[Congressional Record Volume 149, Number 93 (Monday, June 23, 2003)]
[House]
[Pages H5696-H5701]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  REPUBLICAN PRESCRIPTION DRUG BILL OUTLAWS BULK PURCHASING POWER TO 
                      NEGOTIATE LOWER DRUG PRICES

  The SPEAKER pro tempore (Mr. Garrett of New Jersey). Under the 
Speaker's announced policy of January 7, 2003, the gentleman from Rhode 
Island (Mr. Langevin) is recognized for 60 minutes as the designee of 
the minority leader.


                             General Leave

  Mr. LANGEVIN. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks and include therein extraneous material on the subject of this 
Special Order.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Rhode Island?
  There was no objection.
  Mr. LANGEVIN. Mr. Speaker, tonight I am pleased to be joined by many 
of my Democratic colleagues to discuss the lack of cost control 
provisions in the prescription drug bill before the United States House 
of Representatives, H.R. 2473. In particular, I feel that it is so 
essential that we call

[[Page H5697]]

attention to the fact that this bill does nothing to use the country's 
bulk purchasing power on behalf of our seniors to lower the high cost 
of prescription drugs, the purchasing power we should be using to 
ensure the lowest cost of medications for our senior citizens. Quite 
the contrary, this bill expressly forbids it.
  Like many of my colleagues, I held a sincere hope that the 108th 
Congress would overcome the inaction that has plagued this issue at the 
expense of America's senior citizens for so many years. I am extremely 
disappointed that the bill before the House this week not only fails to 
offer a structured and sound prescription drug benefit for Medicare 
beneficiaries, but also contains provisions that threaten the stability 
of the program that has provided health benefits for millions of 
elderly people and young adults with disabilities for the past 38 
years.
  While we all come to the floor with a range of grave concerns about 
this bill, my Democratic colleagues and I join together tonight with 
the united message that the House of Representatives must take action 
to address the rapidly rising costs of prescription drugs. H.R. 2473 
not only fails to address this crisis, it actually contains a 
noninterference clause prohibiting the Secretary of Health and Human 
Services from using the bulk purchasing power of Medicare beneficiaries 
to negotiate for the lowest prices for senior citizens, a tactic that 
has proven effective in the State of Maine and is developing in 
Illinois and in other States.
  Like many other places in the country, my home State of Rhode Island 
uses bulk purchasing power for seniors eligible for Medicaid to 
negotiate discounts for this population. America's seniors have made it 
clear that they want the government to assist them in obtaining their 
prescription drugs at a fair price.
  Now, it infuriates me that in a situation where we have over 40 
million people with a common and basic need, instead of taking 
advantage of that purchasing power to negotiate the lowest prices for 
the most rapidly increasing component of health care, the Federal 
Government is considering outlawing that practice. Amazing. The Federal 
Government is considering outlawing that practice.
  An analysis of H.R. 2473 by the Consumers Union shows that spending 
on prescription drugs continues to grow. In fact, if we do not take 
action to curb the costs now, seniors will pay more out of pocket in 
2007 with the prescription drug benefit as is currently proposed than 
they are paying in 2003 without it. Yet, just last week, the Committee 
on Energy and Commerce defeated an amendment that would have repealed 
the noninterference provision and allowed the Secretary of Health and 
Human Services to negotiate with drug companies in a similar manner to 
that of the Secretary of Veterans Affairs and Medicaid programs. I 
think that is something that is worth noting. It is already being done 
successfully with the Veterans Administration in providing a drug 
benefit to our veterans at very low cost, and the government is able to 
buy these at obviously a reduced cost, in making sure that our veterans 
get the benefit that they need, these vital medications that are so 
important in keeping them healthy. Yet we are going to prevent the 
Secretary of Health and Human Services from doing the exact same thing 
for the rest of the seniors in this country who are struggling to get 
by in paying for their prescription medications. It is simply 
counterintuitive.
  Studies show that seniors in other industrialized countries are 
paying significantly less for their prescriptions than America's 
seniors. And, in this case, the short answer really does sum it up. It 
