[Congressional Record Volume 148, Number 101 (Tuesday, July 23, 2002)]
[Senate]
[Page S7194]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      A PRESCRIPTION DRUG BENEFIT

  Mr. NICKLES. I will be brief and yield myself 5 minutes.
  Madam President, I hope this week the Senate will be able to pass a 
positive prescription drug proposal. It may be mission impossible. I 
wish that was not the case.
  If we would have done it the ordinary way, the regular way, the way 
we have handled almost all Medicare bills in the last 20-some years, 
every single one except for one, it would have gone through the Finance 
Committee and been reported out with bipartisan support. Frankly, that 
bill would have been the basis, the foundation for reporting a bill 
that would eventually become law.
  Unfortunately, we were not allowed to do that in this case. This 
particular bill happens to be probably the most important and the most 
expensive expansion in Medicare history, more expensive than any other 
changes and amendments we have made to Medicare since its creation in 
1965. Yet we haven't had a hearing in committee on this proposal or the 
other proposals. We haven't had a markup. We had some bipartisan 
meetings, but we didn't have a chance to have a bipartisan markup. 
Maybe it is because it was likely that the product to be reported 
wouldn't have been what the majority leader wanted. It would have been 
a majority of the members of the Finance Committee.
  I am very troubled by what we see in the Senate time and time again. 
If we have a committee that may not report something that the majority 
leader wants, we don't let the committee work. That happened earlier 
this year when we had a very extensive, expensive energy bill. Twenty-
one members of the Energy Committee didn't get to offer an amendment. 
Now we have 19 members of the Finance Committee who have not reviewed 
this product or didn't have a markup on this product.
  We are going to be voting at 2:45 on a bill that was introduced by 
Senator Graham and Senator Kennedy and Senator Daschle and others. It 
is 107 pages. The committee has not reviewed this. We didn't have a 
hearing on it.
  I guess we now have somewhat of a scoring by the Congressional Budget 
Office, and they say it is $594 billion over the next 10 years. We find 
out it doesn't go 10 years. This is a benefit that is started but 
stopped. It doesn't start until the year 2005, but it stops in the year 
2010. So we are going to pay part of your prescription drugs, but we 
are going to stop after a few years.
  I find that to be very hypothetical at best. In fact, it wouldn't 
happen. Once you start an entitlement program, you never stop it, 
especially one that would be as popular as this.
  But what are we starting? Some of us were estimating that the 
Democrat proposal, as originally outlined--I say ``the Democrat 
proposal''; Senator Graham and some Democrats are supporting other 
proposals, but the Graham-Kennedy-Daschle proposal was going to be a 
lot more expensive than $600 billion.
  Keep in mind the budget we passed with bipartisan support last year 
called for $300 billion. Keep in mind the President requested $190 
billion. Yet now we find one at 600. I thought it would be more 
expensive. The reason why it is not is because they decided to ration 
prescription drugs.
  If our colleagues would look on page 62, it says:
  The eligible entity [health plan] shall . . . include . . . at least 
1 but no more than 2 brand name covered outpatient drugs from each 
therapeutic class as a preferred brand name drug in the formulary.
  In other words, you can come up with one, maybe two drugs in each 
therapeutic class. For arthritis there must be a dozen drugs. For blood 
pressure there must be at least eight or nine or ten brand name drugs. 
Only one or two are going to get payment. The rest of it, you are on 
your own. If you are not the Government-chosen drug, I am sorry 
patients, you don't get any help from the Federal Government. You don't 
get any help from this new drug benefit. You are out of luck. You are 
on your own.

  The beneficiary is responsible for the negotiated price of the 
nonformulary drug:
  In the case of a covered outpatient drug that is dispensed to an 
eligible beneficiary, that is not included in the formulary established 
by the eligible entity for the plan, the beneficiary shall be 
responsible for the negotiated price for the drug.
  In other words, beneficiary, you pay 100 percent. You choose or take 
the Government-selected drug, which would be a very small percent. 
Maybe that would cover about 10 percent of eligible drugs in the entire 
population. If you don't get that drug, you are out of luck. You are 
responsible for 100 percent.
  I could go on and on. We are limited on time. I have several speakers 
on our side who wish to address this. This is one of many serious 
mistakes that are in this bill. It is one of the mistakes we made by 
following the process of not marking it up in committee. I am sure if 
it had been discussed in the Finance Committee, we would have modified 
it. Unfortunately, we didn't have that chance.
  If I thought this were going to pass, we would be talking about it a 
lot more because it has several fatal flaws that would be very 
injurious to America's health. It would mean rationing of prescription 
drugs; certainly something that we don't want to do.
  I urge my colleagues to vote no on the Graham-Daschle-Kennedy 
amendment at 2:45.
  I yield the floor.

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