[Congressional Record Volume 148, Number 82 (Wednesday, June 19, 2002)]
[House]
[Pages H3712-H3719]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   MEDICARE PRESCRIPTION DRUG BENEFIT

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 3, 2001, the gentleman from Arkansas (Mr. Ross) is recognized 
for 60 minutes.
  Mr. ROSS. Mr. Speaker, for the next hour I plan to visit with the 
Members of the United States House of Representatives, and other 
Members will be joining me throughout this hour, to talk about the need 
to truly modernize Medicare, to include medicine for our seniors. This 
is something that both parties have talked a lot about. They have 
talked about it for years. Yet we continue to live in a society where 
today's Medicare, if you really stop and think about it, is designed 
for yesterday's medical care. What I mean by that is I recently 
encountered an elderly woman in Glenwood, Arkansas, in my congressional 
district who is a retired pharmacist who just happened to have been a 
relief pharmacist at the pharmacy that my family used in Prescott, 
Arkansas, when I was a small child growing up there. She talked about 
how if she filled a prescription and it cost more than $5, she would go 
ahead and fill the next prescription while she tried to build up enough 
courage and confidence to go out and tell the patient that their 
medicine was going to cost $5. My, my, how times have changed. How 
times have changed and indeed today's Medicare really is designed for 
yesterday's medical care.
  I have stepped across the aisle and voted with my Republican Members 
probably as many times as any Democrat in this Chamber. So I think I 
can say with some credibility and with some respect that when it comes 
to the need to provide our seniors with a prescription drug benefit, in 
my opinion the Republicans are dead wrong on this issue. This is coming 
from a conservative Democrat from south Arkansas, one who has crossed 
over that aisle and

[[Page H3713]]

voted with the Republican Party numerous times over the past 17 months. 
The reason I know that their prescription drug plan is bad is because, 
you see, I understand this issue. I own a small-town family pharmacy. 
My wife is a pharmacist. I understand this issue. And I understand what 
our seniors need. They need an affordable, a voluntary, a guaranteed 
prescription drug benefit for all seniors.
  I am going to spend the next hour talking about the differences in 
the Republican plan and the Democrat plan, and I am proud to be one of 
four lead sponsors on the Democratic plan, one that will truly 
modernize Medicare to include medicine for our seniors. But before I 
get into that, I would like to yield to the gentlewoman from Ohio (Mrs. 
Jones).
  Mrs. JONES of Ohio. I thank the gentleman from Arkansas (Mr. Ross) 
for yielding. I came to Congress in January of 1999. In 1998 I was 
campaigning on behalf of senior citizens throughout these United 
States. I was campaigning particularly because my dad is 82 years old, 
my mom is 81 years old, all of my friends have parents that are 
octogenarians; and I talked to them constantly about what is it that I 
can best do if and when I go to Congress to support you. All of them 
said to me, save Social Security, make sure Medicare is strong, and we 
need a prescription drug benefit.
  In my congressional district, which is the 11th Congressional 
District of Ohio, we have had two or three sessions with senior 
citizens where we have given them a chance to come out and talk about 
the issue of a prescription drug benefit and what it would mean for 
them. Many of them are talking about taking as many as nine or 10 
different drugs and that as a result of having to take that many 
different drugs, the cost of drugs, their prescription drugs, is so 
significant that they are really choosing between eating and choosing 
between, in the twilight of their lives, having an enjoyable time 
versus having the chance to enjoy the benefits of all the work that 
they have done.
  Recently on the front page of The Washington Post, there was an 
article entitled ``Kicked in the Teeth,'' which lamented the impact of 
America's soccer team victory over Mexico during the World Cup 
competition and the implications that such a loss had upon our 
neighbors to the south. The article went on to discuss the 
embarrassment of this loss for a nation with a great soccer tradition 
such as Mexico.
  Well, today I want to borrow from that title to discuss the GOP 
prescription drug plan that was marked up this week. Senior citizens in 
America are not unlike Mexico's soccer fans. They expected a win and 
what they got was a loss. But this loss was not at the hands or feet of 
a foe, but rather the House leadership. Once again the leadership has 
created an industry-based bill that further alienates and confuses 
senior citizens on what they can expect. According to experts, the GOP 
plan is, and I quote, ``Hollow, highly ideological and worthless. It 
will roll back Medicare and leave senior citizens in the country 
choosing between food and medicine.'' So in essence they have been 
kicked in their teeth.
  The disappointment senior citizens must be feeling cannot be measured 
or polled; but I would encourage all those grandmothers, grandfathers, 
aunts, uncles, mothers and fathers to remember that your sacrifice to 
build, protect and maintain the greatness of this country is not being 
respected by the House leadership, but rather sold to the highest 
bidder.
  ``Sold'' is the word you hear at the end of a successful auction. I 
would like to invite all of you here in town tonight to join my 
Republican colleagues at the close of their prescription drug benefit 
auction tonight at the pharmaceutical-industry-sponsored GOP 
fundraiser. All you need is about $25,000 and just no conscience at 
all.
  However, I would impart one word of advice. The only thing they are 
going to serve tonight is corn on the cob, so if you have been kicked 
in the teeth you better find somewhere else to eat. So if you show up 
tonight with a hearty appetite for change and you are looking for a 
truly compensive prescription drug benefit, the soup line is forming to 
the rear. I would suggest you tell all of your congressional Members 
that they should support the Democratic substitute that is being 
offered by my colleague, the gentleman from Arkansas (Mr. Ross).
  I thank the gentleman from Arkansas for his leadership on this issue. 
I am confident that once the American public has had a chance to listen 
to the difference between the Republican bill and the Democratic bill, 
they will understand that the Democrats in this House are pushing for a 
real prescription drug benefit.

