[Congressional Record Volume 148, Number 71 (Tuesday, June 4, 2002)]
[House]
[Pages H3143-H3148]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                PRESCRIPTION DRUG BENEFIT UNDER MEDICARE

  The SPEAKER pro tempore (Mr. Osborne). Under the Speaker's announced 
policy of January 3, 2001, the gentleman from New Jersey (Mr. Pallone) 
is recognized for 60 minutes as the designee of the minority leader.
  Mr. PALLONE. Mr. Speaker, just as I finished before the Memorial Day 
break talking about the need for a

[[Page H3144]]

Medicare prescription drug benefit, and was very critical at the time 
about the fact that the Republican leadership in the House had failed 
to bring up a bill to address the need for a Medicare prescription drug 
benefit, I come back here today after the Memorial Day recess and the 
district work period believing stronger than ever that there is a need 
to pass such legislation.
  We had during the course of the Memorial Day recess, a number of 
Members had forums, opportunities to be back in our respective States 
and talk to our constituents. When I came back to the floor of the 
House today for the votes this afternoon, I had so many colleagues come 
up to me, particularly on the Democratic side of the aisle, and point 
out this was the concern that was raised most by their constituents 
during the Memorial Day recess. I do not understand how the Republican 
leadership continues to delay and not address this issue and not bring 
legislation into committee and onto the floor of the House that 
provides for a prescription drug benefit.
  We heard over a month ago that this was going to be addressed on the 
floor before the Memorial Day recess. Of course, that time passed. Now 
we hear today that they are going to address it next week. I frankly 
doubt it. I would not be surprised if they never address it. But I 
certainly intend to call upon them to address it, to basically lay out 
what their proposal is. But every indication we have had is that their 
proposal is not something that is going to be beneficial to perhaps 
anyone. It is not a Medicare benefit. It is basically premised on the 
idea that we are going to throw some money, almost like a voucher, to 
private insurance companies and hope that they will come up with some 
type of Medicare benefit, primarily for low-income seniors, not for the 
average senior.
  We hear nothing on the Republican side that would address the issue 
of cost, which is what most of my constituents were asking about. They 
cannot afford the prices of prescription drugs, and something needs to 
be done about that. I have a number of colleagues here tonight that 
want to address this issue, and I will just start out by mentioning two 
editorials on the issue. One was in the New York Times, and the other 
was in the Star Ledger, which is our major daily in the State of New 
Jersey. The Star Ledger sums up how I feel. This was from May 21, and 
it talks about the Republican plan and it basically says what I feel 
about the Republican plan, although we do not have a plan, we hear 
rumors and press conferences about what they might do. We do not have a 
bill.
  The editorial from the Star Ledger is titled, ``An Unrealistic Drug 
Plan,'' and if I can read parts of it: ``Prescription drug coverage for 
Medicare is something almost every politician agrees is absolutely 
necessary. From the beginning, the effort to create a drug program 
should have been part of a comprehensive effort to update and reform 
Medicare. The way medicine is practiced with drugs a greater and 
greater share of treatment options, it is ludicrous to continue 
Medicare without a prescription benefit. Providing a genuine one means 
offering more than what the Bush administration and the House 
Republican leadership have been discussing. From the start, they have 
looked only for solutions routed in the private sector, and have 
continued to side step one of the most important issues, how to demand 
pharmaceutical price breaks worthy of Medicare's massive bargaining 
power.
  ``If Congress had ever planned to do the job right, no one would have 
promised what the House Republican leaders did, a quick fix that they 
could vote on by Memorial Day. They will not make that unreasonable 
deadline because Congress cannot decide which part of Medicare will get 
cut to beef up another part enough to cover drugs. GOP leaders are 
looking for $350 billion over 10 years for their drug program, a sum 
that many Medicare advocates say is inadequate.''
  I will skip down to the end. It says: ``The President took time on 
two occasions last week to urge congressional action on a Medicare drug 
plan. He reminded representatives that they face another election this 
November, and that their constituents will not be happy if the hottest 
domestic political issue, Medicare drug coverage, has not been 
addressed. Since the President set aside only $190 billion over 10 
years in his budget for that drug benefit, his remarks sound more like 
political cover than a pep talk.
  ``There has been enough talk and enough promises. The thing that has 
been lacking is candid, determined leadership.''
  Mr. Speaker, I could not have said it better. The main goal of our 
Special Order, for both myself and my colleagues, tonight is to demand 
that the Republicans address this issue. They say they are going to, 
and they have not. With that I yield to the gentlewoman from Florida 
(Mrs. Thurman), who has accompanied me many nights on this issue.

