[Congressional Record Volume 148, Number 52 (Wednesday, May 1, 2002)]
[Senate]
[Pages S3589-S3591]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           PRESCRIPTION DRUGS

  Ms. STABENOW. Mr. President, I come to the floor today to respond to 
a proposal of principles that has been released this morning by our 
Republican colleagues in the House of Representatives.
  First of all, I commend them for speaking out in support of 
prescription drugs and lowering the costs. But I come today, along with 
other colleagues, to ask them to join with us in doing more than just 
offering principles, but, as my colleague who is now presiding has 
indicated, show me the money--show me the resources. Unfortunately, for 
a senior who got up this morning and had to decide whether or not to 
eat or take their medicine, a set of principles will not purchase those 
prescription drugs. What they need is action. They need action now from 
us. We have the ability, the capacity to do that.
  The first principle that has been put forward by the Speaker of the 
House is to lower the cost of prescription drugs now. I could not agree 
more. We have put forward a set of proposals to do exactly that, to 
increase the ability to use generic drugs, to open our borders with 
Canada so that our American consumers can purchase American-made drugs 
sold in Canada for half the price. So that our business community, our 
hospitals can have free and open trade with Canada to bring back drugs 
at half the price and sell them to our consumers. We can do that right 
now. It does not cost anything. Just take down the wall at the Canadian 
border.
  We also know that we need to encourage the drug companies to put as 
much emphasis on research as they do on advertising. Right now, they 
are allowed to write off advertising costs deduct them. Taxpayers 
subsidize that. We know they are deducting twice as much on advertising 
as they do on research, and we know if we simply said, you can deduct 
as much on advertising as you do on research, we would save money, and 
we could put that money into Medicare for a prescription drug benefit.
  We also know that the State of Maine has taken leadership in bulk 
purchasing, so that, on behalf of their consumers and their pharmacies, 
hospitals, and doctors, they are going to begin the process of 
purchasing in bulk to get a group discount. It is common

[[Page S3590]]

sense to get a group discount. We believe we ought to make that same 
approach available to all of our States that choose to do that.
  Right now, that is being challenged in court by the pharmaceutical 
drug companies. So we welcome--I welcome--the House joining with us. We 
have legislation to lower the cost now.
  The second principle is to guarantee all seniors prescription drug 
coverage. Certainly, our caucus--and a majority in this Senate--has 
been fighting very hard for this. We, again, are ready to do that right 
now. But it has to be real. One of my concerns is that our seniors have 
been hearing, for a long time, about updating Medicare and that we are 
going to provide Medicare coverage. We all know it has to be done.
  In 1965, when Medicare was developed, it covered the way health care 
was provided at the time: You went into the hospital, you might have 
penicillin, you had procedures in the hospital. At that time, Medicare 
covered the way health care was provided.
  Health care coverage has changed. Treatment has changed. We now rely 
to a great extent on medications. We are proud that those are developed 
in our country and that we have these new opportunities for treatment. 
I am proud, as an American, to be able to have that. But we also know 
it does not work if those who use the most prescriptions, the older 
Americans, do not have prescription drug coverage under Medicare. So 
there is no question that we are ready to do that in the Budget 
Committee.
  I am very proud to have been part of the Budget Committee putting 
forward a resolution this year that would place a substantial amount--
$500 billion--into Medicare and prescription drug coverage that we 
would put aside, as a country, to begin to address in a very 
substantive way what our seniors have to deal with every single day 
when they are struggling to pay for their prescription drug coverage.
  My concern is that when you add up--and we have had a chance to look 
at an initial review of some of the principles from a wire story this 
morning that spells out the premiums, the copays, and the deductibles, 
and all of that--when you add it all up, unfortunately, what our 
Republican colleagues in the House are talking about just isn't good 
enough. It just simply is not good enough.
  There are not enough resources. In fact, in looking in my State at an 
average senior who might be spending $300, as an example, per month on 
prescription drugs. For instance, a breast cancer survivor who is 
spending $136 a month on tamoxifen, and possibly needing cholesterol 
medication or blood pressure medication, or some other combination. 
With all those, a $300-a-month bill is not unheard of. Many of our 
seniors pay that. But if you add up what we are finding--and if this is 
not accurate, we welcome hearing the specifics--it appears from the 
paper they are suggesting something in the range of a $37-a-month 
premium, with a $250 deductible, that 80 percent up to $1,000 would be 
paid, and that 50 percent up to $2,000 would be paid. But for anyone 
who is spending between $2,000 and $5,000 a year--and that is many of 
our older Americans, or a family with a disabled child, or someone else 
with a health problem--there would be no assistance whatsoever.
  When we add that all up, for someone who might be spending $300 a 
month for prescription drugs, it ends up being less than 20 percent of 
their bill being covered under what is being talked about by our 
Republican colleagues in the House of Representatives. It would end up, 
for $3,600 a year, that senior being out of pocket about $2,795, 
leaving them to get $805 in support through Medicare. That is just not 
enough. That is not enough. That is not what our seniors expect. That 
is not what people have talked about. That is not what was talked about 
in the Presidential campaigns. That is not what we know we need to do 
on behalf of our seniors. Less than 20 percent of the bill is just not 
good enough.