                              {time}  1630

  Mr. ROSS. Mr. Speaker, I thank the gentlewoman for sharing her 
thoughts with us on the prescription drug issue and for all that she 
does.
  Mr. Speaker, let me just visit for a moment about my experiences, not 
as a Member of the United States Congress, but as someone who is 
married to a pharmacist, who owns a small-town family pharmacy in our 
hometown of Prescott, Arkansas, a town of 3,400 people. Let me talk to 
you for a moment as a family pharmacy owner, someone who has 
experienced all of the trials and tribulations that our seniors go 
through day in and day out.
  I actively managed that business before coming to the United States 
Congress; and I can tell you, I can put faces and names with patients, 
but patient confidentiality, thank goodness, prevents that. But I can 
put faces to these stories in my own mind as I relay them today of 
seniors who would come into the pharmacy, who were literally forced to 
choose between buying their medicine, buying their groceries, paying 
their rent, paying their light bill.
  We are talking about the Greatest Generation. We are talking about 
seniors who have given so much to this country, who supposedly live in 
the most industrialized society in the world, and yet we live in a 
society where they cannot afford their medicine or cannot afford to 
take it properly.
  Living in a small town, I would see seniors leave without their 
medicine; and living in a small town I would learn a week, 10 days 
later, where they are in the hospital in Hope, Arkansas, some 16 miles 
away from my hometown of Prescott, running up a $10,000 or $20,000 
Medicare bill, or a diabetic who has to have a leg amputated, or a 
diabetic who has to have kidney dialysis, all things that Medicare pays 
for, and all things that could have been avoided; but they were not, 
because Medicare does not include medicine and our seniors simply could 
not afford the $40 or $50 prescription that could have saved the 
Medicare trust fund $10,000, $20,000, $50,000, as much as $250,000 for 
some kidney dialysis patients.
  Again, today's Medicare is designed for yesterday's medical care. And 
it is time we did right; it is time we did right, by our seniors.
  Some people say, well, the government cannot afford it. I say the 
government cannot afford not to, and here is what I mean by that. 
Health insurance companies are in the business to do what? Health 
insurance companies are in the business to make a profit. And then they 
cover the cost of medicine. Why? Because they know it helps hold down 
the cost of needless doctor visits, it helps to hold down the cost of 
needless hospital stays, it helps to hold down the cost of needless 
surgeries.
  It is time we truly modernized Medicare by creating a voluntary, but 
a guaranteed, Medicare part D prescription drug benefit. What I mean by 
that is this. Part A covers going to the hospital. Part B covers going 
to the doctor, medical equipment and so forth and so on. The part D 
that we are proposing would be voluntary, meaning if you are one of the 
few seniors in America who are fortunate to have medicine coverage from 
a previous employer, and, by the way, there are very few that fit that 
category in my congressional district, but if you are one of the few 
that have prescription drug coverage through a previous employer, one, 
you ought to count yourself lucky and fortunate, because very few 
seniors have any coverage at all. But if you fall in that category and 
like what you have, you ought to be able to keep it. That is why our 
plan is voluntary. But it is a guaranteed part of Medicare, just like 
going to the doctor and going to the hospital.
  Now, the drug manufacturers do not like my plan. They do not want to 
be held accountable. I have got bottles of pills, medicine, tablets, 
capsules on the shelves of my small pharmacy back

[[Page H3714]]

home in Prescott, Arkansas, that cost $3,000, that are being sold in 
Canada and Mexico for $300 or $400.

