[Congressional Record Volume 149, Number 170 (Friday, November 21, 2003)]
[House]
[Pages H12107-H12113]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
PROVIDING FOR CONSIDERATION OF MOTIONS TO SUSPEND THE RULES
Mr. SESSIONS. Mr. Speaker, by direction of the Committee on Rules, I
call up House Resolution 456 and ask for its immediate consideration.
The Clerk read the resolution, as follows:
H. Res. 456
Resolved, That it shall be in order at any time on the
legislative day of Friday, November 21, 2003, for the Speaker
to entertain motions that the House suspend the rules. The
Speaker or his designee shall consult with the Minority
Leader or her designee on the designation of any matter for
consideration pursuant to this resolution.
{time} 0915
The SPEAKER pro tempore (Mr. Simpson). The gentleman from Texas (Mr.
Sessions) is recognized for 1 hour.
Mr. SESSIONS. Mr. Speaker, for the purpose of debate only, I yield
the customary 30 minutes to the gentleman from Massachusetts (Mr.
McGovern), pending which I yield myself such time as I may consume.
During consideration of this resolution, all time yielded is for the
purpose of debate only.
Mr. Speaker, this rule provides for suspensions that will be in order
at any time on the legislative day of Friday, November 21, 2003. It
also provides that the Speaker or his designee will consult with the
minority leader or her designee on any suspension considered under the
rule.
Mr. Speaker, as I noted yesterday, the Republican leadership of this
House has set out on an aggressive legislative plan for this week on
behalf of the American people. The goal of this plan is to pass a
number of bills over the next few days which will dramatically improve
the quality of life for all Americans.
This week we have already succeeded in passing an energy conference
report that will bring our Nation's outdated energy policy into the
21st century through comprehensive legislation that promotes
conservation, reduces America's growing dependence on foreign oil, and
creates new jobs and cleaner skies.
Today we will consider legislation to make sure that America uses
best practices technology and procedures to prevent tragic wildfires,
like the ones that California just suffered through, from ravaging our
Nation's forests. This important bipartisan legislation takes a healthy
step forward in providing a better approach to addressing the problems
that have to date prevented the proper management of forest health on
private forest land.
This bill creates new programs to detect and suppress dangerous
forest pests. It also creates two new programs which help family forest
owners to manage their forests, protect watersheds, and help to protect
wildlife on private lands. Both of these programs use a nonregulatory,
incentive-based approach to promote conservation, rather than a top-
down, one-size-fits-all regulatory approach.
For the balance of the week, we are slated to consider legislation
to, among other things:
Number one, to authorize spending levels for the intelligence
activities we need to win the war.
Number two, to reform Medicare to make sure that more of our seniors
have the prescription drug coverage that they need while giving them
much more and more choices for their health
[[Page H12108]]
care coverage, and also to allow all Americans to begin planning for
their health needs through savings accounts that can be purchased, can
grow, and can be used on a tax free basis.
Number three, and to provide for a uniform national credit reporting
system that ensures that consumers are protected from identity theft
while giving them access to the fast and reliable credit that makes our
economy the envy of the world.
I understand that Members on either side of the aisle may have
different views about how to address each of these issues that I have
talked about, but we will have an opportunity to hear a great deal of
debate from both sides over the next few days on each one of these
issues, and so many other things. However, a great deal of the
legislation that the Republican House leadership has also scheduled on
behalf of all Americans has broad support from both the majority and
the minority, and in an attempt to make sure that this important work
is finished by the end of this legislative week as well, we are here
today to pass a rule to provide for the consideration of those bills.
Mr. Speaker, this balanced rule provides the minority with the
ability to consult with the Speaker on any suspension that is offered,
ensuring that their input and views are duly considered before any
legislation considered under this rule is brought to the floor.
Mr. Speaker, I encourage my colleagues on both sides of the aisle to
support this uncontroversial and balanced rule which passed yesterday
by a voice vote.
Mr. Speaker, I reserve the balance of my time.
Mr. McGOVERN. Mr. Speaker, I thank the gentleman from Texas for
yielding me 30 minutes, and I yield myself such time as I may consume.
Mr. Speaker, we have no objection to this rule which would allow for
this House to consider suspension bills today. We are not going to ask
for a vote. There is no controversy over this and there is no reason to
debate this. But I do want to just take a couple of minutes to alert my
colleagues to something that I think is quite serious, and that is the
fact that we probably some time today will consider the so-called
Medicare prescription drug bill.
Mr. Speaker, this bill, if I understand correctly, was filed at about
1:20 a.m. this morning and under House rules, Mr. Speaker, all Members
of this House, Democrats and Republicans, are supposed to have 3 days,
3 days to review any conference report so they can actually read what
is in it so that they will know what, in fact, that they are voting on.
It is obvious, as has been the case so many times over and over, that
the Republican majority is choosing to ignore the rules of this House
and it is particularly disturbing that they have chosen to do so once
again with regard to a bill that I think is so very important.
This is a bill, in my opinion, that is going to end Medicare as we
know it. It is going to privatize Medicare and is not going to provide
our senior citizens with the prescription drug benefits that they
expect. But yet we are rushing it to the floor with very little
consideration and with almost no opportunity for Members to know what
is in it.
