[Congressional Record Volume 148, Number 98 (Thursday, July 18, 2002)]
[Senate]
[Pages S6976-S6977]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           PRESCRIPTION DRUGS

  The PRESIDING OFFICER (Ms. Landrieu). The Senator from Missouri is 
recognized.
  Mr. BOND. Madam President, I rise today to comment on the overall 
policies we are working on today. While this bill we are debating, the 
underlying bill, is a generic drug bill that came out of the Committee 
on Health, Education, Labor, and Pensions, we all know that ultimately 
we are going to be talking about Medicare and prescription drug 
coverage.
  We all recognize the lack of prescription drug coverage demonstrates 
clearly Medicare has not kept up with the rapid advances in medical 
care, placing ultimately the health care security of too many seniors 
at risk.
  When Medicare was created in 1965 to provide health care for our 
Nation's elderly and disabled, prescription drugs were not included as 
part of the program's benefits. At that time, that made sense because 
pharmaceuticals played an extremely minor role in the world of 
medicine. In the last 35 years, medical practice has changed 
dramatically and prescription drugs have become a vital part of health 
care. In the last decade or two, we have seen a pharmaceutical 
revolution. Hundreds of amazing new drugs have been developed to treat 
and manage all different kinds of diseases and medical conditions. 
Those of our population who suffer from these diseases have benefited 
greatly.
  More and more these days prescription drug are keeping Americans of 
all ages out of hospitals, enhancing the overall quality of life and, 
yes, keeping people alive. Hundreds of drugs that were unknown decades 
ago play a critical role keeping our seniors healthy, active, and 
alive. Yet many of our most vulnerable citizens are seniors who have 
trouble affording prescription drugs because their Government-
provided Medicare coverage has failed to keep pace with medical 
progress.

  In addition to being exposed financially to the cost of needed drugs, 
seniors without prescription drug insurance do not benefit from the 
lower prices that most third-party buyers--such as insurers, hospitals, 
and pharmacy benefit managers--are able to negotiate with 
pharmaceutical manufacturers. As a result, seniors without drug 
coverage must pay the highest retail price for needed medication.
  That is a situation we must change. It is time to modernize our 
Medicare system and to add a prescription drug benefit to protect the 
health care security of our seniors. The Medicare Program needs to be 
updated to reflect the past 35 years of medical progress. The millions 
of Americans who rely on Medicare for their health care deserve no 
less.
  Fortunately, over the past few years the debate in Washington has 
shifted from whether or not to provide a prescription drug benefit to 
how to best craft a program to provide seniors with the best 
prescription drug coverage possible. Now is the time to act to include 
prescription drugs as part of an overall health security package for 
our seniors.
  An issue this important deserves debate and serious consideration. 
How can we consider a serious import issue such as this without the 
benefit and expertise of the Finance Committee? I have heard the 
structure and process of this debate described aptly as one of mutually 
assured destruction, or ``mad.'' This issue is too important to too 
many seniors for this debate to be treated in this manner. Because of 
the terms of this debate, any drug proposal that passes ultimately must 
have strong bipartisan support, because 60 votes will be needed to pass 
it. Is that truly ``mad''? I hope not. But I sense that, without the 
benefit of the Finance Committee working on this, we may be in a very 
difficult situation.
  Some watching may ask how did we get into the situation where a 
prescription drug bill will require 60 votes to pass rather than a 
simple majority. The answer is simple. The first reason is because the 
majority leader has decided to bring a bill straight to the floor and 
bypass the committee process entirely. This is a troubling pattern. The 
farm bill, the energy bill, the trade bill all bypassed the committee 
structure--a mad process.
  This action is troubling to me because I understand there was one 
proposal with the votes to pass in the Finance Committee, the so-called 
tripartisan bill. But the committee was not allowed to act on this 
important issue. That is a shame.
  How in good conscience can we consider the largest addition to 
Medicare since its inception without the thoughtful input of the 
committee with jurisdiction over the Medicare Program? That does not 
make any sense. That is mad.
  The second reason 60 votes are necessary is because we have no 
budget. For the first time since 1974 we have no budget in the Senate. 
This is one of the consequences of not having passed, or even, for that 
matter, considered a budget on the floor. Because there is no budget, 
we are operating under the budget guidelines passed last year that 
would spend about $300 billion over 10 years to add a prescription drug 
benefit to Medicare. Therefore, any prescription drug plan brought to 
the floor must be within the $300 billion or it is subject to a budget 
point of order.
  This is another problem with the scheme under which we are operating. 
We will be considering shortly the largest expansion of an entitlement 
program in the history of our Nation. We bypassed a committee, we have 
not had a hearing on it, we have not had a markup, the Congressional 
Budget Office has not scored it, and we will be bringing the bill 
straight to the floor. Mutually assured destruction. This is mad. It is 
a recipe for disaster and inaction.