  I say this: if the governments in those small countries, Canada and 
Mexico, can stand up to the big drug manufacturers, why can we not do 
the same thing in the United States of America?
  We may have found the answer. The Washington Post, June 19, 2002: ``A 
senior House GOP leadership aide said yesterday that Republicans are 
working hard behind the scenes on behalf of PhRMA, that is the 
Pharmaceutical Manufacturers of America, to make sure that the party's 
prescription drug plan for the elderly suits drug companies.''
  I do not know about you, but I am appalled by that. This is the 
United States House of Representatives. We do not write legislation 
based on what is going to allow our party to raise money. At least I 
hope we do not. It is time we stood up to the big drug manufacturers 
and said enough is enough.
  It is reported that in the year 2000, $360 million was spent by the 
drug manufacturers on lobbying, advertising and political donations; 
and I say that is wrong. Do you ever see those ads on TV where they are 
trying to tell you which drug you need to tell your doctor you need? 
Have you ever thought about that? Slick TV ads put on the air by the 
drug manufacturers trying to tell you which drug you need to tell your 
doctor you need.
  Many drug manufacturers spent more money in the year 2000, the 
numbers are not out yet, but I am quite sure and confident it is the 
same for 2001. Many drug manufacturers spent more money marketing their 
products with these slick TV ads than they spent on research and 
development of drugs that can save lives and help all of us to live 
longer and healthier lifestyles.
  This 1-hour on prescription drugs for our seniors was supposed to 
occur tonight. Why is it occurring now? Because the leadership of this 
body chose to stop voting early today so they could make it to a 
fundraiser tonight that is being hosted by the big drug manufacturers 
at a time when these prescription drug bills that our seniors need and 
are counting on are being marked up, are being debated in the Committee 
on Ways and Means and in the Committee on Energy and Commerce.
  Again, I am a conservative Democrat. I have crossed over that aisle 
and voted with the Republicans numerous times, as many as any Member of 
the United States Congress; but I can tell you when it comes to this 
issue, they are wrong. It is time for them to make a decision. Are they 
going to side, continue to side, with the big drug manufacturers, or 
are they going to join me in endorsing my bill that will truly 
modernize Medicare and include medicine for our seniors and start 
siding with our seniors, for our seniors?
  It is time that this Congress united in a bipartisan manner on the 
need to truly modernize Medicare to include medicine for our seniors, 
just as we have united on this war against terrorism.
  Again, a senior House GOP leadership aide said yesterday that 
``Republicans are working hard behind the scenes on behalf of the 
Pharmaceutical Manufacturers of America to make sure that the party's 
prescription drug plan for the elderly suits drug companies.''
  This ought to be about suiting our seniors. It ought to be about 
giving our seniors a prescription drug benefit that means something. 
This debate should not in any form or fashion be about catering to the 
drug manufacturers.
  Let me talk to you about the differences between the Republican 
proposal for a Medicare prescription drug benefit and my proposal, the 
Democratic proposal, for a Medicare prescription drug benefit.
  A lot of people say, well, what about the guaranteed minimum benefit? 
The Republican proposal, beneficiaries, seniors, must obtain coverage 
through private insurers who may not participate, are not required to 
participate, and can offer vastly different benefits and premiums. In 
other words, the first step at trying to privatize Medicare.
  What does my proposal do, the Democratic proposal? Medicare covers 
prescription drugs like other Medicare benefits, with guaranteed 
benefits, premiums and cost-sharing for all beneficiaries. Not a 
complicated formula. We do not try to privatize Medicare. We simply say 
that going to the pharmacy and getting your medicine ought to be 
treated just like going to the doctor and going to the hospital. It 
should be covered by Medicare.
  Some people say, what about guaranteed fair drug prices? Under the 
Republican plan for a prescription drug benefit, private insurers, 
again, privatizing Medicare, negotiate separately on behalf of sub-sets 
of the Medicare population, diminishing the program's group negotiating 
power.
  Believe me, there is nothing the drug manufacturers want more than to 
whittle this thing down into small groups. If we come at them with the 
entire Medicare population, they know we are going to demand the same 
kind of rebates that they provide the big HMOs and have for years. They 
know we are going to demand the same kind of rebates that State 
Medicaid programs, and, yes our Veterans Administration, gets. And why 
should we not? I am sick and tired of seeing our seniors in America 
subsidize the cost of health care in Canada and Mexico, and that is 
what we are doing.
  What does the Democrat proposal do? It authorizes the Secretary of 
Health and Human Services to use the collective bargaining clout of all 
40 million Medicare beneficiaries to negotiate fair drug prices. These 
reduced prices will be passed on to beneficiaries. And, yes, it is time 
we demanded the same kind of rebates from the big drug manufacturers 
that the State Medicaid programs and big HMOs have been getting for 
years. Those rebates should go directly to the Medicare trust fund to 
help fund this Medicare part D prescription drug benefit.
  What about premiums? In the Republican plan, they will not put it on 
paper, but it is estimated to be $35 a month. In the Democratic plan, 
it is in writing. It is $25 a month. That is the premium that a senior 
would pay for this voluntary, but guaranteed, Medicare part D 
prescription drug benefit, should they choose to decide to sign up for 
it.
  The deductible. The Republican proposal is $250 a year; the 
Democratic proposal, $100 a year. Again, just like going to the doctor 
and going to the hospital.
  Coinsurance. Get ready for this. The Republican proposal makes 
filling a tax return out look simple. It will be very difficult for 
most seniors without hiring a CPA to figure out exactly what it is they 
qualify for and when they qualify for it.
  The Republican plan calls for coinsurance of 20 percent for the first 
$1,000; 50 percent for the next $1,000; and 100 percent for all 
remaining spending up to $4,500 a year. And then something, we are not 
sure what, but something will kick in again.
  Now, think about that a minute. The first $1,000, you are going to 
pay 20 percent out of pocket. Once you hit that $1,000, it is going to 
50 percent out of pocket. Once you have hit that second $1,000, they 
are going to make you pay 100 percent on all remaining spending until 
you hit $4,500 a year.
  I can tell you seniors who live in my district trying to get by from 
Social Security check to Social Security check that averages less than 
$600 a month with a $400-a-month drug bill, they will not ever get to 
the $4,500 because they simply cannot afford to pay for their medicine; 
and as a result, they are going without their medicine or they are not 
taking it properly.

                              {time}  1645

  I recently had a senior tell me she did not know what she would do 
without her son, who is in his 50s. She said he had a good job. He had 
a job where he had health insurance. It just so happened that he took 
the same medicine that she did. It was about 3 bucks a pill, and there 
was no way she could afford it. So he would get the medicine filled and 
give it to her. He was going without his medicine so his mom could have 
her medicine.
  I can tell my colleagues story after story. I have driven 83,000 
miles in the last 17 months in those 29 counties in South Arkansas and 
every day I am out there I hear numerous stories just like that about 
seniors who cannot afford their medicine or cannot afford to take it 
properly.
  So what does the Republican plan do? It says you are going to pay 20 
percent on the first $1,000, and then for some reason, you are supposed 
to have more