  Mrs. THURMAN. Mr. Speaker, I thank the gentleman from New Jersey (Mr. 
Pallone). I accompany the gentleman on these many nights because this 
is an issue that I feel very strongly about, as the gentleman does; and 
he has invested much time in this issue. Quite frankly, it is not for 
us, it is for our constituents who, as the gentleman suggested, when we 
go home over breaks like this where we are out in the communities, and 
sometimes we are not even there to talk about this issue, but no matter 
where we go or what the issue is that we are there to talk about, this 
is just absolutely on people's minds, and their concerns are getting 
even greater.
  I hope that the gentleman from Maine (Mr. Allen) will join in with 
this because I think it is important to understand that we are now 
getting at that point where people are finding out whether or not their 
Medicare+Choice programs in fact are going to be staying in for the 
year, and there is a twofold reason that is of concern. It is the only 
part of Medicare+Choice right now that provides a prescription drug. 
How ironic that they are getting paid out of the trust fund just like 
traditional Medicare fee-for-service, but fee-for-service does not get 
a prescription drug benefit, but under Medicare+Choice they do. That is 
uncertainty; and quite frankly, it is my dollars as everybody else's 
dollars that goes into that trust fund. We need a playing field that 
addresses the Medicare population through Medicare, and not just so a 
few people in fact can have this coverage.
  In fact, in ``Families U.S.A.'' there is a special report, and I hope 
that people will look at this, there is a big concern out there about 
what potentially this bill is that I understand is kind of floating out 
there because we have not seen it, so we do not know all of the details 
of it.
  Today I heard there is a good possibility this will not go through 
the committee; it will directly come to the floor, probably through 
some kind of a rule that limits our ability to debate this. It will be 
covered with a lot of other issues because it is going to deal with are 
we cutting hospitals, are we going to do anything about reimbursement 
to doctors, what kind of technology issues we might have in speeding up 
the ability for technology to meet the marketplace. There is just a 
widespread of issues that will be contained in this Medicare bill, but 
the issue that becomes most important to our constituents is the issue 
on prescription drugs.
  What this special report basically says is that the pending bill, 
which is similar to what was done last year which many of us voted 
against because of these very reasons, was that the insurance industry, 
acting through the Health Insurance Association of America, made clear 
that it had no intention of offering drug-only policies. The industry 
reasoned that drug-only insurance policies would be subject to adverse 
risk selection, that is, they would disproportionately attract 
consumers who have existing health conditions, are sick or disabled, 
and are among the oldest of the old. The failure to attract 
beneficiaries with low drug costs would further drive up premium 
prices, and lead to an increasingly unaffordable price spiral.
  It also went on to say, and something that I touched on a few minutes 
ago in the traditional Medicare program, beneficiaries, and one thing 
that all of us agree with, at least here, can count on a uniform 
benefit no matter where they live, as the following analysis 
demonstrates, rely on private insurance companies to deliver drug 
coverage for Medicare beneficiaries rather than incorporating a drug 
benefit into

[[Page H3145]]

the Medicare program, virtually guarantees that coverage will be uneven 
in availability, cost and value, which is what we have right now under 
the Medicare+Choice program. That is just unacceptable.
  I would say we have the experiences out there, look at Medigap and 
the costs there, most of those plans, up in the top tier are costly, 
and their benefits for prescription drugs are going down; they are not 
going not up.
  Medicare+Choice, premiums are going up, benefits are going down, 
particularly in the area of a drug benefit and prescription drugs 
benefits. They are limiting them and saying we can only give generic. 
There may not be a generic out there because we have a problem with 
drug manufacturers in just being able to extend their patents. This is 
just a mess I think that we are in; and I think quite frankly the only 
reliable drug benefit that we can give to our seniors is through a 
Medicare plan.
  Mr. Speaker, I might just say that I hope, because we are going to 
hear about the cost of this, I hope as we go through this week's agenda 
and as we start talking about the estate tax for those 
multimillionaires, we are going to try to figure out a way to limit it 
to small farmers and small businesses, make sure that they have an 
opportunity to continue to do business as they have been doing and to 
pass that business and that farm on to their families.

