[Congressional Record Volume 148, Number 87 (Wednesday, June 26, 2002)]
[House]
[Pages H4039-H4045]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
THE SKYROCKETING COST OF PRESCRIPTION DRUGS IN AMERICA
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 3, 2001, the gentlewoman from Florida (Mrs. Thurman) is
recognized for 60 minutes as the designee of the minority leader.
Mrs. THURMAN. Mr. Speaker, tonight we have a group of women here who
are very concerned about the prescription drug benefit that we may be
voting on this week and with some particular interest in the high cost
and skyrocketing cost of prescription drugs in this country.
Mr. Speaker, I yield to the gentlewoman from Illinois (Ms.
Schakowsky), who is a valuable member to our caucus and has been
actively involved in the area of prescription drugs.
Ms. SCHAKOWSKY. Mr. Speaker, I thank the gentlewoman from Florida for
yielding to me, who has been such a great leader on an issue that is so
important to the 39 million people who are on Medicare. Those are the
elderly and persons with disabilities.
A lot of times we come to the floor and we talk about people that are
in our districts or people that we have heard about or issues that
affect some segment of our society, but not so often do we come to the
floor and talk about a problem that affects so many people that also
directly impacts our own families.
The issue of the high cost of prescription drugs is hard to escape
from, regardless of the income or the position of one's family. I
found, much to my surprise, sometime ago that my family was not immune
from this particular crisis.
One day I got an e-mail from a cousin of mine that said, ``The reason
I am writing you today, I saw you on C-SPAN giving a speech on
prescription drugs.'' He said, ``I thought you would be interested in
my mom's story.'' This is also my cousin, his mother.
``The last couple of years of my dad's life, he was relying heavily
on all sorts of heart medication and other prescription drugs to keep
him going and maintain a quality of life.''
{time} 1930
Well, Mom kept on putting those drugs on their credit cards. How else
were they going to pay for them? With Social Security? I do not think
so.
Well, anyway Mom did everything she could to make sure Dad got his
meds. When Dad passed away in January 1998, Mom was left with a
mountain of credit card debt. The Tuesday after his funeral, she had to
declare bankruptcy. It just does not seem fair. But if you ask Mom, she
would do it all over again to have a few more days with Dad.
As we the baby boomers get older and the cost of prescription drugs
is skyrocketing, something needs to be done to curb the drug companies.
It cannot all be for recouping R and D. Somebody is gouging somebody.
This e-mail was sent to me almost exactly 2 years ago today. And at
that time there was not a candidate running for office, particularly
for Federal office, who was not promising that something was going to
be done about that high cost of prescription drugs. Oh, yes, elect me
and I will go to the White House or I will go to the Congress and I
will pass a prescription drug benefit for senior citizens. Do not
worry, seniors. Vote for me and I will get you a prescription drug
benefit. There was not anybody running for any office at the Federal
level that did not say that.
Well, those seniors, people in our own families, are still waiting in
line for that prescription drug benefit. We are almost through an
entire session of Congress, and there still is not a prescription drug
benefit. They have been bumped out of their place in line by the
airlines who we bailed out a very short time after September 11. They
have been displaced from their place in line by a very few rich dead
people when we excused them from the estate tax. And now as the front
of the line appears closer and closer, maybe they are getting there,
what they are offered up by the Republicans is a sham and not a plan, a
bill that was written by the drug companies and for the drug companies
that does nothing to control the high cost of prescription drugs,
provides no guaranteed benefit, there is no predictable premium or
copayment, no guarantee even that any insurance company will even offer
them the chance to purchase a plan.
A former member, Bill Gradison, who was president of the Health
Insurance Association of America from 1993 to 1998, criticized the GOP
private market approach to prescription drug coverage saying, ``I am
very skeptical that `drug only' private plans would develop.''
So even those people who are associated with the insurance industry
think that there is not going to be such a plan available. That is what
the Republicans have offered up.
The Democrats on the other hand, we have a plan that does provide a
guaranteed benefit, that is absolutely going to lower the cost of
prescription drugs, will lower the cost by enabling the Secretary of
Health and Human Services to negotiate a lower price for senior
citizens, that says that all the beneficiaries of Medicare, our group
just like an HMO or the Veterans Administration, and they will
negotiate a lower price for senior citizens, and lower the amount of
out-of-pocket costs.
But women, women are the ones who are most affected, that are most
hurt by the high cost of prescription drugs just like my cousin was who
had to declare bankruptcy. Out-of-pocket spending on prescription drugs
by seniors is the single largest out-of-pocket health care component
after premium payments.
Older women spend more out of pocket on prescription drugs on average
than do older men regardless of the type of supplemental insurance
coverage they have. Women on Medicare without supplemental benefits
spend almost 40 percent more on prescription drugs than men, and men
are spending too much. Older women are less likely than men to have
employer-sponsored prescription drug coverage. Women without drug
coverage spend more out of pocket on drugs than men. On average older
women fill more prescriptions than men each year regardless of
[[Page H4040]]
whether they have prescription drug coverage. Older women without
prescription drug coverage on average have 18 prescriptions filled in 1
year compared to 14 for men.
So this is a problem that impacts all Medicare beneficiaries, all
old, every American, but particularly falls the hardest on women. And I
know that my colleagues here, the women here, today are going to talk
about how the Democratic plan is going to directly address the needs of
the elderly, and particularly elderly women; and we will go into that.
