[Congressional Record Volume 148, Number 98 (Thursday, July 18, 2002)]
[Senate]
[Pages S7041-S7042]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. BIDEN:
  S. 2757. A bill to amend title XVIII of the Social Security Act to 
provide coverage of outpatient prescription drugs under the medicare 
program; to the Committee on Finance.
  Mr. BIDEN. Mr. President, today I am introducing a bill to add 
outpatient prescription drug coverage as a new and integral benefit 
under Part B of Medicare. Under this bill, like the rest of the 
services under Part B, Medicare will pick up 80 percent of the cost of 
prescription drugs. This would be the case until a beneficiary hits a 
$4000 annual out-of-pocket limit, at which point the government picks 
up 100 percent of drug costs. Moreover, beneficiaries will not have to 
pay increased monthly premiums or annual deductibles as a result of 
this new drug benefit.
  Now, we have been discussing prescription drug coverage for seniors 
in this chamber for many years, and there have been numerous proposals 
brought forward. Some might ask, why do you feel the need to propose 
your own prescription drug plan; what is wrong with the many previous 
proposals.
  Well, to my way of thinking, we have lost our focus on this issue. In 
developing a drug plan, we have concentrated too much on such things as 
budget allotments, philosophy of government, desires of committee 
chairs, election politics, and other related issues, while ignoring the 
one thing that really counts: what do the citizens of this country, the 
ones who are supposed to use this plan, really want? All of these 
prescription drug plans will be voluntary, and yet unless a plan is 
attractive enough to ensure the participation of close to 100 percent 
of those eligible, it probably won't work from an economic point of 
view. Those of us who were around in 1988 for the debates about 
catastrophic health care remember with great clarity the consequences 
of passing a health-related bill that the citizens don't want.
  Frankly, I have some doubts about whether any of the prescription 
drug proposals to date provide what the citizens in Delaware or 
elsewhere really want. And I think I have a pretty good idea of what 
people want in a prescription drug plan, at least people in my home 
state of Delaware. I live in Delaware, and I commute back and forth on 
AMTRAK every day between Delaware and Washington DC. I have been a 
Senator for 30 years and people in Delaware know me well. They have no 
reluctance about walking up to me at the local diner, on the train, or 
at the drugstore, to give me a piece of their

[[Page S7042]]

minds. And here is what Delawareans want in a prescription drug bill.
  They want something simple and easily understandable. They don't want 
a plan with a lot of fine print, exclusions, complicated payment 
formulas, gaps in coverage, lengthy paragraphs filled with whereases 
and wherefores. They don't want to be in a state of constant anxiety 
because they really don't know what they have signed up for and what 
they are covered for. They don't want to have to spend hours on the 
phone listening to music while waiting for an insurance company clerk 
to answer the phone and try to explain what the benefits are. They 
don't want to spend a whole day filling out paperwork to try to get 
reimbursed for their expenses when they could just as well be playing 
with their grandchildren. They don't want to be caught in the middle of 
a fight between their drug insurance plan and their Medicare over who 
is going to pay for what.
  They want a plan that provides meaningful and substantial financial 
help towards the cost of their medications. For most people I talk to, 
a cut in prescription drug costs from $5000 per year down to $4700 per 
year is not very helpful; they are still faced with choosing between 
paying for medications and paying for rent. With the increasing costs 
of prescription drugs these days, this is a criterion that is just as 
important to the middle class as it is to those with low incomes.
  They want a plan that is stable, reliable, and predictable. They 
don't want to sign up with an insurance company and then have the 
company pull out of the state the following year. They don't want the 
specifics of their benefits to be changing every year. They want to 
know what they are getting.
  They want a guarantee that a plan will be available to them. They 
don't want a guarantee that a plan will be available only if an 
insurance company decides it will offer a plan or if an insurance 
company decides they are a good risk.
  They want a plan that is uniform, not one whose benefits change 
drastically if they happen to move a few miles. Delaware is a small 
state, and people who live or work in Delaware move back and forth 
across state lines with great frequency.
  My prescription drug bill is focused on what consumers want, and it 
fulfills all of these requirements. People are already very familiar 
with Medicare Part B, so the addition of a prescription drug benefit 
will not add any confusion. People know that Medicare is stable, 
reliable, predictable, and the same all over the country. People know 
that Medicare Part B covers a substantial 80 percent of their medical 
expense. We know that people like Medicare Part B, since 94 percent of 
those eligible have voluntarily signed up for it. The addition of a new 
prescription drug benefit to Part B, without any change in monthly 
premiums or deductibles, is almost certain to increase the voluntary 
participation rate close to 100 percent.
  Can we afford such a bill? Absolutely. It's just a matter of 
priorities and choices. And these choices simply reflect our values. My 
values tell me that providing life-saving prescription drugs to the 
seniors and disabled is a higher priority than, say, making permanent a 
tax cut for the well-to-do that they probably don't need and have not 
really requested.
  Many of my colleagues in the Senate, and a large number of their 
staff, have been working enormously hard to develop a Medicare 
prescription drug bill that satisfies everybody's concerns. However, I 
am reminded of the statement by the noted British engineer Sir Alec 
Issigonis, who commented that ``A camel is a horse designed by 
committee''. If the public is expecting a horse, we better not end up 
with a camel.
  Our current situation here in Congress brings to mind a story related 
by a local TV weatherman here in Washington, DC. This weatherman works 
in a very high tech underground office with fancy color radars, 
computers, split-second communications devices, and state of the art 
graphics. Yet before each broadcast, the weatherman goes upstairs and 
looks out the window to make sure it is not raining. I would ask my 
colleagues, as they work through their cost estimates, economic 
projections, and so forth in developing a prescription drug plan, to 
walk upstairs and look out the window. Policy makers must not work in 
protective isolation, in a vacuum; they need a strong dose of reality 
to inform their deliberations.
  I believe that my bill provides the kind of prescription drug plan 
that Medicare beneficiaries in Delaware, and around the country, really 
want. I encourage my colleagues to keep the wants of their constituents 
foremost as they move to craft a vitally-needed prescription drug bill 
for Medicare beneficiaries.
                                 ______