  But let me say, if we look at the rest of the cost of that over a 10-
year period of time, if it should go to repeal, pays for a drug 
benefit, a benefit that will help 42 million people in this country. I 
hope that our constituents and others will continue to look at this. I 
am proud to stand here with my colleagues about an issue that is 
probably the highest priority for Americans.
  Mr. PALLONE. Mr. Speaker, I thank the gentlewoman. I think what the 
gentlewoman is stressing is that the whole Republican strategy of 
essentially privatizing a benefit, in other words saying that we will 
give some insurance companies some money and hopefully they will come 
up with a benefit, prescription drug benefit for some seniors, does not 
make sense. If we look at HMOs, it is essentially what we did sort of 
on an experimental basis a few years ago, was to say to the HMOs if 
they cover some prescription drugs benefits, we will give you some 
money to do it. But they have not been able to do it. It is not 
uniform. A lot of them have dropped the coverage. I think if anything, 
the HMO experience shows that we cannot rely on that to provide a real 
prescription drug benefit.
  Yet we hear from the Republican leadership constantly that they want 
to expand HMO options, that HMOs are still the answer to provide a 
prescription drug benefit, or look at other means of using the private 
sector. We are not opposed to the private sector, but Medicare is not a 
private sector program; it is a government program. It works very well, 
and the logical thing to do is to expand Medicare to include a 
prescription drug benefit for everyone and address the cost by having 
the Health and Human Services Secretary basically negotiate to bring 
costs down.
  Mrs. THURMAN. Mr. Speaker, before Medicare, we had private insurance. 
We have Medicare because there was no coverage under private insurance.
  Mr. PALLONE. Exactly.
  Mr. Speaker, I yield to the gentleman from Maine (Mr. Allen), who 
probably has drawn more attention to the cost issue than any other 
Member of Congress. I agree with the various proposals that he has to 
try to bring prices down.