But I would just like to say that if anybody thinks that their
families, their own relatives, their own parents or grandparents and
aunts and uncles and cousins are immune from the runaway costs of
prescription drugs, think again. If my cousin had not sent me this e-
mail telling me about the bankruptcy in my own family, I would not have
known because my cousin was too proud to tell anyone in the family that
this is what was going on.
So I am just happy to be part of a great group of women who are here
today to stick up for and to go to bat for all of the women who really
need our help with the true prescription drug benefit under Medicare. I
thank the gentlewoman for yielding to me.
Mrs. THURMAN. Mr. Speaker, I thank the gentlewoman and certainly
appreciate the story that you told about your cousins because there are
hundreds and thousands of stories like that throughout this country,
and it puts a face on why this issue becomes so important to us in this
Congress.
At this time, I yield to the gentlewoman from Nevada (Ms. Berkley)
who has been a continued voice of reason from her experience and the
experience from her own State, and we are certainly glad that she is
here to engage us and give us some idea of what has been happening and
happened and why some of these plans just will not work.
Ms. BERKLEY. Mr. Speaker, I thank the gentlewoman from Florida (Mrs.
Thurman) and the gentlewoman from California (Ms. Millender-McDonald),
the cochair of the Women's Caucus for organizing this Special Order.
I am here to discuss an issue that is absolutely crucial to seniors
across America, Medicare coverage for prescription drugs. This is one
of the most important issues that Congress will work on this year. This
is a defining issue. Who exactly do we represent in this body? Do we
represent millions of older Americans or do we represent the CEOs of
the pharmaceutical companies? Seniors have the greatest need for
prescription drugs. In many cases medicine is the most effective,
perhaps the only, treatment for illness; and yet one-third of senior
citizens do not have any prescription drug coverage at all.
This means that millions of seniors in our country have no
prescription drug insurance, and soaring drug prices are putting
necessary medications out of their reach. They simply cannot afford
them. Nowhere is this problem more apparent than in my district in
southern Nevada.
Southern Nevada has the fastest growing senior population in the
United States. When I go home every weekend, my seniors tell me about
the drugs they are taking, the medications they need. They tell me how
much they cost, and they tell me how difficult it is and what difficult
choices they have to make. Do they cut the prescribed doses to make the
medicine last longer? Do they take their medicine every day? Every
other day? Do they pay their rent? Do they pay their electric bills? Do
they buy groceries, or do they buy medicine?
We have to do better as a Nation. We have to do better. We must enact
the prescription drug benefit under Medicare. Our seniors are demanding
it. Our seniors deserve it from their elected representatives. They are
counting on us to honor our promises, our campaign promises to provide
affordable prescription medication under Medicare, where it belongs, to
older Americans.
This legislation, the legislation that the Republican majority is
sponsoring is a sham. It is not a prescription medication benefit. It
is a press release, and it is a campaign ad. Their so-called benefit is
complicated, and it is not guaranteed. There are gaps in the coverage
and it will do nothing, absolutely nothing to lower the prices of
prescription drugs. Their plan will not get the job done for our
seniors.
The majority bill also does a terrible disservice to our Nation's
Medicare providers. If the Republican majority cared one wit for
Medicare patients, for their doctors, we would pass a freestanding bill
to restore Medicare reimbursements to doctors and other health care
providers. Our doctors and health care providers, our nurses, our
hospitals, other health care providers, are being deceived and they are
being hurt by being thrown into the middle of this divisive issue. By
attaching the Medicare reimbursement to a useless sham of an insurance
based prescription bill, the Republicans have unfortunately doomed
both.
I am for a prescription drug benefit that is comprehensive,
affordable and guaranteed. I am for a benefit that will provide uniform
coverage for every senior in America no matter where they live or what
their income. It does not matter if they live in the State of Nevada
where we have a State program. It matters that all seniors are covered
throughout the United States.
America's seniors are depending on us to give them a benefit, the
right benefit. Let us act responsibly and give them what they need,
what they deserve, what they are counting on.
Our Nation is depending on us. They are looking to us to do the right
thing, and it is time for us to step up to the plate, fulfill our
campaign promises and improve the lives of older Americans in this
country.
I thank the gentlewoman, and I appreciate the opportunity.
Mrs. THURMAN. Mr. Speaker, I appreciate the gentlewoman's concern and
her participation in tonight's Special Order.
It is now my privilege to yield to the gentlewoman from North
Carolina (Mrs. Clayton), someone who I have valued over the last 10
years, somebody who came in with me, and somebody I served with on the
Committee on Agriculture, and someone all of us in this House respect
for the work that she has done. We are all very sad that she has made a
choice to go home, but I have met her husband T.T., and I certainly
understand. I am glad to have the gentlewoman here today.
Mrs. CLAYTON. Mr. Speaker, I thank the gentlewoman for her
leadership, and I thank her for yielding and her remarks.
Mr. Speaker, I rise today to remind my colleagues of a promise made
by Members and the Presidential candidates of both parties only a
little less than 2 years ago. We all agreed that the rising costs of
prescription drugs had reached critical mass and that it was forcing
many Americans, particularly our senior citizens, to make choices they
should not, in their golden years, be forced to make.
