[Congressional Record Volume 148, Number 87 (Wednesday, June 26, 2002)]
[House]
[Pages H4051-H4055]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  2130
                       PRESCRIPTION DRUG BENEFIT

  The SPEAKER pro tempore (Mr. Kerns). Under the Speaker's announced 
policy of January 3, 2001, the gentleman from New Jersey (Mr. Pallone) 
is recognized for 60 minutes.
  Mr. PALLONE. Mr. Speaker, let me say to the gentleman from California 
that I listened very carefully to what he said in analyzing that 
Federal court opinion that came down today; and I do agree with him 
that the opinion does not make any rational sense and that the use of 
the term ``in God we trust'' does not in any way violate the 
Constitution.
  I wanted to take to the floor this evening, however, as I have so 
many times in the last couple of months, and talk about the need to 
pass a prescription drug benefit and also to give a little status 
report, if I can, about where I think we are on this, because I am very 
concerned from some of the statements that I have been hearing today 
and some of the reports in the media, as well as some of the things I 
am hearing tonight, leading up possibly to Committee on Rules action or 
inaction, that there is a real possibility the Republicans will not 
bring up their prescription drug bill for a vote before we recess for 
July 4, for the Independence Day celebration.
  I say that because for several months now I have been asking that the 
Republicans bring up this bill because I think that the issue of 
prescription drugs for seniors and the issue of increasing high drug 
prices is one of the major issues that the Congress needs to address.
  When I go home to New Jersey, to my district in New Jersey, many 
seniors and even people in general, not just seniors, complain to me 
constantly about drug prices, about their inability to buy prescription 
drugs and the consequences that fall to their health because of their 
inability to buy the prescription drugs, the medicines that they need.
  So I was rather happy a couple of months ago when the Republican 
leadership announced that they would bring a prescription drug bill to 
the floor before the Memorial Day recess, and I was disappointed when 
we went home for Memorial Day and that had not happened.
  I was once again hopeful when after the Memorial Day recess in early 
June we heard the Republican leadership once again say they were going 
to bring a prescription drug bill to the floor before the July 4 
recess.
  Last week, we actually did have the Republican bill unveiled; and we 
had a 3-day and all-night marathon in the Committee on Energy and 
Commerce, where I serve, where the bill was discussed and the 
Democratic alternative was discussed. Although I think that the 
Democratic bill is the only really meaningful bill, and I will discuss 
that in a minute, I was at least happy to see that we did have the 
opportunity in committee to discuss medicines or prescription drugs for 
seniors.
  So I would be extremely disappointed and very critical of the 
Republican leadership once again if we find out tonight or tomorrow 
that they still do not intend to bring this bill up. I am not surprised 
because I have said many times that the Republican bill is basically a 
sham. It does not provide any benefit for seniors. It has no real hope 
of providing any kind of prescription drug benefit for seniors. It does 
not even try to reduce price, the price of drugs, but at least if we 
had the opportunity to have this bill on the floor tomorrow or Friday 
we could then offer our Democratic substitute and see which side gets 
the most votes.
  I am actually here tonight, Mr. Speaker, because I understand that 
within the next half hour or so we will be hearing from the Committee 
on Rules as to whether or not they will be considering the Republican 
bill tonight, either at 10:00 or 10:30 or 12 o'clock or possibly 
tomorrow morning. If we hear that they are not, then that is a very 
good indication that the bill will not come to the floor for a vote. So 
I am waiting here, Mr. Speaker, to see what the Committee on Rules is 
going to do, hoping that they will allow this bill to come up and we 
will have a debate on probably one of the most important issues facing 
this country.
  I am still hopeful, although I have less and less reason I suppose to 
be hopeful, given some of the comments that have been in the media 
today.
  Let me explain why the Republicans may not bring the bill up. The 
reason they may not be able to bring the bill up is because they do not 
have the votes. The talk this afternoon around the House of 
Representatives was that they were shy 20 or 30 votes on the Republican 
side; and, of course, they are getting practically none, if any, 
Democratic votes.
  Some of the reasons that were articulated today in Congress Daily, in 
the lead story, says, House GOP still shy of majority to pass 
prescription bill, and it mentions about three or four reasons why 
different Members were having problems with the Republican bill, which 
I think go far to explain why the bill is a bad bill.
  So I would like to mention some of these reasons. It says lawmakers, 
this is the Republicans now, variously want more money for home State 
hospitals and rural health care, more attention to drug costs rather 
than coverage and guarantees to protect local pharmacies. The GOP 
leadership aides conceded that these groups of Republicans, in the face 
of the very few Democrats expected to cross party lines on a vote for 
the GOP bill, have left the measure short of the 218 votes needed to 
pass it.
  Let us talk about some of these issues that some of my Republican 
colleagues, rightfully so, believe are wrong or do not justify their 
voting for the Republican bill. Maybe before I do that I should say 
that I am very happy to see that there might be 20 or 30 colleagues on 
the other side of the aisle, on the Republican side, who would be 
willing to say to their leadership that they do not want to vote for 
this bill, because I have said many times, and again, I will give some 
third party documentation, that this bill is nothing more than a boon 
to the pharmaceutical drug industry. In other words, the reason why the 
Republicans have put forth a bad bill and one that will not work is 
because they are beholden to the brand-name drug industry.
  If my colleagues doubt what I say, let me mention that last week when 
we had a markup in the Committee on Energy and Commerce of the 
Republican bill, last Wednesday, a week ago today, they actually had to 
adjourn, the chairman adjourned the markup, the committee markup at 5 
o'clock, because the Republicans had to go to a fund-raiser that was 
primarily being underwritten by the prescription drug