is because their governments took action to protect their interests 
when it comes to pricing prescription drugs. In Canada where citizens 
pay, on average, 50 percent less than the seniors I represent in Rhode 
Island, for the five most commonly prescribed drugs, the government 
uses the bulk purchasing power of its people to help them, and that is 
the way it should be. My constituents are paying 292 percent more, for 
example, for Prilosec than they would be in Italy where again the 
government uses the bulk can purchasing power of people to help them. 
Prices in other countries are not the result of government 
contributions or subsidies to drug companies; they are the result of 
governments using purchasing power of significant blocks of people to 
negotiate better prices. It is very basic.
  Let us also look at another area while we are on this subject of 
using mechanisms to reduce drug costs. Another place where we can take 
action to reduce the high cost of medications is generic drugs. Last 
week our colleagues in the Senate took substantive measures in their 
Medicare reform bill to address the rapidly escalating cost of 
prescription drugs by easing market entry of generic drugs. In fact, 
their vote to do so was nearly unanimous: 94 to 1. At the same time, 
the House leadership, though, in a quest to push through a mere 
pretense of a prescription drug benefit, has failed to acknowledge that 
without measures to control the cost of prescription drugs, any benefit 
will deteriorate in value over time. America's seniors deserve better 
than this.
  Mr. Speaker, it is amazing. The Republican leadership is so eager to 
subsidize the insurance companies and allow drug manufacturers to 
continue to exploit America's seniors in the name of the free market 
system, but is apparently unwilling to use that same free market system 
to allow the natural market force of 40 million individuals, our 
struggling senior citizens, to come into play.
  The noninterference clause, a small section on page 250 of a 321-page 
bill, must be brought to light. We must draw attention to the fact that 
any prescription drug benefit is rendered meaningless unless action is 
taken to curb the out-of-control costs of drugs that people need to 
stay alive.
  I thank my colleagues who have joined me on the floor tonight to 
highlight the fact that at this very moment America's seniors are 
making choices between taking their medications as prescribed and 
putting food on their tables. Just this morning I joined Dr. Sarah 
Fessler and the Rhode Island Academy of Family Physicians in releasing 
a survey showing that a third of seniors in Rhode Island are relying on 
physician samples for their necessary medications, and 20 percent are 
failing to take them as prescribed because of costs, skipping 
prescriptions to make them last longer, and failing to refill them. The 
survey reiterates what we already know: that cost is the greatest 
barrier to seniors taking their prescriptions.
  This situation, Mr. Speaker, will not fix itself. I urge my 
colleagues to pay careful attention to the details of H.R. 2473 and to 
think critically about the effect, or the lack thereof, it will have on 
the seniors in their districts.
  Mr. Speaker, I am pleased to yield to the distinguished gentleman 
from Maine (Mr. Michaud), who in his first term has taken tremendous 
initiative by introducing the America Rx Act under which the Federal 
Government would act as a pharmacy benefits manager to negotiate low 
prescription prices for America's seniors, and it is very appropriate 
that he be the first speaker this evening, and I welcome him.
  Mr. MICHAUD. Mr. Speaker, I thank the gentleman for yielding me this 
time.
  Mr. Speaker, this week we are prepared to debate a Medicare 
prescription drug package. We are focusing all of our energy on trying 
to pay for expensive prescription drugs. But one important aspect of 
this debate is missing; that is, finding a way to make drugs less 
expensive to begin with.
  The fact is that drug prices continue to rise and are spiraling out 
of control, forcing more people to choose between medicine and food. 
Talking about paying for prescription drugs without talking about 
prices is like going to a grocery store telling them to fill up your 
cart and handing them a blank check. We are letting the company decide 
how much to charge and then we are proposing to have the government 
foot the bill.
  Last month, I met with a group of seniors in my district in Bangor, 
Maine who were on a bus trip to Canada so they could buy the medicine 
they need at a price that they could afford. And guess what they saved? 
Out of 18 senior citizens, they saved over $19,000, just by crossing 
the border. That is a crying shame.

