[Congressional Record Volume 149, Number 94 (Tuesday, June 24, 2003)]
[House]
[Pages H5804-H5808]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
IMPACT OF PRESCRIPTION DRUG BILL
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 7, 2003, the gentleman from Arkansas (Mr. Berry) is recognized
for half the time until midnight as the designee of the minority
leader.
Mr. BERRY. Mr. Speaker, we are here this evening to talk about the
impact of this very cynical prescription drug bill that is proposed by
the majority side and what would happen if that bill, were we so
unfortunate as a Nation as to have that bill enacted into law and put
upon our senior citizens.
We are indeed pleased that the gentleman from North Carolina (Mr.
Ballance) is here with us, and at this time I would like to yield the
floor to him and let him make whatever comments he sees fitting in
regard to this particular issue; and we thank the gentleman from North
Carolina.
(Mr. BALLANCE asked and was given permission to revise and extend his
remarks.)
Mr. BALLANCE. Mr. Speaker, I want to say at the outset that it is an
honor for me to be standing in these hallowed halls as we address
issues of such great import to the people of this country.
A little more than a year ago, I campaigned in rural eastern North
Carolina. I spoke to citizens at AARP meetings, at senior centers, at
residences and elsewhere; and like most of my colleagues in this 108th
Congress, I made a solemn promise that I would support and vote for a
prescription drug benefit program. Each of us, I believe, most of us I
know, made that promise to our constituents; and I, and I hope most of
my colleagues, will keep that promise. I know that I will keep mine,
and I will not vote for a plan that simply has the label on it.
The plan that the Republican leadership of this Chamber has proposed
would not benefit our seniors in the way that they need and deserve. It
is not a real prescription drug plan. It is what I would call an empty
promise.
Mexico, Canada, Germany, England and France, what do all these
countries have in common? Their seniors all pay lower prices for the
exact same prescription drug medication that American seniors today
cannot afford. One month's supply of Zocor, a prescription commonly
taken by seniors to lower their cholesterol, costs $124 in the United
States. In Europe, the same medication costs $28. The antidepressant
Prozac, also widely prescribed throughout America, costs nearly $100
for just 20 pills. In Canada, those same 20 pills cost $20.
Throughout America, seniors have for years been forced to choose
between food on the table and medication, stories that we have heard
about cutting pills in half or going without. Hardest hit are seniors
and disabled of rural America, such as those in Arkansas and in North
Carolina, the area that I represent.
We have three plans before this Congress: the House Republican
measure that focuses on nothing less than the absolute dismantling of
Medicare as we know it; a Senate bipartisan measure that is somewhat
better, although still falls far short; and we have a Democratic plan
that is affordable, it is available, guaranteed and will maintain
Medicare. Our plan has no gap in coverage, no doughnut hole, does not
depend on the whims of HMOs or private insurance companies. However, we
all know full well that, because it is a real plan, it probably will
never see the light of day.
Hopefully, however, the Democratic plan will force the Republican
leadership to reconsider their devastating proposal and treat our
seniors fair. So tonight we focus on the reality of how House
Republican leadership efforts hurt seniors in rural America,
disenfranchise, dismantle and ultimately devastate.
That is what we can expect in eastern North Carolina if the House GOP
has its way with this prescription drug coverage. That plan will
privatize the prescription drug benefits by relying heavily on HMOs to
facilitate these programs.
Anyone who lives in rural America, such as eastern North Carolina,
already knows the health crisis facing families and seniors, as big
HMOs have abandoned them and consider them unprofitable.
I am going to close because I think we know what we are facing. We
know what we must do. We must fight to ensure that even hard-to-reach
rural communities are included equally and with real results in a much-
needed drug coverage plan; and we, Mr. Speaker, must keep our solemn
promise.
Mr. BERRY. Mr. Speaker, I thank the gentleman from North Carolina for
his comments, and appreciate his leadership in this matter that is so
critical to the senior citizens of this country and the tremendous
impact it will have not only on our seniors but on all Americans
because when the government makes it possible for one person or group
of persons like the prescription drug manufacturers of this country,
when the government makes it legal for them to rob and to steal from
senior citizens, when the government allows that to go on day after day
after day, it is our job to speak out. It is our job as best we
possibly can to do something about it.
It is an interesting thing, every speaker that talks about this
refers to the fact that the United States of America and American
citizens pay three to four times as much for their medicines as any
other nation in the world, and yet the President of the United States
has within his power the ability to change that with the spoken word.