But I also would like to point out that what the Republican
leadership is just now getting around to offering is a choice that
really is no choice. They have tied two issues that really should be
dealt with separately. One is the prescription drug plan that is
deficient at best and probably is dead on arrival in the Senate. The
second matter is increasing reimbursements to rural hospitals and
medical facilities by Medicare to better reflect the costs of providing
a better service which I support but not in this bill. And especially
as a co-chair of the Rural Caucus and the member of the Rural Health
Caucus, we know the devastation that rural hospitals are suffering. So
they need this reimbursement.
So they have tied these two issues together with their Medicare
Modernization and Prescription Drug Bill. The Republican leadership
pits struggling health care facilities against struggling seniors. In
this, the majority party shows us the height of their cynicism and the
depth of their partisan politics at the same time. That is quite a
feat, unfortunately. It would do nothing serious to help solve our
seniors' problems relating to access and affordability when we
understand what they have provided.
Now, it does do something, I have to say, in terms of the hospital.
But it will not be enough to solve the financial crises being
experienced by our hospitals and our clinics, particularly in rural
areas, and as a result of inadequate Medicare payments.
The choices too many of our seniors are forced to make result in the
difference between life and death in a struggle to juggle the very
basics of
[[Page H4041]]
their life such as rent, utilities, food, medicine and having those
conditions that senior citizens have to juggle each time to make sure
they are living.
Disproportionately to men, this is the common quandary in which
senior women find themselves. Senior women find themselves far greater
in the quagmire. First of all, women live longer than men.
{time} 1945
It is also a fact that cardiovascular disease is the leading cause of
disability and death for women. Women have the highest incidence of
diabetes, stroke, high blood pressure and cholesterol problems. There
are also maladies like Parkinson's and Alzheimer's disease, breast
cancer, arthritis and others, all of these requiring a lot of
medication.
As a result of years of gender pay inequity and other factors, older
women are poorer than older men. Seventy-five percent of all elderly
poor are women. Older women are twice as likely as older men to have
incomes below $10,000. Sixty percent of all Medicaid beneficiaries are
women, many widowed; and among Medicare beneficiaries of all ages with
incomes below the poverty level, nearly 70 percent of them are women.
Women are living longer than men with less money, usually on fixed
income and with more medical problems to deal with, therefore requiring
more prescription drugs, but prices for these drugs are increasing at
triple the rate of inflation.
According to a recent study by Families USA, which analyzed price
increases for the 50 most commonly prescribed drugs for seniors over
the last year, for the last year, nearly three-quarters of these drugs
rose at least 1\1/2\ times the rate of inflation and over one-third
rose three or more times the rate of inflation.
Ten of the 50 most prescribed drugs for seniors are generics, only 10
of them. The average price for generic drugs is only about $375.
However, the average price for the 40 that are not generically
available is $1,103, three times that.
So women who have less money, less income, more health problems, find
themselves having to rely on drugs that are four and five times the
cost of generics or they are not available.
Helping our hospitals by modernizing the payment schedule for medical
services provided under Medicare and helping our seniors cope with the
costs of life-sustaining medicines that are spiraling out of control
are both worthy causes. We should be doing both but differently. They
have different objectives, and they should be separated in different
bills. These two issues should be debated separately in order to spare
the people affected a divisive fight they did not pick.
I have my rural hospital calling me right now to tell me to vote for
this bill, and they know that I understand their plight. I also have my
senior citizens calling me that this is insufficient.
We should not be having these divisive fights by struggling rural
hospitals and struggling rural citizens. We are pitting them together.
The leadership knows what it is doing. It is putting together a
poison pill for us to swallow. This is no choice because, indeed, my
senior citizens should not indeed have to do this.
We can do better, and we should do better, and the Republican
leadership knows this is indeed only a fight of ideology, not really a
worthy fight of principle.
I thank the gentlewoman from Florida as well as the gentlewoman from
California for having allowed me to participate in this special order
on this very special subject.
Mrs. THURMAN. Mr. Speaker, I thank the gentlewoman from North
Carolina for her participation and her wonderful information that she
has shared with us here tonight.
I would like to now take some time to ask the gentlewoman from
California (Ms. Millender-McDonald) to speak. I know she has some
words. She has been a great leader on this, and she has worked so well
with the Women's Caucus in trying to bring the issues and make sense of
some of these things that we are hearing about in potential bills. I
know tonight that we had especially one Republican Member of their
caucus that got up and kind of talked about some issues that really
kind of go to the essence of part of our message here tonight. So I
would love to yield to the gentlewoman from California.
Ms. MILLENDER-McDONALD. Mr. Speaker, I thank the gentlewoman from
Florida for her leadership on this issue. She has been absolutely front
and center with us on this very critical issue, an issue that is
absolutely critical and important to women, senior women, seniors, and
women as a whole.
I was struck tonight by one of my Republican colleagues who came to
the floor, the gentleman from Minnesota (Mr. Gutknecht), and he said
something to the effect that we know the bill has problems, he says,
about his Republican bill. He also said we must do something serious
about this critical issue. It was amazing that he admitted to the fact
that the Republican bill has problems, but I want to turn our attention
to this chart I have behind me, because this chart speaks volumes to
the experts who have also spoken about their concerns about the
Republican drug bill.
Bill Gradison, the former president of the Health Insurance
Association of America, says, I am very skeptical that drug-only
private plans would develop.
