[Congressional Record Volume 148, Number 68 (Thursday, May 23, 2002)]
[Senate]
[Pages S4742-S4744]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           PRESCRIPTION DRUGS

  Mr. DASCHLE. Madam President, again I thank my colleague from 
Michigan. As all of my colleagues know, this is an issue on which she 
made a commitment to her people before she got elected. She reminds me 
every day of that commitment and her absolute determination to address 
this issue soon.
  I was in Maine a couple of days ago and was reminded again of what an 
emotional issue it is for seniors who have no other recourse but to go 
to Canada to get help, who pay bills and have to decide whether it is 
drugs or groceries, drugs or rent, drugs or car payments, drugs or 
fuel.
  That kind of a decision in this day and age for people vulnerable as 
they are economically and in so many other ways is a matter that simply 
cannot rest until we have addressed it.
  I thank the Senator from Michigan for her willingness to keep coming 
to the floor and reminding us of how important it is to keep organizing 
and effectively pressing for action in the Senate.
  I know she wishes to make her statement at this time, and so I yield 
the floor.
  The PRESIDING OFFICER. The Senator from Michigan.
  Ms. STABENOW. I thank our Senate majority leader. If we did not have 
his leadership, we would not have the opportunity to be talking about 
specific proposals for a comprehensive Medicare prescription drug 
benefit or opening the doors to Canada or in other ways lowering prices 
for families, seniors, businesses, workers. The entire economy is 
affected by this issue, and we would not be in a position to do that 
without the leadership of Senator Daschle.
  I thank him for that and also say that this week, as we are 
celebrating the leadership of another colleague, it would not be 
possible without Senator Jim Jeffords. I commend him. As our majority 
leader talked about going to Canada, Senator Jeffords has been at the 
forefront of breaking down those barriers so we could open the border.

[[Page S4743]]

  I find it ironic we are debating an open trade bill, fast track, so 
we can have more trade and yet the only thing we cannot trade with 
Canada is prescription drugs made in the United States and subsidized 
by American taxpayers. Yet if they go to Canada and the prices are 
dropped in half, we cannot benefit from that.
  Senator Jim Jeffords has been a leader. I am very proud to be joining 
with him on a bill with Senator Dorgan and many others. I once again 
commend Senator Jeffords for his courage in so many ways in stepping 
forward on matters that directly affect people every day. It is no less 
true on this question of prescription drugs.
  It is true, as our Senate majority leader said, people are choosing 
every day between food and medicine, paying the light bill, and being 
able to pay the rent. I have been inviting people from Michigan to come 
to my Web site and be a part of something we are calling the 
Prescription Drug People's Lobby. People have said to me, Why do you 
call it that? Well, it is very simple. We looked up the numbers, and 
today there are six drug company lobbyists for every one Member of the 
Senate. Their voice is heard, and they spend every day doing everything 
to, unfortunately, stop us from lowering prices. They do wonderful 
work. We celebrate American-made ingenuity that creates these new drugs 
from which we can benefit, but if they are not affordable, then they 
are not available. It is as simple as that.

  We have to address the question of prices and updating Medicare to 
cover prescription drugs. So I have formed something called the 
Prescription Drug People's Lobby in Michigan. I have colleagues doing 
the same. I know Senator Jean Carnahan is doing this. Senator Durbin 
and others are joining in this whole effort to invite people to share 
their stories to make their voices heard.
  I am very pleased today to share one of those stories from Mrs. 
Malissa Askin. I share a story that reflects exactly what our 
Democratic leader, our majority leader, was indicating. Mrs. Malissa 
Askin, from Romulus, MI, e-mailed me 2 days ago and asked that I share 
her story. I appreciate that she is allowing me to do this. She starts 
out by saying:

       I guess my story is no different from the many Americans, 
     when it comes to deciding if I can afford food to live, or 
     medications. It boils down to a choice these days (what can I 
     afford to keep myself alive?), once I pay my bills.

  Then she goes on to say:

       I am 68 years old. My husband is deceased and I have no 
     family. I have had a heart bypass, both arteries in my neck 
     cleaned out and now in April I was operated on for cancer, 
     not to mention other surgeries. I am supposed to be on nine 
     medications. However, at the price of these meds, I can only 
     afford three. I do not know what will happen with me by not 
     being able to be on the meds I cannot afford, but it makes me 
     wonder what I am living for. I feel like nobody cares.