All he has to do is tell the Secretary of Health and Human Services,
Mr. Thompson, certify that we can put a stop to this, certify that we
can safely reimport medicine and let our people be treated fairly, but
the President refuses to do this.
So it is left up to us, once again, to attempt legislation that will
make it possible for the senior citizens of this country to be treated
fairly. How can we deny the pain and suffering that this policy, that
this country has put in place, causes to our senior citizens and to
their families? How can we continue to let that go on? Yet when a
remedy is proposed, in this cynical way that we will be presented with
before the end of this week, I think it is called the Thomas-Tauzin
bill or the Tauzin-Thomas bill, but we cannot devise a more cynical
attempt to trick the American people and the senior citizens of this
country.
[[Page H5805]]
That bill, if we would be so unfortunate to see it enacted,
specifically prohibits the government from trying to achieve the best
possible price for our citizens. It specifically makes it possible for
the drug companies to continue to rob the senior citizens.
It would privatize Medicare. Medicare came into being because private
insurance did not want to insure people that were older and sicker, and
yet now we are going to turn this back to the insurance companies. If
anyone thinks that that is a good idea, I would suggest that they go
out and try to buy some health insurance from a private company for a
65-year-old citizen.
It will end Medicare as we know it. One of the authors of this bill
came before the Blue Dog Coalition this afternoon, very proud of his
work. It was interesting as he sat there and described this; and he
said, I have softened this part of the bill; instead of just ending
Medicare as we know it in 2010, we are going to phase that, ending in
over 3 or 4 years. So it just will not be quite as noticeable.
I could not help but think as I was listening to that about my
brother when we were young boys. He had worked hard one summer and
saved his money, and he wanted to buy himself a shotgun for hunting
season. He went to town and went to the hardware store, and he asked
this fellow how much will you take for a certain shotgun. The
proprietor said, well, I do not have one; but if I did, I would sell it
to you for $100. So since the fellow did not have one, he went on
around the square, and he came to another hardware store and went in
there and asked him if he had that gun. He said, yes, I do. He said,
well, how much will you take for it? He said, I will take a $110. He
said, well, the other fellow on the other side of the square said he
would take $100 for his, but he did not have one. He said, well, if I
did not have one, I would take $100 for mine.
That is the way this deal works. It does not even go into effect for
2 years, 2006. Our seniors have an urgent need today. We have the
ability to provide relief today; and yet we are going to be presented
with this cynical, horrible piece of legislation that is nothing more
than an attempt to trick our senior citizens in desperate need into
doing something that will make their desperation even worse.
What kind of a legislative body would do something like that? This is
absolutely amazing that the leaders of the Republican Party in the
House would be so cynical that they would be willing to attempt to take
advantage of senior citizens who have already paid the price, done the
work, lived by the rules, and built this great Nation into what it is
today; and now they are going to be treated like this by those of us
that inherited this wonderful place.
{time} 2300
I am astounded that we have to come to this floor this evening and do
everything we can to try to prevent such an outrageous act by the
majority.
Mr. Speaker, I now yield to the gentleman from Texas (Mr. Rodriguez).
Mr. RODRIGUEZ. Mr. Speaker, let me first of all thank my colleague,
the gentleman from Arkansas (Mr. Berry), for being out here. It is 11
p.m. eastern time, and people might wonder what we are doing here this
late. Well, we are talking about an issue that is important. We are
talking about an issue when I go to a church on Sunday where people
still confront me and ask me what we are doing about this issue. I know
myself and we have the gentleman from Texas (Mr. Sandlin) out here
tonight to talk about an issue that continues to confront us, yet we
continue to play games with the American people and with our seniors.
That is not right. We need to make sure that we do the right thing.
Mr. Speaker, we know that our seniors are having difficulties. We
know that the majority of them do not have the resources to pay for
their prescriptions. We also know on the Republican side and on the
Democratic side that the private sector, the insurance companies,
cannot make a profit on our seniors when it comes to prescription drug
coverage. We recognize that.
When this all first started, with LBJ, there is a little story that
is told about this. When LBJ was trying to put Medicare together, the
biggest obstacles were the insurance companies back then, and the
doctors. He finally got the insurance companies there and he told them,
look, I am going to do you a favor. You have been making a profit off
of the young people and insuring them while they are healthy, and as
soon as they get sick on you, you have been dumping them and dropping
them off your insurance rolls. So we know that the companies were doing
that then and they are still continuing to do that now. So when he got
them in there he said, look, I will do you a favor. You keep taking
those profits while they are healthy but allow us to establish Medicare
so that we can take care of them in their later years when they become
seniors and they need the assistance, and you can continue to make your
profits.