[[Page H5698]]

  Like most Members of this House, I believe that expanding access to 
prescription drugs is one of the most important issues that we face. 
That is why I have taken the creative Maine Rx approach, which just 
received a favorable ruling from the United States Supreme Court, and 
brought it to this Congress.
  Earlier this year, in an attempt to make prescriptions more 
affordable for all Americans, I introduced H.R. 1694, the America Rx 
Act of 2003. America Rx uses the power of the free market to negotiate 
lower prescription prices for all Americans who lack adequate coverage, 
similar to what they do in the Veterans Administration. We are the only 
industrialized Nation that does not negotiate lower cost for 
prescriptions, and it is time for a change.
  Like Maine Rx, America Rx is a fresh approach that will not cost the 
taxpayers a single dime. This approach is simple, it is fair, and it 
works. It is time for America's seniors to gain access to affordable, 
lifesaving prescription drugs. We will be doing all Americans a 
disservice if we do not include ways to contain the cost in the 
upcoming debate.
  Mr. LANGEVIN. Mr. Speaker, I thank the gentleman. Again, I share 
wholeheartedly in the statements that he has made, and I want to 
commend him for introducing H.R. 1694, the America Rx Act. Again, as 
the gentleman states, this bill establishes an America Rx program to 
establish fair pricing for prescription drugs for individuals without 
access to prescription drugs at discounted prices and, as the gentleman 
said, modeled after the Maine Rx program, by the Federal Government 
acting as a pharmacy benefits manager to negotiate the lowest prices. 
This approach uses the power of the free market to allow millions of 
American senior citizens, with no access to discount, to pool together 
and negotiate as one block. I cannot see what could be more basic than 
that. That is what certainly this Special Order is all about tonight.
  I am now pleased Mr. Speaker, to yield to the gentleman from Maine 
(Mr. Allen), who has shown tremendous leadership on this issue by 
introducing the Prescription Drug Fairness for Seniors Act, which would 
require drug manufacturers to allow pharmacies to purchase drugs for 
resale to Medicare beneficiaries at the same price equivalent to the 
average foreign price based on the price consumers pay in six other 
industrialized nations.

