[Congressional Record Volume 148, Number 76 (Tuesday, June 11, 2002)]
[House]
[Pages H3437-H3442]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 THE REPUBLICAN PRESCRIPTION DRUG PLAN

  The SPEAKER pro tempore (Mr. Keller). Under the Speaker's announced 
policy of January 3, 2001, the gentleman from Kentucky (Mr. Fletcher) 
is recognized for 60 minutes as the designee of the majority leader.
  Mr. FLETCHER. Mr. Speaker, it is truly a privilege to be here this 
evening representing the leadership, the Republican leadership, on a 
very, very critical issue.
  Let me go back in time just briefly and look at when Medicare was 
first developed. We know that has been one of the most successful 
programs for our seniors, for their retirement security, for their 
health. Certainly it has been extremely successful.
  But since that time, medicine has changed tremendously. It has moved 
from a system that primarily was focused on acute care. In other words, 
if you had a problem, if you had a disease diagnosed, if you needed 
surgery, you went to the hospital, to the physician, and that was cared 
for. It was acute care.
  Medicine has transitioned tremendously since we first established 
Medicare. Medicare needs to be enhanced and improved and strengthened 
to meet those changes.
  Now, the Republican Party has already, over the last few years, 
certainly begun that change as we have increased some of the efforts 
toward diagnosis of early disease and screening of disease, and also on 
prevention, particularly in areas like diabetes, which certainly 
represents a tremendous problem in this Nation. Hopefully, through our 
increased funding of not only Medicare but NIH, we will find cures for 
these diseases.
  But we have already begun to move Medicare into an enhanced, improved 
program and strengthened it. Now, tonight, we would like to talk about 
prescription drugs. I think it is probably the most critical issue 
facing the United States and the health care, certainly, of our 
seniors, so it is certainly an honor for me to be able to be part of 
the Speaker's task force addressing this issue. Let me just review it 
briefly.
  First off, this program focuses and will provide coverage for all 
seniors. Every senior who is eligible for Medicare will be eligible for 
this program, and this program will cover them. It has been estimated 
about 95 percent of those seniors will take advantage of this.
  The other thing, it would provide immediate help, help right now: a 
30 percent estimated reduction of drug costs, prescription drug costs, 
immediately. This is an up-front discount that will take effect 
immediately on the bill passing not only the House but the Senate and 
being sent to the President's desk, where he certainly is very much in 
favor of this.
  It is voluntary, and it provides at least two choices guaranteed to 
every senior. It cannot be taken away. It is not like a program that 
some others are offering on the Democratic side that would be sundowned 
or sunsetted. This program will not be able to be taken away. It has 
the same provisions and the same assurance guaranteed by the U.S. 
Government as Medicare and as Social Security.
  One thing, it also has provisions to ensure our seniors do not have 
to choose between food and prescription drugs. Certainly, I have seen 
that occur, and I will talk about that a little later. For those on 
fixed incomes, it certainly is critical that we provide this help to 
those.
  It also protects people from the bankruptcy of runaway drug costs. We 
have a lot of wonderful new medications that help tremendously, but the

[[Page H3438]]