[[Page H4052]]

industry. So lest there be any doubt about what they were doing, it is 
all laid out here in the Washington Post.
  This is the Washington Post from that day, which says, ``Drug Firms 
Among Big Donors at GOP Event. Pharmaceutical companies are among 21 
donors paying $250,000 each for red-carpet treatment at tonight's GOP 
fund-raising gala starring President Bush, two days after Republicans 
unveiled a prescription drug bill the industry is backing, according to 
GOP officials.
  ``Drug companies, in particular, have made a rich investment in 
tonight's event. Robert Ingram, GlaxoSmithKline PLC's chief operating 
officer, is the chief corporate fund-raiser for the gala, and his 
company gave at least $250,000. Pharmaceutical Research 
and Manufacturers of America, a trade group funded by the drug 
companies, kicked in $250,000, too. PhRMA, as it is known inside the 
Beltway, is also helping underwrite a television ad campaign touting 
the GOP's prescription drug plan.

       Pfizer Inc. contributed at least $100,000 to the event, 
     enough to earn the company the status of a ``vice chairman'' 
     for the dinner. Eli Lilly and Co., Bayer AG and Merck & Co. 
     each paid up to $50,000 to ``sponsor'' a table. Republican 
     officials said other drug companies donated money as part of 
     the fund-raising extravaganza.
       Every company giving money to the event has business before 
     Congress. But the juxtaposition of the prescription drug 
     debate on Capitol Hill and drug companies helping underwrite 
     a major fund-raiser highlights the tight relationship 
     lawmakers have with groups seeking to influence the work 
     before them.
       A senior House GOP leadership aide said yesterday that 
     Republicans are working hard behind the scenes on behalf of 
     PhRMA to make sure the party's prescription drug plan for the 
     elderly suits drug companies.