[[Page H3715]]

money as a senior on a fixed income so you should be able to afford to 
pay 50 percent on the next $1,000, and after that, you are on your own 
when you hit $4,500 and then we will be back and we will kick in some 
more.
  Folks, it is time we brought common sense to the United States 
Congress. This is not common sense.
  What does the Democratic proposal do? It is just like going to the 
doctor or going to the hospital: Twenty percent copayment, period. That 
is it.
  Out-of-pocket maximum. I mentioned the Republican out-of-pocket 
maximum is $4,500 a year. Again, most seniors in my district can never 
get to the first $4,500 because they cannot afford $4,500 in out-of-
pocket before some kind of so-called Medicare prescription drug benefit 
kicks in. The out-of-pocket maximum on the Democratic plan is $2,000. 
And what that means is, every time you go to the pharmacy, well, first 
you are going to pay a $100 annual deductible. After you have met that, 
you are going to pay 20 percent of the cost of medicine; Medicare will 
pay 80 percent of the cost of medicine. If you have a $100 
prescription, you are going to pay $20, instead of $100 like you are 
paying today. And once you have spent out of pocket $2,000, then 
Medicare kicks in and pays the full price. That is significant. And 
that will help our seniors who need help the most.
  Some people say, what about coverage gaps? The Republican proposal 
says this: Beneficiaries who need more than $2,000 worth of drugs must 
pay 100 percent out of pocket, but keep paying the premiums until they 
reach the $4,500 out-of-pocket cap. Again, our seniors cannot afford 
this. They will continue to do like many of them are doing today, and 
that is to go without their medicine, or not take it properly.
  What about coverage gaps in the Democratic plan, my plan? 
Beneficiaries always have coverage. There are no gaps. It is not more 
complicated to figure out than an IRS tax form. It is plain and simple, 
$25 a month annual premium, $100 annual deductible. After that, every 
time you go to the pharmacy, you pay 20 percent, Medicare pays 80 
percent. And after you have been out $2,000 a year total, Medicare 
kicks in at 100 percent. Nothing complicated. You will not have to hire 
a CPA to figure it out. You will not wonder from month to month what 
you do and do not qualify for and what your copay will and will not be. 
It will always be the same. Again, it is structured just like going to 
the doctor and going to the hospital is under Medicare.
  Some ask about access to local pharmacies. I have to tell my 
colleagues, the Republican plan allows these private plans to limit 
which pharmacies participate in their network. There may be a senior 
that has used the same pharmacy for 60 years and, all of a sudden, 
under the Republican plan, you are going to be told that you have to 
use mail order, or that you have to use a pharmacy in another town or 
on the other end of town.

  Under my plan, the Democratic plan believes in providing you with the 
freedom to choose any pharmacy willing to play by the Medicare rules 
and accept the rate of reimbursement that is established, not by that 
pharmacy, but by Medicare, can participate, just like Medicare is with 
going to the doctor and going to the hospital. If those providers or 
doctors and hospitals agree to participate under the rules and 
regulations and fees set forth by Medicare, then you have the freedom 
to choose. The same thing here with the Democratic plan. Our plan does 
not tell you which pharmacy you must use. We let the senior decide.
  Some people say, what about access to prescribed medicines? Well, the 
Republican proposal says that private insurers can establish strict 
formularies and deny any coverage for all formulary drugs. Now, what 
does that mean? Well, I can tell my colleagues what it means. I have 
allergies and I have to take a nasal spray and my doctor wrote it for 
one brand. I got to the pharmacy to get it filled and they wanted to 
charge me a higher copay or deductible, copayment. They wanted to 
charge me a higher copayment if I stuck with the brand that I wanted, 
but if I would go to the preferred brand, my copayment would almost be 
cut in half, meaning my out-of-pocket would be cut almost in half. 
Well, I got to looking and, guess what? They wanted to switch me to a 
drug that as a pharmacy owner, it costs me $10 more.
  Now, why in the world would a health insurance company in the 
business of making a profit want to punish me for going with the 
cheaper drug and reward me for going with the higher priced drug? The 
answer, unfortunately, is quite simple. Because the rebates on the more 
expensive drug that that health insurance company is receiving from the 
drug manufacturer are so huge. We are going to continue to see that 
game played under the Republican proposal because, again, it creates 
formularies and if there is not a kickback being afforded on a drug to 
these private insurers, again, privatizing Medicare, then under their 
proposal, the drug your doctor wants you to have will not be covered.
  I am sick and tired of seeing health insurance companies, 
prescription benefit managers, accountants, bean counters, trying to 
play doctor. If the doctor says you need a particular drug, I think 
that is the drug you ought to get, and under the Democratic proposal, 
that is what happens. Beneficiaries have coverage for any drug their 
doctor prescribes, period. Under the Democratic proposal, whatever your 
doctor says you need is what you are going to get, not some complicated 
formulary based on who is kicking back to who how much, as the 
Republican proposal provides.
  Low-income protections. Under the Republican proposal, low-income 
beneficiaries may have to pay $2 or $5 as a copayment and 100 percent 
of costs in the coverage gap. Drugs may be denied if the beneficiary 
cannot afford this cost-sharing.
  Under my plan, the Democratic plan, here is what we say about low-
income seniors. There is no cost-sharing or premiums. When I talked 
about paying a 20 percent copayment, when I talked about paying the 
premium of $25 a month, we waived that if you live up to 150 percent of 
poverty, and then there is a sliding scale for premiums phased in 
between 150 and 175 percent of poverty. So if you live in poverty, 
under the Democratic plan, you get your medicine, no 20 percent copay, 
no premium. Under the Republican plan, they are still going to require 
you to pay $2 or $5. Again, it is a complicated formula on what you 
have to do under one set of rules.
  These are huge differences, I say to my colleagues, between these two 
proposals. The Republican plan again caters to the big drug 
manufacturers.
  The Washington Post, June 19, 2002. A senior House GOP leadership 
aide said yesterday that Republicans are working hard behind the scenes 
on behalf of PhRMA to make sure that the party's prescription drug plan 
for the elderly suits drug companies.
  Again, as a conservative Democrat, I have crossed that aisle and I 
have voted with the Republican Members of this body as much as any 
Member of this Congress has done. When they are right, I will stand 
with them. As a small town family pharmacy owner, as someone who served 
on the State Senate public health committee for 8 years back home in 
Arkansas, as someone who has a 90-year-old grandmother back home who 
lives from Social Security check to Social Security check, I can tell 
my colleagues that when it comes to the need to provide our seniors 
with a prescription drug benefit, they are dead wrong. You cannot side 
with the big drug manufacturers and still come down on the side of 
seniors. You have to choose.
  Now, the Republican national leadership decided we were going home 
early today so they could go get all dressed up for their big fund-
raiser tonight that is being sponsored by these drug manufacturers 
while at the same time we are sitting here in the United States 
Congress simply asking for a hearing on our bill, a bill that I helped 
write, that will truly modernize Medicare to include medicine for our 
seniors. And they are out wining and dining with the big drug 
manufacturers at a fund-raiser to benefit the Republican Party on the 
night following one of the most comprehensive hearings and markups to 
ever occur as it relates to the need to modernize Medicare to include 
medicine for our seniors.
  Mr. Speaker, these bills are being debated and written as we speak in 
the House Committee on Ways and Means and in the House Committee on 
Energy and Commerce. I have to tell my colleagues, I am very 
disappointed to see

