the gentleman from Texas (Mr. Turner), not only 
in the Blue Dogs, not only on prescription drug and health care 
matters, but also as we work through this budget, through the other 
issues that are going to determine whether or not we are going to have 
these kinds of benefits for our seniors.
  Mr. Speaker, our majority leader ever since 1995 has mentioned on the 
floor I believe that we should let Medicare wither on the vine. This is 
precisely the direction we are headed in if we do not do something 
about not only a prescription drug benefit for Medicare, but making 
sure that we have adequate funding in that program to see that our 
seniors will have Medicare and a prescription drug benefit in years to 
come.
  The budget we are going to be asked to vote on tomorrow will actually 
make that situation worse, not better. We all know that. There is 
expected to be a provision in there that basically robs the Medicare 
trust fund, takes away our ability to provide even the services that we 
are providing now to our seniors. I think that is absolutely 
irresponsible.
  Mr. TURNER. Mr. Speaker, I thank the gentleman from Arkansas. I found 
it very interesting, his comments about the last election. That was so 
true. Every candidate that was running for office last November was 
talking about trying to provide a prescription drug benefit for our 
senior citizens.
  I am sure there are many seniors out there tonight that wonder what 
happened; how could all of these Members of Congress be campaigning for 
office, talking about how committed they were to helping our seniors 
afford prescription drugs, and now nothing has happened. Very seldom do 
we hear any discussion of the issue, and those of us who bring it to 
the floor, as we are tonight, are doing so in a special order

[[Page H1841]]

hour, not with the opportunity to bring it before a committee that 
would have the opportunity to actually take some action, or bring it to 
this floor on a regular calendar, where we could actually vote on a 
program, but we are relegated to this special order evening hour, which 
is set aside for discussion of issues that we choose to talk about to 
begin to discuss once again the problem of prescription drug coverage 
for seniors.
  I do not know if the gentleman saw any of the ads that were run 
during the last campaign, but I watched them carefully. It was very 
interesting to me to see them. I think it is important perhaps for us 
to talk a little bit tonight about why it is so difficult to pass a 
meaningful prescription drug benefit plan in this Congress when all of 
the Members of the Congress profess to say they are for it.
  I think it is important for us to discuss a little bit what the 
roadblocks really are, because when it comes right down to it, there 
are powerful forces at work opposing our efforts to provide a 
prescription drug benefit under Medicare for our seniors.
  The foremost opposition that we have faced comes from the 
pharmaceutical industry itself. I think there are a lot of our seniors 
out there and across America who do not understand why it is we cannot 
do something about this problem, but the truth is, the pharmaceutical 
industry has consistently opposed a prescription drug benefit under 
Medicare.
  Some folks may say, why in the world would they do that? The 
gentleman knows and I know and many others in this House certainly know 
that the pharmaceutical industry is afraid that if we have a 
prescription drug benefit under Medicare, that the government will no 
longer pay them those exorbitantly high prices that they are currently 
able to charge our seniors for prescription drugs.
  Is that not really about what it comes down to?
  Mr. BERRY. Absolutely. Mr. Speaker, if the gentleman will yield, one 
of the interesting things is that analysts have looked at the situation 
and they indicate that our people would use a lot more medicine if they 
could afford it, and that it actually would not damage the 
pharmaceutical companies' profits at all, that they would continue to 
be very successful.
  And we want them to be successful, but it all comes down to money. I 
think it is such an irresponsible thing to expect our seniors and to 
expect other Americans that have to take medicine to continue to pay 
two and three times as much for their medicine as anybody else in the 
world.
  I happened to be in Cuba about this time last year. We were there to 
meet with the ministers of the Cuban government to talk about them 
buying food from us, and also talk about buying our medicine.
  As we were beginning to conclude these talks, we said to them, ``You 
have said you want to buy our food, and we are pleased about that. We 
certainly want to sell it to you. Our farmers need the business. Our 
markets are in bad shape and we need your help, and you need our food. 
But you had not talked about medicine. Do you not want to buy our 
medicine?''
  And they laughed a very cynical laugh and looked across the table at 
our delegation. They said, ``We can buy your medicine anyplace in the 
world cheaper than we can go buy it from you. We can buy it in Canada, 
Mexico, Panama, Great Britain, Argentina; just pick a place, we can buy 
it for one-third of what you are paying for it.''
  Then they looked me right in the eye and they said, ``Why do you do 
that to your own people?'' I do not believe I have ever felt more 
inadequate than I did at that moment. I did not have an answer for 
them. The best answer that I could give them is, ``We are trying to 
change it.''
  We are going to keep trying until we get it done, because it is just 
a matter of basic fairness.
  Mr. TURNER. I certainly agree with the gentleman. I am sometimes 
discouraged when I try to talk to seniors in my district about this 
issue, because they know they are paying more for medicine than their 
counterparts in Mexico or Canada or anywhere else in the world, and 
they do not know why it is that we cannot do something about it here in 
the Congress, why we cannot provide a benefit under Medicare.
  What I try to point out to them is what I mentioned a moment ago, and 
that is that the pharmaceutical manufacturers have opposed our efforts, 
and try to explain to them how many dollars are actually at stake for 
these big pharmaceutical manufacturers.
  I suspect that what the gentleman just said is the truth, that if we 
could have prescription drugs at affordable prices, they would sell 
more of them and they will still make profits. But to date, they do not 
seem to be convinced.
  In fact, in the last campaign cycle, they spent over $2 million in 
direct campaign contributions to try to influence this Congress not to 
have a prescription drug benefit under Medicare. In fact, they spent 
$75 million over the last session of the Congress just lobbying the 
Congress, trying to be sure that no bill moved through the House or 
Senate to provide a prescription drug benefit under Medicare.
  That tells us, Mr. Speaker, that those pharmaceutical manufacturers 
really feel threatened by this proposal to provide a prescription drug 
benefit under Medicare. I guess they are kind of the last segment of 
health care that is not covered under the Medicare program.
  I think that there is a way for reasonable people to sit down and to 
work out a piece of legislation that will give our seniors access to 
prescription drugs under Medicare, and do it in a way that our 
pharmaceutical manufacturers will understand that in the long term, 
they are going to be better off working with us than working against 
us.
  Last year in this country nine out of the top ten drug manufacturers 
spent more money marketing than they spent on research and development. 
A lot of times these big pharmaceutical manufacturers say, ``Oh, if you 
make us have our drugs purchased by the government or available to our 
seniors under a Medicare program, we are not going to make as much 
money. We will not be able to do all this research and development that 
allows us to come up with all these miracle cures.''