  I am glad to see that they did not work hard enough, because as of 
this afternoon and maybe tonight we will see, once the Committee on 
Rules decides what they are going to do, there were about 20 or 30 
Republicans that were not willing to go along with this sham proposal 
so maybe PhRMA has to work a little harder so that they can make sure 
that this Republican bill that is basically written by the 
pharmaceutical companies does come to the floor.
  Again, as I say, Mr. Speaker, I am not saying I do not want it to 
come to the floor. I wish they would bring it up because I think we can 
defeat it and we can pass a good bill, which is the Democratic 
substitute.
  I see my colleague from Connecticut is here tonight. He has been here 
before to talk about this bill, and I appreciate his coming, and I 
would like to yield to him at this time.
  Mr. McDERMOTT. Mr. Speaker, I thank the gentleman from New Jersey for 
yielding to me and again applaud his efforts on behalf of senior 
citizens all across this country. Clearly, if I might piggyback on some 
of the things that he said earlier, it has been our hope all along 
that, and I am so pleased he mentioned the number of valiant 
Republicans who are holding out, who are holding out on behalf of 
senior citizens all across this country, who implicitly understand that 
this specific remedy for prescription drugs belongs rightfully under 
Medicare, where it should have been placed in 1965 at the bill's 
inception, and it is because of their great courage that they are 
willing to go against their leadership, which is a difficult thing to 
do, and to go against the vested interest of the pharmaceutical 
industry, as my colleague has pointed out, and stand with those seniors 
in their district who have become refugees from their own health care 
system, people who have to get in automobiles or trains or buses and 
travel to Canada in order to obtain the prescription drugs at an 
affordable price that their doctors have told them they must have in 
order for their survival.
  These are the same people that, without congressional action, will 
have to be making the nightly decision between feeding themselves or 
taking the prescription drugs that their doctors have said they must 
need in order to sustain themselves or, in our neck of the woods, 
either heating their homes in the winter or cooling them in the summer.
  This is unconscionable. We are a better Nation than that. I commend 
my colleagues on the other side of the aisle, and I hope they can 
resist the unbelievable pressure I am sure that will be brought to bear 
on them over the next several days to conform with the majority party's 
desire to bring this program forward.
  As the gentleman from New Jersey has said, I hope that we bring some 
benefit forward. My concern, it is one that I have expressed back in my 
district, is that we have an opportunity to see the plans side by side 
so that the American public gets to see the opportunity that Congress 
has presented them as a benefit to deal with the ever-escalating costs 
of prescription drugs.
  We have said before on this floor, and it has been well chronicled, 
that especially when we talk about our seniors, that they are the 
greatest generation ever and rightfully so. They have been heralded by 
Tom Brokaw. They have been talked about on countless TV shows, heralded 
in the movies, in books, in literature. But what they really want is an 
end to the platitudes and the realization of policy, policy by way of 
prescription drug relief that is affordable, that is accessible, that 
is available.
  The Democratic plan offers that kind of a program to seniors. Perhaps 
the other side believes that their program is more viable; and, hey, 
this is a great country and we ought to have room for people to 
disagree and present their programs, but American citizens ought to 
know the choices that they have and the difference between the 
programs.
  My local paper, the Hartford Current, the other day issued an 
editorial saying that they thought there was very little difference 
between the programs.

                              {time}  2145

  I could not disagree more with that assertion and that this was not a 
bad first step, something we have heard on this floor from our 
colleagues. If the Republican plan were to be initiated, it would be a 
step in the wrong direction. I believe we have to be pretty practical 
about this stuff, and the paper brought out that they were concerned 
about costs and a number of issues that they raised with respect to a 
comparison between the Democratic plan and the Republican plan. Let us 
be clear about it. We are unabashedly proud of the fact that we believe 
this should be included under the Medicare program, and we believe it 
should be included under Medicare because, at its inception in 1965, 
prescription drugs were not thought to be the problem that they have 
become today. But clearly this is a benefit that our elderly not only 
need but richly deserve, and so it makes ever so much sense for it to 
be included here.
  I hail from the First Congressional District in Hartford, the 
insurance capital of the world, perhaps, arguably, the HMO capital of 
the world as well. And I have talked to the CEOs, and I have talked to 
the people in this business. The proposal that Republicans have put 
forward, and I have to believe they have done it in good faith, they 
have many bright and talented people on that side of the aisle, but 
this is an underwriter's, an actuary's, a risk manager's nightmare. 
Aside from setting up obvious adverse selection, the pricing involved 
in trying to come up with the program like this is out of reach for so 
many of our elderly and so, therefore, from our perspective, a sham.
  I commend those on that side of the aisle who have the courage of 
their conviction to stand up and say this is wrong. It is my sincere 
hope as a Member that we are going to get to vote on the Republican 
plan and the Democratic plan. This is what the American public 
deserves. This is what a democracy is all about. Let the two proposals 
stand on their respective merits and end all the so-called partisan 
quibbling by simply and matter of factly putting forward two plans side 
by each for all of our constituents to examine. Let us not be harried 
by rules. Let us not have this whole issue cast aside and only one vote 
that is going to come forward. Let us look at the proposal side by each 
and then stand up and be counted.
  Our colleagues on the other side who have resisted going along with a 
plan that privatizes prescription drugs should be commended, should be 
supported. But even if Democrats and valiant Republicans on that side 
who believe with us fail, we should at least have the opportunity in 
this body to vote on the plans that we believe in, that we have gone 
back to our districts and talked about with our constituents who are 
crying out to us for help.