Mr. Speaker, let me read today the lead paragraph in an editorial
that appeared in today's Washington Post. ``Before we say anything else
about the Medicare bill that the House-Senate conference committee
approved yesterday, it is important to point out that the process by
which this bill was created hardly reflects well on our political
culture. This is an extremely expensive, 1,100-page bill that will have
a profound effect on the Nation's fiscal and physical health and
although it was not finished until yesterday afternoon after several
months of a largely secret conference, last night House leaders were
planning to bring it up for a vote tomorrow. If they do, most Members
will have no real idea of what they are voting for or against.''
Now, my colleagues on the other side will say, gee, we are coming up
to Thanksgiving and we all need to go home and we need to get
everything done before Thanksgiving. Well, most Americans have a couple
of days off at Thanksgiving and then they go back to work the following
week. There is no reason why this House cannot go to work the following
week and do the people's business and do it right.
One of the problems with not being able to read bills before they
come to the floor is that oftentimes days later, weeks later, sometimes
months later we find out that there are little goodies, special
interest provisions that are hidden in these bills that are very
expensive, that help one particular special interest, but do great harm
to the American people.
Mr. Speaker, I do not want anyone to have an excuse that they do not
know what is in this bill. And there are people on the other side of
the aisle who also had requested early on that we have at least 3 days
to review this important piece of legislation. I think it is
unfortunate that we are moving today on a very important piece of
legislation, a bill, as I said before, that in my mind undermines one
of the most important and successful social programs in the history of
this country, and is being rushed to the floor without giving Members
or their staff the opportunity to read the bill or to go home and check
with their constituents.
In case my colleagues forgot, constituents are the people who elect
us. We are supposed to be serving constituents who have elected us to
this high office, and I think we are doing a great disservice to those
by allowing this Medicare bill to come to the floor without at least
respecting the rules.
Mr. Speaker, let me finally say if my Republican colleagues want to
continue to waive these rules and not report rules, why do they not
just repeal all the rules? There is no sense to have rules of this
House if they are not going to follow them.
Mr. Speaker, I reserve the balance of my time.
Mr. SESSIONS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, the gentleman from Massachusetts (Mr. McGovern) is
exactly correct. We are going to this morning, in about 35 minutes,
walk upstairs here in the Capitol. We are going to go to the Committee
on Rules. Our young chairman, the gentleman from California (David
Dreier), will open up the meeting where we will be open for debate and
I am sure controversy. But most of all, it will be part of the process
that has been something that the Committee on Rules in this House has
done for a long time, and that is follow through with the process to
make sure that people at 10 o'clock Eastern time in Washington, D.C.,
and Members of Congress have a chance to walk upstairs and to talk
about this bill and to present their ideas and to talk about what this
conference report is all about.
Obviously, this conference report is debatable. It is nonamendable.
It will be an up-or-down vote. This is part of a process that has taken
place where Members of this great body, with our colleagues on the
other side of the Capitol, the Senate, got together, worked through
problems. But I think that if we were trying to wait until today, as my
colleague from Massachusetts would suggest, to find out what people
want back home, I think we have made a terrible mistake. I think
Members on this side of the aisle have already gone home and listened
to people. That is what this is about, to be a body that has heard
people. And we have passed not only this legislation as a result also
of consultation back home, but even last January when we handled the
budget we talked about what we thought this bill would look like. And,
of course, our colleagues on the other side of the aisle, said there is
no way that we could do that. We just would never pull that off.
Well, Mr. Speaker, today it looks like we have. And I would like to
describe a little of what we pulled off. We will hear the details at 10
o'clock upstairs, but those details essentially include competition in
the area of health care. This competition that we are talking about,
which will be debated up in the Committee on Rules, is about allowing
families back home, including people who may not be in Medicare yet, to
begin saving for their future. We are going to have something that is
called health savings accounts that were previously known as MSAs.
These health savings accounts are going to allow people to save on a
pre-tax basis and then save this money on a tax-free basis and then
spend it in health care on a tax-free basis.
[[Page H12109]]
Why is this important? This is important because over the lifetime of
a person and their family they will be able to prepare with this money
for what their needs are going to be for health care. Why is that
important? That is important to our Nation because a consumer that has
money in their pockets can make wiser decisions, rather than showing up
in a system like Medicare where many times they cannot even find where
their doctor accepts Medicare.
This will change health care for this country as we continue on a
moving-forward basis. It empowers people. We think it is the right
thing. We think that is what people are asking for back home.
Mr. Speaker, on the prescription drug angle, no question in my mind,
the Washington Post is probably right. Oh, my gosh, this is an
expensive bill. But you know what? We did it in a way that will help
people who need the most help and I am proud of that.
So, Mr. Speaker, I know that my friends want to talk about all the
things that are going on up in the Committee on Rules here in just a
few minutes. I can assure them and the American public that what we are
all about is about process and doing the right thing for people back
home.
Mr. Speaker, I reserve the balance of my time.
{time} 0930
Mr. McGOVERN. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I appreciate the gentleman from Texas' comments, but he
missed the whole point of what I was trying to say. On substance, we
will debate that later.
This bill is a lousy bill. It privatizes Medicare. It does not
provide our seniors with a prescription drug benefit that they believe
they are going to get, and that they expect and deserve. This is a
lousy bill.
But what I was talking about was the process. We will talk about the
substance later. This process stinks, and the bottom line is that you
and the majority continually ignore the rules of this House or waive
the rules of this House.