Then we have John Rother, the policy director of AARP, and he says,
There is a risk of repeating the HMO experience.
These experts are talking about this Republican drug bill.
Then we have Richard A. Barasch, chairman of Universal America
Financial Corporation, and he says, I do not think it is impossible but
the odds are against it, insurance participation. In fact, he is
talking about the insurance company's participation.
Then we have Thomas Boudreau, the senior vice-president and general
counsel of Express Scrips, and he says, We are not enthusiastic about
that approach.
When we have these four to five experts that are experts in
prescription drugs and Medicare and they are saying they have a problem
with this Republican drug bill, then it solidifies just what we
Democrats have said all along. This bill is flawed. This bill does not
speak to what the Democrats have in our plan that we call the Medicare
Modernization and Prescription Drug Act of 2002. This is a plan that is
universal, affordable, dependable and accessible, and in spite of all
of those fake things the Democratic plan has, it is voluntary.
When the gentlewoman from Florida (Mrs. Thurman) talks about that, I
am happy to join her and the other Members who have now come to the
floor so that we can talk about some of the stories that we have, that
we can bring to the American people about the difference between the
Democratic prescription drug plan and the Republican prescription drug
plan. So I will turn it back to her. Then, of course, she will
introduce the other two ladies, and we will get started on what the
people are telling us about the difference.
Mrs. THURMAN. Mr. Speaker, reclaiming my time, before we move on to
that, because I think the gentlewoman's poster says what the experts
are saying about the Republican drug plan, one of the big differences
that we all need to recognize is that, under the Democratic plan,
seniors would have a new benefit under Medicare.
Let me repeat that, under Medicare, and that would look and operate
like the benefits they already get such as hospitalization and
physician care because we would use those same providers that we use
today. However, very interesting, the Republican bill can only
guarantee private HMO-like drug plans and will participate in every
area we think almost by bribing the taxpayer, because this is what they
do. This goes directly to my colleague's poster, directly to her
poster. To entice plans to participate, the Republicans allow a
giveaway to the private insurers of up to 99.99 percent of the risk
they would incur. In other words, in areas of the country where private
plans are worried they might not make a profit, the government would
guarantee at least a minimal profit to the private insurers at
taxpayers' expense.
The GOP plan does not require that the HMO-like insurers pass on the
subsidies to the beneficiaries, directly to what they are saying.
First of all, we do not know that there would even be a plan that
would
[[Page H4042]]
be offered. If there is not one, they are going to actually entice them
at taxpayers' funding, similar to what we have done under Medicare
Choice programs that have created all kinds of problems for us and,
just as importantly, in this plan we still do not give the authority of
the Secretary to, in fact, negotiate and use the power of 40 million
Medicare beneficiaries to achieve greater discounts for seniors.
Guess what? This is proven. Look at the programs that we talk about
up here. The gentlewoman from Florida (Ms. Brown) can tell us. She is a
member of the Committee on Veterans Affairs. She has been an outspoken
member on the Committee on Veterans Affairs and, in particular, dealing
with prescription drugs both at the VA level and for our military
retirees that we have offered. She can tell my colleagues that the
power of people, and when we put a number like 40 million people into
the risk pool, the costs are reduced.
She has done a fabulous job in this area, and I would love to hear
some of her maybe comments and experiences that she has even had in
that realm, showing why it is so important that this goes under
Medicare and not to private insurers. We are so glad she is here
tonight, and we really do appreciate her leadership on this issue.
Ms. BROWN of Florida. Mr. Speaker, let me just say that I want to
thank the gentlewoman for yielding, but I want to also thank her for
her leadership on this matter. We both share the great State of
Florida, and we also share the many problems. Being one of the oldest
aging populations, we understand what our seniors are going through,
and we know we have got to bring some relief from the Federal
Government, because clearly both of us serve, she served in the Senate
and I served in the House, we know that in Florida, just as in
Washington, the only thing that is going on is tax breaks, tax breaks,
tax breaks, and not addressing the problems that our senior citizens
are experiencing.
Let me just tell my colleagues about my experience. When we had our
little break in March, I went home. Just like all of us when we go
home, we are going to do what we can to help out with our family; and
so I am going to go to pick up my grandmother's prescription. Of
course, I went there, and I am ready with my money, and I am waiting
for the prescription. I know she pays this bill every month, $53, so
that she can get a reduction and with an HMO. So I thought it would be
a $10 or $15 co-payment, just like we have a co-payment of a small
amount.
The amount of the bill was $91 for one prescription. I could not
believe it, $91. I talked to the doctor, and I wanted to know, I talked
to the pharmacist, what is the problem, and what they told me was that
her benefit had run out. We are talking about March. Three months with
this HMO, and her benefits had run out.
So when I think about my grandmother, who I could write a check for
$91, I think about all the other grandmothers. We have a responsibility
to look out for the grandmothers who cannot afford $91 a month for one
prescription, and most people are taking four and five. It does not
make any sense.
During the last election, and my colleagues know the kind of hanky-
panky that went on in Florida, but one thing we do know for sure, that
all of the candidates were saying that, if elected, I will provide a
prescription benefit for the seniors.
{time} 2000
Well, let me tell everyone something. We have been waiting 2 years
for that promise to be kept, and in the meantime we have had constant
tax cuts. We have had the terrorists operate; and if we are not
careful, the seniors who cannot afford it will be the ones who are left
out in the cold.