                              {time}  1945

  Mr. ALLEN. I thank the gentleman from New Jersey for yielding. I am 
pleased to be back here again with him talking about the high cost of 
prescription drugs and what we should do about it.
  One thing that strikes me is that this is an issue that is hard to 
understand. This really is not a contest between the parties over the 
number of times we can mention the words prescription drugs, but there 
is a fundamental difference and the gentlewoman from Florida mentioned 
it. We have on the agenda this week a bill to make permanent the estate 
tax repeal. In other words, once again, tax cuts take a higher 
priority, particularly tax cuts for the wealthiest Americans, take a 
higher priority than providing prescription drugs at an affordable 
price to seniors on Medicare who simply cannot afford to take the drugs 
that their doctors tell them they have to take.
  We saw it with the original tax cut. So much money was taken out; in 
fact, all of the non-Social Security surplus was taken out for the next 
5 or 6 years. So when we look at which party is likely to provide real 
relief for prescription drugs, it will not be the party that says all 
the time, smaller government, lower taxes. It will be the party that 
says, we have a plan that will help all Medicare beneficiaries with the 
high cost of their prescription drugs, and that is what we are trying 
to do.
  So here we are again revisiting a plan that the majority in this 
House has still not brought forward, but that we know is coming forward 
and we know it will be the same old, same old story. Essentially it 
will say, the way to provide prescription drugs for seniors is to rely 
on the private sector, to rely on HMOs. HMOs, Medicare managed care, 
otherwise known as Medicare+Choice, does not operate everywhere in the 
country. In fact, there are 15 States where there is no Medicare+Choice 
plan at all that covers prescription drugs. In another seven States, 
there is one Medicare+Choice plan. Where you have one of the major 
insurance companies providing coverage for prescription drugs to 
Medicare beneficiaries, every year we see that the premium goes up and 
the cap on coverage goes down. There is no future here. There is no 
future here for the same reason that Medicare was passed in 1965. The 
private insurance companies do not want to cover people who are old and 
sick and poor. If we are going to cover everybody, and I do not mean 
just the very poor, I mean just ordinary retirees who are living mostly 
on their Social Security, that group is simply not going to get covered 
by these private sector plans.
  But what is fundamental in my mind is the Republican plan is really 
an assault on rural American seniors. The reason I say that is that the 
15 States which are not covered tend to be rural States in this 
country, the places where it is not economic for the large insurance 
companies to go and provide Medicare+Choice, managed care, HMO 
coverage. They are rural States. But all those people who live in those 
States, like mine, in Maine, they are all part of Medicare. When it 
comes to part B, the physicians services, they get treated the same way 
as people in other States. Why should it be that people in at least 
certain parts of New York and Florida and California and Texas get 
treated one way, but people in Maine and Vermont and Montana and 
Wyoming, North Dakota, Iowa, Wisconsin, Nebraska, Utah, and Arkansas 
get treated differently? There is no good reason for doing that. That 
is why we need a Medicare benefit.
  I have advocated one thing you could do in the short term is simply 
pass the legislation that I have introduced which would provide about a 
35 percent discount for all Medicare beneficiaries on all their 
prescription drugs at no cost to the Federal Government. It would 
essentially give Medicare the power to bargain with these large 
insurance companies and set rates that are no higher than the average 
in the rest of the industrialized countries, the six major 
industrialized countries.
  If that is too simple for the other side, then we go to a Medicare 
benefit. And, sure, a Medicare benefit costs some money, but seniors 
are obviously going to be paying a significant amount, anyway. They 
need a benefit that is worth signing up for, that virtually everyone 
will sign up for, but we are not likely to see that. We are not likely 
to see that brought forward by the Republican majority in this House 
because it involves strengthening in a major way an important 
government program.
  If you believe in smaller government and lower taxes and that is 
always the priority, there will always be another tax you want to cut 
before you take care of our seniors, and that is the dilemma that we 
are facing. I believe that what we are really looking for is a Medicare 
benefit which applies to all our seniors, which is voluntary but which 
is appealing, which people will sign up for and pay the monthly premium 
in order to get the benefit. That

[[Page H3146]]

is the only way to make this work. That is what the Democratic plan 
would do. But it will not work to create the illusion of a plan and 
call it a Medicare prescription drug benefit when by its very terms 
seniors will not sign up for it because it does not make economic sense 
for them to sign up for it.