The rules are that when you file a conference report, you are
supposed to have 3 days to review it. This was filed, this important
historical legislation that you talk about, was filed at 1:20 a.m. in
the morning. All right. I do not know whether you read the whole thing,
but I am going to tell you, most Members on both sides did not.
Let me read you a letter that was sent to the gentleman from Illinois
(Speaker Hastert); to the gentleman from Texas (Mr. Delay), the
majority leader; and to the majority whip, the gentleman from Missouri
(Mr. Blunt).
Dear gentleman: We write to request that if the conferees
on the Medicare Prescription Drug and Modernization Act of
2003 report to the House a conference report, that copies of
the text of the conference report, the text of the
explanatory statement and the text of the Congressional
Budget Office cost estimate for the conference report be made
available to all Members at least 3 calendar days after
filing, excluding Saturdays, Sundays and legal holidays,
unless the House is in session on those days, and prior to
consideration of the conference report or to any measure
reported from the Committee on Rules providing for the
consideration of the conference report.
``The general public will evaluate not only what Congress does
regarding Medicare and prescription drugs, but the way in which it does
it. A bill proposing such substantive changes to its Medicare system
and costing an estimated $400 billion over the next decade deserves the
careful and thoughtful consideration of all Members.''
It goes on and on. I will include this letter for the Record, Mr.
Speaker.
October 29, 2003.
Hon. J. Dennis Hastert,
Speaker, House of Representatives, Washington, DC.
Hon. Roy Blunt,
Majority Whip, House of Representatives, Washington, DC.
Hon. Tom DeLay,
Majority Leader, House of Representatives, Washington, DC.
Dear Gentlemen: We write to request that if the Conferees
on the Medicare Prescription Drug and Modernization Act of
2003 report to the House a Conference Report, copies of the
text of the Conference Report, the text of the explanatory
statement, and the text of Congressional Budget Office cost
estimate for the Conference report be made available to all
Members at least three calendar days after filing (excluding
Saturdays, Sundays, and legal holidays, unless the House is
in session on those days) and prior to consideration of the
Conference Report or to any measure reported from the
Committee on Rules providing for the consideration of the
Conference Report.
The general public will evaluate not only what Congress
does regarding Medicare and prescription drugs, but the way
in which it does it. A bill proposing such substantive
changes to the Medicare system and costing an estimated $400
billion over the next decade deserves the careful and
thoughtful consideration of all Members.
Allowing Members adequate time to properly evaluate the
Conference Report will avoid a needless and difficult
internal fight on the Rule, and allow Leadership to
concentrate its efforts on final passage of the Conference
Report. It will also lead to more public confidence in the
legislative process and greater acceptance of that process'
final product.
Therefore, while some of us are likely to support and
others to oppose the Conference Report on H.R. 1, each of us
strongly urges you to abide by regular order and provide at
least three calendar days for Members to review the
Conference Report and materials necessary to properly
evaluate the Conference Report.
Sincerely,
Mr. John Kline, Mr. C. Michael Burgess, Mr. Randy
Neugebauer, Mr. Johnny Isakson, Mr. Tom Tancredo, Mr.
Dave Weldon, Mr. Virgil H. Goode, Jr., Mr. Donald
Manzullo, Mr. Jim Ryun, Mr. Todd Akin, Mr. Gil
Gutknecht, Mr. Ernest J. Istook, Jr., Mr. Jeff Flake,
Mrs. Sue Myrick, Mr. Jeff Miller, Mr. Phil Crane, Mr.
Trent Franks, Mr. Mike Pence, Mrs. Marilyn Musgrave,
Mr. Pete Hoekstra, Mr. Joseph R. Pitts, Mr. Scott
Garrett, Mr. Tom Feeney, Mr. Kevin Brady, Mr. Roscoe
Bartlett, Mr. William ``Mac'' Thornberry, Mr. Tim
Murphy, Mr. Steve King, Mr. Ron Paul, Mr. Johnson
Boozman, Mr. John Culberson, Mr. J. Gresham Barrett,
Mr. John Carter, Mr. John N. Hostettler, Mr. Devin
Nunes, Mr. J. Randy Forbes, Mr. Mark E. Souder, Mr. Jim
DeMint, Mr. Mark Kennedy, Mr. Charlie Norwood, Mr.
Chris Chocola.
This was signed by 41 Republican Members of this House, and it is
clear by the fact that we are moving in the fashion that we are today
that not only do you not care that those of us on the Democrat side
feel it is important, but you do not even care what your Republican
Members think with regard to being able to read this bill.
So, Mr. Speaker, I would say to my colleague from Texas, what I am
complaining about right now is the process, and on a bill this
important, Members, staff and our constituents deserve to know what is
in this bill. Quite frankly, the sound bites and the press releases
from the leadership of this House, from the gentleman from California
(Mr. Thomas) and others, that does not cut it. We have been there, we
have done that before.
What we need to do is read the fine print to find out what other
special interest goodies are tucked in there for the pharmaceutical
industry or the HMOs.
Mr. Speaker, I yield 4 minutes to the gentleman from California (Mr.
George Miller)
Mr. GEORGE MILLER of California. Mr. Speaker, I thank the gentleman
for yielding me time. I think he makes a very important point.