[[Page H4053]]

  The Hartford Current concluded that this issue should be taken up. 
This is a match that cannot be postponed, because of the ongoing daily 
needs that so many senior citizens have in this country. So I commend 
the gentleman from New Jersey (Mr. Pallone) again for his outstanding 
efforts in this area and again thank our colleagues on the other side 
for at least now having the temerity to bring the issue forward. I 
disagree with their privatization attempt. I think it is wrong. I think 
it is an unworkable situation that people in the insurance and HMO 
industry understand as well; but I do think it is important that we 
vote this issue up or down and have an opportunity to examine side by 
side what the programs will offer.
  And one last thing, because the paper concluded that the costs might 
be too high. We have gone through a horrific time in this Nation since 
September the 11th. I commend the President of the United States for 
bringing this Nation together, for having us focus as communities, as a 
Nation, calling upon Americans to sacrifice as we move forward. But 
this Greatest Generation lived through the first day of infamy back on 
December 7, 1941; and now having lived through a second day of infamy 
on September the 11th, they should not be made to be the only people 
making sacrifices here. So when we say there is not the money there to 
assist these people, that is an outrage. Of course there is the money, 
and if that means freezing the tax cuts that we have put forward 10 
years out, then that is what we should do on behalf of these citizens 
who have given so much to their Nation. Minimally, we owe them the 
opportunity to live out their final days in the dignity that we would 
want for each and every one of our parents.
  I commend the gentleman from New Jersey.
  Mr. PALLONE. I want to thank my colleague from Connecticut, Mr. 
Speaker, because he raises so many really good issues, and I just want 
to key in on a couple of them, if I could.
  The gentleman mentioned the Hartford paper talking about the cost of 
the plans. I have said it so many times, and the gentleman basically 
touched upon it as well tonight, that it is not only that seniors 
deserve a prescription drug benefit, but it also makes sense from a 
financial point of view. Think about the fact, as the gentleman said, 
that, first of all, it could easily be paid for by simply postponing 
some of these tax cuts that primarily went for the wealthy and for 
corporate interests. We are not even talking about now. We are talking 
about in the outyears, 10 or 12 years from now.

