[Congressional Record Volume 148, Number 58 (Thursday, May 9, 2002)]
[Senate]
[Pages S4087-S4088]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PRESCRIPTION DRUGS
Ms. STABENOW. Madam President, I want to speak to an issue that
relates to health care. I am so honored to join with our colleagues,
particularly on this side of the aisle in the Democratic caucus, who
continue to work very hard to bring a sense of urgency to the question
of health care for our families, to health care insurance, and to
affordability for our small businesses and family farmers and the
larger business community.
We know today that one of the major costs economically and from a
business standpoint--and certainly for families, and particularly for
our seniors--is the whole question of being able to provide health care
and being able to afford health care for our families.
We also know the major reason we are seeing health care costs rise
relates to the uncontrollable increase in prescription drug coverage.
Today, I once again come to the floor to speak about the need for
real action now.
I challenge and invite our colleagues on the other side of the aisle
and those in the other Chamber who have come forward with principles--
the Speaker of the House and those who will be speaking today about a
plan--to join with us in something that is real and tangible.
Words are not going to buy prescriptions for seniors. We know there
are seniors watching right now who are deciding today whether to pay
that utility bill or eat supper tonight or do they do those other
things which they need to do in order to have the quality of life we
want for our parents and grandparents and older Americans of this
country--or do they put all of their money into paying for lifesaving
medications? That is not a good choice.
Shame on us for having a situation where seniors have to make that
choice. Yet when we come to the floor, we talk about the need for a
real Medicare prescription drug benefit. And when we talk about the
need to lower prices for all of our families and lower prices for
everyone so we have health care available for everyone in this country,
we get more words than we get actions.
I am deeply concerned today as we look at what has been proposed by
our colleagues on the other side of the Congress, our Republican
colleagues in the House have said that they wish to lower the cost of
prescription drugs now. Yet at the same time we see old proposals to do
minimal kinds of discounts through discount cards and so on--things
that are already available which folks want to take political credit
for, maybe change the name or maybe put it under Medicare. But it
doesn't do anything to actually lower the prices and make prescription
drugs more available.
I am very concerned when we come forward with proposals that will, in
fact, lower prices that we are not yet seeing the support.
We want that support to be there to be able to use more generic drugs
when they are available after the patent has run out--the same drug and
the same formulation--and at a lower price.
We want to have the ability to open our borders so we can get the
best price of American-made drugs regardless of where they are sold
around the world.
In Michigan, simply crossing the bridge to Canada, which is a 5-
minute drive, cuts the price in half on American-made drugs. It is not
right. We think when we are talking about fair trade we should open the
border to the one thing that we don't have fair and open trade on; that
is, prescription drugs.
We also know the fastest growing part of the cost of that
prescription bottle is advertising costs, and that the top 11 Fortune
500 companies, last year, spent 2\1/2\ times more on advertising than
research.
I was pleased to join with my colleagues earlier this week in
introducing legislation to simply say: If you are doing more
advertising than research, taxpayers are not going to subsidize it. We
will allow you to deduct the amount of advertising and marketing that
you do up to the level that you spend in research. We want more
research. We want more innovative drugs. We do not want more market
research; we want more medical research. So we propose items to lower
costs to help everyone, right now, to lower those prices.
We also come forward saying it is time to update Medicare for today's
health care system. When Medicare was set up in 1965, it covered the
way health care was provided in 1965. If you went into the hospital,
maybe you had a little penicillin, or maybe you had an operation in the
hospital, and Medicare covered it.
Medicare is a great American success story. But health care
treatments have changed. I have a constituent who showed me a pill he
takes once a month that has stopped him from having to have open-heart
surgery. It is a great thing: One pill a month. The pill costs $400. I
said: I want to take a close look at that pill. I hope it is gold
plated. But the reality is, that pill stops expensive open-heart
surgery and allows this person to be able to continue living and
enjoying a wonderful quality of life with his wife and family.
If he went in for that surgery, Medicare would cover it. They don't
cover the pill. So that is what we are talking about. But we need this
to be comprehensive.