  Well, Mrs. Askin, people do care. We care. I care. Our Senate 
majority leader cares.
  Mr. DASCHLE. Will the Senator yield?
  Ms. STABENOW. Yes, I will yield.
  Mr. DASCHLE. I thank the Senator for her poignant story and for again 
reminding us of the human face behind this issue. Those faces come so 
effectively to mind when one reads the words and listens to the 
extraordinarily difficult, agonizing decisions these older Americans 
have to make as they make their choices, as the Senator has indicated.
  Has the Senator ever thought of the irony we find in our country 
today where those people most vulnerable, those people who need 
prescription drugs the most, are the very ones who have no access to 
prescription drugs through the health plan to which they subscribe?
  Those of us who are younger, those of us who have private health 
plans today, have plans to which we can subscribe that have all kinds 
of prescription drug coverage available to us. I can go to a drugstore 
and have many of my drugs paid for, if I would ever find the need, but 
my mother cannot. She is part of Medicare. My relatives and my 
constituents cannot if they are in Medicare because they are in a 
program that has never adopted a prescription drug benefit program, in 
spite of the need that has been clearly demonstrated given the trends 
in health care delivery out of hospitals and into the more outpatient 
treatment care that is provided today.
  I know the Senator from Michigan hears the same stories----
  Ms. STABENOW. Absolutely.
  Mr. DASCHLE. About the ironic state of circumstances we face. I 
wonder if she could comment on that.
  Ms. STABENOW. I could not agree more. In 1965, we set up the promise 
of health care for those over age 65 and those who are disabled through 
Medicare, a wonderful American success story. Yet because it has not 
been updated to cover prescriptions, it no longer covers the way health 
care is provided today.
  My mother as well, my aunt, my uncle, my other relatives who have had 
health care coverage when working, now find themselves in a situation 
where they cannot really get what they need because most of what they 
need is outpatient prescription drug coverage. I know that is why we 
are working so hard in the Senate to bring the sense of urgency that 
Mrs. Askin feels to pass a comprehensive prescription drug benefit, not 
one like, unfortunately, our colleagues on the other side in the House 
have been proposing, which for most people would give less than 20 
percent coverage and cut our hospitals and create more costs for home 
health care in the process. That plan is not good enough.
  What we are talking about is something that would allow us to provide 
comprehensive prescription drug coverage without adding costs for home 
health or cutting our hospitals that have already been cut but looking 
at something comprehensively.
  When we look at Mrs. Askin, the bottom line for her is if she were to 
do what she needs to do to remain healthy, it would be a monthly bill 
of $938. How can someone do that? How can someone do that and live?
  Mr. DASCHLE. The Senator from Michigan points out another irony. We 
often hear about people voting with their feet. We hear it in another 
context generally. A lot of times immigrants vote with their feet as 
they leave their countries to come to a safer place, a place with a 
better future. I find it ironic--and I am interested in the comments of 
the Senator from Michigan--that our seniors today appear to be voting 
with their feet in driving in large buses and caravans to Canada to get 
health care today. What does that say about the American health care 
system? What does that say about Medicare? What does that say about 
their own satisfaction with a system that appears to be so broken, so 
incapable of providing them the care they need, they have to go to 
another country to get it in order to afford it?
  That, too, is voting with one's feet. I find that whether it is in 
letters to the Senator, or letters to any of us, or in the expressions 
of dismay, the current circumstances they face, more and more of our 
seniors are voting with their feet, going to Canada, to another health 
care system, to get what they cannot get here.

  Could the Senator from Michigan comment on that?
  Ms. STABENOW. I would be happy to comment on that situation.
  From Michigan, it is a simple 5-minute drive across the bridge from 
the tunnel from Detroit to Canada; or from Port Huron, or Sault Sainte 
Marie, a simple 5-minute drive to Canada. We have worked together, on a 
number of occasions, with the Canadian Medical Society and pharmacists 
in Canada.
  I find it most outrageous that these are American made drugs, the 
exact same drugs. We took a group of breast cancer patients using 
tamoxifen, at $136 a month in Michigan, 5 minutes across the border for 
the same drug sold for $15. I am told the companies make a modest 
profit on the $15.
  There is something wrong, something desperately wrong. I support 
underwriting basic research. I support the ability to create patents so 
companies do not have to have competition for their name brands for 15 
or 20 years, so they can recover their costs and all the other things 
we do to help create these wonderful lifesaving drugs. What do we get 
for it? The highest prices in the world. It is simply not good enough.
  Mr. DASCHLE. Again, I compliment the distinguished Senator from 
Michigan. One day, hopefully in this session of Congress, you and I and 
all of our