  We really come back to this issue we talked about last time. It was 
quite a spectacle last year and will be, I suspect, quite a spectacle 
this year. The largest and most powerful lobby in Washington, the 
pharmaceutical industry, will say to the Republican majority, what we 
need in this country is drug-only insurance policies offered by the 
major insurance companies, and we should provide those companies with a 
subsidy to encourage them to offer that kind of policy. And the 
insurance companies will say, We don't like that idea. There's no way 
we are going to offer drug-only insurance policies.
  That is why it is all smoke and mirrors. That is why it is all an 
illusion. They have developed a plan for private insurance, private 
prescription drug coverage, which will not be offered and if it were in 
fact offered, it would not cover everybody. Rural States would be left 
out. Other beneficiaries would find it ineffective. This resistance, 
this fear of taking Medicare, the most cost-effective health care plan 
we have in this country, and not simply using it as the vehicle for 
improving the assistance to seniors on prescription drugs, it just is 
staggering. But that is what we are contending with. There is no 
question in my mind that if we are going to have equity, if we are 
going to have a plan that actually works in the real world, if people 
are going to be able to get their prescription drugs at a cost they can 
afford, the Republican plan that will be presented to us will not do 
the trick.
  I want to thank the gentleman from New Jersey for organizing this 
Special Order and being here once again to talk through the issues, 
because it is not easy. Americans can often hear the words over and 
over again and think we are talking about the same thing, but we are 
not. There is a huge, fundamental difference between the two types of 
approaches; and what we need is to give America's seniors the same type 
of coverage that people working when they have prescription drug 
coverage get from their insurance company. American workers get their 
prescription drug coverage through their health insurance company. 
America's seniors should get their prescription drug coverage through 
their health care plan. It is called Medicare. It works, it is cost 
effective, and it is how we ought to approach this problem.
  Mr. PALLONE. I want to thank the gentleman. Again, I appreciate all 
his efforts, particularly when he brings up the cost issue. I just 
wanted to say two things to comment on what he said. First of all, part 
of the problem that we face, and again this was happening during the 
Memorial Day recess, is that the drug companies start these campaigns 
where they pretend and try to get the public to think that what the 
Republicans and the President are proposing are somehow going to be 
beneficial to them. We have this multimillion-dollar TV ad campaign now 
by a front group, United Seniors Association, that basically the drug 
companies have been sponsoring. Ads were running during the Memorial 
Day recess. I was pleased to see that a couple of weeks ago some of the 
groups that are concerned about seniors got together to try to expose 
this.
  I just wanted to mention, apparently some of these groups filed a 
formal complaint at the Federal Trade Commission over deceptive 
advertising. What they point out is that what you are seeing with the 
drug companies now is that they are using money to basically go on TV 
and try to tell the American public that the Republican prescription 
drug proposal is a good one. Then they use money to try to essentially 
influence Congressmen through their campaigns to support the Republican 
proposal, and then they do all the advertising in general with regard 
to the drugs. And who is paying for it? The consumer. It is just a sad 
thing. It is very hard, I think, as the gentleman says, to explain to 
our constituents the difference between what the Democrats and the 
Republicans, are proposing because they hear all these conflicting ads 
on TV.
  I just wanted to say briefly and then I will yield to the gentlewoman 
from New York, what the Democrats have been saying is that we would 
like to simply add a prescription drug benefit to Medicare, to the very 
successful government program called Medicare that we now have that 
covers your hospital bills and your doctor bills. What the Democrats 
are proposing is very similar to what is now called part B of Medicare, 
which covers your doctor bills. You pay a fairly low premium, I think 
for your doctor bills now it is about $40 or so a month. The amount 
that you would probably pay for a prescription drug benefit would be 
even less than that under the Democratic proposal. You have a very low 
deductible under part B right now. It is $100 a year. Eighty percent of 
your costs are paid for by the Federal Government.

  And there would be a fairly low catastrophic. In other words, after 
you spend a certain amount of money for that 20 percent copay, all the 
costs would be paid for by the Federal Government. So we are not 
reinventing the wheel here. We are basically saying we want a 
prescription drug benefit under Medicare very similar to what you have 
now under part B Medicare to pay for your doctor bills. And for those 
who cannot afford a premium just like part B, the premium is simply 
waived for those who are below a certain income. And then we have a 
cost containment measure which says that the Secretary of Health and 
Human Services is mandated to bring the cost down, to bring prices down 
because he has the power to negotiate for these 40 million seniors that 
would be part of the Medicare program.
  I have no doubt that that would go far towards reducing the cost of 
prescription drugs. It is a very simple thing. This is what we as 
Democrats are proposing. It is vastly different from the privatization 
that the Republicans are proposing. With that, I yield to a health care 
professional, the gentlewoman from New York (Mrs. McCarthy), who is a 
nurse by background and who is very familiar with the issue at hand. I 
thank her for being here.
  Mrs. McCARTHY of New York. I thank my colleague from New Jersey for 
taking such leadership on this. As he had mentioned, I have spent over 
30 years of my life as a nurse, so I would like to talk about why it is 
so important that we have a prescription drug benefit under Medicare. I 
am going to try and cover this a little bit widely why some people that 
are even younger, that are not on Medicare, on why it is so important 
to support this because they are going to be there one day, and I think 
that is important. Nobody talks about that.
  I will say to you, I am only 58 years old. I am a healthy person. 
Yet, of course, once I turned 55, you start going for your physicals 
and I discovered that I had extremely high cholesterol. There is a drug 
on the market to help me reduce that. I tried exercise, did the diet; 
but apparently my problems with cholesterol are hereditary and there is 
nothing that can be done except being on this medication. I have been 
taking the medication faithfully, my cholesterol is down very low; but 
March 1 of this year, my prescription drugs went up 100 percent. Like I 
said, I am healthy and I am only taking one drug right now.
  But the reason I talk about this, because our seniors were also hit 
with those increases, especially those in New York and in many parts of 
this country. That is why as a health care professional who happens to 
be in Congress, I am fighting to make sure that our seniors get the 
medication that they need to have a healthy life. Why? If our seniors 
are taking the medications mainly because it prolongs our life, makes 
our life more productive and, by the way, a lot of times these seniors 
because they are productive are continuing to work.

