[Congressional Record Volume 149, Number 167 (Tuesday, November 18, 2003)]
[House]
[Pages H11510-H11511]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MEDICARE CONFERENCE REPORT
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 7, 2003, the gentleman from New Jersey (Mr. Pallone) is
recognized for half the time until midnight as the designee of the
minority leader, which is approximately 10 minutes.
Mr. PALLONE. Mr. Speaker, I just tell my colleague from Massachusetts
that I will be glad to have him join in and make some comments during
the course of my 10 minutes if he likes.
I just wanted to follow up on some of the debate that was held this
evening on the motion to instruct from the gentlewoman from Nevada and
particularly pay attention to some of the comments that were made by
some of my Republican colleagues who I know are well-intentioned but I
think were very wrong in what they said about this Medicare conference
report that we are going to be voting on in a few days.
First of all, I mentioned earlier when the gentlewoman from New
Mexico said that Medicare is very successful, and I said to her at the
time, well, if it is very successful, then why are the Republicans in
this Medicare conference report trying to essentially change and gut
and I think destroy Medicare the way we know it?
{time} 2340
Now, what the Democrats have been saying all along is, if you have a
pot of money and you want to provide prescription drugs to senior
citizens pursuant to the Medicare program, which you admit is a
successful program, then why not just add the prescription drug benefit
to the existing Medicare program?
We know right now that all seniors are entitled to Medicare, because
if they are over a certain age, they are entitled to Medicare. It is an
entitlement. We have a program for hospital care; we have a part B
program for doctor care. And what the Democrats have been saying is we
can simply do for prescription drugs the same thing we do with the
physician care, the physician payment. Like part B, which right now
says if you pay $50 a month, and after the first $100 deductible, 80
percent of your doctor bills are paid for by the Federal Government, up
to a certain amount, at which time 100 percent of your bills are paid
for by the Federal Government. Democrats have been saying we can add a
prescription drug benefit to Medicare in the same way.
And what we actually proposed and voted on here in the House of
Representatives during the summer was exactly that, a program that
would say you pay $25 a month premium, after the first $100 deductible
on your drug bills, 80 percent of the cost is paid for by the Federal
Government. You have a 20 percent copay. And at a certain point, after
you have paid a certain amount out of pocket, 100 percent of the costs
are paid for by the Federal Government. Very simple. It builds on the
existing Medicare program.
That is not what the Republicans are doing here. This is not even
about a prescription drug benefit any more, because they are not
providing a meaningful benefit. And I want to associate myself with the
remarks made by the gentleman from Indiana (Mr. Burton) when he said
this is not even a benefit you will want to sign up for because you
will end up paying more out of pocket than you will get back in actual
benefit. So it is not a real benefit. It is not a meaningful benefit.
It is not an affordable benefit. It is not a comprehensive benefit.
Most importantly, the only way you get this prescription drug benefit
under the Republican proposal is if you join an HMO. You are forced,
contrary to what some of my colleagues said on the other side of the
aisle, you are forced under this Republican plan to join an HMO.
Because the only way you could get any kind of prescription drugs
without the HMO or the private plan is if it is not available in your
area.
What the Republicans have done is they are putting so much money,
they are giving $12 million, $1 billion, they are adding all this money
to the private plans, to the HMOs, giving them all this extra money so
that certainly there is going to be someone who is going to offer this
managed care HMO plan, this private plan in your particular State or
your particular jurisdiction, so you will be shut out. You will not be
able to have traditional Medicare and get any kind of prescription drug
benefit.
Now, I know that some of the discussion here tonight is, well, why
does the AMA, the doctors support this? Well, why does the AARP support
this? Why do the drug companies support this? There is a very simple
answer to that, and it is that they are all getting a piece of the
action. The AARP is essentially an insurance company, so they want to
sell insurance. They think it is great. The insurance companies are all
getting extra money, HMOs, private insurance companies, all getting big
windfall profits from the Federal Government under this bill.
And the doctors? Well, they have been suffering. They face a 4.5
percent cut in their reimbursement rate. So what the Republican bill
does is wipe out that cut and give them a 1.5 percent increase, I
think. So, naturally, they feel well it is better to have a 1.5 percent
increase than a 4 percent cut, so they get a piece of the pie. They
think it is great.
Then what about the drug companies? Well, it is a windfall for them
because there is no competition. There is no price controls. There is a
specific
[[Page H11511]]
provision in the bill that says that the Secretary of Health and Human
Services and the Medicare administrator cannot negotiate price
reductions. We do it for the Veterans' Administration. We do it for the
Department of Defense for our military. But we are not allowed to do it
under this bill because the drug companies want a windfall.