Mrs. THURMAN. Mr. Speaker, I want to talk about that for just a
second and what the gentlewoman from Florida (Ms. Brown) talked about
in the benefit plan and particularly because it was under probably a
Medicare Choice program of some sort; and by the way, the Medicare
Choice plans would be covered under the Democratic plan. There has been
some conversation on this floor over the last couple of days saying
they would not be able to keep what they already have. That is not
true. That is number one.
Number two, though, the gentlewoman from Florida (Ms. Brown)
mentioned a couple things that I think are extremely important to point
out. Number one, under the Democratic plan it is a guaranteed minimum
benefit, that is guaranteed; and under the Republican plan it is not.
Guaranteed lower drug prices, for Democrats the answer is yes. For
Republicans, it is no. Guaranteed monthly premium, that is a good
thing. We think that is wonderful. Ours would be $25 set in the bill.
It says $25. In the Republican plan we have no guaranteed monthly
premium.
What we have is a CBO estimate that it might be on an average premium
of $34, not set in the bill. Annual deductible, again a most important
part. The gentlewoman from Florida (Ms. Brown) talked about her
grandmother in March. Well, under the Democratic plan it says $100
deductible, period. Under the Republican plan it says $250 or an amount
that makes benefit actuarially equivalent. I am not an actuary; so I am
not sure what that means, but somebody will explain it. Co-insurance
paid by beneficiary per year, 20 percent under the Democratic plan
until out-of-pocket cost is $2,000. Under the Republican bill, listen
because we have got to make this difficult, 20 percent for $251 to
$1,000; 50 percent for $1,001 to $2,000; 100 percent of above $2,000
until out-of-pocket cost is $3,800.
Ms. BROWN of Florida. Mr. Speaker, would the gentlewoman yield?
Mrs. THURMAN. I yield to the gentlewoman from Florida (Ms. Brown).
Ms. BROWN of Florida. Mr. Speaker, I just want my colleagues to know
that my grandmother cannot afford $3,800 a year. She is 96 years old.
She does not have $3,800; and there lies the problem because our
seniors just do not have it, and I do not understand why these other
people do not get it. They are deciding. They have to pay their rent,
they have to pay their mortgage, they have to buy food, and they just
do not have this kind of money. I do not understand. Since the
Republicans have taken over, what they practice is what I call reverse
Robin Hood, reverse Robin Hood. When I was coming up, I used to watch
Robin Hood. Reverse, stealing from the poor and working people, and now
our frail elderly, to give tax breaks to the rich.
Ms. MILLENDER-McDONALD. Mr. Speaker, if the gentlewoman from Florida
(Mrs. Thurman) will yield, if I can just show this chart. As the
gentlewoman from Florida (Mrs. Thurman) laid out, the actual premiums
and the comparison of the two bills showing that the Democratic plan is
the better plan, this is how much the average senior will save. The
Republican plan, only 22 percent, compared to the Democratic plan that
they will save 68 percent; and this is according to the CBO, the
average senior will spend $3,059 on prescription medicine in 2005, the
first year of any Medicare drug benefit. This right here absolutely
outlines by the Congressional Budget Office that the comparisons are so
stark that we can see that the Democratic plan absolutely gives a
better benefit to seniors than that of the Republican plan.
Mrs. THURMAN. Mr. Speaker, one other issue that the gentlewoman from
Florida (Ms. Brown) brought up that I also think is very important in
this debate and quite frankly it is an issue that our Republican
colleagues are having, I can say from CongressDaily today, one is the
cost issue. They are concerned about it. The gentleman from Minnesota
(Mr. Gutknecht) came on the floor and showed the comparison of what we
do in this country as compared to the same cost of that drug in another
country, an industrialized country which is important to appreciate and
understand and the price issue but it is the pharmacist issue.
Let me tell a little story that I think makes a really good point. A
couple of years ago, my mother, who lived with me, and I took care of
her when she was sick and she was in Florida with me during one of my
breaks, she had been at one of our teaching hospitals, Shands. I had
brought her home after she had been in the hospital for a couple of
days, and they had said to me, You know, Karen, we think these are some
of the things we think are wrong, and what we want to do is go ahead
and put her on some medications, but we would like you to bring her
back in about 10 days to see how she is doing.'' I said, okay.
[[Page H4043]]
So I go to the pharmacist, and I pick up the medicines. And I am not
even going to speak to the cost of the medicines, but my dad was
military, so my mother had always had the opportunity to go to the
bases to get her medicines and she was in sticker shock, I think, for
the very first time to see what the real cost of medicines were for
other folks, or for her friends.
But listen to how important this was. Just leaving the pharmacist out
of this equation, which is another thing they do in this bill
basically, because they do not have to include the pharmacist, our
local pharmacies, my pharmacist said to me, You know, Karen, I can give
you the full month's prescription on this, and it will cost you X
amount of dollars, he said, but when does your mom go back to the
doctor to get a checkup? And I said, Well, in about 10 days we will
take her back to see how things are going. He said to me, You know
what. I will just give you a 10- or 11-day supply. Why should I make
you pay for 30 days when they may end up changing her medication
because it may not be doing what it is supposed to be doing.
