[Congressional Record Volume 149, Number 148 (Tuesday, October 21, 2003)]
[Senate]
[Pages S12910-S12911]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Ms. STABENOW. Mr. President, I thank my colleague from North Dakota 
for his comments and associate myself with them as well.
  As we move through Appropriations Committees, there are a number of 
important issues that confront us. I rise to speak to the issue of 
health care and add my voice to the growing chorus of people who are 
concerned about our Nation's health and want us to have a sense of 
urgency about health care.
  We have just passed a bill that will allow our tax dollars to be used 
in Iraq for a universal government-paid health care system for the 
Iraqis. There are people in the United States asking: What about us; 
what about making sure each of us has health care as well?
  There are businesses seeing their premiums double. The average small 
business is seeing their premiums double now every 5 years, and that 
is, in fact, growing even higher. Large businesses, negotiating 
contracts, find themselves dealing with the issue of health care as the 
top concern of both the business and employees.
  When we look internationally at our ability to compete around the 
world, the health care system that is tied to employment has created a 
situation where our large businesses competing in the world are having 
more difficulties competing successfully in this competitive 
environment where every dollar counts. We are hearing from unusual 
places a call for a focus on health care, a focus on a more universal 
kind of system that will allow us to have the health care we want for 
our families and our businesses to be able to compete both within our 
country and around the world.
  What is most disturbing is when we look at the numbers in terms of 
the costs going up and the number of people now without insurance. A 
new survey by the Kaiser Family Foundation and the Health Research and 
Education Trust found that employer-sponsored health insurance premiums 
increased almost 14 percent this year. This is the seventh straight 
year of premium increases and the largest increase since 1990. Premiums 
now average over $9,000 a year for the typical family health insurance 
policy. And for an individual, it is $3,383. Rising premiums are 
placing a very heavy financial burden on our families and are making it 
increasingly difficult for families to find and afford health care.
  Because there is no successful plan to stimulate the economy right 
now, we are seeing more and more Americans go without health care and 
other basic needs. According to a recently released U.S. Census Report, 
the number of Americans without health insurance has jumped by 5.7 
percent to almost 44 million people. That equals the populations of 24 
States plus Washington, DC. Think about that. The number of people who 
are uninsured now equals the population of 24 States and Washington, 
DC. If this is not a crisis, if we do not need a sense of urgency, I 
don't know when we will, when we look at what is happening.
  Families U.S.A. has done their 2001-2002 survey and determined that 
in Michigan 2.3 million Michiganians under age 65 went without health 
insurance sometime within that year. That means one in four people in 
my great State of Michigan, under the age of 65, went without health 
care during this time period. This is not acceptable and we need a 
sense of urgency about these issues.
  Who are these people? Well, the majority of them are working. 
Actually, more than 80 percent of the uninsured live in working 
families. The majority of those who are uninsured are working. So this 
is a small business issue. This is an issue of people who are working 
but are not in businesses that can afford health insurance themselves 
for their employees, which is why we need to tackle this issue working 
with our small business community as well as our large business 
community.
  When one member of a family is uninsured, it can affect all of the 
family and their quality of life. We know many young people going out 
into their first jobs are not insured and run a high risk of something 
happening and of their not being able to deal with it in a productive 
way.
  One of my major concerns right now, as we move forward in the work on 
a Medicare prescription drug benefit, is that we not forget that there 
are important parts of cost containment in that legislation that would 
affect all of those who need health insurance, or have health 
insurance. We know that about half of the reason the cost of insurance 
premiums is going up for businesses right now is because of the cost of 
prescription drugs.
  So one of the primary ways we can help businesses to be able to 
afford health insurance and be able to provide more opportunities for 
people to have health insurance is to lower the price of prescription 
drugs. The average prescription brand name drug is going up faster than 
three and a half times the rate of inflation. So when we look at what 
we are debating right now under Medicare, there are two very important 
focus areas for us. One is to eliminate patent loopholes that stop 
patents from coming to an end and allow lower cost, unadvertised brands 
to be able to go on the market through our generic drug process.
  We passed a bipartisan bill in the Senate not once but twice since I 
have been here in the last 2\1/2\ years. This needs to be passed by the 
entire Congress and put on the President's desk this year, whether it 
is part of the Medicare conference report or whether it is done 
separately.
  We also know that if we create more competition by tearing down this 
artificial border which doesn't allow Americans to purchase safe FDA-
approved prescriptions from other countries, particularly Canada, where 
we know their supply chain and safety processes are virtually 
equivalent to ours, if we do that, we can also create great competition 
to lower prices.
  There are a lot of stories right now in the paper about concerns 
about the safety of prescription drugs at home as well as abroad--
legitimate issues that deal with what is happening with

[[Page S12911]]

wholesalers in our country, issues that need to be addressed by the FDA 
and all of us. We need to be increasing the ability for the FDA to have 
the inspectors and enforcement powers against those kinds of activities 
that create unsafe medication.
  But when you talk about the issue of what has been called 
importation, we are talking about a process that allows the local 
pharmacist, the licensed pharmacist at the local pharmacy or the local 
hospital, to have the same ability to do what every part of the 
pharmaceutical industry does right now, which is to do business with 
those in another country and bring a supply chain of prescription drugs 
back to the local pharmacies.