costs of those are accelerating. We need to protect our seniors from 
the possibility of runaway drug costs that will end up causing them to 
have substantial financial problems, and even bankruptcy.
  It also improves access and availability to hospitals, to physicians, 
nursing homes. With some of the provisions, it works to improve the 
reimbursement particularly for rural hospitals. It helps in general, 
again, with our health care of our seniors. I think it is one of the 
most pressing issues.
  I am pleased also to be accompanied here this evening by the 
gentlewoman from West Virginia (Mrs. Capito), who has taken a 
leadership role in helping chair this task force.
  I yield to the gentlewoman from West Virginia (Mrs. Capito).
  Mrs. CAPITO. Mr. Speaker, I thank my colleague for inviting me to 
join him on this evening to talk about a very critical issue. I think 
he has addressed a lot of the basic things concerning a prescription 
drug plan for seniors.
  I represent the State of West Virginia, which happens to have, or to 
be the oldest State in the Union. We have a higher percentage of older 
senior citizens. I see this every day when I travel throughout the 
district, when I talk to my constituents, and when I talk to other 
seniors that do not happen to live in my district but might see me at 
an airport or see me somewhere else, and they are always telling me 
that the cost of prescription drugs is something that needs to be 
addressed, and most importantly, needs to be addressed now.
  I think we have done a lot of talking about this issue. I have 
certainly talked about it a lot in my town meetings, in my meetings 
with folks that represent the chain drug stores, the pharmacists, the 
hospitals, all sorts of variety of folks throughout the district who 
are expressing concerns about how we are going to address this problem. 
But talk is, as they say, talk is cheap, and action is what we really 
need. It is what our seniors deserve.
  I think the ability to afford medications in one's golden years is 
really a form of retirement security. We talk a lot about Social 
Security and the sanctity of that promise made in Social Security and 
how very important it is. But I think also it is important for our 
seniors to have as part of their retirement security the satisfaction 
and necessity of being able to afford prescription medications.
  I share everyone's concern, and the gentleman's as well, over the 
rising cost of prescription drugs. It must be and should be an 
essential part of any health care plan; but unfortunately, as the 
gentleman mentioned, Medicare is not one such plan that covers 
prescription drugs.
  Americans over 65, those covered by Medicare, are the least likely to 
have help with the cost of their medications, and are the ones in most 
need of help. So time is ticking, the cost is ticking for Congress, for 
us to get something done now.
  The gentleman mentioned the House Prescription Drug Action Team. I am 
very privileged to be serving on that. I think it is important for us 
to raise the level of our voices to talk about a most important issue 
to our constituencies and to Americans. This Prescription Drug Action 
Team, I think, has worked hard with the committees and the committee 
Chairs in a bipartisan coalition to try to work together with the other 
side of the aisle to develop something that we can get to the 
President's desk.
  The men and women of West Virginia sent me here to lower the drug 
costs for seniors. I am particularly interested in seeing this done now 
and in an affirmative way.
  For instance, when we kicked off the Prescription Drug Action Team, a 
constituent of mine was here speaking with us, Betty White from 
Martinsburg, West Virginia. Betty has a monthly prescription drug cost 
of $340, which, in my math that I worked out in my office, gets her to 
$4,080 a year, astounding costs for Betty. She cannot afford to keep 
paying this and also make the other arrangements in her life to pay for 
her food and shelter and her necessities in her life, and still pay 
$4,000 a year for her prescription medications.

  I think we are on the right track looking at the principles that the 
gentleman is going to be talking about here in a few minutes, I think, 
the principles behind the drug plan. But I think it is important for 
those in West Virginia that are listening to me tonight to realize that 
all 288,000 seniors in West Virginia will benefit from this plan. That 
is significant.
  I think the plan, the plan we are working on, and it is evolving, has 
more help for the lower-income folks. In my State of West Virginia, 
again, 79,000 West Virginians, or 28 percent of our State's seniors, 
live at or below 100 percent of the poverty level. These extremely 
limited incomes make it impossible to afford astronomical costs of 
pharmaceutical medication, so a plan that really helps those folks that 
are having to make the day-to-day struggle for their health, for their 
well-being, is a plan that I think we need to get in front of Congress 
immediately.
  Another aspect of a good, solid plan I think is catastrophic 
coverage. A lot of the drug therapies, and my colleague, the gentleman 
from Kentucky, alluded to this, the drug therapies are very, very 
expensive, and get beyond Betty White's $4,000 and go on into the 
$8,000 or $9,000 a year range, astronomical costs. I think we need a 
plan that is going to help our seniors cap off that cost at a certain 
point where Medicare will pick up the remaining costs of those runaway 
prescriptions, of exorbitant rates. It is a plan that I know we are 
going to be able to put together here in the next several weeks.
  I think we have to make sure that we look at special parts of our 
population. I am a woman serving in Congress. Women live longer than 
men, and they are accounting for 72 percent of the population 85 and 
older; but unfortunately, women are more likely to have lower incomes 
in their retirement age. There are twice as many women as men aged 65 
or older with annual incomes of less than $10,000. This will help the 
seniors. This will help women who are seniors. I think that is 
significant.
  Many women, unfortunately, when they retire, they look at the 
retirement benefits, or if they have not been in the workforce, they 
have a problem. They have been home raising their families, 
contributing to society in a lot of ways, but have not picked up that 
paycheck. What are we doing for these women? This plan will come and 
help save these women from having to make the tough choices.
  I am here to stand by to let my fellow West Virginians, my 
colleagues, know that I will fight for relief. Lowering the cost of 
prescription drugs cannot be a political issue. It is not a Republican 
issue; it is not a Democratic issue. It is a human issue that cuts 
across all lines across America.
  As I have said before, the time is ripe. The time is now. We need to 
capitalize on this momentum and make sure that we join together in a 
bipartisan way and formulate a prescription drug plan for our seniors 
now. The time is now.
  Mr. FLETCHER. Mr. Speaker, I certainly want to thank the gentlewoman. 
Again, let me just thank her for her hard work, her dedication, and 
certainly her loyalty and care about those senior citizens in West 
Virginia. As the gentlewoman has mentioned, that is a large part of her 
population. I know she has worked very hard up here, and certainly I 
just want to thank the gentlewoman for coming this evening and sharing 
this time with us. I thank the gentlewoman for her work for those 
seniors back home. I know they will appreciate it.
  I just hope as we go through these next few weeks, and I believe we 
will be able to get this bill passed out of the House, I hope that it 
will continue to have work done so that eventually it gets on the 
President's desk and so those seniors back in West Virginia will see 
the kind of benefits that the gentlewoman has talked about. I thank the 
gentlewoman very much for joining us.
  I next yield to the gentleman from New York (Mr. Grucci), who has 
worked very hard also on this prescription drug plan. We appreciate him 
being here and sharing this time with us tonight.
  Mr. GRUCCI. I thank the gentleman for yielding to me, Mr. Speaker. I 
just want to comment and commend him on his great work and vision in 
the field of health care for all of America, but specifically for our 
senior citizens.