                              {time}  1815

  Well, that gets your attention because the pharmaceutical 
manufacturers have done an excellent job coming up with new medicines 
for our ailments, and we want to be sure they continue to do that. But 
the truth is, when they spend more money on marketing than they do for 
research and development, that argument sort of rings hollow with me. 
After all, we are all familiar with the TV ads that are running all the 
time now telling us to go down and ask our doctor for some prescription 
medicine. And I am sure there are a lot of people that see those ads 
that go down and get the medicines. That is why they are running the 
ads. And that is great they now know about them, and they will go take 
the medicines. But the truth is, they are spending millions of dollars 
peddling their products to the American people at exorbitantly high 
prices when compared to the rest of the world.
  So I think it is time to get a prescription drug benefit under 
Medicare. It is a voluntary plan. Everybody that wants to sign up for 
it can sign up for it. If they do not want to sign up for it, they do 
not have to sign up for it. It is going to cost not only the seniors in 
a monthly premium, but there is a cost that we are going to have to pay 
here at the Federal Government so that we can keep the premium within 
reach of the average senior, and that cost has been estimated to be 
something in the neighborhood of $300 billion. That is a lot of money. 
But that is only about 5 or 6 percent of this budget surplus that we 
are so proud of.
  My colleagues would think that if we have a $5.6 trillion surplus 
that is going to show up here in Washington over the next 10 years, we 
could not only cut our taxes but we could take care of the most 
vulnerable segment of our society, our senior citizens, that consume 
the majority of the prescription drugs in this country. It seems that 
surely we could be compassionate enough to take care of those who are 
most vulnerable.
  I know, as the gentleman from Arkansas knows, that the fight is not 
an easy one, and our fight has been long. Our fight has been hard. We 
have both talked about this subject since we first came to Congress 
over 4 years ago, and I suppose we are going to have to keep talking 
about it before we will ever see

[[Page H1842]]

it happen. I know and the gentleman knows that we can do something 
about it and we can put a prescription drug benefit under Medicare. I 
think it is really a disgrace to have a budget coming before this 
Congress tomorrow, the conference committee report, without having in 
it a clear set-aside of the money necessary to provide a meaningful 
prescription drug benefit for our seniors. It is going to be an empty 
promise in that budget; there is no doubt in my mind about that.
  The Senate debated it. They had a vote on putting $300 billion or 
more in the budget. That vote was 50 for and 50 against, with the Vice 
President voting no and defeating the amendment. But we are coming 
close. We are getting closer, and we are going to get there; and I am 
just very hopeful that at some point in this session of the Congress 
the President and the leadership of this Congress will step forward and 
do the right thing, provide a meaningful press drug benefit under 
Medicare.
  There are some here who advocate it, but they say we are going to do 
it after we reform Medicare. Now, I am a little unclear about reforming 
Medicare. I think Medicare has worked very well for our seniors. Most 
of the seniors that I talk to got upset when we started seeing this 
Congress a few years ago, before the gentleman and I arrived, change 
Medicare so that seniors could go through an HMO and get their Medicare 
coverage. They were enticing seniors to sign up with all kind of add-
ons, like a little prescription drug benefit; and the first thing you 
know, all those HMOs decided to cancel their coverage and left 
literally thousands of seniors all across this country without any 
prescription drug coverage, which was the very reason they had signed 
up with an HMO in the first place.
  So I do not know what Medicare reform is. Does the gentleman have a 
feel for what that means? I do not know. And I know the gentleman has 
worked on this issue, as I have. Everybody says, well, we will provide 
prescription drug coverage when we reform Medicare. Has anybody told 
the gentleman what reforming Medicare really is going to be?
  Mr. BERRY. Well, if the gentleman will yield, I am afraid it is going 
to be that buckeye in that rainbow stew I referred to earlier.
  As best I am able to determine what the plan by the party across the 
aisle and by the administration currently is, it is to force our 
seniors into a managed care plan. And the only way they will be able to 
get a prescription drug benefit is to accept this managed care plan as 
a substitute for Medicare. It will have the same result that the 
gentleman just referred to; it will be an insurance company effort that 
the insurance companies will pull out of, ask continuously for more 
money, and we will be spending our Federal dollars for insurance 
companies rather than for health care for our seniors.
  Mr. TURNER. That is what I was afraid of. Our time has expired; but, 
Madam Speaker, I thank the gentleman from Arkansas for joining me.

                          ____________________