[[Page H3716]]

this article today and to see what is going on in this Congress.
  This should not be about the drug manufacturers. It should be about 
standing up to the big drug manufacturers and standing with our 
seniors. It is not that complicated, and the Republican plan tries to 
complicate it. It is more complicated than filling out a tax return. 
Our seniors do not need any more complications in their lives. They do 
not need politics in their lives. They simply need a Medicare 
prescription drug benefit that allows them to get their medicine just 
like Medicare allows them to go to the doctor and to go to the 
hospital.
  I am very concerned about how this proposal by the Republicans 
privatizes Medicare. The Republican bill forces seniors to obtain 
coverage through private drug-only insurance plans or HMOs. It is not a 
true Medicare benefit like parts A or B where all seniors are 
guaranteed a defined set of benefits at a uniform price.
  Under their bill, there will be no universal Medicare-sponsored 
prescription drug plan. The Republican bill moves Medicare towards a 
defined contribution program with the ultimate goal of turning Medicare 
over to the private insurance market. I, for one, think that would be a 
huge mistake, and so do so many other senior organizations that have 
endorsed my bill that takes on the big drug manufacturers, that holds 
the big drug manufacturers accountable, and provides our seniors with a 
meaningful Medicare part D voluntary, but guaranteed, prescription drug 
benefit.
  However, do not just take my word for it. Listen to what others are 
saying.

                              {time}  1700

  ``I'm very skeptical that `drug only' private plans would develop.'' 
That comes from Bill Gradison, former Republican Congressman and former 
president of the Health Insurance Association of America.
  States have tried to get the private insurers into the business of 
providing seniors with a prescription drug coverage. Who is going to 
buy the plans? Those who have the high drug bills. If one does not need 
drugs and is on a fixed income, one is not going to buy the plan. That 
is why the plan will not work. The premiums will exceed, if not cost as 
much as, the cost for the medicine.
  With regard to the proposal to rely on private drug entities for drug 
benefits, ``There is a risk of repeating the HMO experience.'' We all 
know the HMO experience did not work. They tried that. We have been 
there; we have done that. They are all getting out of the drug 
business, and they are all getting out of the Medicare business. That 
quote comes from John C. Rother, policy director of AARP, formerly 
known as the American Association of Retired Persons.
  With regard to whether private insurance plans would participate in 
the Republican Medicare drug plan: ``I don't think it's impossible, but 
the odds are against it.'' That is Richard A. Barasch, chairman of 
Universal American Financial Corporation of Rye Brook, New York, which 
sells MediGap coverage to 400,000 people.
  When asked if they favor being placed at financial risk, as the 
Republican plan requires, ``We are not enthusiastic about that 
approach,'' says Thomas M. Boudreau, senior vice president and general 
counsel of Express Scripts.
  With regard to their experience with accepting financial risk for 
providing drug benefits: ``We are typically paid a fee, generally less 
than $1, for each claim. But we do not bear financial risk.'' That is 
Blair Jackson, spokesman for AdvancePCS, one of the outfits that the 
Republican plan calls to help run this attempt at privatizing Medicare.
  I hope each and every Member of the United States Congress will put 
politics aside, read the Republican plan on modernizing Medicare to 
include medicine for our seniors, read my bill, the Democratic bill 
that will truly modernize Medicare to include medicine for our seniors, 
and compare them.
  If they do that, I think they will agree with me that it is time for 
us to put politics aside. It is time for the Republicans to stop siding 
with the big drug manufacturers. Let us hope tonight's fundraiser that 
is hosted by the big drug manufacturers, that they do not belly up to 
the trough with the big drug manufacturers, trying to raise money in 
the middle of a debate on something so lifesaving and so important for 
our seniors.
  It is time for this Congress to unite behind the need to provide our 
seniors with a prescription drug benefit, just as we have united on 
this war against terrorism. So I challenge my colleagues on the other 
side of the aisle: read my plan and read the Democratic plan. Read 
their plan. Then do what is right, not by the big drug manufacturers, 
but by our seniors.
  Again, from The Washington Post, look it up, June 19, 2002: ``A 
senior House GOP leadership aide said yesterday that Republicans are 
working hard behind the scenes on behalf of the Pharmaceutical 
Manufacturers Association to make sure that the party's prescription 
drug plan for the elderly suits drug companies. These same drug 
manufacturers are hosting a multi-million dollar fundraiser this very 
night for the Republican Party.'' That is from The Washington Post.
  I am appalled by that. It is time for the Republicans to make a 
choice. Are they going to continue to side with the big drug 
manufacturers, or are they going to side with our seniors? I encourage 
them to stretch across this aisle and endorse my bill, the Democratic 
bill, that gives the help to our seniors, America's Greatest 
Generation, that they so desperately need.
  Mr. Speaker, I yield to my friend and colleague, the gentleman from 
New Jersey (Mr. Pallone).
  Mr. PALLONE. Mr. Speaker, I want to thank the gentleman for yielding 
to me. I just want to tell the gentleman what a great job he has been 
doing on this Special Order in pointing out what the Republican 
leadership is up to.
  Mr. Speaker, I just want to back up what the gentleman is saying. I 
see he has that quote from the Washington Post: ``A senior House GOP 
leadership aide said yesterday the Republicans are working hard behind 
the scenes on behalf of the Pharmaceutical Manufacturers Association to 
make sure that the party's prescription drug plan for the elderly suits 
drug companies.''
  I just came from the markup in the Committee on Energy and Commerce, 
and I can assure the gentleman the quote he had up there is absolutely 
true. We just broke at exactly 10 minutes to 5 because the 
Republican leadership on the committee admitted that they were going to 
that fundraiser tonight. The chairman actually held up the ticket for 
the fundraiser, and said, maybe you guys want to join us at the 
fundraiser tonight. So there is absolutely no question that the reason 
that we could not even finish the bill today was because they had to 
run, the Republicans on the Committee on Energy and Commerce, had to 
run to this fundraiser tonight.