[[Page H3439]]

  Mr. Speaker, I rise tonight on behalf of the men and women in my 
district on Long Island who have told me in town hall meetings, public 
events, and in the calls and letters to my office how much they need a 
voluntary Medicare-administered national prescription drug plan.
  Over the past few weeks, I have spoken to hundreds and hundreds of 
senior citizens in town hall meetings all across Suffolk County 
outlining how this proposed Medicare-administered national prescription 
drug plan will actually help them.

                              {time}  2145

  And they told me in no uncertain terms that they need this drug plan. 
They need it now. They need it right away. They do not need it 
tomorrow. They do not need it the day after or the year after that. 
They need it now because their pain and suffering is real and their 
economic conditions are real. But they also told me they do not want to 
sacrifice their hospitals or their doctors. They do not want to cut 
reimbursement rates. They do not want to jeopardize the quality of 
their health care beyond that of prescription drugs. And on Long 
Island, seniors needs relief. They need relief from the high cost of 
prescription drugs and they do need it now. No senior should ever have 
to choose between purchasing food or purchasing the much-needed 
medicines to make the quality of their life a better place, to be able 
to give them the kind of life that they have earned all through their 
working years.
  The plan will save Americans hundreds and hundreds of dollars on 
their prescription drugs, and especially help those living on a fixed 
income, while also preventing cuts to our hospitals, to our doctors and 
to our home care providers, all of which are very important in the 
quality of life for our seniors as they move forward into their golden 
years.
  This legislation will lower the cost of prescription drugs now and 
guarantee all senior citizens prescription drug coverage. I would like 
to thank the Speaker, the gentleman from Illinois (Mr. Hastert), for 
inviting me to serve on this prescription drug action team, to create 
this Medicare-administered drug benefit program covering all senior 
citizens. I now have the opportunity to focus my efforts on ensuring 
that the program strengthens Medicare, while guaranteeing prescription 
drugs and preserving the integrity of the health care system and all at 
the time of making it affordable for our senior citizens and making 
sure they have the ability to buy the drugs they need to protect 
themselves and to ensure their quality of life.
  Far too many seniors are faced with the skyrocketing costs of 
medicines they need for a healthy quality of life, and that is just 
wrong in a country as mighty, as powerful and as affluent as this 
country is. We can do better for our seniors. We will do better for our 
seniors, and this program ensures that they will have that kind of a 
quality of life. It is time for the rhetoric and the petty partisan 
difference to end. It is time to act on behalf of our senior citizens.
  We need to put the qualities of our senior citizens' health care 
first and the way that we do that is by establishing an affordable drug 
benefit program as part of Medicare. That is very simple. It is what 
should have been done a long time ago. And I am glad to see that my 
colleagues in the House of Representatives and certainly those that 
have joined with me on the Speaker's task force have seen the need to 
do that, rose to the occasion, and have worked from inside the budget 
and are going to create benefit for our senior citizens, the likes of 
which they have never had before.
  I am proud to have been chosen as a member of that prescription drug 
action team and I am proud to have been a voice for our hospitals in 
the formation of this plan, saying that any final plan could not have 
imposed cuts to our hospitals and to reimbursements to our doctors, 
home care providers.
  I am proud to have been a voice for Suffolk County, for Suffolk 
County seniors, fighting to make this plan address our HMO 
reimbursement problems, a problem that has seen so many of our health 
care providers flee our county and move, not across the country, but 
across county lines, and in some instances into the city where the 
reimbursement levels are greater. And as a result, our senior citizens 
lack the kind of attention they need to take care of their health and 
their quality of life and that is just wrong.
  This plan is vitally important to the health and quality of life for 
our parents, our Nation and our senior citizens. That is why I lobby to 
target a prescription drug benefit for seniors as the GOP freshman 
class priority of 2002. The time is now. It is time for our senior 
citizens from Long Island and across this great Nation to have access 
to an affordable prescription drug benefit program through Medicare. I 
ask my colleagues to join me in working to secure a fair and equitable 
plan to strengthen Medicare by providing a prescription drug benefit 
without hurting our doctors, without hurting our hospitals, and without 
hurting our health care providers.
  I yield back to the gentleman from Kentucky (Mr. Fletcher), and I 
comment once again on his vision and his help, not only in this 
instance but in his leadership when it came to creating a Patients' 
Bill of Rights, a program that I helped to work on with him, and I was 
impressed with his credentials at that time as I am tonight. He has 
done a great job for this Nation and a great job for the people of 
America. I yield back to the gentleman.