We thought we had an agreement. In fact, we had the word of the
Speaker of the House there would be a 3-day layover period for this
legislation so Members and interested parties could read this
legislation to discover exactly what is in it.
The Republicans make a great deal out of the fact that this bill will
provide for competition. We know it will not provide for price
competition on pharmaceuticals, because it specifically prohibits price
competition. It does not let the Secretary of Health and Human Services
negotiate lower prices, lower costs, for senior citizens in the
Medicare program.
But, interestingly enough, Mr. Speaker, and maybe every Member of
Congress will want to read the bill very closely, the gentleman on the
other side says what we do here is we promote competition. We are going
to put in place private health plans that are going to compete with
Medicare, and people are going to get better services, more services,
at a lower cost.
Now, that is an interesting notion of competition. I don't know where
the free market is, but they decided now in this bill that they are
going to have to give these plans almost a 30 percent increase, more
than they pay for Medicare, to try to make these plans run. But this
competition is such a good idea, and it is pushed by the Republicans.
The victims are going to be the
[[Page H12110]]
senior citizens, but the Republicans are saying this competition is a
great idea.
Well, I want to tell my Republican friends in the House who have not
read the bill, pick up the Wall Street Journal today. See what your
Senators have done. This is a great bill for competition. It is so
good, it is so good, that Senator Gordon Smith of Oregon, Senator Kyl
of Arizona, Senator Specter, and there is one other Senator whose name
I cannot pick out of the story here, have decided it is so good, they
have excluded their areas in their States from the competition.
They say, ``Oh, no, you are not going to do this in my area. You are
not going to do this with my senior citizens.'' The Senators apparently
are a little closer to the process here, and they have read the bill.
They said, ``You know, we had one of these demonstrations a number of
years ago, and it blew up in our face, both in terms of cost and in
terms of services to the senior citizens.''
So, Senators, you know how they make their deals over there; we
cannot do this over here because of the Committee on Rules, they got in
there in the last minute and said, ``Exclude my area in Pennsylvania,
exclude my area in Arizona, exclude my area in Oregon. I am not having
any of this competition for my senior citizens. Just those lucky-
duckies over there in the House that have one of these competition
plans lands on their congressional district. Then we will see how it
goes.''
That is why you want to read the bill. That is why you want to be
able to have a 3-day layover period to protect the rights of every
Member of this House and the constituents and the people that they
represent in their congressional districts.
But the arrogance of this leadership, the arrogance of the Speaker,
the arrogance of the Committee on Rules just constantly suggests that
democracy means very little to them; the rights of each and every
Member mean very little to them. They now have the power, the
Republicans have the power, and, with that power, slowly has come
arrogance. And they have decided that there is no reason for debate;
there is no reason for us to be able to try to tell the American people
what is in this bill before we vote on it so maybe they can
participate.
They want to run the Congress like AARP runs their organization; one
person at the top makes a decision, and 30 million people out there are
put in jeopardy. That is not the democratic process. That is not the
democratic process.
I cannot wait to see the Constitution you guys want to write in Iraq.
If this is what you are doing to the People's House on the most
important piece of social legislation in this country, you want to shut
down debate, you do not want to give people time to read it.
If you cannot read the bill, my colleagues in the House, read the
Wall Street Journal. Read the Wall Street Journal, because maybe you,
too, can scramble up to the Committee on Rules in the next hour and get
an exemption from competition like those wonderful, powerful Senators
have done. Do not read the bill, read the Wall Street Journal.
announcement by the speaker pro tempore
The SPEAKER pro tempore (Mr. Simpson). The Chair would remind all
Members that they should refrain from improper references to Senators.
Mr. GEORGE MILLER of California. Mr. Speaker, I do not know how to
identify them if I do not identify them by name.
The SPEAKER pro tempore. The Chair would remind all Members they
should refrain from identifying individual Senators by name.
Mr. SESSIONS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, this competition angle is an important part of what this
Medicare bill will be. You see, we Members of Congress that
occasionally go home who are aware of the things that happen at home in
the real marketplace, some of those things that are very exciting in
the world of competition are happening in health care. They are
happening all across this country.
Sometimes when you go home and you open up a newspaper, or you watch
on TV and they talk about LASIK eye surgery. LASIK eye surgery used to
be $1,200 an eye. Due to competition, due to machines, due to
procedures now becoming available, they are $299 an eye. That means
that as a result of competition, as a result of physicians, medical
doctors, learning how to do these procedures, we have sent these
teachers all across the country, and they have perfected this
technique. That is an example of where competition does work. Over 1
year these surgeries have gone from over $1,200 to $299 an eye. We
think competition will be a huge part of the success of this Medicare
bill.
But let us go back to the process. The process is that this has been
debated not only in the public and in newspapers and TV and on this
House floor since January, or before, when many of our colleagues on
the other side were saying, where is that prescription drug bill? Where
is that prescription drug bill?
Mr. Speaker, we now have it on the floor of the House of
Representatives. It will be in the Committee on Rules today and on this
floor very quickly. It will be something that has, by popular demand,
been asked for, and it comes as a result of these two bodies, the House
and the Senate, working through very difficult negotiations.
It is a process that has been followed, it is a process that works,
it is a process that I think has allowed people for a long time to know
the answer as to what is in this bill, so much so that the Democrat
leadership has already blasted the AARP a week ago for supporting the
bill because they knew what was in the bill.