When our colleagues come forward, and their second principle is
guaranteeing all senior citizens prescription drug coverage, we say:
Yes, come join with us. Let's make it real. But, unfortunately, when we
run the numbers on what is being talked about--and the bill has not
been introduced yet, but we have all kinds of information about what
appears to be coming. From what we know, let me share with you some of
the numbers.
If you are a senior or if you are disabled and you have a $300-a-
month prescription drug bill, which is not uncommon, when you get all
done with the copays and the premiums and the deductibles that they are
talking about, you would end up, out of $3,600 worth of prescriptions,
paying, out of pocket, $2,920. So less than 20 percent of your bill
would be covered under Medicare.
That is not what we are talking about. That is not comprehensive
coverage under Medicare. That is really a hoax. That is a proposal
being put forward to guarantee all seniors prescription drug coverage
that is words, not actions. Again, words will not pay the bills. Words
will not guarantee that seniors get one more prescription covered, that
they will get that blood pressure medicine, that they will get that
cholesterol medicine, or make sure they have that pill that stops them
from having to have that open-heart surgery.
So we come today to this Chamber to say: Yes, guarantee all seniors
prescription drug coverage. But the proposal coming forward by the
Speaker of the House, and those on the other side of this building,
will not do it. Unfortunately, what is being talked about will add
insult to injury because they are talking about paying for their less-
than-20-percent coverage by another cut to hospitals.
I know the Presiding Officer from New York shares the same concern I
have because I know hospitals in New York have been cut, hospitals in
Michigan have been cut. My colleague from Florida is in the Chamber. I
know he has the same stories--and our leader from Nevada. We know that
whether it is rural hospitals or urban hospitals or suburban hospitals,
they have had enough cuts under Medicare. It is unbelievable we would
be talking about another cut for hospitals while they are proposing
this minimal prescription drug benefit.
The other thing I find incredible is that they are talking about a
copay of $50 for home health visits. We already have seen dramatic
cuts. We have had over 2,500 home health agencies close
[[Page S4088]]
across this country because of the excessive cuts in home health care
payments since 1997. Many of us have been saying: Enough is enough.
We cannot say that the home health help you need will cost more when
we are trying to give a little bit of help with prescription drugs
because it is the combination of home health care and prescription
drugs that allows people to live at home when they have health care
needs. It allows families to take care of mom or dad or grandpa or
grandma, to make sure if someone is disabled and needs care at home,
that they are not inappropriately placed into a nursing home or out-of-
home care. The combination of home health care and affordable
prescription medications will help our families care for their loved
ones and help people to live in dignity at home.
So I find it incredible that you would have, first of all, a minimal
proposal on prescription drugs coming forward, and then it would be
coupled with the fact they are talking about cutting hospitals and
copays for home health care to pay for it. This is an amazing situation
to me.
We need to be strengthening Medicare, not undermining it. Many of the
other parts of this proposal would turn Medicare over to private
insurance companies. It would basically create a situation where the
drug companies or insurance companies may believe they benefit but at
the expense of our seniors.
I am going to yield a moment to my colleague from Florida, who I know
cares deeply about this subject. I thank him for coming to the floor
today to join me, as we rise to say to our Republican colleagues in the
House of Representatives: Come join with us. Come join with us to make
sure we can, in fact, put the words into action. Words are not enough.
We need comprehensive Medicare prescription drug coverage. We need to
lower prices now.
I yield time to my colleague from Florida.
The ACTING PRESIDENT pro tempore. The Senator from Florida.
Mr. NELSON of Florida. I thank the Senator from Michigan for
yielding. I want to underscore a number of the remarks the Senator from
Michigan made--this issue of health care, home health care, and
prescription drugs.
I start my comments by saying, has the Bush administration taken
leave of its senses with regard to a number of these proposals? What
the Senator from Michigan has just said in relation to copayments for
home health care, home health care is something we want to encourage.
Home health care is certainly an alternative to being in a nursing home
from a cost standpoint. It is certainly a cost incentive as an
alternative to being in a hospital. But home health care, if it is the
right kind of medical care, is also a lot better quality of life for
the patient than having to be in a nursing home or a hospital, if that
is the appropriate medical care, because they are surrounded by family
in their home.
The Bush administration now wants to propose a new copayment.