  The reason we are seeing so much activity now, so many ways people 
are trying to find prescription drugs that are affordable to them, is 
because prices are too high. The fact is that people cannot afford 
their cancer medicine, their blood pressure medicine, and those other 
kinds of medicines they need to be able to live productive lives or, in 
many cases, be able to survive.
  The reason we are seeing so many people looking for other ways to 
find prescription drugs is because the prices are too high. We need to 
work together to have a system with integrity and with safety, that 
creates a product that is affordable, that creates a product that can 
be available to our citizens who desperately need these lifesaving 
medicines.
  If we do that, we address half the reason health care costs are 
rising. We then need to focus on the question of the uninsured and how 
we partner to be able to make sure people have access to health care, 
so we can bring those prices down.
  In closing, we need a sense of urgency about health care. We need a 
sense of urgency here just as every business, every employee, every 
family has a sense of urgency about health care now and whether it will 
be available to their families. I hope we will make that a top priority 
for this Senate.
  The PRESIDING OFFICER (Ms. Murkowski). The Senator from Delaware is 
recognized.
  Mr. CARPER. Madam President, before the Senator leaves the floor, I 
have observed that she has been diligent in continuing to focus on 
health care issues, including our need to somehow effect and moderate 
the growing cost of health care in this country. She has seen an exodus 
of manufacturers out of her State and millions of manufacturing jobs 
from the United States. Among the reasons why they are leaving is the 
extraordinary cost of health care. Companies also tell us they are 
considering other places to locate and do business because of 
litigation costs, legal costs that flow out of the costs of doing 
business in our country. Those costs could deal with asbestos 
litigation, which has taken down now over 60 companies that have gone 
bankrupt.
  Unfortunately, a lot of people who have been hurt or exposed to 
asbestos haven't gotten the kind of money their families deserve, and 
people who haven't been sick have taken away money from those who need 
it.
  Another area with respect to legal costs that will get a lot of 
attention on this floor this week is the cost of class action 
litigation and whether or not the way our class action system works in 
this country is appropriate or needs to be changed.
  Let me say from the outset that I think when a person is hurt or 
damaged in some way by the acts of another person or a company, that 
person should be compensated. They should be made whole. When a number 
of people, or a class of people, are hurt or damaged in some way by the 
actions of a company or business, that class of people should be 
compensated and made whole as well.
  I submit to my colleagues today that our sense of balance, though, 
has been lost. We are seeing national class action litigation not 
taking place in Federal courts but in many instances taking place in 
local courts with locally elected judges against defendants from other 
States.
  When the Framers of our Constitution provided for a Federal 
judiciary, one of the reasons they did so was to say when you have 
plaintiffs in one State and you have defendants in another State, just 
to make sure there is an objective legal system, we need a Federal 
judiciary to help provide for that leveling of the playing field.
  All too often today national class action litigation pits plaintiffs 
in one State and defendants in another State in a local court where you 
have a locally elected judge whose election or reelection depends in no 
small part on their ability to satisfy the plaintiffs within their 
State. We've just lost our sense of balance.
  There have been efforts for five years now to try to make changes 
with respect to class action litigation. It started out far different 
than where it has ended up. The current bill is much more moderate than 
those that came before it. Also, there is no effort with this bill to 
cap noneconomic or attorneys' fees. There is no effort to limit joint 
and several liability.
  I want to talk about the bill that will come to the Senate floor if 
we agree to the motion to proceed tomorrow.
  First of all, the legislation that will come to us is not perfect. It 
might need to be amended or changed further. It is certainly not the 
final product, but it is a good starting point. If we agree to the 
motion to proceed tomorrow--it takes 60 votes--we will have the 
opportunity for those of us on our side, the Democratic side, and the 
Republican side, to offer amendments, to have a full and open debate 
and decide whether or not we are going to change the bill. It can be 
improved, and I certainly will support amendments. I may talk about 
those later today or tomorrow.
  Let me take a minute to describe the legislation that may come to the 
floor. The issue we are trying to get at is venue shopping, where you 
have, in some cases, litigation that is being brought and litigation of 
national scope that ought to be in a Federal court, where the attorneys 
who brought the lawsuit are looking for a venue where they can get a 
friendly judge and friendly jury.
  In some places, it is almost a cottage industry, whether it is 
Madison County, IL; Jefferson County, TX; and other places, such as 
Alabama and Mississippi. There is a perception that a defendant is not 
going to get a fair shake in a national class action litigation in 
those venues.
  The PRESIDING OFFICER. The time controlled by the minority for 
morning business has expired.
  Mr. CARPER. I thank the Chair. I will have more to say about this 
later today.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. THOMAS. Madam President, I ask that the next 15 minutes be 
equally divided between the Senator from Idaho, Mr. Craig, and the 
Senator from Oregon, Mr. Smith.
  The PRESIDING OFFICER. Without objection, it is so ordered. The 
Senator from Idaho.
  Mr. CRAIG. Madam President, I and my colleague need to be off the 
floor by 10:30 a.m. Will the Chair alert me when 5 minutes have passed?
  The PRESIDING OFFICER. The Chair will so notify the Senator.

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