  Mr. LARSON of Connecticut. Exactly.
  Mr. PALLONE. The second thing is what the Republicans have done with 
these tax cuts, of course, is to drive us back into debt where we are 
now using the Medicare and Social Security trust funds to pay for daily 
operating expenses of the Federal Government. I would much rather see 
the Medicare trust fund used for a Medicare benefit, like prescription 
drugs, rather than to run the country, because that is not what it is 
for. It is supposedly for the Medicare program.
  The last thing, and in many ways the most important, is the fact that 
we provide a generous benefit under Medicare, and we are not proposing 
anything that is out of line. We are just modeling it after part B. 
Part A of Medicare pays for the hospital bills, and part B pays for the 
doctor bills. And right now if an individual wants their doctor bills 
paid for, they pay a premium, I think it is like $45 a month, with a 
$100 a year deductible, and 80 percent of the cost of the doctor bills 
are paid for by the Federal Government.
  Well, we are doing the same thing with our bill. Our bill says we 
will create a new part D, where an individual pays only $25 per month 
for their premium, they have a $100 deductible, and 80 percent of the 
cost of their drug bills, up to $2,000, is paid for by the Federal 
Government. After that, it is 100 percent.
  This is not rocket science here. This is just the same old, same old 
Medicare, but now using the same principle used for paying doctors we 
are now using to pay for prescription drugs.
  The problem is, as the gentleman said, and I will go to the second 
point the gentleman made that I wanted to mention, is that we came up 
with a simple proposal under Medicare, and Medicare has worked for 35 
years; and yet the Republicans say we cannot do that. They do not want 
to continue and extend Medicare; they want to give money to the private 
insurance companies in the hopes that somehow they will provide a 
benefit. But they do not define what that benefit is; they do not say 
how much is to be paid for the benefit. We do not even know if they 
will offer the benefit.
  And as the gentleman says, most of the insurance companies and the 
trade associations are saying they do not want to provide it. No one 
can go out and buy a drug-only policy now, so why should they provide 
it overnight because the Federal Government gives them a little money? 
It is not going to happen.
  So the biggest concern we have as Democrats, and the main reason we 
think the Republican bill is a sham, is because these policies are not 
going to be sold. And if they were to be sold, we calculate that the 
benefit to the average senior is about 20 percent of the cost of their 
drug bill. So who would even pay $35, $45, $50, whatever the premium is 
per month, to get only 20 percent of their drug bill paid for?
  So the whole thing really is just a sham. It really is. I yield to 
the gentleman.
  Mr. LARSON of Connecticut. It is not practical. And I do not want to 
say this, because I hail from a part of the country that has a deep 
understanding of insurance and a deep understanding of risk management 
and spreading risk over a large population; but actuarially and from an 
underwriting perspective, when they take a look at trying to underwrite 
very narrowly those who would opt in to a voluntary program, by its 
very nature it sets up an adverse selection.
  So, therefore, to price this would be very difficult. If they are 
further forced to price it artificially, we have all seen what has 
happened to HMOs across the country when this happens. They pull out of 
the program and the elderly are left without insurance or, in this 
case, they would be left without prescription drug coverage. It is 
intuitively obvious; and I think that people, the elderly out there, 
understand it.
  My dad, God rest his soul, and the gentleman reminded me of something 
that he would say all the time when he was addressing the fairness of 
this issue, especially when we look not only here in this country but 
into our immediate borders, but also when we look all across the 
industrialized world and see the benefits that they provide for their 
seniors.
  My dad used to give his lectures to the family. He would, on Sunday 
afternoon dinners, and usually by evoking the holy family's name, but 
always talking about how great the country was and how we had risen to 
be the preeminent military, social culture, and economic leader in the 
world. Then he would turn to my mother and say, But look at the 
benefits that are offered to the very people we defeated in the Second 
World War. We defeated the Germans and the Japanese; and then we, as 
only this country would do, turned around and rebuilt and restored 
those nations so they are our very economic competitors today. He would 
turn to my mother and say, And look at the benefits that they have; 
look what they offer their people. And he would say, ``Jesus, Mary, and 
Joseph, Pauline, who won the war? ''
  His point was that their countries valued the service of their 
citizens more than our country. And while we all know how much we value 
the great service, because clearly we have chronicled it, as I have 
said earlier, in books and in movies and on talk shows, but the proof 
ultimately is in the legislation and the policy that we write here.
  If we care about those veterans that serve so valiantly, if we care 
about our aging population, then what we should do is provide them with 
the benefit that they have richly earned.

                              {time}  2200

  This is not an entitlement in the sense that it is something that we 
are handing out. This is something that has been more than paid for by 
the sacrifice of a generation who made us what we are today. For us at 
this point in time, at this historic moment to turn our backs on our 
elderly in their time of need is just outright wrong.