And so now we have a situation where our seniors still reach that age
where they need that assistance, where they need our help, where they
need prescription drug coverage, and what angers me the most is that
the drug companies are the ones that are making a profit off the ones
who can least afford to pay for these prescriptions.
We talk about the fact that those same prescriptions are sold, Mr.
Speaker, in Mexico and Canada, the same company, same brand, only
cheaper. And why? Because they are sticking it to the Americans. And we
have allowed that to happen. We have allowed that to continue to occur.
We talk about free trade but yet we do not allow our own Americans to
cross the border into Mexico to buy prescriptions. Why not allow free
trade from that perspective? It is only good for companies, but not for
the average person to do that.
So we need to make sure that, number one, the bill has to be
affordable for people. The senior has to be able to purchase it. I can
attest to my colleagues that the majority of my district, with a median
income of $23,000, $21,000, and especially my seniors, who if you live
in rural Texas or rural America you do not have a pension because you
did not work for a major corporation or the government, so you do not
have a pension. All you have is Social Security. So you do not have
extra money to buy additional coverage. And if you did, believe me, the
insurance companies do not want that because of the fact that they are
not going to make a profit off you. We know the data. We know the
seniors sometimes need up to $2,900 per year. So if you need $2,900 per
year, close to $3,000, they are not going to make a profit from you. We
know that. Yet we are playing games and doing gimmicks.
But this President and this administration has to come up this coming
year in November for reelection and they are going to have to tell us
what they have done when it comes to prescription drug coverage. They
will be asked what they have done. Because I recall the last 2 years,
and I want to ask my constituents to remember this, because any
Republican who had serious opposition the last time there were ads that
came out. We had an ad for the gentleman from Texas (Mr. Bonilla) back
home, and that ad said, ``Call Congressman Bonilla to thank him for the
prescription drug coverage you received.'' Well, I am going to ask you
right now: Have you received anything back home? No. It is a gimmick.
It is all nothing but sarcasm. It angers me because they play games
with the American people and they play games with our seniors.
So we have to make sure if we come up with a program that it is
affordable. What the Republicans have is not affordable. Secondly, it
has to be meaningful. It has to be real. It has to be guaranteed. We
cannot afford to have these little gimmicks. The reality is that the
bill that the Republicans have is meaningless. It is private insurers
that can change the terms of the agreement.
We had the HMOs. I have rural counties. I had 13 counties, now I have
11 counties after redistricting, and those counties, wherever the HMOs
and the managed organizations were not making profits, they did not cut
the individuals, they cut the whole county. So we are not going to be
able to have access in rural Texas, in rural America. So it is
meaningless.
Finally, we also understand that we have to make sure that we
guarantee our seniors the accessibility to these prescriptions. This is
the most powerful country in the world. We have the capability and,
yes, we have the best
[[Page H5806]]
health care system in the world. But what good does it do if it is not
affordable; if it is not accessible; if it is just not there? Yet we do
have the best health care system. It is ridiculous for us to be doing
this, and it is unfair to our seniors to be playing games with their
lives, especially as they reach their twilight years when they need
this the most and they have to sometimes go without buying all the
prescriptions that are needed.
So, Mr. Speaker, I want to thank my colleague for being here tonight,
and I thank the gentleman from Texas (Mr. Sandlin) for being here and
spending time talking about this critical issue. I want to personally
just congratulate my colleagues and let them know that we have to keep
this fight up. We have to keep talking about this, and we have to stop
playing games.
When that Presidential race comes up again, we have to let everyone
know what he has done for prescription drug coverage. The Republicans
have control of the Presidency, they have control of the Senate, they
have control of the House. What are they doing? They are playing games.
This is not the time to do that.
Mr. BERRY. Mr. Speaker, I thank the gentleman from Texas and
appreciate his passion and concern for all senior citizens in this
country.
This bill would not only end Medicare as we know it, but,
interestingly enough, it does not have a defined benefit. It does not
have a defined premium. It turns this business over to insurance
companies that have a very poor record of being able to deliver service
when it is called on to do that.