That 10-day supply was something that cost me less, cost my mother
less; and more importantly, when she went to the doctor in 10 days,
guess what, they in fact did change and prescribe something different.
And I just have to say that that kind of a story is so important to why
the local pharmacists need to be involved in this issue, because we
depend on them.
Ms. BROWN of Florida. Mr. Speaker, if the gentlewoman will yield on
that point. I had the Committee on Government Reform do a study in my
district, and we compared what the seniors in the Third Congressional
District of Florida pay. We pay 131 percent more for a brand-name
prescription than other consumers and 98 percent more than consumers in
Canada and Mexico.
Mrs. THURMAN. Reclaiming my time, Mr. Speaker, I want to get back to
that issue, because I want to talk about an amendment that we offered
to try to bring the cost down.
But at this time I would like to take the opportunity to invite the
gentlewoman from Texas (Ms. Jackson-Lee), a valued Member of this body,
who has been actively involved in this issue and who I think has some
information that we might have skipped over. So I would like to invite
her into this discussion.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the distinguished
gentlewoman from Florida (Mrs. Thurman), and might I acknowledge my
other colleagues, the gentlewoman from California and, of course, the
gentlewoman from Florida (Ms. Brown) for their leadership, and
particularly the areas of expertise that they all generate.
I thought it would be helpful, as I was listening to my colleagues,
to come to the floor and share some of the messages and the concerns
that I bring back from Texas, but also the history of the Medicare
legislation that many of my colleagues are familiar with.
I would like to, as I show them some very important facts in pictures
tonight, I would like to hold up a picture of President Johnson signing
this legislation in 1965. If we were to track the aging of America, we
would determine that post-1965 our senior citizens have lived longer
because of the implementation of Medicare. And what we talk about
tonight is the component that will add to the life of seniors today who
are losing ground because so many of them now do not have a
prescription drug benefit. That is what we are talking about with
the Democratic plan, a benefit. That is quite the contrary from a
voluntary optional program which an individual can choose to
participate in.
Now, many of my friends have said, and as many of my colleagues know,
particularly the gentlewoman from Florida (Mrs. Thurman), we have been
on this issue now for at least, I guess in our life, two or three
terms, but 6 years or more, and some even longer; and for many times
during that time frame, we budgeted very responsibly, meaning
Democrats, in preparing ourselves for the expenditure. In fact, I want
to cite for the record that last year, March 2001, we had about $5.6
trillion in our surplus. We were prepared for what this might cost.
I listened to the gentlewoman from Florida (Ms. Brown) discussing her
grandmother, and I took a tour of my senior citizen centers and asked
couples and singles how many of them are cutting their prescription
drugs, and hands went up; and how many of them are not taking the drugs
or not taking them in the right amount, and hands went up. There, right
in front of my eyes, was the undermining of their health.
In addition, about 2 years or so ago, I was running around my
district in a panic because my seniors were in a panic. We were trying
to answer concerns, because what had happened in Texas was that HMOs
had shut their doors, literally shut their doors. We had seniors in
Harris County who had become reliably comfortable with HMOs, between 3
and 4 million people. Many of us, elected persons and others, begged
HMOs either to come back or to stay. I remember us getting into
negotiations where we asked if they could stay an extra 90 days. My
senior citizens know what I am talking about. Their HMOs shut down on
them.
My fear with the Republican plan, this plan that is a card or some
kind of membership, is that when we get to a point and we find that it
is not profitable, and when I say ``we'' I mean those who are engaged
in this plan, when they find it is not profitable, am I to expect that
those pharmaceuticals will shut their plan down?
So I wanted to show another picture to say why this can be done and
why it is imperative that we do this. Because imagine becoming
dependent on this voluntary card, imagine seniors having accepted it,
having become comfortable with it, that is, if it even works, and they
get a few dollars off from it, and they hold this card in their hand
and, all of a sudden there is some analyst locked up in a room
somewhere in corporate headquarters that says, you know what, they are
not making any money in Jacksonville, they are not making any money
near Orlando or Houston, Texas, so shut it down. Then I have got
thousands of seniors without the ability to secure their medicine.
I want the American public to understand that this is a well thought-
out process; and we believe, many of us, that when we look responsibly
at the tax cut, and I know there are many shades to the tax cut, but if
we look responsibly, and we are talking about that major one that
really just focused in on 1 percent of the population, there were other
side-bar tax cuts, but it is that big one, and we believe when we look
at that seriously we can find 64 percent of the people that would not
be opposed to rolling back the tax cut that Congress passed last year
and using that money to provide a prescription drug benefit under
Medicare for seniors.
So this dialogue tonight, and I thank the gentlewoman from Florida
for it, this dialogue tonight is not reckless, it is not an attempt to
use what we do not have. It is, frankly, a recognition of really the
concern we all have. And I want to be responsible, but sometimes I
visit my seniors and there is panic. And I use that word only because I
have seen it, the panic they might face by going one more month, one
more day without a real drug benefit.
{time} 2015
Mr. Speaker, I simply say in closing that I know the other body is
discussing this issue. We have to recognize the other body. Why pass
legislation in the House that has absolutely limited chance in a
compromise effort in the other body? We are trying to get legislation
that is realistic and will answer the concerns of all seniors.