  It also appears that this is something that would be turned over to 
private insurance companies, which I understand actually are very 
reluctant right now to do this. We are hearing from them that the 
private insurance companies would administer the plans, even though 
they are saying they are very reluctant.
  We have had a similar experience with Medicare+Choice where HMOs and 
insurance companies have left the plan. We know about the problems 
there. Why in the world would we want to make the same mistakes with 
the prescription drug benefit?
  So I see something being proposed that is inadequate--woefully 
inadequate--being administered by those who say they do not want to 
administer the program. We have experience that tells us it is not the 
best way to proceed.
  We also know that under private plans the premiums could vary and, 
for the first time in the history of Medicare, we could have 
inconsistent premiums from region to region.
  So there are a lot of concerns with the proposals we have seen from 
the other side of the Capitol, from our colleagues on the Republican 
side of the aisle in the House of Representatives.
  My biggest concern is that while we continue to see people talk about 
principles--principles that talk about lowering prescription drug costs 
and talk about Medicare coverage--those principles alone will not buy 
one pill for a senior in Michigan. It will not buy one month's 
prescription for a family with a disabled child. It will not help one 
small business lower their cost and their health care premiums so they 
can make sure they cover their employees.
  We need action now. We need the same sense of urgency in this Senate 
and in the House of Representatives that every family in America feels 
on this issue. We need the same sense of urgency that every senior 
citizen in this country feels when they walk into that pharmacy and 
today pay the highest prices in the world for their prescription drugs.
  Shame on us for not acting. Principles are fine, but they are not 
enough. I know that the people I represent in Michigan are way beyond 
principles. They know what the principles are. They want to know when 
we are going to act on them, when we are going to cut the costs and 
provide prescription drug coverage under Medicare. They want to know 
when we are going to stop talking and start doing.
  So I call upon my colleagues to take those principles and put them 
into legislation immediately. Let's make sure that it will work, that 
it covers more than 20 percent of costs under Medicare, and to join 
with us in a focused effort to lower the costs of prescription drugs 
for all of our citizens.
  I thank the chair. I yield the floor.
  The PRESIDING OFFICER. The Senator from New York.
  Mr. SCHUMER. Mr. President, I need 1 minute to confer with the 
Senator from Michigan. I suggest the absence of a quorum and ask 
unanimous consent for 1 minute when I am recognized.
  Mr. REID. Reserving the right to object, I say to my friend from New 
York, I think under the agreement, our time is about up. We have 2 
minutes left on our time.
  Mr. SCHUMER. Then I will speak for 2 minutes.
  Mr. REID. I say to my friend, there is no one here from the 
Republican side, so there being nobody here, until someone shows up, he 
can speak for up to 10 minutes without any problem.
  Mr. SCHUMER. I thank the Senator.
  Mr. President, I ask to speak for 10 minutes under morning business.
  The PRESIDING OFFICER. The Senator is recognized.
  Mr. SCHUMER. Mr. President, I compliment the Senator from Michigan 
for the great work she has done in leading our caucus to discuss the 
issue of prescription drugs. We all know we are in a real dilemma. The 
dilemma is a very simple one. We have, praise God, these miracle drugs. 
You take a pill and it makes you better. You take a pill and you don't 
have to go under the knife for an operation. You take a pill and you 
live longer and healthier and happier. It is amazing.
  All of us recognize that those pills don't grow on trees. It takes 
lots of research and effort to come up with them. But we are facing a 
dilemma in America--a dilemma faced by senior citizens; by young 
families who may have a child who needs one of these miracle pills; by 
small business men and women who have to pay for health care; by HMOs; 
by General Motors and the UAW. The cost of these medications is getting 
to be so high that we are living in a bifurcated society.