                              {time}  2145

  Mr. ALLEN. Mr. Speaker, I thank the gentleman for yielding, and I 
thank him for his leadership in holding this Special Order tonight.
  Many people across the country are really confused about what all 
these prescription drug plans mean for them. They are trying to sort 
out whether the Republican plan or the Democratic plan or whatever plan 
may be up, how it might possibly help them in the future. And, frankly, 
you cannot blame anyone for being confused out there because there are 
so many descriptions flying back and forth. But it is worth 
highlighting one that the gentleman from Rhode Island (Mr. Langevin) 
highlighted before and my friend, the gentleman from Maine (Mr. 
Michaud) was mentioning as well and that is the way these two 
approaches treat the subject of price.
  It seems that in every instance the Republican plans do everything 
they can to avoid trying to reduce prices; and, obviously, that is 
consistent with what the pharmaceutical industry wants. But the most 
remarkable thing about the prescription drug proposal made by the 
Republicans here in the House is actually like the Senate bill; it 
contains a provision essentially saying to the Secretary of Health and 
Human Services, you shall not negotiate lower prices for Medicare 
beneficiaries. And what are they afraid of? What are they afraid of?
  Every private insurance company in the country tries to negotiate the 
lowest prices they can for themselves and for their beneficiaries. It 
really makes a huge difference. But here you have the Republicans in 
the House saying you cannot negotiate lower prices. They might as well 
say to the Federal Government, to Health and Human Services, we think 
you should pay higher prices to the pharmaceutical industry. Above all, 
we do not want the pharmaceutical industry to be paid less.
  I did not bring them tonight, but I have some charts that go back in 
history; but they show that over the years every time there has been a 
major effort to improve the ability of seniors or anyone else to get 
their prescription drugs, they show that the pharmaceutical industry 
comes in and says, if you do this to us, if you make generics more 
widely available, if you have a rebate program under Medicaid, those 
are the two major developments over the last 15 years, if you do either 
one of these things, then we will have to cut back on research and 
develop.
  And what happened in the aftermath of those acts? The 1988 Hatch-
Waxman Act, which made it easier for generics to get into the market 
and in the mid-1990s a provision that basically capped Medicaid prices. 
In both cases, the industry said, we will have to cut back on research, 
and in both cases what the industry did was dramatically increase 
funding on research.
  The truth is that all of this fear about what the pharmaceutical 
industry will do is misplaced. What our people need is very simple. 
They need lower prices.
  Now, our seniors pay the highest prices in the world, the highest 
prices in the world for their prescription drugs. Here you have the 
biggest health care plan in the entire country, Medicare, 40 million 
beneficiaries, obviously some real ability to leverage lower prices; 
and the Republican bill in the House explicitly says we will not allow 
the Secretary to negotiate for lower prices. That is not where our home 
State of Maine is going. That is not where private insurance companies 
go. It really is completely off the wall. There is absolutely no reason 
to do that.
  But when you look at the Republican plan in the House, you can also 
see that the benefit is not very good. It is really not very much. For 
example, if you pay, if you wind up with $4,900 of drug expenses in the 
course of a year, you are going to wind up paying about $3,600 of that 
all by yourself. For many Americans, for those whose drug expenses are 
less than $1,367 a year, all of those people, if they sign on to this 
plan will pay more in than they ever get out. It will not make any 
sense for them. And it is also true between about $2,400 and $4,900; 
those people with lose money as well. It is because the benefit is 
completely inadequate.
  Now, we have our friends on the Republican side coming down here and 
saying what this country needs, what our seniors need is the same kind 
of prescription drug benefit that members of Congress have. Well, if 
that is what they need, why not provide it for them? Why not give them 
a prescription drug benefit more or less like we have, one with an 80/
20 co-pay, for example? But they will not go there. And there is a 
reason why they will not go there. They cannot go there. They have 
given all the money back. They have basically got tax cuts; if all of 
their plans go into effect, they will have reduced tax revenues over 10 
years by about $4 trillion. No wonder there is no money left for a real 
prescription drug benefit under Medicare. No wonder there is not enough 
money to fund Head Start or not enough money to fund special education 
or not enough money to even fund the President's initiative, No Child 
Left Behind. They have given the money back to people who earn over 
$370,000 a year.
  Now, I suppose some people would say that is a very needy group; but 
it is hard to figure out, particularly when you have seniors all across 
the country who are choosing between food, rent and prescription drugs. 
I mean, there are so many stories; they cannot all be repeated. But I 
know one couple where he takes his medication one month, she takes her 
medication the next month because they cannot possibly pay for both of 
them. And that is why so many people in Maine and across the country 
now get their prescription drugs through Canada.
  What does Canada do? Why is Canada so special? The bill I have 
introduced, H.R. 1400, the Prescription Drug Fairness for Seniors Act, 
basically says to the pharmaceutical companies, you cannot charge 
Americans more than the you charge the Germans and the French and the 
British and the Italians and the Canadians and the Japanese, the other 
6 countries in the G-7.

[[Page H5699]]

  Just take the average foreign price, you cannot charge more to our 
people, our Americans, than you to do to those people in those other 
countries. It is that simple. And yet that is exactly what the 
Republicans will not do. They simply will not go there because their 
friends in the pharmaceutical industry cannot abide the thought of 
having the government do what the insurance companies do, which is 
negotiate lower prices.
  We hope, in the State of Maine, and we hope across the country that 
people will finally understand that unless the government works to 
negotiate lower prices, our seniors will continue to pay the highest 
prices in the world. It is not right, and it needs to change. But it 
will not change in this House this week when the Republicans pass their 
prescription drug bill because they will talk about choice, but there 
is not much choice out there.
  The President was out on the stump not so long ago and he said, we 
want seniors to have the kind of choices that members of Congress have, 
choices among many plans. Well, in my State and many States, guess how 
many choices I have? One. I have one plan in the State of Maine, one 
health care plan that I can choose. One. Not two, not three, not ten. 
One. And that is all there is. And this is what this bill promises. 
This bill promises, they say they are going to try to give the 
insurance companies enough money so there will be two plans in every 
district; but, in fact, this is a product that does not exist, this 
kind of insurance on prescription drugs. It looks and feel like another 
way to get past the next election, to have a plan. It does not take 
effect until 2006. What are we really talking about?