[[Page S4744]]

colleagues will be on the floor voting on a bill that will rectify that 
situation. We should not have to wait through another election. We 
should not have to wait for any other development. We know the facts. 
We know the people are going to Canada. We know the people are making 
these tough choices. We know heartfelt letters such as these are 
written, pleading for the Congress to respond. The only thing we do not 
know is how long it will take for the Congress to do what it needs to 
do; that is, to respond effectively with a comprehensive approach to 
universal access to good prescription drug coverage with cost 
containment as part of that coverage. That will happen someday as a 
result of the leadership shown and the extraordinary persistence of the 
Senator from Michigan.
  I thank the Senator again for that effort.
  Ms. STABENOW. I am deeply grateful for the comments of the Senate 
majority leader. His leadership, truly, on so many issues, particularly 
this issue, touches the lives of so many people every day. I am very 
grateful to the majority leader for that leadership.
  We are focusing on bringing bills to the floor so we can solve the 
problems addressing what Mrs. Askin from Romulus, MI, has written 
about. We cannot say: We will wait another year: Mrs. Askin, why don't 
you wait on medications that you need, wait until next year or the year 
after or the year after?
  This is not like buying a new car or a new pair of tennis shoes or 
are you going to wait on buying a piece of clothing. This is lifesaving 
medicine. There has to be a sense of urgency.
  Health care has changed. Most of the time we are not admitted into 
the hospital. Thankfully, medication will allow people to avoid open-
heart surgery or allow them to live with dignity at home or allow 
parents to care for children who are chronically ill or disabled, that 
allow them to live longer. We welcome these new innovations. It is 
wonderful.
  I am proud that in this country we are in a partnership with 
investments from all taxpayers to the National Institutes of Health, 
utilizing the American ingenuity of the companies that go to work. It 
is wonderful.

  Unfortunately, the end result is not wonderful. At the end of this 
process, the very people who help invest in the process cannot afford 
these lifesaving medications. Something is wrong. When we get to the 
end of the process and the health care system we have set up for older 
Americans who use the majority of medications, or those who are 
disabled who use the majority of medications, does not recognize these 
new lifesaving drugs incorporated in part of the health care system 
called Medicare, there is something wrong.
  When we are creating these medications and they are sold to every 
other country in the world at half the price they are sold to us, there 
is something wrong.
  When we see today these lifesaving medications are treated like any 
other product and twice as much or 2\1/2\ times more is spent on 
advertising than the research, and we, as taxpayers, pay for that 
through tax writeoffs, something is wrong. More was spent on Vioxx last 
year for advertisement than spent by Budweiser on beer, Coca-Cola on 
Coke, Pepsi-Cola on Pepsi. There is something wrong. It is fine to 
advertise and promote, but when the companies drive the prices beyond 
our ability to be able to afford the medications, when this advertising 
and promotion and sales going on in doctors' offices all over the 
country each day create a situation where a small business has to drop 
their insurance for their employees because they cannot afford the 
premium, it has gone too far.
  When manufacturers have to stop providing health care for retirees or 
lay off people because of rising health care costs, most of which is 
the cost of their prescription drugs, it has gone too far. I could go 
on and on with examples of what has been happening.
  Right now one of the largest costs, one of the costs driving every 
part of our economy, is the explosion in the pricing of prescription 
drugs. We can do better than that. We can open the border to 
competition for Canada. We can limit the amount we are willing to 
subsidize in those explosive advertising costs. We can support States 
in innovative ways. They are looking for ways to bring down prices for 
their own citizens such as in the State of Maine and the innovations 
they have incorporated, making sure when patents run out and it is time 
for the generic, the same formula can be sold without the brand name at 
pennies on a dollar. Those generic laws work, and we are, in fact, 
doing that. We have a plan that works. It is now time to put it into 
action.
  In closing, I say to Mrs. Askin that people do care. We are working 
very hard to get it right. We are working hard so citizens will not 
have to decide every morning what bill to pay, what food they can 
afford, or whether or not they can afford their medicine. It is time to 
get it right. I will work very hard until we get it right so you can 
know that you can benefit from the wonderful new medications that have 
been placed on the market to save lives, to extend life, so you can 
also enjoy all the other wonderful parts of your life without worrying 
about whether you can afford your medicine.
  I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  Ms. STABENOW. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. HOLLINGS. Madam President, I ask unanimous consent the order for 
the quorum call be dispensed with.
   The PRESIDING OFFICER. Without objection, it is so ordered.

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