  I do not know if the gentleman went through it, and some of these 
companies are even in my district, but I just have to give the 
gentleman a little information on that same Washington Post article.
  It says: ``Drug companies, in particular, have made a rich investment 
in tonight's event. Robert Ingram, GlaxoSmithKlein PLC's chief 
operating officer, is the chief corporate fundraiser for the gala; his 
company gave at least $250,000. Pharmaceutical Research and 
Manufacturers of America, that is PhRMma itself, the trade group funded 
by drug companies, kicked in $250,000, too. PhRMa, as it is best known 
inside the Beltway, is also helping to underwrite a television ad 
campaign. . . . ''
  Basically, just what they did, just in terms of the Committee on 
Commerce today, they spent the last month, PhRMa and the other brand 
name drugs, financing this $4 million to $5 million TV ad campaign 
telling everybody how the Republican prescription drug proposal, when 
it came forward, would be the best thing we have ever seen since apple 
pie, okay?
  Then they bring the bill up this week, we had it in committee today, 
and they have the fundraiser tonight, and they have to break the 
committee to go to the fundraiser. Then they are going to take that 
money from the fundraiser tonight, which is mostly soft money, as the 
gentleman knows, and they are going to use it putting on ads telling 
them how great the Republican members are because they voted

[[Page H3717]]