[[Page H4054]]

  That is why I have come to the floor so many nights along with the 
gentleman from New Jersey (Mr. Pallone) to express our concern. All I 
am asking is that we get an opportunity to vote on the plan that we 
believe is in the best interests of senior citizens and the American 
public. Let them stand side by side, and let them go through the test 
of being under the bright lights, and then let people across this 
country decide what truly is the best plan.
  Mr. PALLONE. Mr. Speaker, we are supposed to have an idea within the 
next 5 or 10 minutes about whether or not the Committee on Rules is 
going to consider the Republican bill and then whether or not they will 
consider a Democratic alternative. I hope, as the gentleman said, we do 
have an option to vote on the issue and debate the issue over the next 
few days, and in the context of that we do have the Democratic 
alternative or other options, certainly.
  Mr. Speaker, if I can spend a little time talking about some of the 
reasons that we have seen in the media over the last 24 hours why there 
may be as many as 20 or 30 of our colleagues on the Republican side who 
are not willing to vote for this Republican bill. I think we sort of 
articulated already the general reason, which is that this Republican 
bill is not a Medicare benefit. It is not guaranteed to anyone because 
it basically operates through private insurance companies, and they may 
not offer it at all, or in various parts of the country.
  But there were other specific things that came up today, and again I 
am looking at Congress Daily this morning that has an article, ``House 
GOP Still Shy of Majority To Pass Prescription Bill.'' The Republican 
bill does not address the issue of cost, does not do anything to reduce 
prices for prescription drugs. In fact, there was a reference that was 
pretty clear where one Member specifically said if the bill did not 
address the price of prescription drugs, what good is it, because how 
can we ever afford it if there are no price reductions.
  I go back to the fact that this bill was largely written by the 
pharmaceutical industry, and the major issue that we could see when we 
had the markup in the Committee on Energy and Commerce, not only were 
Republicans unwilling to vote for the Democratic substitute and make 
this a Medicare substitute, but, more than anything else, they were not 
willing to vote for any amendment or measure proposed by the Democrats 
that addressed the issue of price reduction. We had a series of 
amendments which they refused to consider.
  Of course, the Democratic substitute, as the gentleman knows, says 
that because this is a Medicare benefit and all 30 to 40 million 
seniors are part of the program and get the benefit, that we mandate 
under the Democratic bill that the Secretary of Health and Human 
Services negotiate prices for those 30-40 million seniors that would 
lead to reductions in price and lower cost.
  Because there is this huge insurance pool now, we know that he would 
be able to reduce prices significantly, just as we have with the VA or 
the Federal Supply Schedule or some of the other Federal programs where 
they have reduced prices 30-40 percent because of the negotiating power 
of having so many people.
  The one thing that was interesting to me was not only was every 
amendment on price struck down by the Republicans, but during the 
markup we realized that they had actually put in a section in the bill 
that was entitled noninterference. I am not going to read all of it, 
but this title specifically says, in carrying out the administrator of 
the prescription drug program's duties, it says that, ``The 
administrator may not require or institute a price structure for the 
reimbursement of covered outpatient drugs; 2, interfere in any way with 
negotiations with regard to the prescription drug sponsors or 
Medicare+Choice organizations, drug manufacturers, wholesalers or other 
suppliers of covered outpatient drugs.''
  Not only have they not put something in affirmatively to address 
price, but the Republican bill does not allow the administrator of the 
program to do anything to affect price. So they clearly, totally go 
down the road of what the pharmaceutical companies say and do not deal 
with the price issue at all.
  Mr. Speaker, I yield to the gentleman from Connecticut.
  Mr. LARSON of Connecticut. And yet they have a great opportunity. I 
want to commend those valiant Republicans who have stood up to their 
leadership. I will not use the Member's name who said, I have to choose 
between my leadership and the senior citizens that I represent.
  We have seen this happen before. We saw it with campaign finance 
reform. I saw a member of my delegation, the gentleman from Connecticut 
(Mr. Shays), stand up along with many Republicans on that side and do 
the right thing in terms of campaign finance reform. We saw the same 
thing in the Patients' Bill of Rights. We saw the gentleman from Iowa 
(Mr. Ganske) stand up and do the right thing, and the Patients' Bill of 
Rights was achieved. We have an opportunity here if we come together 
and are able to examine these various proposals side by side and then 
vote on them.
  I believe in my heart of hearts, and I have no illusions that many 
people around the country are listening to the dialogue between the 
gentleman from New Jersey (Mr. Pallone) and myself, but for those that 
are and can still contact and call people in their respective States to 
tell them just how important this is, to have a vote, to deny people to 
be able to have an amendment on pricing in the United States Congress 
just is so contrary to everything that we stand for.
  Mr. PALLONE. If the gentleman would yield, I just found the 
reference. It was the gentleman from Minnesota (Mr. Gutknecht) who 
spoke earlier on the floor tonight. He was the one quoted in this 
article in Commerce Daily.