  Mr. FLETCHER. Mr. Speaker, I thank the gentleman from New York (Mr. 
Grucci). The gentleman could probably tell us a few situations. The 
gentleman mentioned he had been in a town hall meeting or meetings and 
this is probably the number one issue I hear about when we talk about 
health care, particularly with our seniors. I know that the gentleman, 
having owned and operated a small business, providing health care, and 
as we worked on the Patients' Bill of Rights, I remember a lot of times 
we spent together and the gentleman talking about making sure we could 
continue to provide the kind of health care we need. And it is good to 
see the gentleman now taking a leadership role on this prescription 
drug plan.
  Mr. GRUCCI. Mr. Speaker, I thank the gentleman for those kind words. 
I can tell the gentleman that the people in my district consider this 
to be amongst the top tier issues in the country. Certainly the war on 
terrorism and making our homeland safe is something that is on 
everyone's mind, but short of that, health care and our senior citizens 
and prescription drugs is something that our senior citizens have been 
clamoring for, been asking for, been begging for, for a number of 
years. And I am glad to see that we have now risen to the occasion and 
are going to be able to provide them the much-needed help.
  An average senior in my district is no different than across the 
Nation. They spend about $2,150 a year on their prescription drug 
benefits. When I asked them that question, the majority of the room 
raised their hand in that area. Some had more than $4,000 of 
prescription drug benefits. This program will go to help pay for those 
above that cost. They told me this is the plan that they were hoping 
for to arrive in their lifetime and we are now able to deliver to them. 
And the gentleman has been doing an outstanding job on that. I am sure 
your district is no different than mine.
  Mr. FLETCHER. Mr. Speaker, the gentleman is absolutely right. In 
central Kentucky, probably throughout the State, when I talk to seniors 
at town hall meetings, and I was recently at a senior citizens center 
where there was probably 200-plus senior citizens there, and it was 
just the major issue on their mind. Virtually all of them seemed to be 
on some sort of prescription drug. I remember one lady that got up and 
she gave me her income and she said, How much will I have to pay? I was 
glad to tell her, and I will be looking just briefly at these charts, 
that lady who is on a fixed income, and I think the gentlewoman from 
West Virginia (Mrs. Capito) talked about this, this affects 
particularly women that have worked all of their life very hard, many 
in the home, and they are on a fixed Social Security income and now 
they have these high drug costs. I was glad to tell her that actually 
this plan will pay for all of her medication costs, that it would help 
her tremendously, or virtually all of the costs would be covered. And 
that is something that I think as I get out around

[[Page H3440]]

the district and tell people, they really understand how good this plan 
is and how comprehensive it is, covering all seniors. And certainly we 
get a tremendous amount of support out there.
  Mr. GRUCCI. Mr. Speaker, if the gentleman would yield, I would say 
the same is true in my district. The thing that we use together between 
the prescription drug benefit is the uncertainty our seniors have over 
the rhetoric that is coming out about their Social Security and are 
they going to lose it, are their benefits going to be taken away from 
them, are we going to pay for a prescription drug benefit and the 
health care of our Nation on the backs of our seniors through their 
Social Security? When I tell them there is no plan, neither a Democrat 
nor Republican plan to do away with Social Security or to privatize 
Social Security, a word that seems to have been cropping up in the 
vernacular these days in an attempt to scare our senior citizens into 
believing that there is some evil plan afoot here in Congress to do 
away with their Social Security or to privatize it and put it in 
jeopardy, when they understand that is not the case and that is not 
going to happen and they realize that this prescription drug benefit is 
actually new monies and not coming on the backs of their Social 
Security, they really understand the benefit that this program is going 
to have for them.
  When I told my senior citizens, and I probably did three to four of 
these town hall meetings, each with as many as 200 senior citizens in 
them as well, they understood that they were going to see savings. When 
I said to them, they will see six, eight, 900 and $1,000 back, you can 
hear the sigh of relief because to some Americans that may not be a lot 
of money, but to these folks, it makes the difference.
  People hear us talk about the choice between buying food and putting 
heat in their house and buying the medicine. Well, the seniors that I 
talked to are the people that are making those choices. I want to 
eliminate that choice. They should not have to make that choice. They 
should be able to have their Social Security benefits as well as their 
retirement. They should be able to have a prescription drug as part of 
a program that the Federal Government has said is right for them and is 
going to help them with. I could not be happier that this is coming 
about. I hope we can get this to the floor very quickly so that the 
Senate will be able to act on it and we can get it to the President for 
his signature.