for the Republican plan, and how bad the Democrats are because they did 
not vote for it. That is what this is all about.
  Today when the Democrats on the Committee on Energy and Commerce were 
trying to make amendments, we were told the amendments were not 
germane. The reason was very simple. First of all, they did not want us 
to have a long debate, because they had to get to the fundraiser. 
Secondly, since they have already decided what the bill is going to 
have, because it is essentially written by the pharmaceuticals, they do 
not want to change the bill. They already have the TV ads running 
saying how great the bill is. They cannot change it, because if they 
do, it will not be what they are saying they are going to do.
  There was absolutely no way for the Democrats or anyone who had any 
questions about this Republican legislation to have any significant 
input today. I am sure tomorrow is going to be the same.
  I just want to go through a little more here. I am going to turn to 
page A 5 in this same article that the gentleman has been talking 
about, just to give a little more idea, because I do not want to just 
mention three or four drug companies. There are quite a few.
  It goes on here to say that ``Pfizer, Inc., contributed at least 
$100,000 to the event, enough to earn the company the status of a vice-
chairman for the dinner. Ely Lily and company, Beyer, and Merck and 
Company each paid up to $50,000 to sponsor a table. Republican 
officials said other drug companies donated money as part of the 
fundraiser extravaganza.''
  I would say to my colleague, the gentleman from Arkansas, we are 
referencing Republican sources here. These are not Democrats saying 
this; these are Republicans. As I said, they do not have any shame, any 
shame whatsoever about saying that this whole effort on the Republican 
side is totally bankrolled by the drug companies.
  To give another idea, we had a discussion at the very end of the day, 
before they broke at 5 for their fundraiser, where we pointed out that 
all the things that they are saying about the Republican bill, like the 
Republicans that were here last night during a Special Order, and the 
gentleman may have seen them, they were saying that the bill is a 
Medicare benefit.
  The only way it is a Medicare benefit is because the seniors over 65 
are the ones that theoretically are targeted. It is not actually a 
benefit under Medicare. It is not a government program. It is a program 
that gives money to private insurance companies, hoping that they will 
provide some meager benefit.
  Then we had questions in the Committee on Energy and Commerce today 
that said, well, the Republicans suggest that this program has a $45 
premium, that it has a $250 deductible, that it is going to pay a 
certain amount of money for the drug benefit; but then when asked, the 
gentleman from Michigan (Mr. Dingell), who is the ranking Democrat, he 
said, show us in the Republican bill, because we finally do have the 
bill now, where it says that the premium is only $35, where it says 
that the deductible is only $250, where it says that the Federal 
Government is going to pay for a certain amount of the drug benefit.
  There is nothing in the bill. The counsel for the committee admitted 
that was all speculation based on CBO estimates. In other words, they 
tell the CBO that they are going to throw a certain amount of money to 
the private insurance companies, and what do they think is likely to 
happen if they do that? Then they come back and say, well, maybe the 
premium would be about $35 a month, or that the deductible would be 
$250. But there is no guarantee that the deductible in New Jersey is 
$250 or that the premium in Arkansas is $35. It could be $85 in 
Arkansas. It could be $150 in Nevada. There is absolutely nothing in 
the bill, in the Republican bill, that guarantees any kind of benefit, 
because it is all up to what the private insurance companies want to 
do.
  Then I asked, well, they keep talking about how they are going to 
have lower prices. Last night on the floor, the Republicans who did the 
Special Order said they are going to lower prices for drugs. I said, 
where is that in the bill? The Republican bill, the language says that 
the private insurers can negotiate lower prices, that they can provide 
discounts, but they may, they may negotiate, they may provide 
discounts, or they may pass on those discounts to seniors, but there is 
nothing that requires them to do so. Why in the world would we believe 
that they would? I have no reason to believe that they would.
  This is the most or the biggest scam that I have ever seen. I do not 
understand how our colleagues can even suggest that they are providing 
any kind of benefit at all.
  I do not want to keep going. I will yield back to the gentleman, but 
I assure the gentleman that what he has been saying, because I have 
been listening to some of it with one ear, is absolutely coming to 
fruition, particularly that quote about making sure that the 
Republicans' prescription drug plan suits drug companies.
  Mr. ROSS. Mr. Speaker, maybe we can visit a little bit about this, 
because it is so important. I want to make sure we use every second of 
every minute that is afforded to us to visit here in the United States 
House of Representatives about an issue that literally, for many 
seniors, is life or death.
  It is just unfortunate to me that we have two proposals, one that 
sides with the big drug manufacturers, that being the Republican 
proposal, and one that sides with our seniors, that being the 
Democratic proposal.
  Why can this Congress not unite on the need to modernize Medicare to 
include medicine for our seniors, just as we have united on the war 
against terrorism? I have tried to do that. It is H.R. 3626. The 
gentlewoman from Missouri (Mrs. Emerson), a Republican, and I wrote a 
bill; and yet the Republican national leadership, they are in the 
majority, they decide what bills get a hearing, what bills get a vote 
in committee and on the floor. For months I have begged, I have pleaded 
for our bill, a bipartisan bill, to get a hearing and to get a vote.
  If the majority party, those who call the shots, decide what gets 
voted on and when, what gets heard in committee and when, if they 
really care about this issue, really care about helping our seniors, 
and if what their rhetoric is is more than just election-year politics, 
and it is really wanting to do the right thing and modernize Medicare 
to include medicine for our seniors, why did they not let the 
gentlewoman from Missouri (Mrs. Emerson) and I get a hearing on that 
bill?
  Much of that bill is now incorporated into the Democratic proposal. I 
am a Democrat and my colleague, the gentleman from New Jersey, is a 
Democrat. But do not take our word for it. I challenge anyone to go to 
their hometown and visit their hometown pharmacist. Ask their 
pharmacist which proposal is best for America, which proposal is best 
for our seniors. Every single time they will tell us that the Democrats 
are right on this issue. They may tell us that the Democrats are not 
always right on every issue; but they will tell Members, according to 
the Gallop poll, the most trusted profession in America, pharmacist, 
and again, I am not one, my wife is, but they will tell us that on this 
issue the Democrats are right and the Republicans and the big drug 
manufacturers are dead wrong.
  Mr. PALLONE. Mr. Speaker, I appreciate the gentleman yielding 
further, and again, his comments are so appropriate.
  Process-wise, let me tell the gentleman, we got the Republican bill 
24 hours ago. We have never had a hearing on the Republican bill. We 
went straight to markup. The first thing they started to do was to 
amend their own bill. Before we even had an opportunity to digest the 
initial bill, they were making amends to the bill.
  So the process that the Republicans are using on this is just 
outrageous because nobody knows what is going on. We literally have to 
read the bill and amendments as we are sitting there in the committee.
  But the gentleman talked about a possible compromise or a consensus, 
a bipartisan effort.

                              {time}  1715

  I have no doubt that that could be done, but the will is not there on 
the Republican side. I have been critical of the Republican proposal 
because it is

[[Page H3718]]

not a very generous proposal. In other words, even if everything they 
speculate was true and they were going to have a $35-a-month premium 
and they were going to have a $250 deductible, at least it would be 
something if it was under Medicare and it was guaranteed.
  I would suggest if the Republican leadership wanted to say, okay, we 
will put in a bill that has these benefits, and that has these premiums 
and these deductibles but it is part of the Medicare program and it is 
guaranteed to everyone around the country, then I think we could sit 
down, and we could compromise because the Democrats have a much more 
generous plan, and the Republican plan is pretty meager, but we could 
figure out the differences between the two and maybe strike a consensus 
or strike a compromise.
  What I have been saying and I have said all along and continue to say 
that the problem with the Republican proposal is that it is not real. 
It is not a Medicare proposal. It is not providing a Medicare benefit. 
There is no guarantee anyone is ever going to get the benefit, not to 
mention the fact that it does nothing to lower prices.
  So the problem here is the Republicans are not being real. They are 
not giving us a Medicare proposal. They are not giving us something 
that we can say, okay, let us see where we are going to go and we will 
compromise and we will come up with the amount of the benefit and what 
it is going to mean. No, no, no. What we are doing here is just the 
same old thing we saw 2 years ago with the Republican leadership. Throw 
some money to private insurance companies, and I really think that what 
they are up to is that they really do not want any bill to pass. In 
other words, the pharmaceuticals, the statement that was made there 
about a Republican drug plan that suits drug companies, essentially the 
pharmaceuticals do not want any benefit because they like the status 
quo. They like the fact that they continue to raise prices, that they 
continue to make big profits, that they continue to get tax breaks.
  I do not think that they and the Republican leadership really want to 
come up with a bill that would pass here, pass in the other body and be 
signed by the President, because it would be very easy. Like the 
gentleman said, he had cooperation with the gentlewoman from Missouri 
(Mrs. Emerson). It would be very easy to put something down on paper 
that we could all agree on, but the leadership on the other side does 
not want to do that.
  I am convinced from what I saw today they just do not want to do it. 
They do not want any bill to pass ultimately and go to the President.
  Mr. ROSS. Mr. Speaker, I can tell my colleague for the last 17 months 
that I have had the privilege to serve and be a voice for the people of 
Arkansas' 4th Congressional District here on the floor of the United 
States House of Representatives. I have begged, I have pleaded, I have 
scratched, I have crawled to try and get a hearing on my first bill, 
H.R. 3626. I could not get a hearing on that. Now I am pleased to be 
one of four of the original lead sponsors on this new plan which 
incorporates much of what was in my earlier bill.
  It is like all we get from the other side of the aisle is a lot of 
games. We get a lot of games on the need to truly modernize Medicare, 
to include medicine for our seniors, and that is so unfortunate.
  First out of the chute was this idea that what our seniors needed was 
a discount prescription drug card, a discount card, like it was some 
new novel concept. My dad got one in the mail for free 6 months ago. A 
person can watch any cable TV program late at night and for $7.95 a 
month they can get one.