I am disappointed that we cannot come to a conclusion on something
that deals realistically with a guaranteed benefit, and I might say
protection of our rural hospitals and urban hospitals, taking care of
some of the formula problems that we have, there seems to be no reason
why we cannot do this. I thank the gentlewoman from Florida (Mrs.
Thurman) for her leadership.
I smile because lawyers have more than one closing, but this is a
closing. Women, I have been hearing this all day long, have a greater
use and/or need for Medicare drug benefit, not diminishing the men, but
we are finding out that many older women are living longer, and we are
going to help with research to help men, living as widows without
income, they are really suffering. I think we can do better.
[[Page H4044]]
Mrs. THURMAN. Mr. Speaker, I thank the gentlewoman from Texas (Ms.
Jackson-Lee) and her concern for her constituents and the stories that
they have told the gentlewoman.
I do want to say one other thing. We are getting phone banked in our
offices right now. I had a conversation with my staff this afternoon
about this phone banking. I asked what are they saying.
They said, first of all, we get this phone call, and then all of a
sudden there is a click and somebody is on the phone. We say, this is
the office of Mrs. Thurman; and they say, I want you to vote for
whatever the bill number is on this piece of legislation.
My answer is, I will be glad to vote on a Medicare prescription drug
benefit but not one that is privatized. They say, that is exactly what
I want you to do.
Just remember, all of us standing here tonight are for a prescription
drug benefit that is under Medicare.
Mr. Speaker, I yield to the gentlewoman from California (Ms. Watson),
former ambassador, as well as a State legislator, who has dealt with
State health issues in California and I know had some very difficult
times after some propositions out there.
Ms. WATSON of California. Mr. Speaker, I thank the gentlewoman from
Florida (Mrs. Thurman). I thank all Members who are making the case for
our seniors and particularly those who are women, because they rely
more heavily on prescription drugs than the average American. Although
they represent just 13 percent of the population, they consume more
than one-third of all prescriptions. Not only do seniors use more
drugs, they also rely on more costly medications. Drug expenditures for
seniors constitute 42 percent of the Nation's total. Seniors with
health insurance find themselves without coverage for prescription
drugs more often than not.
More than 10 million Medicare beneficiaries lack coverage, and
millions more have inadequate and unreliable drug plans. Part of the
solution to our current problem is the enactment of a meaningful drug
benefit within the Medicare program.
I am from California, and I know some Members did not really
understand what our substitute Democratic proposal had in it. They said
it will hurt California. The only reason that perception was out there
is because California has an excellent MediCal program where we offer
about 32 to 35 more benefits than are required under Medicaid. That
accrues to the Medicare program as well. This proposal that is a
substitute proposal or a supplemental proposal will only benefit our
seniors in California, not hurt them.
Republicans have proposed a bill to address the problem that is just
plain bogus. The American public must filter out the rhetoric and see
the Republican plan and the Democratic substitute for what they really
are. The phone calls that the gentlewoman is getting are people who
have been deceived and misled. We need to clarify so they will know. I
want to spend a second clarifying.
The Republican bill covers less than one-fourth of Medicare drug
costs over the next 10 years. The Republican bill does not help with
any drug cost between $2,000 and $5,600. The Republican drug benefit is
vague. They offer a standard suggestion for what private plans might
offer. In addition, their bill does not guarantee that seniors will
have affordable, and that is the keyword, affordable drug coverage.
The House Democratic proposal adds a new Part D in Medicare that
provides voluntary prescription drug coverage for all Medicare
beneficiaries beginning in the year 2005. The Democratic proposal
authorizes Medicare contractors to obtain guaranteed reductions in
prices.
The Secretary of Health will have the authority to use the collective
bargaining power of Medicare's 40 million members to negotiate prices
on particular drugs. The basics are: $25 a month premium, $100 a year
deductible; and beneficiaries pay 20 percent, Medicare pays 80 percent
and a copay; and a $2,000 out-of-pocket limit per member per year.
That, Mr. Speaker, is the Democratic plan. That is not a Republican
maybe plan.
Yes, it has a price tag. But the Republican $1.6 trillion tax cut
would pay for this program several times over. Just do the math.
Members should be able to respect older Americans, and we need to be
able to give aid to New Yorkers post 9-11 and fight the terrorist
threat at the same time. We can do it all if we were not foolishly led
to support a $1.6 trillion give-back to the wealthiest Americans.
Mrs. THURMAN. Mr. Speaker, I thank the gentlewoman.
Mr. Speaker, it is my privilege to introduce the gentlewoman from
California (Mrs. Davis) who is a freshman, who was one of those out on
the campaign trail when everybody was saying we have got to have a
prescription drug benefit. We are so pleased that the gentlewoman is
here and is such an active voice on this issue.
Mrs. DAVIS of California. Mr. Speaker, it is true when I was out on
the campaign trail we talked a lot about health care. That is why it
was so interesting to me a few months ago when I was in Costco on the
weekend with my husband doing some shopping and I noticed that people
were following me around the store. I started getting a little nervous
and finally stopped long enough for them to approach me.
Basically what they said is that they know that Congress has got to
focus on the war on terrorism, that that is our priority, and I support
the President in his efforts. Then they said, we understand that, but
when is Congress going to get back to talking about health care? They
proceeded to tell me about the difficulty that they are having with
their mother and her prescription drug costs.
I know that Members get e-mails and letters daily. I have one here.