  It says, ``The most problematic revolt is coming from a group of 
Republicans who want the bill to address price issues rather than 
coverage.'' It has a quote by the gentleman from Minnesota (Mr. 
Gutknecht). ``The central issue is affordability. As we move down the 
path towards passage of a drug benefit, that issue has been given short 
shrift.''
  He wants to include in the bill an amendment he has pushed through 
the House before. It would make it easier for Americans to reimport 
U.S. made drugs from other countries at controlled prices. He said, ``I 
am tired of subsidizing the starving Swiss.'' He was actually on the 
floor tonight talking about the reimportation issue, which is one way 
to bring down price. If we allow drugs to come from Canada or other 
countries and create competition that way, prices would come down 
considerably.
  But this was an amendment just like his that I offered in the 
Committee on Energy and Commerce that the Republicans voted against 
because they did not want to see any reimportation because it would 
address the issue of price.
  Mr. LARSON of Connecticut. Mr. Speaker, we are in the minority. We do 
not have the numbers to stop whatever the majority will is. Within the 
Republican caucus reside Members like the gentleman from Minnesota (Mr. 
Gutknecht) who are in my mind true heroes in this body who are willing 
to go against the tide, who are willing to stand up to their own 
leadership, who are willing to stand up to the pharmaceutical industry 
and say, wait a minute, these seniors have waited long enough. They 
have endured far more than they should. I applaud the gentleman from 
Minnesota (Mr. Gutknecht) and those valiant Republicans.
  Mr. PALLONE. Mr. Speaker, this says at the same time the gentlewoman 
from Missouri (Mrs. Emerson), who supports the amendment of the 
gentleman from Minnesota (Mr. Gutknecht), and wants to add a measure 
she is sponsoring to make it more difficult for brand-name drug 
companies to delay the market entry of generic medications.
  Again, that is something that is in the Democratic substitute. As the 
gentleman knows, if there is a patent exclusivity for a period of time, 
then of course the company that developed and gets the patent has an 
exclusive right.
  To be honest, something like 50 percent of the brand-name drugs are 
under patent right now, exclusivity, and therefore we cannot bring a 
generic to market. That basically inflates the price of the 
prescription drug.
  What happens is when those patents run out, the pharmaceutical 
companies

[[Page H4055]]

use all kinds of gimmicks to try to delay the generic coming to market. 
That is what the gentlewoman is trying to eliminate. I know that the 
gentleman from Ohio (Mr. Brown) has a bill, and some of that language 
is included in our Democratic substitute that would close those 
loopholes. Again, this is a pricing issue. Because if we bring generics 
to market, we reduce the cost of prescription drugs.
  Mr. LARSON of Connecticut. Mr. Speaker, the gentlewoman from Missouri 
(Mrs. Emerson) is absolutely right. I think what is also compelling 
about the Democratic initiative is the ability, and I think people 
understand this readily, to be able to leverage the great buying power 
that the Federal Government would have in terms of initiating a program 
under Medicare.
  Currently, whether you are a large corporation, whether you are the 
Federal Government itself, or whether you are a large labor union, you 
have the opportunity to go directly to pharmaceutical companies and 
leverage deep discounts in order to make prescription drugs 
more affordable. Medicare is a Federal program. Medicare would provide 
us with an opportunity to have large numbers that will allow us to 
leverage and bring down the cost, just like every other western 
industrialized country in the world is able to do. This makes common 
sense.