We have been fighting the Patient's Bill of Rights battle in this
House all the time that I have been here. We still do not have a
Patient's Bill of Rights. But the pressure got to be so great on the
insurance companies that they did stop the grossest abuses that they
have engaged in to deny coverage and deny service to our American
people. They would be allowed to define their own benefit. They would
be allowed to set their own premium. They would be able to create many,
many different plans, and it would be nearly impossible for a senior
citizen to tell the difference.
I have to believe, Mr. Speaker, that our Founding Fathers would be
saddened and sickened to see the great Nation that they brought in to
being, that has succeeded and prospered beyond all imagination, to the
point where we have the ability to do these wonderful things for our
seniors, and yet when the opportunity presents itself, the majority
chooses to use that opportunity in a cynical way and in a way that only
serves to enrich a few people in this country.
I want to now yield to the gentleman from Texas (Mr. Sandlin), who
has worked tirelessly on this issue to defend our senior citizens
against such activities as would be used against them if this bill were
to be passed.
{time} 2310
Mr. SANDLIN. Mr. Speaker, I would like to thank the gentleman from
Arkansas (Mr. Berry) who is both a good personal friend of mine and a
political friend of mine, and I want to thank him for 7 years of
political leadership in addition to his practical leadership due to the
fact that he is a pharmacist and speaks with a great deal of authority
on these issues.
Mr. Speaker, in looking at this bill it is clear, it is the old bait
and switch. I rise today to join the gentleman from Arkansas (Mr.
Berry) and my colleagues in speaking to the Republican House leadership
abandonment of rural America by crafting a sham prescription drug
benefit. Because at the end of the day, it is no plan at all. What a
cruel joke on America's seniors.
As the United States Representative of rural east Texas, I am
gratified to have an opportunity on the Committee on Ways and Means to
be a voice for my constituents at home. The seniors in my district have
told me clearly that they need real relief for their soaring medical
expenses; and yet once again this year the majority leadership in
Congress has rejected its responsibility to deliver a true prescription
drug benefit to our parents and grandparents and friends at home. Just
like last year, the Republican majority has delivered an alleged
prescription drug plan which favors profits over people, insurance
companies over seniors, HMOs over American families.
Today I want to talk about choices and who is choosing what. Our
Republican colleagues in the House of Representatives love to say that
they are giving our parents and grandparents and friends choices for
their prescription drug benefit. Mr. Speaker, that is simply not true.
They also have stated that if our seniors and disabled folks want
prescription drug coverage, then they have to look to HMOs and private
insurance companies, not Medicare for help. That is the choice they
have, and what kind of choice is that? It is clear, it is absolutely no
choice at all.
Now anyone who lives in rural areas knows that this little rule is
anything but a choice. Rural areas have been flat out abandoned by
private insurance companies. We know this, Medicare+Choice, the great
managed care experiment in our Nation's seniors, should have been named
``Medicare Minus Choice.'' It has been a disaster.
Just look at the facts. Between 1998 and 2003, the number of
Medicare+Choice plans dropped by more than half. In the great State of
Texas, over 313,000 Medicare+Choice enrollees have been dropped just
since 1999, 313,000 people in my State. Further, this is occurring all
over the country. The 10 States, including the District of Columbia
with the highest percentage of their enrollees dropped in any 1 year
from 1998 to 2003 were South Dakota, the Mount Rushmore State, 99
percent; Delaware, the First State, 95 percent; Arkansas, the Land of
Opportunity, 90 percent; New Hampshire, 85 percent; Maine, 82 percent;
Maryland, 79 percent; Utah, 76 percent; District of Columbia, 71
percent; Kansas, 54 percent of the people dropped; Connecticut, 52
percent of the people dropped. It goes on and on.
Mr. Speaker, over 80 percent of rural Medicare beneficiaries today
live in an area that private insurance companies have made a choice,
that is the choice, they have made a choice not to serve. Now please
note, this is not an entitlement program. This is not entitlement as we
know it under Medicare. You have no guarantee. This is this kind of an
entitlement, it is an entitlement to ask to be able to make an offer to
purchase a plan from a reluctant, profit-seeking insurance company that
may or may not accept your offer.
By the way, it is very important to note this: not a single insurance
company in the United States of America has agreed to take part in this
program. Let me say that again. Not one single insurance company in the
United States of America has agreed to take part in this plan anywhere
in America. That is a fact.