  Mr. FLETCHER. Mr. Speaker, certainly I appreciate the gentleman's 
words and help again. As we begin to look at this problem, I am 
thinking of a lady who said that she was living on, it was around 7 to 
$800 a month, if you look at what it takes to provide, put food on the 
table, clothing, heating, a home, she was getting some assistance from 
family members, and we see that all across. It is not only the seniors 
that are very interested in this, but we all have parents, and there is 
a lot of younger folks out there that are struggling to make it and 
they are helping their parents right now because their parents are on a 
fixed income. They are having to contribute to that cost. So this is 
something that I agree immediate relief is certainly needed. And as the 
gentleman just said, there are a number of people out there struggling 
to make ends meet. They are having to decide whether there is food on 
the table and whether they will take the prescription drug.
  Mr. Speaker, again, I thank the gentleman for his work and for coming 
and sharing the time tonight.
  Mr. GRUCCI. Mr. Speaker, I appreciate that. I will close by saying 
that the person I run this by is Mama Grucci, and when she tells me 
this is a good plan, I believe it is a good plan. I thank the gentleman 
and I appreciate his time.
  Mr. FLETCHER. I thank the gentleman for that high note of credibility 
he just added to this plan.
  Mr. Speaker, as I looked, the gentleman from New York (Mr. Grucci) 
also mentioned that some people are trying to scare seniors and talk 
about Social Security and spending Social Security money, taking Social 
Security away or privatizing, all of those terms that they use to try 
and scare our senior citizens. Let me say that is unconscionable 
because they do know that there is no plan afoot, no intent to that, 
and that we are actually trying to do and are working, and I think 
successfully, and certainly have come up with a plan that we will 
unveil shortly to help shore up retirement security, improve it, 
enhance it.
  As a matter of fact, this year as I served on the Committee on the 
Budget, we specifically set aside $350 billion over the next 10 years 
for the very purpose that we are here talking about tonight and that is 
to provide a prescription drug plan and to strengthen Medicare.
  Now we set aside for that very purpose. And let me say at that time 
the Democrats had no plan. They set aside no money for Medicare. They 
set aside nothing to plan for the future of prescription drugs. And I 
know that many of them desire just like we do that we have a 
prescription drug plan. And we just need to set the record straight 
that when we rolled out a budget here on the House floor, there was no 
alternative budget that provided the kind of money that we did or 
provided any provision for prescription drugs. We provided $350 billion 
over the next 10 years to address this critical health care issue in 
America.
  Let me share, I have practiced medicine before I came to join this 
honorable body. I was a family practitioner. I can remember situations 
like the one I will relay. A lady that came in who had high blood 
pressure, hypertension. I prescribe the medication for her. She goes 
home. She comes back, I check and the blood pressure is not controlled 
and I scratch my head. I increase the medication. She goes home, comes 
back, and the blood pressure still is not controlled. Finally when you 
sit down and she begins to pour out her heart, she says, Look, I cannot 
afford this medication and when the samples you gave me ran out, I 
could not afford to get them.
  I have seen folks that say, I take it every other day, or I could 
only take half of the dose you gave me. These are problems where people 
are not only have having to decide between food and medicine but it has 
a critical impact on their health and long-term security. If we are not 
controlling things like hypertension or diabetes or high lipids or 
cholesterol, then we are not doing all we can for the health of our 
seniors. And that will lead to diseases and problems that they would 
not have otherwise had if we do not provide the care that we are 
talking about here this evening.