So I think it is a misnomer to think that we just do not know or do
not understand. People who wish to know, people who wish to be a part
of this bill could gain the information. I am proud of what we are
doing today. The gentleman from California (Chairman Dreier) will open
up the Committee on Rules in about 20 minutes, and the debate there
will start.
But, let us not forget, this is not about amending a bill. This is a
conference report. This is not like one Member in this body can change
one word that is in this document, because that is not our process or
procedure. It will be an up-or-down vote. It will be based upon what a
Member thinks is the right thing to do. I trust their judgment.
Mr. Speaker, I reserve the balance of my time.
Mr. McGOVERN. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, the gentleman from Texas keeps on talking about the
Committee on Rules and the action we are about to take, as if something
important is going to happen.
What is going to happen in the Committee on Rules is we are going to
waive all the rules. We are going to waive the rule that says Members
have a right to read this bill. So I guess it is historic in the fact
that once again we are going to trample on the rights of Members of
both parties.
I should say to the gentleman from Texas, it is not just Democrats
that are complaining about the need to read the bill. I just cited to
him a letter that was signed by 41 of some of the most conservative
Republicans in this House who said, we should read the bill. One of the
reasons why, I suspect, is if you read the Washington Post today, there
is a headline, ``Drug Makers Protect Their Turf.'' I will insert this
article in the Record.
[From the Washington Post, Nov. 21, 2003]
Drugmakers Protect Their Turf
medicare bill represents success for pharmaceutical lobby
(By Ceci Connolly)
No industry in negotiations over the $400 billion Medicare
prescription drug bill headed to the House floor today
outpaced the pharmaceutical lobby in securing a favorable
program design and defeating proposals most likely to cut
into its profits, according to analysts in and out of the
industry.
If the legislation passes as Republican leaders predict, it
will generate millions of new customers who currently lack
drug coverage. At the same time, drug-manufacturing lobbyists
overcame efforts to legalize the importation of lower-cost
medicines from Canada and Europe and instead inserted
language that explicitly prohibits the federal government
from negotiating prices on behalf of Medicare recipients.
``It couldn't be clearer there is going to be a positive
effect overall,'' said Dan Mendelson, president of Health
Strategies Consultancy, which bills itself as a think tank
and consulting firm. ``The volume will definitely go up.
There will be a lot of people who didn't have coverage before
who will have it now and a lot of people getting an upgrade
in terms of coverage.''
Democrats and consumer advocates complain that the
Republican-crafted compromise does little to contain soaring
drug
[[Page H12111]]
costs. They say that by handing the Medicare drug program's
administration to private insurers, Congress missed a chance
to exert pressure on pharmaceutical companies to reduce
prices.
But Republicans and some industry analysts say that
adopting a drug-purchasing mechanism similar to those in
corporate health plans is the best way to extract discounts
from drugmakers.
If Medicare negotiated on behalf of its 40 million
beneficiaries, ``I wouldn't be negotiating; I'd just be
fixing the price,'' said Thomas Scully, the program's
administrator. ``Let's get seniors organized into big
purchasing pools and get bulk discounts and see how they
fare.''
Representatives of the industry's main lobbying arm, the
Pharmaceutical Research and Manufacturers of America (PhRMA),
declined yesterday to discuss the legislation. But the
clearest indication that the bill offers a brighter future
for the industry came from Wall Street, where pharmaceutical
stock prices have steadily risen over the past week as the
legislation's prospects for passage improved. Analysts at
Goldman Sachs & Co. project the new Medicare benefit could
increase industry revenue by 9 percent, or about $13 billion
a year.
After objecting for years to proposals to add prescription
drug coverage to Medicare, the pharmaceutical lobby recently
shifted positions and poured enormous resources into shaping
the legislation. Since the 2000 election cycle, the industry
has contributed $60 million in political donations and
spent $37.7 million in lobbying in the first six months of
this year.
The lobbying continued in earnest this week with a
television and print advertising campaign urging passage of
the bill. In one series of witty commercials sponsored by the
industry-backed Alliance to Improve Medicare, elderly
citizens look into the camera and demand: ``When ya gonna get
it done?''
One Republican with ties to the industry said drugmakers
eluded the three things they feared most: legalized
importation of lower-cost medicines, many of them patented or
made in the United States; government price controls; and
easier market access for generic drugs that cost considerably
less than brand-name drugs. ``In their view, by improving
access for all seniors, we will ameliorate any pressure on
the industry toward price controls or reimportation,'' the
source said.
About 24 percent of Medicare beneficiaries--nearly 10
million senior citizens--do not have any prescription
benefits. some of them buy medicine at the highest retail
prices. Academic studies and anecdotal evidence suggest,
however, they many go without prescription medicines and
would become new customers for drugmakers if the bill becomes
law. The remaining 30 million Medicare recipients but some
supplemental drug coverage, according to the most recent
government figures.
Even those with some drug coverage are expected to spend
more with the new benefit, said Fredric E. Russell, whose
investment management company owns several drug stocks.
Whenever a new health benefit is offered, he said, patients
and doctors jump at the chance to take advantage of it.
Under the bill, beginning in 2006, all Medicare
beneficiaries would have the option of buying a drug plan for
about $35 a month, plus a $275 annual deductible. Insurance
companies and pharmacy benefit managers (PBMs) would
administer the programs for the government.