                              {time}  2000

  I think that is important to look at. But if they do not take their 
medications because they cannot afford it, what happens? They end up in 
the hospital, sicker than before, because the medications that they 
were taking, they choose to either take a half a dose or skip a day.
  Now, people that are on medications have to follow the directions 
that the doctor or the health care provider tells

[[Page H3147]]

them to do. But when it comes down to our seniors that might not be 
able to afford prescription drugs on a monthly basis, because I have to 
tell the gentleman, a year and a half ago I asked all my seniors in my 
district to send me their prescriptions. I wanted to see how much they 
were paying. I wanted to really see what was going on, just in my 
district alone.
  I was astounded by what the majority of my seniors were paying on a 
monthly basis. A lot of them are on fixed incomes, and a lot of them 
said ``I do not take my medication every day.'' We are not talking 
about one drug, two drugs, three drugs; we are talking about $700 to 
$800 a month just on their medications. Some of them have absolutely no 
choice. They could be having a reaction to a heart medication, so they 
are taking that, and a lot of times it takes a lot of balance.
  But it comes down to this, it really, really does. I want the 
American people to really understand why we as Democrats are fighting 
for a good prescription drug plan. We will be keeping America 
healthier. By the way, I cannot tell you, when I was back in my 
district in the last couple of weeks, how many people, young people, 
people that are taking care of their parents, are saying to me, ``I 
cannot afford to help my parents anymore to pay for their prescription 
drugs.'' So not only are we hurting the elderly people, we are now 
seeing that, because our mothers and fathers are living longer, we are 
also seeing now the families being affected, because they have to help 
chip in to pay for their medication.
  This is why it is important. If we were rewriting Medicare today, I 
do not even think that we would think twice about whether to put a 
prescription drug benefit in with it. So, again, with the amount of 
monies that we spend here to try certainly to keep everybody healthy, 
why we would not be doing something with prescription drugs, I have no 
idea. Let us remember, our hospitals right now are under a crunch time, 
and the more times that they can help their patients stay out of the 
hospital, that is what they want to do. Prescription drugs are the 
answer.
  I think we have to start looking also at other ways of reducing 
prescription drug costs. Of course, that has to do with looking at 
genetic medication also. Again, here we have the pharmaceutical 
companies fighting us on this. All they have to do is change one little 
molecule in a medication and it makes it a whole new drug and it stops 
it from getting it on to the market. We can do things to make the 
American people and our seniors healthier, and, in the end, we will 
have a more productive society in many ways.
  So I am hoping to be very honest with you. Here we are in June. We 
might break by the end of September, maybe October, with the 
legislative work that we have ahead of us. I do not know whether we are 
going to get to this issue now. It is really a shame, because since I 
have been here in Congress, which is going on 6 years, we have been 
talking about doing something with prescription drugs, and here we are 
ending another session, the 107th Congress, without really doing 
something.
  I do not want people to be fooled. If something does get passed in 
this House, is it going to help the American people? Is it going to 
help our seniors? I think that is something that people and consumers 
have to be smart about.
  This is where, in my opinion, seniors can get involved. They should 
be calling their Congressperson, they should be calling their Senators, 
to say to get involved and to have a prescription drug policy that they 
can afford. I think that is the most important thing.
  Again, I thank the gentleman for his leadership, who has been talking 
about this issue many a night by himself.
  I have to say, when I talked to health care providers, when I talked 
to doctors, when I talked to pharmacists, they said ``we make no money 
on these prescription drugs,'' because they know that they have to make 
sure that their seniors get their medications. A lot of times they give 