                              {time}  2200

  Let me review again some of the principles of this plan because I 
think they are critically important.
  First of all, it strengthens Medicare with a prescription drug plan 
coverage. It lowers the cost of prescription drugs now, and I want my 
colleagues to see that word ``now,'' Mr. Speaker, because I think it is 
critically important. People, I hear, need immediate relief and that 
means they need it now.
  This immediate relief is allowing us to reduce those costs. It is 
estimated at 30 percent. In the last year or so there have been 
Democrat plans that have been rolled out, and they are estimated only 
to reduce it about 10 percent. If my colleagues can remember, during 
the last Presidential election a plan was rolled out. The Democratic 
candidate, the estimate reduction was only 10 percent. We are providing 
three times the price reduction, and we are doing it immediately under 
this plan, as soon as this plan will be signed into law; and we get out 
the competition that would bring down the cost of those medications, 
the up-front cost as seniors walk into their pharmacy by up to 30 
percent.
  It guarantees all seniors prescription drug coverage under Medicare. 
This is a plan that cannot be taken away from. Our Congressional Budget 
Office has estimated that 95 percent of the seniors will take advantage 
of this; and let me say, if, and this is a question I got at some of my 
town hall meetings, Mr. Speaker, and that is, if a senior citizen now 
has a prescription drug plan, this will not take away their ability to 
keep and maintain that prescription drug plan. It will allow them to 
maintain a plan that they like.
  So it does not restrict their freedom. It provides choices. It 
improves Medicare with more choices and more savings. We have already 
talked about a 30 percent saving immediately. With a small premium, 
there will be substantial savings.

[[Page H3441]]

  It also protects from any catastrophic drug costs that would result 
in bankruptcy because of runaway drug costs.
  It provides choices. We guarantee that a senior has at least two 
choices. This is unlike the Democrat plan that said we are going to 
give people one choice, one formulary that is going to be listed. That 
means that people have got a bureaucrat or bureaucrats controlling what 
is in the medicine cabinet of the seniors across America.
  Let me tell my colleagues, I worked with companies, insurance 
companies, that only had a single formulary, and sometimes it is 
nightmare to get the particular medicine that the patient needs, and so 
we wanted to make sure, as one of our basic principles, that we 
provided multiple choice. We guaranteed at least two choices, and 
hopefully there will be more than that, but more choices, more savings.
  We strengthen Medicare in the future. One of the problems we are 
seeing across this country and certainly in Kentucky is that a new 
Medicare patient has a difficult time of getting an appointment with a 
physician. We also see struggling rural hospitals and nursing homes and 
home health agencies because of reimbursals that are about to be cut or 
have been cut and the tightening or disparity in payments for rural 
hospitals. That makes it very difficult for these essential rural 
hospitals to continue to operate, and believe me, I think all health 
care is local.
  When we look at how important it is to have immediate care, when 
someone has something like a heart attack or a stroke, it is critically 
important to have that care right in the community, maintain those 
rural hospitals. Part of this plan will certainly help do that and 
improve the reimbursal for those rural hospitals. So I think that is 
critically important.
  Not only that, but it prevents this rather ridiculous plan of the way 
we were going to pay physicians and the reduction that would cause many 
of them to quit taking Medicare, and that is why I think it is 
critically important that we pass this, to improve the accessibility 
and availability of health care to our seniors.
  I see now I am joined by the gentleman from Connecticut (Mr. 
Simmons). I am very glad to have him here and his work on prescription 
drugs. So let me yield to him.
  Mr. SIMMONS. Mr. Speaker, I thank the gentleman for yielding to me, 
and in particular, I thank the gentleman for sharing his expertise on 
this subject, not only with Members of this body, but with all 
Americans who are concerned about this particular issue.
  I represent a small State, Connecticut, which has been fortunate in 
many ways because over the last 17 or 18 years, the State of 
Connecticut has benefited from a state-based prescription drug plan, 
what we call ConnPACE, which is the Connecticut pharmaceutical contract 
for the elderly, and what this ConnPACE program does is provides 
prescription drug coverage to those senior citizens and those disabled 
citizens who are low income, and so it is income based. It is not asset 
based. It is income based.

