Congressional Record, Volume 148 Issue 76 (Tuesday, June 11, 2002)

[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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