[Congressional Record Volume 149, Number 151 (Friday, October 24, 2003)]
[Senate]
[Pages S13207-S13208]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    PHARMACEUTICAL MARKET ACCESS ACT

  Mr. JOHNSON. Madam President, while the pharmaceutical industry is 
the most profitable industry in the world, millions of uninsured and 
underinsured Americans continue to struggle to afford medicines they 
need when prices are out of reach.
  The facts paint a disturbing picture. According to a 2002 Families 
USA report, the pharmaceutical industry has been the most profitable 
industry in the U.S. for the past 10 years, being five-and-one-half 
times more profitable than the average Fortune 500 companies. A Public 
Citizen June 2003 report found that in 2002, the top 10 drug companies 
netted profits of $36 billion, or more than one-half of all profits for 
Fortune 500 companies. While drug companies claim that their high 
prices support research and development one study found that eight 
major American pharmaceutical companies spent more than twice as much 
on marketing and administrative costs than on research and development.
  And while powerful drug manufacturers continue to bring in high 
profits, American consumers continue to pay the highest prices in the 
world--three to ten times more than other developed countries pay. 
South Dakotans cross the border every day to go to Canada in the hopes 
of purchasing lower-priced drugs that will prevent them from having to 
make the tough decision of choosing between buying groceries or life-
saving medications.
  And the recent actions of many of our State leaders indicate that 
Americans are fed up with paying by far the highest dollar prices in 
the world for prescription drugs that often times their tax dollars 
helped to develop. State governments have resorted to taking matters 
into their own hands: Maine now allows the State to negotiate fairer 
drug prices for all residents using the buying power of its Medicaid 
program, several States including Illinois, Iowa and Minnesota are 
exploring the possibility of importing prescription drugs from Canada 
for State employees, and Minnesota's Attorney General filed a lawsuit 
against GlaxoSmithKline alleging that the pharmaceutical company is 
violating antitrust laws by ``spearheading an industry-wide 
conspiracy'' to prevent U.S. residents from reimporting U.S.-made 
prescription drugs at a lower cost from Canada.
  The American people are fed up. They are demanding that Congress end 
the ``sweetheart deal'' that gives the powerful pharmaceutical industry 
a captive market. A recent poll taken by the Washington Post and ABC 
News found that two-thirds of Americans support the legal importation 
of FDA approved prescription drugs and I have joined several of my 
colleagues to introduce the Pharmaceutical Market Access Act which will 
do just that. I thank Senators Dorgan, Stabenow, Dayton, Pryor, Levin, 
Feingold, Snowe, Jeffords, and McCain for staying committed and working 
with me on this very important issue.
  This bill, which is the companion to House reimportation bill H.R. 
2427 that passed with broad bipartisan support, will finally provide 
American consumers with immediate access to FDA-approved medicines in 
Canada, as well as other industrialized nations. It contains strong 
safety protections that will ensure that the U.S. drug supply remains 
safe. Innovative techniques such as counterfeit-resistant packaging and 
drug wholesaler pharmaceutical shipment testing will ensure this 
safety.
  American consumers are already importing $500 million to $1 billion 
in prescription medicines from Canada and elsewhere. This is on top of 
the already $13 billion U.S. made prescription drugs already being 
reimported by pharmaceutical manufacturers under the authority found in 
the Prescription Drug Marketing Act of 1988. The Congressional Budget 
Office has estimated that the reimportation provisions found in this 
bill could provide approximately $40 billion over 10 years in savings 
to

[[Page S13208]]