  Why do they want to push a discount card? Because any savings which 
averages 50 cents to $3 came at the expense of a hometown family 
pharmacy and did not cost the big drug manufacturers a dime.
  A senior that has $400 a month in drug costs and takes five 
prescriptions a month, even if they save $3 per prescription, which is 
the best some do with these so-called discount prescription drug cards, 
$3 a month savings, five prescriptions, that means on a $400 drug bill 
they would save $15 a month. That does not help a senior choose between 
buying their medicine, buying their groceries, paying their light bill 
and paying their rent.
  Thank God when we created Medicare we did not say here is a discount 
card, go cut a deal at the local doctor or go cut a deal for whatever 
surgery someone needed. We provided them a meaningful health care 
benefit, and it is time we did the same when it comes to their 
medicine.
  I am pleased to be joined by another one of my colleagues here this 
evening, and at this time I yield to my friend and colleague, the 
gentleman from Texas (Mr. Lampson).
  Mr. LAMPSON. Mr. Speaker, I thank the gentleman for yielding to me.
  I have been listening to the comments that he has been making and the 
gentleman from New Jersey (Mr. Pallone) and all of the work that he has 
done about this. I think it is obviously an extremely critical issue 
for citizens all over this country who are speaking out at every 
meeting that I go to as it being one of the most important things in 
their lives.
  We have been working on some mechanism to assist people to get access 
to pharmaceuticals that they cannot afford to purchase for a long time, 
and we have heard unbelievable stories about people who have foregone 
payment of rent or purchase of food in order to buy the medicines that 
their doctors and other health care professionals are telling them that 
they have to have in order to stay healthy. Well, if a person does not 
eat and they do not have a decent place in which to stay and they are 
buying medicine, the chances are they are going to have other kinds of 
problems in their life, and it is a terrible decision to have to make.
  I know firsthand what some of those difficulties are. My own mother 
is 92 years old and is in reasonably good health right now, but 
unfortunately, has had problems like many elderly citizens have. She 
has people to help take care of her. Hopefully, she is not going to be 
one of those who will die in poverty, but at the same time, she expects 
dignity, and I think that is one of the most important things that I 
learned in the White House Conference on Aging a number of years ago in 
1995, that people would like to be able to live out their lives with 
independence and with dignity.
  We are going to be judged in this country and everywhere in the world 
about how we treat our elderly, and the youngest of us among us, but 
the elderly particularly, and if we wad our people up and throw them 
away after they are no longer productive, shame on us, and we will be 
paying for that for an eternity, and I certainly hope that we do not.
  We need what the drug companies do for us. We need their research. We 
need their development. We need the ability to stay healthy, and we 
know they are going to be providing it. I think it is incumbent upon 
this House of Representatives, this government, to find a mechanism to 
allow people to have access to that help that they need, and our 
program that works through the Medicare system will give people an 
opportunity to have a higher quality of health and consequently a 
longer life because of it.

  It reaches out to a significantly larger number of people than what 
other plans that are before the House of Representatives are doing. I 
think that the basic difference, at least in the way of my mind, in how 
we see this issue is how we are going to go about implementing this 
program.
  I know that our time is short. Let me turn it back to the gentleman 
from Arkansas (Mr. Ross).
  Mr. ROSS. Mr. Speaker, I would like to thank the gentleman from Texas 
(Mr. Lampson), my friend and colleague, and my friend and colleague, 
the gentleman from New Jersey (Mr. Pallone), for coming over and 
spending the last hour with me as we talk about the differences, and 
that is what makes our democracy so great, that we are able to sit here 
in a democracy, stand here in a democracy in our Nation's capital and 
talk about the differences in the Democratic and Republican plan to 
offer a prescription drug benefit for seniors.
  I would just close by simply encouraging my colleagues to go back 
home to their districts this weekend, stop by as many local pharmacies 
as my colleagues want to, chain pharmacies, any kind of pharmacy they 
want to go to, does not matter if it is home-owned or

[[Page H3719]]

if it is a chain, stop and talk to a pharmacist. I do not know if they 
are a Democrat or a Republican, show them what is included in the 
Republican plan, show them what is included in the Democratic plan, and 
every single time I can assure my colleagues they are going to tell 
them that the Republican plan must have been written by the big drug 
manufacturers and that the Democratic plan must have been written by 
our seniors.
  Do not take our word for it. Regardless of my colleagues' party 
affiliation, go talk to the hometown family pharmacist. Talk to the 
pharmacist. Ask them who is right on this issue.

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