The great unknown is what sort of prices those insurers
will ultimately negotiate on behalf of their Medicare
clients, said Kristine Bryan, senior health care analyst at
Brown Brothers Harriman & Co. ``Generally, when you have a
large purchaser, you have the ability to demand better
pricing,'' she said.
Republican congressional staffers also point out that
because the bill waives a requirement that state Medicaid
programs receive the ``best price'' available, the new
private insurers could save Medicare $18 billion. It would,
however, likely increase states' drug costs.
Many Democrats say private purchases have not been as
successful at bargaining as have government programs such as
the Veterans Administration and Medicaid, which secure some
of the steepest drug discounts available.
``We've been going through PBMs for 10 years and nothing's
happened except the price of drugs has gone up,'' said
Democratic presidential candidate Howard Dean, a physician.
Perhaps the most striking political victory for the
pharmaceutical industry was the decision to reject provisions
that would have allowed Americans to legally import drugs
from Canada and Europe, where medications retail for as much
as 75 percent less than in the United States. Polls show that
an overwhelming majority supports the change, and the House
approved the provision, 243 to 186. But the Bush
administration and pharmaceutical lobby said the move was
dangerous and would cut into future research and development.
The provision was dropped from the bill's final version.
{time} 0945
Mr. Speaker, it talks about all the special sweetheart deals that are
in this bill for the pharmaceutical industry. I do not know whether the
gentleman was aware of all these little deals that were cut. I
suspected they were there, but now I want to find out who is getting
what and how much. I want to connect all the dots here. That is why we
want to read the bill.
So, again, what we are saying here is not anything radical, quite
frankly. We are saying follow the House rules. We have rules of this
House. If you do not want to follow the House rules, if you keep on
ignoring them, then do away with the rules. Do not have any rules. But
we do have rules to protect not only the rights of the minority, but
your Members, so they know what you are voting on.
Mr. Speaker, I yield 4 minutes to the gentleman from Oregon (Mr.
DeFazio).
Mr. DeFAZIO. Mr. Speaker, I thank the gentleman for yielding me time.
Mr. Speaker, 14,345 days. That is how long it has been since Medicare
was enacted, the most important social program to lift seniors out of
poverty in the history of the United States.
I worked with seniors, ran a senior citizen program, studied in the
field of gerontology. Before Medicare, we had double the rate of
poverty among seniors because they were driven there because of the
cost of medical care.
Medicare has been a tremendous benefit to our seniors. It was opposed
by the Republicans, it was opposed by the AMA, it was opposed by the
nursing homes and all of them. Now, of course, they are the greatest
supporters of the program because of the reimbursement and the business
it provides.
But now we are about to make the most important changes in the
13,435-day history of Medicare, and we cannot have 1 day. We are not to
be allowed 1 day to read a 791-page bill, which, to the best of my
knowledge, and the gentleman can correct me on his own time if this is
wrong, is not available in printed form. Some people like to read 791
pages on a computer screen. I do not. I think there are a lot of other
Members of this Congress and the public who would like to actually have
a printed copy in their hand to be able to flip back and forth easily
and understand what this bill really does. But we are not going to have
printed copies, or perhaps we will at some point when the debate
begins. But even with speed reading, that is going to be tough.
So a 791-page, unbelievably complicated bill making extraordinary
changes in a program which we have had for 39 years, and we cannot take
24 hours, or even, as the rules would provide, 72 hours to read it.
What would be the harm in voting on Monday? Let it sit over the
weekend. Let everybody have a chance to read it. I would be willing to
stay over the weekend, work through the weekend, get through the other
work and vote on this bill on Monday.
The gentleman talks about competition in the marketplace. This is a
bizarre bazaar of a marketplace, because this is more like a souk,
where there are all these back-room deals, and you do not know what is
going on.
Competition? Well, it has subsidies for the private health insurance
industry, HMOs, who still continue to enjoy an antitrust exemption, so
there will be no requirement that they offer these plans; there will be
no requirement that they guarantee seniors coverage beyond a 1-year
basis; and there will be no requirement for them to take seniors who
are not good risks or keep seniors after they make a claim. As many of
my constituents know, as soon as you claim against an insurance company
these days, they tell you are going to be terminated when your
renewable comes up. That is what is going to happen to seniors in these
private plans.
Then we have protectionism. The party of free trade, free trade over
here, the Republicans are trading our jobs to China and all these other
places, this bill is protectionist. It is not going to allow Americans
to reimport FDA-approved, U.S.-manufactured drugs from Canada or any of
the other developed industrial nations who bargain on behalf of their
citizens and get huge price reductions. So Americans are going to have
the door slammed on the one place they can get less expensive drugs.
And none of the benefits under the bill, even at the cost of $400
billion, will reach the simple benefit that my constituents can get by
importing FDA-approved, U.S.-manufactured drugs from Canada.
So we are going to spend $400 billion, create this unbelievable Rube
Goldberg, and the benefit for every one of
[[Page H12112]]
my constituents will be less than they can get today by buying from
Canada, and we are going to slam that door with this bill. So they are
not going to have that opportunity any more. They are going to be
forced to buy drugs at higher prices, even with the so-called coverage
under this bill. That is price fixing.
So we have a bill that has protectionism, price fixing, subsidies for
the HMOs, the insurance industry is exempt from antitrust laws, and the
gentleman says somehow this is the marketplace of competition.