  We need to reduce prices for our seniors. We ought to do it now. I 
thank the gentleman; I appreciate his time and leadership on this 
issue.
  Mr. LANGEVIN. Mr. Speaker, I thank the gentleman for his words and 
for his leadership on this issue. He was very eloquent tonight, as he 
has been so many times in the past in addressing the prescription drug 
problem, in fighting for our seniors. I commend him for his service in 
this House and for his work on this issue.
  I am now, Mr. Speaker, very pleased to yield to the gentleman from 
Illinois (Mr. Emanuel), who has consistently worked to reduce 
prescription drug costs through targeted market reforms, a freshman 
Member of this House who has already shown his compassion for seniors 
and his leadership. I thank him for being here this evening.
  Mr. EMANUEL. Mr. Speaker, I would like to thank my colleague from 
Rhode Island.
  Tomorrow in a bipartisan fashion with about six Republicans and six-
or-so Democrats, we will be introducing an amendment to the 
prescription drug bill that focuses on bringing competitive forces to 
the pricing of prescription drugs so we can make prescription drugs 
affordable to not only our elderly but our American families.
  I think one of the things that is missing in this entire debate, in 
this entire strategy, is how to make drugs and prescription drugs more 
affordable and more accessible to people. How do you do that?
  There are three parts to this bill. The first part would bring 
generic drugs to market quicker so name-brand drugs and pharmaceutical 
companies cannot employ frivolous lawsuits to keep generics off 
markets. If you had competition between generics versus prescription 
drugs, you would bring prices down from name-brand drugs.
  The second portion of that bill, and that portion of the bill has 
been adopted by the Senate and also enjoys bipartisan support in this 
Chamber as it enjoys in the other Chamber. The second, as my good 
colleague from Minnesota, a Republican, a good colleague, enjoys 
overwhelming bipartisan support and also adopted in the Senate in 
bipartisan fashion, was the market access bill. It enables consumers, 
elderly as well as other families, to buy medications, Canada, Mexico, 
Israel, Italy, Germany, France, Netherlands, Great Britain and all of 
those countries, the same name-brand medications sold here in this 
country are sold in those countries at 50, 60, 70 percent reduced 
prices, but they are American-made medications.
  Now, if we can import steel, we can import cars, we can import 
software, we can import wheat, food products and everybody always wants 
to espouse the virtues of globalization, well, let us allow them 
globalization to bring prices down here at home for prescription drugs.
  Globalization is not supposed to be a one-way road just for 
corporations and their bottom line. Globalization is supposed to work 
for consumers. So allow globalization to work so if you can find that 
drug in the German market or the British market for cheaper, you could 
be allowed to buy it. It is called market access. So competition 
between generics versus name-brand. Allow us to buy products in West 
Germany or Canada or Mexico, wherever you can find them cheaper. Allow 
the global marketplace to determine the best price for the consumer.
  The third portion of the bill is a bill that allows, take the family 
of drugs for cancer or AIDS. Every one of the medications on the market 
today was developed with government research, taxpayer money through 
the NIH. Allow the NIH to get a 10 percent royalty for that investment 
back to the taxpayers. You would do that, and in 10 years the NIH would 
be fully self-funded. It is one of the great venture capital arms in 
the entire world.
  I worked in the private sector. We used to believe you look for a 30 
percent IR, which is an investment return on your equity. Anything 
below a 30 percent return was considered ``dumb money.'' And we have 
been treating the taxpayers like dumb money. Give the taxpayers a 
minimum of 10 or 15 percent return on their investment, and the NIH 
would be fully funded in 10 years through investment royalties.
  In addition to that tax-funded research, whether it is in cancer, 
AIDS or any medication out there, today the taxpayers subsidize 
research through the R&D tax credit, research and development tax 
credit. And so not only are the taxpayers in this country paying on the 
tax credit on the upfront side through NIH funded research, but on the 
back side through research and development tax credit. We are paying 
for it twice. And the only benefit left to the American taxpayer is 
they get to pay the highest price for that drug when it comes on the 
market. They fund the research, and they get to pay the highest price.