Furthermore, even if they do decide to participate at some time in
the future because they think they can make big profits, under this
latest Republican drug proposal, if the private drug plan or insurance
company decides rural America is not lucrative enough for their
company, they can withdraw every 12 months. So much for our seniors
having the choice of continuity of care.
Knowing this, how can we approve a plan that does not even have a
fall-back option of traditional Medicare providing drug coverage if
private care pulls out? How is that a fair choice for the 9.3 million
seniors and disabled folks that live in America? What kind of choice is
that?
Let us be clear, this legislation does not and this legislation
cannot require insurance companies to offer prescription drug plans in
rural America, and they will not. They have not and they will not. If
we are going to talk about the choice of being fair, we are going to
have to talk about prices. Under this bill, the HMOs and pharmaceutical
companies are given the express choice, there is that word again, they
are given the choice to determine how much to charge and what
prescription drugs to offer seniors and the disabled.
Mr. Speaker, what do you think they are going to choose: high prices
or low prices? More coverage or will they choose less coverage? Mr.
Speaker, the answer is clear, it is profits over people. That is their
choice.
Yesterday the President said, ``When the government determines which
drugs are covered and which illnesses are treated, patients face delays
and inflexible limits on coverage.'' Yet now he wants to turn over
those very decisions to insurance companies who have a financial
interest, who have a financial gain to make in denying coverage
[[Page H5807]]
to America's seniors. They make more money, the more seniors they deny,
the more money they make and the circle goes on and on. That is not a
good choice.
We have an opportunity to deliver a true prescription drug plan to
our seniors this week, and to do so Congress must come together and
choose to soundly reject this Republican albatross, this madness. If we
shine a light on this, we can see the many problems with this sham
prescription drug proposal. It does not provide a guaranteed, defined
set of costs and benefits; it does nothing to reduce the high price
Medicare beneficiaries are forced to pay for their prescription drugs.
For seniors it is simply high on cost and low on benefits with a gap in
coverage so large that our seniors would forget they have a drug
benefit if they were not still writing a monthly check for the premium
while they were not getting any benefits. Still paying a premium, not
getting any coverage. That is not a nice choice.
Our Republican colleagues say we do not have enough money to give a
better prescription drug benefit. Mr. Speaker, that, too, is just a bad
choice they have made, to enact $1.7 trillion in tax cuts. While we are
paying $1 billion a day in interest for the wealthy rather than serve
our Nation's seniors is an outrageous and true reflection of their
priorities. It shows you where their heart is. You can get lost in the
details, but the result is clear. This is a terrible piece of
legislation. Let us forget the gimmicks, it is time to deliver a real
drug plan to our Nation's seniors. All they want is an affordable drug
benefit with a reasonable premium cost that is defined and meaningful
benefits, and that means a benefit without a $3,000 gap in coverage.
They just want a benefit that is available to all seniors regardless of
whether they live in Texas or California or New York City.
{time} 2320
The Republican plan is just a shameless smoke and mirrors scheme. Let
us reject this tired bait and switch scam. We know the end game, do we
not? Everybody in here does. Former Republican Speaker of the House
Newt Gingrich said Medicare should wither on the vine, and recently our
Republican colleague in the other body, Senator Santorum, said
traditional Medicare should be phased out. That is the goal. That is
the object. That is the plan.
Let me read something I did not say, something the Republicans did
not say, something the Democrats did not say. This is in Newsday June
23, 2003. ``The House proposal would replace Medicare's guaranteed
coverage with a guarantee only that the elderly would get a sum of
money to buy whatever kind of benefits at whatever price private
insurers chose to offer. Those who want traditional fee for service
Medicare would be forced to pay higher premiums. So at least now we
know the drug plan, skimpy and fraught with uncertainties, is merely a
cover for achieving former House Speaker Newt Gingrich's dream of
forcing Medicare to wither on the vine.'' Newsday. That is the plan.
This ill-conceived and inadequate plan is not an attempt to provide
drug coverage to seniors. It is an attempt to set up the very
destruction of Medicare and place HMOs and insurance companies in the
catbird seat. It is as simple as that. We all know that.
Now Congress has to make a choice. Seniors and healthcare, HMOs and
profits, privatization or Medicare. Mr. Speaker, it is our choice to
make. Whom do we stand for? Whom do we stand for in the United States
Congress?
Mr. BERRY. Mr. Speaker, I thank the gentleman from Texas for his
great leadership in this matter and continued willingness to do the
battle on behalf of our senior citizens in this country.