  During the 8 or 10 years that I served as a State representative in 
the State of Connecticut and I traveled around during election time, 
knocking on doors, with increasing urgency senior citizens expressed 
their concern for additional help for prescription drugs. As I said, 
Connecticut had a program, but because it was income based, an 
individual who was slightly over the income limit became ineligible 
and, therefore, could not take advantage of this program.
  What I felt over those 8 or 10 years was that the Federal Government 
should play a larger role, and when I was I elected last year and came 
to Washington, my colleagues may recall that the President offered what 
he called his Immediate Helping Hand Program, and as I understood it, 
it was a program where the Federal Government would make a grant to the 
States to a certain amount to assist them in the programs that they 
had. I took that idea to heart.
  I introduced some legislation here on the Hill that reflected that 
concept, where the Federal Government would help those States, but when 
I went back to my district and when I talked to the senior citizens at 
the senior citizens centers and at gathering places across the 
district, what I discovered was they really wanted to go beyond that. 
They did not want to have an income-based program. They did not want to 
have a program that limited the benefit only to those seniors in 
greatest need. They wanted a broader-based program, and this is where 
the gentleman's proposal and the proposal that I understand will be 
coming out of the Committee on Ways and Means hopefully in the near 
future really fills the bill.
  It includes all seniors. It provides coverage for all seniors, and it 
allows them to have some choice, and I think, most importantly, for 
those States that do not have a state-based program, it gives seniors 
immediate access.
  What I hear time and time again is that senior citizens want this 
coverage now. They have heard the talk. The talk has been going on for 
a long time, and they feel that it is no longer a time to talk the 
talk. It is time to walk the walk. So they want to do it now, and they 
want to do it this year.
  It is interesting when we think about it. I know the gentleman has a 
substantial background and experience in medicine, and I respect and 
appreciate that; and I understand how his expertise is really bringing 
this legislation to the fore.
  My background is more in the area of military issues; and so when 
September 11 came along, it was a traumatic event for me and my 
citizens, my constituents who died on that terrible fateful day. We can 
look at national security issues and they are extremely important. 
There is no question about it. We can look at intelligence and national 
security issues, and they are extremely important.
  In the polling in the months after September 11, there was great 
public interest in that issue, although that polling has now gone down, 
but think for a moment about a senior citizen on prescription drugs 
with limited resources. They may not be frightened on a daily basis 
about a terrorist attack, they may not feel that they are in jeopardy 
because of international terrorists, but they are in jeopardy because 
of their prescription drugs.
  Every day they have to face concern and anxiety and insecurity 
because they have to make a choice between drugs and food. They are not 
sure that they have the resources available to buy that prescription 
drug in the coming months. So we have to put ourselves in their shoes, 
and we have to be considerate of their concerns.
  We have to move forward with this program. We have to get it done and 
we have to get it done now, and I am so happy to be part of the 
Speaker's task force that addresses this issue. This is a critical 
issue for senior citizens, for disabled and for those on Medicare, and 
it is time for us to provide this coverage for them.
  So I thank the gentleman very much for his leadership, I thank him 
for his expertise, and I think the time is going to come sooner rather 
than later when many citizens across this great country of ours, so I 
am going to thank the gentleman and all those working with him, to 
bring this critical program to fruition, to bring it to our senior 
citizens.
  Mr. FLETCHER. Mr. Speaker, I thank the gentleman from Connecticut 
(Mr. Simmons) for joining me tonight. I thank him for his work on the 
task force, and I know as he mentioned certainly his sincere desire to 
help the folks in Connecticut, particularly in his district, I am sure 
they feel as I do, certainly appreciate the tremendous amount of work 
he has done on this, and I think he is focused.
  His background, as he has already mentioned, is one of serving the 
country and yet going well beyond that of focusing, not only as he 
mentioned on the national security, but now on the retirement security 
and security of our seniors' health. So I thank him for his work, and I 
know if he is like myself and some of the other folks that have joined 
us this evening, it is just an issue that they hear regularly around 
the district.

  Mr. SIMMONS. Mr. Speaker, if the gentleman would yield for just a 
moment, he captured the concept so beautifully. We are concerned about 
retirement security. We are concerned about health security. We are 
concerned about national security, and these are

[[Page H3442]]