                              {time}  2200

  The pharmaceutical industry in this country has been treating the 
seniors of this country and the American families with sick children as 
their profit guinea pig. They earn their profits off the back of 
Americans who have paid for the research.
  It is my view what is missing is we need the market forces to bring 
the prices down so they are more affordable and more accessible to our 
elderly. If we are going to spend $400 billion on a prescription drug 
bill do my colleagues not think we want to get the most for our money? 
So in my view what is missing from this debate, what is missing from 
this discussion, what would make sure that we spend our $400 billion 
wisely is a market forces of competition from generic to name brand, 
prices overseas in Europe to American prices and then a return on our 
investment. That would bring real competition, and therefore, we would 
have the market forces working on behalf of the taxpayer rather than 
against them.
  I am proud that we have a bipartisan bill, a lot of Republicans on 
it, a lot of Democrats. I think it represents our common values, but a 
number of people in this Chamber who will always be up here, we will 
hear them on every other debate, espouse the virtues of a free market. 
I am going to allow free market to reign. I came from the private 
sector. I think it is a wonderful thing.
  I do not fault the pharmaceutical industry. They bought and paid 
themselves out of a free market when it comes to name brand versus 
generics. They have bought themselves out of a free market when it 
comes to preventing consumers from buying things in other marketplaces 
like they do any other product, and they have treated us like nothing 
but chumps when it comes to getting our tax dollars to fund the 
research. Yet they get the profit and we get the biggest payday with 
the highest prices.
  So it is my view that if we bring the market forces to bear we will 
make drugs affordable, and most importantly, because the government 
will be

[[Page H5700]]

funding the research as they do today, we will guarantee that those 
drugs continue to come to market and America stands as number one in 
the area of research for new drugs, new medications to cure other 
illnesses.
  The Boston Globe did a story, and I will bring this back up. Thirty-
two out of 35 of the drugs that they targeted were developed with NIH 
or FDA funding. We can make the whole NIH which is $26 billion fully 
self-funded. The last time in 1984 is when we passed a bill to get 
bring generics to market. Are we saying in close to 20 years our laws 
do not need an update, what it means to accelerating this research, 
that our laws allow pharmaceutical companies to keep generics off the 
market?
  So we can do this, we can make the medication on our $400 billion we 
spend on a prescription drug benefit go farther, insure more people, 
get benefits and drugs cheaper to seniors, if we would allow the free 
market to reign when it comes to the pricing of drugs.
  I know my fellows on the other side of the aisle believe in the free 
market. I am just going to give them a chance to put their money where 
their mouth is, and I look forward to the support of others in this 
area. I am pleased that my colleague organized this today because we 
focus the country on this. We are going to do I think what is right, 
get a prescription drug bill, but just because we do it does not mean 
it is right. It is how we do it that determines whether it is right.
  I am pleased that we have support for all this. It is the right type 
of area. It makes sure that we have affordability. It makes sure, too, 
that we stay in the frontlines of having the best medications developed 
because we have been focusing on the taxpayers funding this research, 
now we are going to guarantee we get a return on our investment. As 
long as they want that tax R&D credit, which they should have, the 
pharmaceutical companies, we are going to make sure we get a 10 
percent, 15 percent royalty on those dollars we invested.
  Every cancer drug on the market today was funded by the taxpayers. 
Corporations got the profit and we got the biggest bill in America. Our 
brothers and sisters and fellow consumers in Germany and England and 
France are enjoying the benefits of taxpayer funded research. They are 
paying minimal prices at 50 percent, 60 percent less than we are. We 
are paying the highest price. They get the drugs for a cheaper price, 
and the corporations in America get the profits, and we get to pay the 
highest bill.
  As we would say in Chicago, such a deal. That is what has happened.
  So we need to take this three-step approach, all of it based on the 
principle of the free market. We bring the free market, we bring 
competition, it will drive prices down, spend $400 billion, reach more 
seniors with better affordable prescription drugs, and we will make the 
medications more accessible, more affordable because they will be 
cheaper in price.
  Again, I want to thank my colleague from Rhode Island for organizing 
this and bringing the attention to this issue and allowing all the 
different perspectives to be brought to bear here in this Chamber.
  Mr. LANGEVIN. Mr. Speaker, I thank the gentleman from Illinois for 
his very powerful words on this debate. I could only wish that every 
taxpayer in America could have heard those words tonight, along with 
our seniors, because it really crystallizes the debate itself, and I 
know we are going to be working on this together, both tomorrow, the 
rest of the week and until we bring this issue home. I thank the 
gentleman from Illinois for his comments.
  That is an important aspect of this debate, the fact that taxpayer 
dollars have funded so much of this research, have developed these 
medications, and the only thanks that our taxpayers have received in 
return, our seniors have received in return, is high cost prescription 
medications that they cannot afford. That is outrageous and it is 
wrong.
  We, as a compassionate Nation, as a determined people, have to do 
something about it. We have to change that and we have to make our 
prescription medications within reach for our seniors. No senior in 
America should have to make the choice between food and medication or 
paying their rent, not when it was their taxpayer dollars in the first 
place that helped develop those medications.