I yield to the gentleman from Massachusetts (Mr. Olver).
Mr. OLVER. Mr. Speaker, I thank the gentleman for yielding, and I
want to commend the gentleman from Arkansas for bringing this
particularly important issue before us because this plan is a
particularly cynical plan as far as it affects rural districts around
America. People do not usually think of my Massachusetts district in
the western and northwestern part of the State of Massachusetts as
being a rural district, but it is in fact that.
Mr. Speaker, rural seniors like all seniors need help now paying for
their prescription drugs. The Republican leadership's prescription drug
plan leaves seniors waiting 3 years more for relief. But by 2006 when
it finally goes into effect, this ingeniously devious legislation still
will not give rural seniors a prescription drug benefit because there
will not be a prescription drug plan available for them to access. The
Republican leadership claims this plan will provide choice for all
Medicare beneficiaries. The Republicans say that seniors all across the
country including rural areas will have access to two different
prescription drug plans, one, a private HMO health plan which includes
prescription drugs, and, two, a prescription-only plan offered by a
private insurance company but deliberately not a part of the Medicare
that seniors trust.
Rural seniors know that private insurers are not going to offer such
plans at an affordable price. The evidence is clear. The
Medicare+Choice program shows how private HMO's role in Medicare has
failed in rural areas. These Medicare HMOs have abandoned millions of
Medicare recipients living in rural districts like mine all over this
country. Currently four out of five seniors in rural areas have no
access to an HMO managed care plan under Medicare leaving rural seniors
with no choice. Why have HMOs abandoned the rural areas? It does not
take an economist to figure that out. With the sparse populations in
rural areas, these private HMOs could not turn a big enough profit; so
they had no compelling reason to stay and provide services. Since
Republican leadership knows rural seniors will not fall for promises of
Medicare HMOs again, they have also provided the choice of a
prescription-only benefit provided by private insurance companies while
allowing seniors to stay in the Medicare that they do trust.
But this legislation makes a promise of insurance that does not
currently exist and can never exist in any affordable form for the
exact same reason that HMO insurance plans could not make a profit in
rural areas. Prescription drug costs are exorbitantly high; yet the
Republican leadership expects that private insurers will be eager to
provide this prescription-only benefit to the segment of the population
that uses the most prescription drugs but has the least available cost.
There are no incentives for the insurance industry to provide this
benefit.
In the end the high premiums and high costs will fall to seniors who
will be left with the same exorbitant drug costs they currently pay.
Worst of all, by the year 2010, the Republican leadership is determined
to undermine Medicare and eliminate the fee for service program so
Medicare can be exclusively run like an HMO. This will leave no choice
whatsoever because rural seniors will have neither of the plans they
have been promised.
The Republican leadership is placing the lives of our rural seniors
in the hands of insurance companies that they do not and cannot trust,
who have abandoned them in the past but in reality by 2006 the promises
being made now to rural seniors to provide a prescription drug benefit
and a Medicare HMO choice will never be kept. Rural seniors will have
no choice. There will be no private insurance providers riding to the
rescue, and rural Medicare beneficiaries will still pay the same
exorbitant drug costs they now pay.
The Republican bill nullifies every promise to take care of our
poorest and sickest seniors. It is a sham and a cruel hoax for rural
America.
And I want to again thank the gentleman from Arkansas for his
leadership in bringing this issue before the floor this evening.
Mr. BERRY. Mr. Speaker, I thank the gentleman from Massachusetts and
the gentleman from Texas.
Mr. Speaker, rural pharmacies are the only professional healthcare
providers we have in many of our rural communities. If this bill were
to become law, it would wipe out those institutions. It would make it
impossible for them to stay in business because they would be forced to
compete with a mail order operation that would be so full of gimmicks
that it would be impossible. These mail order operations would be set
up by the prescription
[[Page H5808]]
drug manufacturers with the cynical reason of taking the healthcare
providers out of these communities. HMOs will have an incentive to put
profits before patients. Headlines in the Wall Street Journal today
documents a situation exactly like that where an insurance company or a
pharmacy benefits manager chose to put profits before patients.
Let us not wipe out healthcare for senior citizens in rural America.
Let us deny this bill and send it back until we can do what we know
that we have the ability to do, and that is to provide to seniors
citizens of this country with a reasonably priced prescription medicine
program that will serve them well and serve this country well.
____________________