  I commend our colleagues on the other side of the aisle who 
understand at the heart of this issue is price and getting the cost 
down here and being able to have a program that is affordable, that is 
accessible, and will be ready available and, most importantly, workable 
for our seniors. Again, that is why I commend the gentleman from New 
Jersey (Mr. Pallone) for his efforts.
  Mr. PALLONE. Mr. Speaker, I am going to just mention one more 
Republican because I cannot praise them too much here. It is 
interesting to see that some are standing up to their leadership. This 
one is the gentleman from Pennsylvania (Mr. Peterson) who said he 
absolutely would vote against the measure unless more money is included 
for rural hospitals. He said once pharmacy is a part of Medicare, there 
will be no extra cash any more.
  What he is referencing is the problem for rural areas because, as the 
gentleman knows, just like with the HMOs that do not offer, do not have 
benefits, we do not have HMOs in a lot of rural areas, the same problem 
will exist here because you do not have a guaranteed Medicare benefit. 
It is unlikely in a lot of rural areas there would be any kind of 
private drug policy offered, which is what the Republicans are saying. 
The concern is that rural areas will be left out, and there will be no 
insurance policies for them to buy.
  The other thing is with regard to the pharmacies, particularly in 
rural areas. What would happen with a private insurance plan, just like 
with HMOs, they will decide what vehicle to use to dispense the drugs. 
They may use a large chain or may decide to do it through mail order 
and not through the local pharmacy. There is a real problem with those 
in rural areas, our colleagues who are concerned about whether any 
benefit would be available at all because an insurance company would 
not sell in those areas. Or, secondly, if there is one, it will operate 
like an HMO and will exclude any kind of dispensing of medicine from 
the local pharmacy.
  Of course, we in our bill do the opposite. We say this is a Medicare-
guaranteed benefit, and you can go to any pharmacy or any outlet to buy 
the medicine.
  Mr. Speaker, I yield to the gentleman from Connecticut (Mr. Larson).
  Mr. LARSON of Connecticut. Mr. Speaker, again, I thank the gentleman 
for pointing out the many Republicans on the other side who understand 
this.

                              {time}  2215

  This is an age-old battle between Democrats and Republicans and why I 
feel it is so important that we vote side by side on the differences 
between the proposals and commend those Republicans who have come 
forward with their own concepts and are focused on pricing, because 
they are among the few and the brave and the valiant who are willing to 
go against their own conventional wisdom and ideology.
  Roosevelt said it best during the struggles to bring Social Security 
to the forefront. He was amazed at the time that Republicans seemed to 
be, as he said, frozen in the ice of their own indifference to what the 
policies they would perpetrate would do to the American public. Frozen 
in the ice of their indifference to what their proposals would do to a 
Nation that is crying out for relief. That is why their Members who are 
standing up and maybe not in total unison with us but standing up for 
what they know is right for senior citizens deserve a great deal of 
credit.
  It is my sincere hope that the Rules Committee will provide an 
opportunity for all of us to have an opportunity to vote on the 
measures that we believe will best provide relief for those we are 
sworn to serve in this country.
  Mr. PALLONE. I want to thank the gentleman for joining me tonight. We 
probably can find out as soon as we yield back our time what is the 
situation with the Rules Committee. But, again, I agree with you. We 
just want this to be brought up, we want to have a debate, we want to 
have an opportunity for the Democratic position to be considered side 
by side with the Republican.
  And it is not, at least I do not think for most of us it is really an 
issue that is partisan or even ideological. I just think the problem is 
we know that Medicare works. We have seen it work. We know that before 
the 1960s when Medicare came into being that it was virtually 
impossible for senior citizens to buy any kind of insurance policy that 
was affordable, that would pay for their hospitalization or their 
doctor bills. That is why Medicare started, because the private sector 
did not provide that opportunity.
  This has been a very good government program. It is a government 
program, so maybe some of our colleagues on the other side of the aisle 
have a problem with Medicare ideologically. I am sure some of them do. 
But you have to throw that aside and look at what is practical and what 
works for the American people. The Democrats are simply saying Medicare 
works; and the best way to provide this prescription drug benefit, 
really the only way in the system that we have, is for the government 
to expand Medicare to include prescription drugs, which is what we are 
advocating.
  Again, I do not know whether it is the ideology or, maybe going back 
to what I said at the beginning, it is just the money from the 
prescription drug industry that prevents the Republican leadership from 
going ahead with a Medicare program and addressing the issue of price 
because that makes sense. I have to believe it is the money from the 
drug companies that is really behind the effort to stop a Medicare 
program.

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