Well, all that I have been saying and all the Democrats have been
saying is if you really believe that HMOs and private plans can compete
with the traditional Medicare, then why not just have pure competition?
Do not give them all this money. Do not give the HMOs all this money,
the insurance companies all this money. Do not give the windfall and
prohibit the Secretary of Health and Human Services from negotiating
prices. Have real competition. Say that the private plans have to
really compete with the private plans and do not get any additional
money. Or, in the case of the drug companies, have the Medicare
administrator essentially negotiate through competition price
reductions. That is what negotiation is all about. It is a form of
competition. Do not say that they do not have the power to negotiate.
The one thing I want to say, and then I will yield to my colleague
from Massachusetts, I listened to what the gentleman from Indiana (Mr.
Burton) said and he talked about reimportation. Reimportation is a form
of competition. If you say that Canadian drugs can come in here, you
are creating a form of free-market competition with the companies here
that want to charge the higher prices.
But, no, we cannot have competition, we cannot have free market, we
have to prohibit the Canadian drugs from coming in here. This bill is
not competition. This is a windfall for the HMOs. This is a giveaway to
the drug companies and the insurance companies.
And I want to yield to my colleague from Massachusetts because he
wants to talk about the date.
Mr. DELAHUNT. Mr. Speaker, I want to pose a question to the gentleman
from New Jersey (Mr. Pallone) and then restate the question that I was
going to ask to the gentleman from Indiana (Mr. Burton).
I think it is important that the seniors in this country who happen
to be viewing us tonight understand that next year, when they go to
their local pharmacist and present their Medicare card, will they get a
drug benefit under this particular proposal?
Mr. PALLONE. Reclaiming my time, Mr. Speaker, they will get nothing.
They will get nothing, because under the Republican proposal, and I
think it is very important that you mentioned it, this plan does not go
into effect until the year 2006.
Mr. DELAHUNT. Mr. Speaker, if the gentleman will continue to yield to
me, seniors better live to 2006. They do not want to get sick in 2003
or 2004 or 2005.
Now, I look at my two colleagues from the other side of the aisle,
and I think we can all agree that next year, 2004, happens to be an
election year. Is that an accurate statement?
Mr. PALLONE. Absolutely, for President, Senate, and House.
Mr. DELAHUNT. If the gentleman will continue to yield, the gentleman
from Minnesota (Mr. Gutknecht) and the gentleman from Indiana (Mr.
Burton) are both here, so let me just emphasize this. One of the great
bipartisan efforts that this House has witnessed since I have served in
this Congress is under the leadership of both of those gentlemen, along
with yourself, the gentleman from Illinois (Mr. Emanuel), and other
Democrats when we got through this Chamber against the forces of the
pharmaceutical industry. And it was a shock for everyone, the right of
Americans to reimport drugs from Canada. And so they deserve credit
along with those who worked very hard to get it accomplished.
But can the gentleman from Indiana (Mr. Burton) tell me, is there
anything in this bill that will be coming to the floor this week that
allows for reimportation? And if it does, is it real and tangible,
something, as the gentleman from New Jersey indicates, which will allow
for real competition? Because you know and the gentleman from Minnesota
(Mr. Gutknecht) knows and the gentleman from New Jersey (Mr. Pallone)
knows, they purchase their drugs significantly cheaper in Canada than
our folks do here.
Mr. BURTON of Indiana. Mr. Speaker, if the gentleman from New Jersey
will yield, the language in the bill is essentially the same as it is
right now, and that is that the head of the health agency, HHS, all he
has to do is say there is a safety issue, which he has already said,
and there will be no reimportation.
Mr. DELAHUNT. So there is no reimportation under this bill. That is
important.
Mr. PALLONE. Mr. Speaker, I think the gentleman from Massachusetts is
making a very good point, which is essentially this bill is nothing but
an election-year gimmick. The bottom line is if they are really serious
about providing a prescription drug benefit, and I will grant I do not
like what they are suggesting, because I do not think it is a real
benefit, why are they not doing it now? Why are they not doing it in 6
months? Why are they not doing it in a year? They wait until 2006
because they do not have any intention of doing anything, and they are
hoping people do not find out until 2006 what a terrible bill this is.
As the gentleman from Indiana (Mr. Burton) said, even if you bought
into the idea we could wait until 2006, and I do not, why not let
reimportation take place in the meantime, so at least people can get
the cheaper drugs from Canada? But they are not going to do that
because they want the drug companies to have the windfall, and the drug
companies are against reimportation.
Mr. DELAHUNT. Mr. Speaker, if the gentleman will yield for a moment,
what is happening here is competition is being precluded by this bill
and huge amounts of dollars, tens of billions of dollars, are being
given to the pharmaceutical industry. That is what this bill is about.
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