consumers. We need to bring these savings to the American people and 
finally eliminate the price disparity experienced in this country by 
passing a strong drug reimportation law and ensuring that it is 
actually implemented. Please support this important legislation.
  Mrs. CLINTON. Madam President, I rise to express my strong opposition 
to S. 3.
  This Senate is poised to criminalize a medical decision made between 
a woman and her physician. Despite claims to the contrary, the 
legislation before us today will ban many abortions routinely conducted 
in the second trimester because the simple truth is that ``partial-
birth abortion'' is a political term, not a medical one.
  The conference report returned to us by the conferees is different 
from the legislation passed by the Senate back in March in one critical 
way--it is stripped of Senator Harkin's amendment affirming the law of 
the land--Roe v. Wade. This resolution made it clear that the policy of 
the Senate is for abortion to be legal, safe, and rare. And the 
conferees stripped out this language, making it clear that their true 
intent is to make abortion obsolete, regardless of the effects on 
women.
  I remain perplexed--as I was in March--that this has risen to the top 
of our priority list. Back in March, we were about to send our troops 
to battle in Iraq, we were losing hundreds of thousands of jobs a month 
and long-term unemployment was climbing to the highest level in 
decades.
  Well, the more things change the more they stay the same. Long-term 
unemployment is now at the highest level in 20 years. The number of 
Americans falling into poverty has increased for 2 straight years after 
a decade of decline. Six hundred thousand more people are unemployed 
than they were in March, and we have lost more than 200 U.S. soldiers 
since the war began.
  Yet, we have found time to ban what should be a private medical 
decision between a woman and her doctor.
  We also have to complete the most basic work of Congress--to pass the 
year's spending bills. At this point, we have considered Defense, 
Labor, HHS, Energy, Homeland Security and the Legislative Branch. But 
we still have left to consider Agriculture, Commerce-Justice-State, the 
District of Columbia, Foreign Operations, Transportation, and VA-HUD. 
We should bring these bills to the floor, debate them, modify them with 
amendments and then send them to conference. As we get closer and 
closer to our target adjournment date, I have to wonder why on earth we 
are not going full speed ahead to bring these bills to the floor?
  We also have a Medicare prescription drug bill pending in conference. 
This is an issue that all of us hear about every time we go home. It is 
one of the most important issues to the American public--and has been 
so for years.
  With so much uncertainty here at home, the Republican leadership has 
made the choice to debate how best to criminalize a medical procedure 
for women.
  I have to ask myself: Why was this moment chosen for this debate? Why 
aren't we debating the steps we could take to help the 8.4 million 
Americans who are out of work? Why aren't we debating how we can 
balance our Federal budget and begin to diminish these overwhelming 
deficits and this increasing debt load we will leave on the backs of 
our children? Why are we not debating the necessity of our paying our 
bills? Why are we not debating how to provide an affordable, meaningful 
prescription drug benefit for elder Americans? Why aren't we debating 
how to help the 34 million Americans living in poverty?
  As I travel around, talking with people in my State, that is what 
they talk to me about: What about this war, Senator Clinton? What about 
homeland security? Are we as safe as we need to be here at home? 
Senator, what can we do about the jobs that are disappearing in the 
stagnant economy? How on Earth can we deal with this overwhelming 
budget deficit? What about not funding No Child Left Behind and the 
burdens that are begin put on public education as a result? When are we 
going to get around to a prescription drug benefit for our seniors who 
are suffering and having to face these large bills? What are we doing 
to protect our environment? We are, after all, stewards of our natural 
environment for future generations.
  Those are the questions I am being asked. Not the ones posed by this 
legislation before us today.
  But nevertheless we are considering this bill and little doubt that 
it will be approved. So, let us be very clear on what it is we are 
about to pass. The way this bill is written, the choice of language 
eliminates the distinction of trimesters. The vagueness makes this bill 
applicable to many other procedures in addition to the ones explicitly 
named. This bill is extreme, deceptive, and unconstitutional.
  As my colleague from Pennsylvania stated back in March: This is the 
beginning of the end. And that is absolutely what he means. If this 
bill passes, it is the beginning of the end of Roe v. Wade. It is the 
beginning of the end of the right of women in this country to make the 
most personal and intimate decisions that any of us would ever be 
called upon to make.
  Why did we ever have to do Roe v. Wade to begin with? Some States 
like mine, let abortion, as long as it was done safely and legally, 
occur under certain circumstances before Roe. Why did we have to have a 
Supreme Court decision? We have to have it because in many parts of the 
country these kinds of decisions were not permitted to be made by 
individual women.
  Look at the progress we have made. The U.S. abortion rate is now at 
the lowest level it has been since 1974. When I was First Lady, I 
helped to launch the National Campaign to Prevent Teen Pregnancy. We 
increased education and public awareness. And since 1991, teen 
pregnancy has also declined. We learned that prevention and education, 
teaching people to make good decisions, really did work. But that is 
not what we are talking about here. We are talking about those few rare 
cases.
  We are talking about those few rare cases when a doctor had to look 
across a desk at a woman and say, ``I hate to tell you this, but the 
baby you wanted, the baby you care so much about, that you are 
carrying, has a terrible abnormality.''
  I have to ask myself, why do we, as government officials, expect we 
can make these decisions? We know that people of means will always be 
able to get any health care procedure they deem necessary. That is the 
way it was before Roe v. Wade. That is the way it will be after this 
passes the Senate.
  We are facing a moment of historic importance, but not about what we 
should be debating at this time in our history. I only wish this 
legislation were not before us. But now that it is, we have to educate 
the American public.
  I will end by referring again to the young woman, Mrs. Eisen, who was 
in my office back in March. She is about 25 years younger than I am. 
She said: I had no idea that the decision I made with my husband and my 
doctor to deal with this genetic abnormality was something I could have 
never had under the laws of where I lived before. And that if this 
passes, it will become illegal in the future.
  I said: Well, you didn't have to think about that. That was something 
that, thankfully, we took off the national agenda. But there are those 
who, from very deeply held beliefs, which I respect, would wish to 
substitute the Government's decision for what should be a difficult, 
painful, intimate, personal decision.
  This bill is not only ill-advised, it is also unconstitional. I 
understand what the other side wants to do. They are hoping to get 
somebody new on the Supreme Court and to turn the clock back 
completely, to overrule Roe v. Wade.
  Is this bill really about what the sponsors say, or is it, as they 
candidly admit, the beginning of the end--to go back in this country to 
back-alley abortions, to women dying from botched, illegal procedures? 
I think you can draw your own conclusions.
  It is up to the American public to determine whether they want 
medical decisions being criminalized by this Senate.

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