it to them at cost, or a lot of times they will give them an extra 
couple of pills, because they know the patient is not taking it.
  We are in America. We are in America. We should not even be 
discussing this. This is a no-brainer. It is the Federal Government's 
job to make sure that we keep our seniors healthy as long as possible, 
and that is by having good medication and making sure that our seniors 
can afford to take it.
  With that, we should be looking at Medicare, at getting a good 
prescription drug plan out there. As far as I am concerned, if we do 
not do the right thing, we have let the American people down. I mean 
that with all my heart.
  Mr. PALLONE. Mr. Speaker, I want to thank the gentlewoman. She points 
out as a nurse and as a health care professional one thing that I think 
we need to stress, and maybe I have not and a lot of us have not 
stressed, and that is the whole preventive aspect.
  In other words, here we have all these miracle drugs that have been 
created in the United States, and if they are available, then people 
are taking them and they do not have to go to a hospital, they do not 
have to go to a nursing home. If they are not taking the drugs, a lot 
of times they are going to end up sicker, and, in the long run, because 
the Medicare program does provide for hospital care and for doctor 
care, it ends up costing the Federal Government even more money.
  Even if you just look at it from a monetary point of view, one of the 
things we never factor in when we do a cost analysis of legislation is 
what the long-term savings or the long-term financial implication is. I 
guess the way we operate with the Congressional Budget Office, they 
cannot look at the 10 or 20 years over the life of the program to see 
what the nature of the preventative nature of something is.
  I forget a lot of times that prescription drugs are a preventative 
measure, and if people are able to take the drugs, they do not have to 
be institutionalized.
  Mrs. McCARTHY of New York. If the gentleman will yield, that is 
something else a lot of people, especially here in Washington, do not 
talk about. Like I said earlier, looking at it holistically on what the 
cost evaluation is, I can tell the gentleman that the longer we keep 
someone healthier and the less time they have to spend in the hospital, 
overall we are going to be bringing down our costs as far as stays in 
the hospital go. That is the most important thing. I think it is every 
health care professional's dream to be put out of business. We love our 
job in the health care profession, but we also know that so many things 
can be prevented.
  As the gentleman said earlier, we have these wonderful, wonderful 
miracle drugs out there, but if you cannot afford to take them, they 
are not doing anybody any good. When these drugs come on the market, 
our seniors that need these medications should have the right, the 
absolute right, to be able to get the medications that the doctor 
prescribes.
  By the way, let us not forget, it is the doctor that is prescribing 
the medication to save the patient. So, again, let us let the doctors 
do the job that they were trained to do and not be dictated by a lot of 
the pharmaceutical companies.
  It is amazing. When you fly down here to Washington, I only have like 
a 40-minute flight, it does not matter what magazine I have anymore, 
there are pages and pages of advertisements about new drugs.
  I think people misunderstand. We, the Federal Government, give the 
pharmaceutical companies a lot of money for research and development. 
None of us that are trying to get a Medicare prescription drug plan are 
trying to stymie the pharmaceutical companies from research and 
development. We are not, because we need to have that stimulation there 
to keep coming up with bigger and better drugs.
  But, again, I say, are we going to go into a two-class system, where 
only those that can actually afford to buy the best medication that is 
out there do, and those that cannot do not? That is wrong. That is not 
what America is about.
  As far as health care goes, everyone should be able to be treated 
equally and get the same treatment. We as nurses do not care if you are 
rich or poor. All we want to do is make sure that you are taken care 
of, the same as whether you are on one side of the room or the other 
side of the room.

  It should come down to the same thing with prescription drugs. 
Everyone should be able to have their medication; everyone.