all interlocked in a way, and we have a responsibility to address them 
all.
  When I look back on what I was trying to do, which was to frame a 
legislative program that would provide block grants to those States 
that had programs and encourage other States to develop programs, what 
I realized was and what seniors told me was we are leaving a lot of 
people out. We are leaving people out in those States that do not have 
a program, and it is going to take them awhile to implement. We are 
leaving those people out whose income levels are sufficiently high that 
they do not get to participate.
  The point is, when it comes to health security, when it comes to 
retirement security, when it comes to national security, we do not want 
to leave anybody out. We want to make sure that everybody is covered. 
We are all a part of this great country of ours. We need to work 
together to make sure that everybody participates.
  Mr. FLETCHER. Mr. Speaker, again I thank the gentleman for joining us 
tonight, and as he said, two critical things, immediate help, help now.
  If we, as we did a couple of years ago, pass a bill out of the House 
here, we sent that over to the Senate. The Senate did not act on it. 
Let us hope it is different this year as we look over the next few 
weeks of passing a bill out here and sending it over to the other body, 
but I do thank him for joining us tonight and thank him for all the 
work, for all the citizens, not only in the State of Connecticut, but 
all over the country.
  Let me just say a few things and close out this evening and remark on 
this. We said no senior should have to choose between food and 
medicine, and yet that is happening in this country, and yet we are 
undoubtedly the wealthiest Nation in the world's history. We have 
developed a tremendous amount of health care technology, including 
wonderful new medications, prescription drugs that help prevent 
disease.
  We now have medications that prevent hardening of the arteries, that 
reduce the rates of heart attacks and strokes. We have medications that 
certainly allow senior citizens to live more comfortably. We have 
medications that treat and sometimes even cure cancer. That would have 
been just unimaginable a few years and decades ago, but oftentimes our 
seniors are having to choose between the food that gives them that 
comfort, that quality of life and even assures them of prolonged life, 
and the medicine, having to choose between food and medicine.
  So we want to stop that. We have a good plan, and let me just review 
a little thing on that.
  First off, it fully subsidizes premium and cost-sharing up to 150 
percent of the poverty level. That means those ladies that are on low 
income and those senior gentlemen that are on low income do not have to 
worry about that problem, as we have shown, choosing between food and 
medicine.
  It also provides a subsidy that is phased out between 150 and 175 
percent. This is a coverage in Medicare, and it is important to 
understand that. It is also important to understand that people have a 
choice.
  There are several plans to choose from, so that they can get the 
medication that they need. It is not just a single formulary that may 
restrict someone or make it very, very difficult for them to get the 
particular medicine that they can tolerate and that treats their 
particular condition the best.
  It brings immediate relief of up to 30 percent cost reduction. It 
helps not only that, but there are a few other things I want to review 
as we close out.
  It protects improvements in Medicare to help reduce adverse drug 
interactions, provides for electronic prescribing to minimize medical 
errors which the complexity of medicine now certainly is needed to 
incorporate all the technology that we have to ensure that we reduce 
the medical errors to as little as few as possible. It allows pharmacy 
therapy management for chronic conditions, and I think disease 
management is part of this prescription drug plan that is very critical 
as we look to not only just treat the acute problems of our seniors but 
make sure we manage their condition to give them the best quality of 
life, again to help them with their retirement security, to secure 
their health for as long as possible.
  So as I close we have a plan that we will be rolling out soon to 
provide immediate relief that is available for all seniors that will 
ensure no one has to choose between food and medicine, that will also 
provide choice and freedom. It will also make sure that those people 
that have drug costs that become quite expensive, that they are not 
going to go bankrupt because of runaway drug costs.

                              {time}  2215

  Mr. Speaker, it is an excellent plan. I certainly hope that we can 
get bipartisan support for this plan as we bring it to the House floor.
  As I mentioned a year and a half ago, we passed a good prescription 
drug bill out of this House. I think we have made marked improvements 
on the plan. I want to share, Mr. Speaker, this plan is not only a plan 
that we have worked on this year, it is the culmination of several 
years of work.
  What we found is that I think we can get a greater participation in 
the way this is structured; and again, the Congressional Budget Office 
predicts that 95 percent of the seniors will sign up for this, this 
voluntary program, because the benefits are so structured and so good 
and so attractive that they felt like seniors would sign up for this, 
and because it is available for all seniors. Again, it provides them 
with the ability to keep the plan that they have. If they have a 
retirement plan, and it provides prescription drug coverage, this does 
not impede their ability to keep that plan.
  It also, again through better negotiating power, gives them an 
immediate 30 percent estimated in their cost. We have a great disparity 
in this country in the fact that most people who are working can walk 
into a pharmacy and they can get prescription drugs at a markedly 
reduced cost because they have an insurance plan that negotiates the 
cost of those drugs and gets a reduced cost, but our seniors do not 
have that. They pay a substantially higher price when they walk in to 
buy their prescription drugs. Why, unless they have some sort of plan 
other than Medicare, they do not get the benefit, the negotiating 
power, to reduce the cost. This plan brings that power to every senior 
that takes advantage of this plan.
  I just wanted to share those few things, and let seniors know that 
not only providing this plan for the reasons we have mentioned because 
of the necessity of improving certainly retirement security and the 
security of our seniors' health, but it is a matter of equity. Medicare 
provides for acute care, and will provide, for example, bypass surgery 
for someone who needs surgery, but it will not provide the prescription 
drugs for hypertension or lowering cholesterol that are necessary.

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