``Dear Congresswoman Davis: I have only one request. That is to help
us, families with members who suffer from Alzheimer's disease. Medicare
does not cover my mother's prescriptions, which is very costly, around
$140 for 30 tablets that she must take. Taking care of her is really
hard. Where are we going to end with medication and treatment for this
disease? We need your help soon.''
And another letter, ``As retired people and getting up in years, my
wife and I are spending an increasing share of our income on medicine.
I hope you can find a way to help us with that problem.''
Well, we are talking about that now, and that is a good thing. The
reason we are here tonight is to talk about the impact that this has
particularly on women. It is all about our priorities, what is
important to us and what do we choose to fund.
We know that in America today over a quarter of women on Medicare,
nearly 6 million women, lack any prescription drug coverage at all. The
average woman, age 65 and older, lives nearly 7 years longer than the
average man, and she is typically widowed, living alone and struggling
to make ends meet on an annual income of $15,615, compared to over
$29,171 for men. It is nearly half of that for men.
So that is why we come before the House today to talk about how this
impacts women. We know that two-thirds of Medicare beneficiaries with
annual incomes below the poverty level are women and that a woman
spends 20 percent of her income each year on out-of-pocket health care
costs.
I am committed, as I know Members here today are committed, to a fair
prescription drug plan under Medicare that does not stifle innovation
or eliminate choice in coverage. I want to help seniors afford the
increasingly expensive prescription drugs that they need to treat or
prevent illness.
We know what is going to be before us does not have the access, has
geographic inequalities that do not work, and has premium concerns that
will not work for our seniors. We need to develop the best
comprehensive plan. We need to develop a prescription drug plan that
provides our seniors with real benefits. An alternative does exist, and
I hope that there will be an opportunity to bring that to the House
floor for discussion.
I thank the gentlewoman for bringing these issues before us today.
Ms. BROWN of Florida. Mr. Speaker, I understand the family of the
gentleman from Indiana (Mr. Kerns) is visiting with us in Washington
here today, and I know that they are very, very proud of you being the
Speaker. I want to thank the gentleman for being here tonight as we
conduct this very important debate.
[[Page H4045]]
Mrs. MALONEY of New York. Mr. Speaker, I thank you, Congresswoman
Thurman for organizing this important special order on the need for
prescription drug coverage.
Medicare provides health care coverage to forty million retired and
disabled Americans.
For decades, Medicare has worked to provide needed, lifesaving health
care to millions, but it is missing a fundamental component: a
prescription drug benefit.
If we have courage, this Congress can make history and give our
nation's seniors what they desperately need: a real, and meaningful
prescription drug plan.
I am proud to joint my Democratic Colleagues, lead by Mr. Dingell,
Mr. Rangel, Mr. Stark and Mr. Brown, as an original cosponsor of the
``Medicare Prescription Drug Benefit and Discount Act.''
I come to the floor this evening to discuss two points:
Number 1: unlike the Republican drug plan, the Democratic plan is
simple because it builds upon a proven model--Medicare.
Just like seniors pay a Part B premium today for doctor visits, under
our plan, seniors would pay a voluntary Part D premium of $25 per month
for drug coverage. For that, Medicare or the government will pay 80
percent of drug costs after a $100 deductible. And NO senior will have
to pay more than $2,000 in costs per year.
There is an urgent need for this plan. The most recent data indicates
that almost 40 percent of serniors--an estimated 11 million--have no
drug coverage. Problems are particularly acute for low income seniors
and seniors over the age of 85 (the majority whom are women).
Additionally, those older Americans who do have coverage find that
their coverage is often inadequate for their needs.
The Democratic plan is a real plan with real numbers, not estimates.
Point 2: the Republican Plan does nothing to bring down the cost of
prescription drugs. The Democratic plan is the only plan that provides
real Medicare prescription drug coverage for our seniors by stopping
soaring drug costs.
Under the buying power of Medicare, through competition and
bargaining we can rein in drug costs. Prescription drug costs are too
high for our older Americans. They need help now!
For instance, look at Prevacid. Prevacid is an unclear medication,
and the second most widely used drug by American seniors. The cost for
this prescription is on average $137.54 per month in New York City--cut
only $45.02 in the United Kingdom, a price different of 200 percent.
Or look at Celebrex, a popular arthritis medication and a drug needed
by many older women, especially, since older women are stricken more
often than men by arthritis. According to a Government Reform Committee
report released by Mr. Weiner and myself, a monthly supply of this drug
costs $86.26 in New York City. In France, a monthly supply of Celebrex
costs only $30.60. This is a price differental of 182 percent. Seniors
in New York City without drug coverage must pay almost three times as
much as purchasers in France.
Prices for prescriptions have risen 10 percent per years for the last
several years, leading to over $37 billion in profits last year for the
giant drug companies. While these corporations wallow in their spoils,
seniors suffer without coverage.
Unfortunately, the brunt of the problem falls squarely on our
nation's olderly women, who are nearly sixty percent of our senior
citizens. We need to take care of America's older women, we need to
help all of our senior citizens.
Mr. Speaker, we must pass the Democratic prescription drug plan
without delay. It is built on a proven model medicare. The Republican
plan only offers gap-ridden coverage. The Republican bill is about
privatization. The Republican plan is all about election year politics.
For the sake of our seniors, we must pass the democratic plan, and we
must pass it now.
____________________