Therefore, for senior citizens who are having difficulty paying medical
bills as it is, because Medicare does not cover everything, now the
Bush administration wants, in fact, them to pay more in order to be
eligible for home health care? Have they taken leave of their senses?
Take, for example, what the Senator mentioned on prescription drugs.
The Bush administration is saying: Oh, we want a prescription drug
benefit. Well, certainly all of us do. Why? Because Medicare was set up
in 1965 when health care was organized around acute care in hospitals.
But 37 years later, health care is a lot different. Thank the Good Lord
for the miracles of modern medicine.
So to provide those miracles of modern medicine--otherwise known as
prescription drugs--to our senior citizens, we ought to be modernizing
Medicare by adding a prescription drug benefit.
The administration says: Yes, we want it. But they are saying, $190
billion over 10 years. That is a drop in the bucket.
The ACTING PRESIDENT pro tempore. Time for morning business has
expired.
Mr. NELSON of Florida. Madam President, I ask unanimous consent that
I may proceed for 5 additional minutes.
The ACTING PRESIDENT pro tempore. Is there objection?
Mr. REID. Madam President, that would be fine. It may necessitate
having the vote at 5 after rather than on the hour.
Mr. LEAHY. I have no objection, provided we then still keep the
period of time prior to the next vote the same amount of time and the
vote will have to slip 5 minutes.
Mr. REID. I say to my friend from Florida, I also got a nod from the
minority that that is fine. We will ask that the vote be scheduled for
5 after 11 and that the Senator from Florida be recognized for an
additional 5 minutes--I am sorry, 11:35.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
The Senator from Florida.
Mr. NELSON of Florida. I thank my colleagues. They are very generous
with the time. I thank the Chair.
I was talking about prescription drugs and providing a realistic
prescription drug benefit by modernizing Medicare. We talked about a
level in the last campaign. This was a primary topic of concern. In
every television debate I had, this issue came up. The level we were
talking about was in the range of $300 to $350 billion for a
prescription drug benefit over a 10-year period.
The fact is, the escalating cost of prescription drugs is going to be
more than that. Of course, with a budget that now has no surplus--we
had about 14 months ago an ample surplus for the next decade--it is
going to be very difficult. But we are going to have to face that fact.
And don't talk about window dressing of $190 billion over a decade
because that is not going to cut it. For example, why don't we step up
to the plate on Medicare reimbursement? Look at the doctors and the
hospitals that are having difficulty making it because Medicare is not
reimbursing on a realistic payment schedule. We are going to have to
address that.
I say to my colleague from the great State of Michigan, the fact is,
eventually this country is going to have to face the fact of health
care reform in a comprehensive way. What are we going to do about 44
million people in this country who don't have health insurance? The
fact is, they don't have health insurance, but they get health care.
They get it at the most expensive place, at the most expensive time;
that is, when they get sick. They end up in the emergency room, which
is the most expensive place at the most expensive time because without
preventative care, when the sniffles have turned into pneumonia, the
consequence is that the costs are so much higher.
Ms. STABENOW. Will my colleague be willing to yield for a moment?
Mr. NELSON of Florida. Certainly.
Ms. STABENOW. He raises such an important point about prevention.
That is why I know we care so much about the issue of prescription
drugs. By making prescription drugs available on the front end, that is
part of that prevention, along with comprehensive care, making sure
that people are able to receive the medicine they need before they get
deathly sick and need to go into a hospital or need an operation.
My colleague raises such an important point, and it is one of the
reasons we are working so hard to make Medicare available with
prescription drugs and to also lower the prices for everyone. Part of
that prevention is making sure that seniors have access to the medicine
they need to prevent more serious injuries and illnesses from
happening.
Mr. NELSON of Florida. And comprehensive health care reform has to
deal with the 40-plus million who don't have health insurance by
creating a system whereby they are covered. That then allows the
principle of insurance to work for you because the principle of
insurance is that you take the largest possible group to spread the
health risk, and when you do that, you bring down the per-unit cost.
Thus, any comprehensive plan is going to have to have pooling of larger
groups. It is going to have to have consumer choice. It is going to
have to have free market competition to get the most efficiency, and it
is going to have to have universal coverage.
I thank the Chair for the opportunity to join the debate on
prescription drugs.
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