[[Page S3591]]

There are those who can afford them because they have wealth or because 
they are lucky enough to have a comprehensive health care plan, who 
live better and longer, and those who can't afford them who live worse.
  It is not part of the American credo. We are happy to say, if you are 
wealthy, you drive a Cadillac and have a five-bedroom house; if you are 
poor, you drive a Chevy and rent a flat. I don't think we are ready to 
say in American society that if you are wealthy, you can live better 
and longer and get better medicine than if you are poor.
  So I join my colleague from Michigan in asking, in demanding that we 
begin to do something about prescription drugs, that we make these 
drugs available to all people.
  We have to do it in two ways: One, we have to make sure Medicare adds 
prescription drugs--it was the big thing left out of Medicare back in 
the 1960s; of course, back then we didn't have these miracle pills--and 
second, that we lower the cost.

  We can do that by the methods on which I have been focusing, generic 
drugs, which lower the cost and provide the same availability without 
crimping the free market. And there are other proposals out there such 
as reimportation. But we have to lower costs for everybody.
  We are here to respond to this: ``House Republican Principles to 
Strengthen Medicare with Prescription Drug Coverage.'' First, I would 
like to welcome my colleagues in the House, Republicans, for getting 
involved in the issue. With this little thing they have put out, you 
haven't even put your little baby toe in the water. Jump in. Join us.
  They have principles: Lower the cost of prescription drugs now--how 
are you going to do it? I don't see anything as part of this that talks 
about that--guarantee all senior citizens prescription drug coverage. 
Let me tell my colleagues over in the House, if you are going to only 
allocate a small amount of money, you are not going to be able to do 
this. You may be able to help the very poor and those with catastrophic 
illness, but you will leave out the huge middle class. That is where it 
seems they are headed.
  They say: Improve Medicare with more choices and more savings. It 
seems to me I smell a little rat in that one. To rob Peter to pay Paul, 
to say we are going to pay for prescription drugs by cutting back on 
other parts of Medicare, I can tell you how our hospitals are hurting. 
I can tell you how doctors throughout New York and America are no 
longer taking Medicare. You are going to make that worse.
  This Republican plan seems to be saying: For a very few people we 
will make prescription drugs available, but we will take away the 
doctors who will be able to prescribe them.
  Finally, they say: Strengthening Medicare for the future, yes, we 
agree with that. Making permanent a huge tax cut which has already 
thrown us more deeply into deficit than the war on terrorism and saying 
you are going to strengthen Medicare is a contradiction. You have to 
decide which one is more important. I think we have, many of us. I like 
cutting taxes. I voted for many tax cuts. But making it permanent now 
when you say we know what jeopardy Medicare is in and we know we need 
prescription drugs? I will tell you what side of the fence most New 
Yorkers would be on, particularly when they know the tax cuts go 
mainly, predominantly to the very people who can afford these 
prescription drugs on their own. They don't need the tax cut to do 
that.
  Again, to my colleagues from the other side, from the other House, 
from the other party, welcome to the debate. We have been waiting for 
you. Let's get real. Let's not have a list of high-minded and somewhat 
contradictory principles. Put your money where your mouth is. What is 
your plan? What are you going to do? Many of us have specific proposals 
that we have been working towards. We would like you to support those. 
If you don't agree with those, what do you agree with?
  Ms. STABENOW. Will the Senator from New York yield?
  Mr. SCHUMER. I am happy to yield.
  Ms. STABENOW. I commend the Senator for his efforts regarding generic 
drugs. There is no question that this is the heart of the matter. I 
know he has held hearings. He has a bill that is moving forward. I 
commend him for going right to the heart of the issue. Hopefully, our 
colleagues on the other side of the aisle and in the other Chamber will 
be willing to embrace what is a very tangible way to cut the cost, 
which he has been working on, holding hearings on, and moving forward 
on. I commend him on this issue to all those listening. The leadership 
of the Senator from New York has been absolutely superb on this.

  Mr. SCHUMER. I thank my colleague from Michigan for those nice words 
and, more importantly, for the great work she does. Our generic bill is 
bipartisan. Senator McCain and I are lead sponsors in the Senate. We 
have sponsors in the House.
  Can you hear me over there in the House? Hop on our bill instead of 
putting out a statement of principles. It is led by Sherrod Brown of 
Ohio, but we have a number of Republican sponsors as well. Again, it is 
joint; it is not intended to be partisan. That is one way to lower the 
costs.
  The pharmaceutical industry is not going to like it. Again, I ask my 
House Republican colleagues: Are you willing to buck them? Are you 
willing to say we are going to lower the costs and prevent the lawyers 
from fleecing the Hatch-Waxman Generic Act clean or not?
  Today is a good little baby step on balance by my colleagues in the 
House, but they have a long way to go to convince the American people 
they really care about this issue.

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