What a bizarre view of a true, free and competitive marketplace. We
could more simply allow these Medicare constituents to have a
negotiated price for the reduction of their drugs, as we do for VA, but
the industry is opposed to that because there would be too much market
force, too much market clout on the part of the government in those
negotiations, and allow the continued, safe reimportation of drugs from
Canada.
And there is a big red herring here. The administration says FDA-
approved, U.S.-manufactured drugs reimported from Canada are not safe,
they cannot guarantee their safety, except we know that the drug
custody chain in the United States of America is much more compromised
than in Canada.
Canada first negotiates about a 50 percent reduction in prices,
licenses the importers, licenses everybody, and tracks all the people
who touch the drugs. In the U.S., the pharmaceutical companies dump
huge amounts of drugs into an unregulated secondary market that is
licensed by the States, into these phony closed-door pharmacies, and
organized crime is involved in getting counterfeit drugs into the
system here in the United States.
There is a huge breach of the integrity and safety of the system here
in the United States, which there is no concern about because the
industry is making money by having that system, but we are going to
say, oh, those Canadian drugs, they are not safe. They are safer, in
all probability. There have been no instances proven in Canada, unlike
the United States, of organized crime getting counterfeit drugs into
the system.
Mr. Speaker, we could do something simpler and cheaper if we defeat
this bill.
Mr. SESSIONS. Mr. Speaker, I have the honor and privilege to yield 4
minutes to the gentleman from Florida (Mr. Foley), a young man who
serves on the Committee on Ways and Means.
Mr. FOLEY. Mr. Speaker, I thank the gentleman for bringing the rule
to the floor and for yielding me time.
Mr. Speaker, there is a commercial on these days that has a catch
line, and it says, ``What is in your wallet?'' Well, I ask Members of
Congress to ask themselves that very question, what is in your wallet?
I will tell you what is in mine. It is a card that I get as a Member
of Congress. It says BlueCross BlueShield Federal Employee Program. It
is a PPO. It has a prescription drug benefit attached to it, a $35
copayment. Certain attributes of this plan work for Members of this
Congress.
In my congressional district I have the fifth largest Medicare-
eligible population of 435 Members of this body, the fifth largest
Medicare-eligible population. When I go home to my town hall meetings,
they say, ``I want what you have. I want choice. I want opportunity.''
Interestingly enough, they do not say, ``I want it all, and I want it
free.'' They want fairness, because they want the system to continue.
The harangues on this floor the last couple days are amazing. We have
heard repeatedly, speaker after speaker, ``We haven't seen this bill;
we haven't read this bill.'' But we have spent hours of time talking
about what is bad about what is in this bill, so either they have not
seen the bill, or they are just guessing what must be in the final work
product.
For 4 years I have been on this committee, and I have met over on the
other side of the Chamber with the respected Senator Bob Graham,
Senator Harry Reid, at that time Senator Chuck Robb and a number of
Members of the Senate as we tried to work out an opportunity to find a
prescription drug plan that would suit the test of time and be
financially equivalent, if you will.
In our bill there is a wellness provision which allows us to do
diagnostic testing for cardiovascular disease, allows us to test for
diabetes early, before the onset of these diseases. There is, in fact,
a drug discount card that will be offered to those lower-income
individuals who need assistance. That drug discount card will have,
much like an ATM, $600 of purchasing power so they will have an
opportunity to buy the vital drugs they need.
Many people on the other side of the aisle decided politically to
sign the AARP pledge. If you read the pledge, it says all Medicare
beneficiaries will have access to a stable prescription drug benefit on
a voluntary basis. Not forced, not coerced, not mandatory. Affordable
prices will be the rule, not the exception. We are trying to do that.
To those who suggest just reimport drugs from Canada, let me ask the
basic question; read the articles in Florida in the newspapers where
there have been numerous arrests because of counterfeit drugs coming
from Canada.
Reasonable premiums, deductibles and copayments. Those are in the
bill. Prescription coverage will leave no individual with extraordinary
out-of-pocket costs. There is a catastrophic provision written into
this legislation. Reduction in soaring drug costs will keep the program
affordable. Extra help for low-income individuals. Help for rural
communities that I represent with their hospitals, their ambulances,
their doctors. We talk about a number of things in the bill that I
think provide relief for every American. Increased fees, if you will,
for physicians, increased index for the hospital what we call the
market basket.
So if you look at the Medicare bill, yes, there may be problems for
some. But AARP, which was, up until last week, described as the ``gold
standard'' of senior lobbying organizations, has decided to take this
first step with us.
Will this be a perfect vehicle? No. No legislation I have ever worked
on in this process has ever been perfect. We have had to come back,
work it, amend it, and deal with some of the consequences. And if we
fail to make this critical step and pass this rule and pass this
legislation, we will have surrendered our ability to bring seniors a
necessary improvement to the Medicare health delivery system that they
so vitally need.
So I urge my colleagues, support the rule and support the underlying
legislation. Let us do for seniors what Claude Pepper and Franklin
Delano Roosevelt tried to do to enhance their safety and security.
Announcement by the Speaker Pro Tempore
The SPEAKER pro tempore. The Chair would remind Members to refrain
from improper references to Senators.