  Mr. Speaker, I said earlier in my remarks, and each of the speakers 
tonight have again reiterated the argument, that we should let the free 
market system determine the cost of these medications, and by that, as 
I have said before, it means allowing our seniors to join together, use 
their bulk purchasing power to negotiate the lowest cost price for 
these medications. No prescription drug benefit should be passed by 
this House without that being a major component of that bill. No other 
insurance company, no other private insurance plan would have a 
prescription drug benefit without that component contained within it, 
and neither should one pass by this House.
  Who does it benefit to pass a prescription drug benefit that does not 
include a component that uses the bulk purchasing power of this Nation 
without it being present in the bill? Is it the taxpayer? Well, 
certainly not because they are not getting the lowest negotiated price. 
Is it the seniors who are struggling to afford their medications? Well, 
certainly not.
  It is the insurance companies, though. It is the pharmaceutical 
companies who do benefit: Let us keep the prescription drug prices 
high, let us keep the profits outrageously high, let us not be able to 
use bulk purchasing power that would negotiate a lowest cost price for 
our seniors, no, because that means that the pharmaceutical companies, 
the insurance companies, are out profits. That is simply wrong, Mr. 
Speaker, and I hope that my colleagues on both sides of the aisle will 
recognize this argument for what it is and do the right thing by our 
seniors.
  Let us do what is done in Canada, in Great Britain, in Italy, in 
Japan, nations that for their seniors use their bulk purchasing power 
to bring down the high cost of medications that allows their people, 
their seniors to get the medications that they so readily need to stay 
healthy, which in many ways are wonder drugs and have become a 
replacement for surgery, but again, what good are they if our seniors 
cannot afford them? They have recognized that in Canada, in Great 
Britain, Italy, G-7 nations. We need to recognize that here in America.
  Mr. Speaker, I thank my Democratic colleagues for joining me tonight 
to bring attention to this critical component of an issue that we all 
continue to debate throughout this week. In particular, I want to 
express my gratitude to the Members who have been persistent in 
supporting stand-alone legislation on the topic of rising prescription 
drug costs in recent years.
  While it has yet to be brought to the floor, there is significant 
support in this Chamber for several pieces of legislation that would 
control prescription drug costs. We have heard about some of them. 
Tonight, we heard of the gentleman from Maine's (Mr. Allen) bill, H.R. 
1400, the Prescription Drug Fairness for Seniors Act, which would 
significantly reduce prescription drug prices for all Medicare 
beneficiaries by requiring drug manufacturers to allow pharmacies to 
purchase medications for resale to Medicare beneficiaries at a price 
equivalent to the average foreign price based on the prices consumers 
pay in six other industrialized Nations. This legislation would provide 
up to a 40 percent savings on prescription drugs.
  There is also bipartisan support for the Greater Access to Affordable 
Pharmaceuticals Act, which would speed the market entry of generic 
drugs by closing loopholes that are being used to lower priced 
competitors in the marketplace. We have heard about this this evening 
as well.
  It is the right thing to do, to look at all of these options for 
controlling the high cost of prescription medications. We owe it to our 
seniors to look at this and do the right thing by them. We owe it to 
our seniors to fight for these cost controls.
  Again, I ask the Republicans in this House to champion an issue that 
they have always championed and that is using the free market system, 
allowing the free market system to operate, to come to an equilibrium 
price. If we do that for our seniors, then everybody wins and we will 
have bipartisan support on that effort. It is the right thing to do. It 
is my sincere hope that the Republican leadership will see the light

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and allow Members to offer these bills and other amendments to the 
Prescription Drug and Medicare Modernization Act of 2003.
  I will continue to work with my Democratic colleagues to promote 
legislation that will provide substantial medication savings for our 
seniors rather than the high profit margins for drug and insurance 
companies.
  Mr. Speaker, I thank my colleagues who have joined with us tonight in 
speaking on this important issue.

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