  What is most troubling to me is the real losers. If the Senate is 
unable to pass a prescription drug benefit, it will be our seniors. The 
seniors are the ones who will be forced to endure another year without 
the safety net that a Medicare prescription drug benefit could and 
should provide.

[[Page S6977]]

  Enough about my concerns about the process. As we look forward to 
this debate, there are a number of fundamental principles that need to 
be outlined as we consider various prescription drug options. These are 
fundamental elements to any serious, responsible, bipartisan 
prescription drug benefit.
  First and foremost, a prescription drug benefit must be permanent, it 
must be affordable, and it must be immediate. Seniors need help now. 
With the high cost of prescription drugs, they cannot continue without 
that assistance. They are hurting today. Seniors often make painful 
choices between buying food and buying prescription drugs. Seniors need 
action and results on this issue--not an election year issue in 
November. Seniors want, need, and, quite frankly, deserve the stability 
of a permanent drug benefit.
  One of my most serious concerns with the majority leader's bill is 
the fact it will sunset after only a few years. A prescription drug 
benefit that sunsets after 2010, just a few years after it finally 
begins, is simply not good enough. Medicare is an entitlement program 
and seniors deserve permanent benefits they can count on today, 
tomorrow, 10, 12, 15 years from now. A hollow benefit, with temporary 
relief that sunsets after 5 or 6 years, does not provide adequate 
health care security for seniors.

  Think about the lunacy of the situation we are in. We seem to be 
unintentionally on a track of telling seniors they had better die in 
2010. We passed elimination of the death tax, but we did not make it 
permanent, so we tell seniors, you had better die in 2010 or the tax 
rates are going to jump back up and the death tax is going to spring 
from the grave. Now we are saying, you can be protected on prescription 
drugs through 2010, but you had better move on because in 2011 this 
program sunsets.
  Somebody is not thinking. Somebody is not realizing what they are 
doing. Let's get serious. We need to make the death tax repeal 
permanent, and we need to make prescription drug benefits for seniors 
permanent.
  Seniors should have the right, also, to choose the prescription drug 
plan that best meets their needs. They should not be told what they 
need by a politician or a Washington bureaucrat. I fear the majority 
leader's bill dictates a one-size-fits-all, Government-run benefit for 
all seniors and puts the Government in the position of determining what 
drugs would be covered under the plan. We must protect our seniors from 
a Government-run drug program that delays, restricts, or denies access 
to the newest and most effective drugs available on the market.
  Seniors should have the right to choose a benefit that best meets 
their needs and does not restrict access to the newest and most 
effective drugs. I fear that the majority leader's bill leaves no room 
for innovation and flexibility in terms of plan design, no choice for 
seniors, and could limit access to breakthrough drugs. A prescription 
drug benefit must address the high cost of prescription drugs and 
attempt to restrain the skyrocketing cost of prescription drugs which 
cannot be sustained long term.
  All existing drug benefits make manufacturers compete to reduce 
prices and pass along the savings from price competition as larger 
discounts and lower premiums for beneficiaries. That is the only proven 
way to keep a drug benefit affordable. The majority leader's bill locks 
in copayments and premiums for beneficiaries and prevents competition 
that could lower drug prices.
  According to the Congressional Budget Office, bills that rely on 
public-private-sector partnerships and an element of competition, such 
as the tripartisan bill, will help manage the cost of drugs. Sadly, the 
CBO found that bills similar to the bill of the majority leader, 
because of the lack of competition and inflexibility of the benefit, 
would in fact increase drug costs. Given the current climate, I simply 
cannot support a plan that increases drug costs or one that sunsets at 
the end of 2010.
  Finally, a prescription drug benefit should be fiscally responsible 
and sustainable long term. The best guess we have, without the CBO's 
scoring, is that the proposal by the majority leader and some of his 
colleagues would cost at least $600 billion over the next 8 years. In a 
time of deficit spending and a tight economy, such a benefit would 
ultimately require cuts in other fields, such as education, Social 
Security, or national defense, and place a heavy burden on the current 
generation receiving benefits, the generation paying for those 
benefits, and the next generation.
  Seniors have a right to demand a drug benefit now, but I believe most 
of them will tell you they do not want to mortgage their 
grandchildren's future in the process. Seniors must be protected from 
catastrophic drug costs. No senior should face financial ruin because 
of an illness that triggers catastrophic drug costs. Our Nation's 
health care system has changed significantly since Medicare was first 
created. To make it effective, we must change Medicare as well.

  We must work to bring affordable prescription drug coverage to every 
Medicare recipient. The Senate has the opportunity to pass a 
bipartisan--tripartisan permanent Medicare prescription drug plan this 
year. The House has already passed a bill. The President has indicated 
repeatedly that he wants a prescription drug benefit for America's 
seniors. With this kind of momentum, the time should be now. I hope we 
will move forward with an honest and open debate that will produce a 
responsible, bipartisan bill consistent with the principles I have 
outlined that fulfill Medicare's promise of health care security for 
all seniors.
  I yield the floor.
  Mr. REID. Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. REID. Madam President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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