[[Page H3148]]

  Mr. PALLONE. I thank the gentlewoman. The other thing she points out 
is, why are we here? Why do we come here on the floor of the House 
after the votes and bring this up?
  I think there is a sort of dual fear on my part, and I am sure the 
gentlewoman's and the Democrats in general, that either the Republicans 
are not going to bring up anything, which is a possibility, because it 
keeps getting postponed, or, if they do bring something up, that the 
danger is it is just there for political purposes. In other words, it 
maybe passes this House, but never passes the Senate because there is 
no effort to bring up something that everyone can agree on, or it is 
something that sounds good, but does not really help the average 
person. Because, as the gentlewoman points out, who is it out there 
that is complaining to us? Not the very wealthy; not the poor who are 
on Medicaid and get prescription drugs under Medicaid; but the vast 
middle class. Your average person, who, right now, because their income 
is not low enough, they are not eligible for Medicaid and they cannot 
afford to pay the high prices. They are like 90 percent of the seniors 
who need this benefit.
  I have been critical of the Republicans and I have been very partisan 
about it, because everything I hear is that their proposals they have 
been airing essentially do not cover prescription drugs for most of 
that middle income or middle class group. It seems like they are 
saying, okay, we will give some money, almost like a voucher, to 
insurance companies, and they will cover prescription drugs for people 
that are just above the poverty line, or they will see if an HMO will 
cover it.
  But, as we know, in many parts of the country, HMOs simply are not 
available and they have cut back on the level of prescription drugs or 
how much you have to pay or what kind of benefit you get. So there is a 
real concern on my part that if we do get a bill, that it not be just a 
hoax, just a sham; that it be something that is really meaningful in 
terms of people's lives.
  So I started this evening talking about two editorials. One was the 
Star Ledger. But I did not mention the one from The New York Times. I 
am not going to read the whole thing.
  If I could just conclude, this was actually on May 28 in The New York 
Times during the break. The title is ``Paralysis in Health Care.'' It 
says, ``Early this year Congress and the White House entertained dreams 
of passing all kinds of health care legislation. President Bush and 
Senator Kennedy were working on a Patients' Bill of Rights. There was 
even talk of enacting a prescription drug benefit for the elderly. But 
such talk has vanished. Lawmakers seem to be betting that voters will 
not punish them for inaction. But they cannot put off the issue 
forever.
  ``A decade ago, when the cost of health care was also soaring, many 
experts were sure they had a solution, managed care and competition. 
But HMOs turned out to be no magic.
  ``Elderly people who came out of the last election with the 
impression that they would inevitably get help with the cost of 
prescription drugs may be in for a disappointment. The Bush 
administration proposed spending less than $200 billion over the next 
10 years, a ridiculously low sum given the public's expectations.
  ``Congress Members had better take the time to listen to voters. They 
are likely to discover their patience is diminishing. Sooner or later 
the demand for health care is going to be high on the agenda, and it 
could happen before the election in November.''
  The New York Times is talking the political aspects of it because we 
know our constituents are demanding a prescription drug benefit. But it 
is, as I said, important for the Republicans, who are in charge here 
and have the obligation to, we as Democrats cannot, we do not have the 
majority, to not only bring up something, but bring up something that 
is going to be meaningful in terms of seniors' lives.
  We will go at this every night until we see a proposal brought up and 
an opportunity to debate this on the House floor, which we have not had 
so far.
  I yield to the gentlewoman from New York.
  Mrs. McCARTHY of New York. Mr. Speaker, again I would like to stress 
why it is so important. In my 30 years working as a nurse, I have seen 
so many different changes in our health care system. But one thing I do 
know is the same is that each and every person in our senior citizens, 
who certainly are some of our most vulnerable people, when it comes to 
their health care, we should make sure that they can get the best.
  I have to say, I did not want to see this country go down the way 
where we have a two-class system. When the gentleman had mentioned the 
middle income, I would be considered middle income on Long Island, and 
yet I am certainly concerned, will I be able to afford the drugs that I 
might need to keep me healthy as I get older?
  So that is why I am fighting. I am fighting as a health care 
provider, but I am also fighting because I am going to be a senior 
citizen one day.
  I thank the gentleman again for his leadership.

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