Mr. McGOVERN. Mr. Speaker, I yield 30 seconds to the gentleman from
California (Mr. George Miller).
Mr. GEORGE MILLER of California. Mr. Speaker, the President stood in
the well and said he wanted the senior citizens to have a drug benefit
like Members of Congress have with this card. Under our prescription
drug benefit, the government pays 80 percent, we pay 20 percent. Under
this bill, of the first $5,000, the seniors pay 80 percent and the plan
pays 20 percent.
You guys have reversed the figures on the senior citizens. Out of the
first $5,000, the seniors pay $4,200. Out of our first $5,000, the
government pays 80 percent. Somewhere between the President's speech
there and this bill, you lost 80 percent of the benefits for seniors.
Mr. SESSIONS. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, there was a statement that was made that I think we just
need to set the record straight on, and that is that this bill does not
talk about reimportation from Canada, where Congress makes a decision
on that issue. We allow the FDA to make that decision. It is not the
Congress that makes that decision.
Mr. Speaker, I reserve the balance of my time.
Mr. McGOVERN. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, let me just say to the gentleman from Texas, he knows
very well what is going on here. The administration already decided
they are not going to allow citizens to be able to get their drugs from
Canada, even though they are cheaper. They already made their decision.
What we have in this bill basically is to protect the status quo,
which means
[[Page H12113]]
our senior citizens get gouged and gouged and gouged and gouged.
Mr. Speaker, I yield 3 minutes to the distinguished gentleman from
Florida (Mr. Hastings), my colleague on the Committee on Rules.
Mr. HASTINGS of Florida. Mr. Speaker, I thank my good friend from
Massachusetts for yielding me time.
Mr. Speaker, it is very difficult to not get involved in the
discussion that is ongoing. There is a great need for us to correct a
few things, and I hope that I can without exuding the passion that I
normally bring to debate.
I would borrow from an article in today's New York Times written by
Paul Krugman where he says, ``Let's step back a minute. This is a bill
with huge implications for the future of Medicare. It is also, at best,
highly controversial. One might therefore have expected an advocacy
group for retired Americans to take its time in responding, to make
sure that major groups of retirees won't actually be hurt, and to poll
its members to be sure that they are well informed about what the bill
contains and do not object to it. Instead, AARP executives have thrown
their weight behind an effort to ram the bill through before
Thanksgiving. And, no, it is not urgent to get the bill passed so
retirees can get immediate relief. The plan won't kick in until 2006 in
any case, so no harm will be done if the Nation takes some time to
consider.''
What we have asked for here is 3 days. That is a part of the Rules of
this House of Representatives, and every Member of this body,
particularly those of us on the Committee on Rules, know that to be
true. Despite my Democratic colleagues' best efforts to make this an
inclusive and comprehensive process, one that addresses the real
concerns of all of America's seniors and disabled, we were shut out
from negotiations. We were shut out in June, and we are shut out now.
What we have before us, plain and simple, is an evisceration of
Medicare. This bill was filed at 1:30 a.m. this morning. There is an
axiom that says, ``He who makes the rules, rules.'' All of us in the
minority know that the majority rules. We should, however, in this
great country be exemplars of fairness, lest we be perceived as fools
making rules. If we cannot be fair, who can? And it is that this
process is wrong, and it is just that simple. It is not a question
about Medicare or anything, if we did this on the next bill, the forest
measure, if we did it on yesterday's bill. This is the first time in
the whole of this year that we have brought a bill in the daylight, and
my colleagues know that.
What we are doing here is critically important. I, for one, do not
want to go back to my district that joins the district of my good
friend the gentleman from Florida (Mr. Foley), where both of us have as
high as 34 percent seniors, and tell them that I sure did read this
information that is in this bill. Never mind about castigating anybody,
the fact of the matter is most Members of this body, all of them on
this side, have not read the present contents of the bill.
Yes, there were hearings; yes, there were opportunities for people to
talk through the years. I came here along with many of you 11 years
ago. We were talking about prescription drugs then. I read my
clippings. I was saying, ``I am going up there and try to get you
prescription drugs.'' The Democrats were in the majority, we did not
get it. The Republicans have been in the majority, and we have not
gotten it. And what we are getting ready to get is have this country in
turmoil because we are not protecting all of our seniors.
{time} 1000
Mr. SESSIONS. Mr. Speaker, I yield myself such time as I may consume.
The Committee on Rules begins testimony in 2 minutes. We came down to
the floor this morning to make sure that we were going to have the
ability to have a same-day rule. I am satisfied that we have broken
into a lot of other things to talk about this morning.
Mr. Speaker, I reserve the balance of my time.
Mr. McGOVERN. Mr. Speaker, I yield myself the balance of my time.
Let me just conclude by saying that on the substance of the bill that
we are talking about, the Medicare prescription drug bill, there is a
fundamental disagreement between me and some of my friends on the other
side of the aisle because to me protecting Medicare is nonnegotiable. I
think we are going down a very dangerous road here with this bill.
But what my frustration is at this particular moment is that we are
going down that road when most Members of this House have no idea
exactly what is in this bill. We get little bits and pieces and some of
what we are finding out, quite frankly, I think most Americans do not
like, little special interest deals for pharmaceutical companies, for
HMOs, a not-so-generous prescription drug benefit for senior citizens,
something that does not kick in for another 2 years. I think the
American people and the Members of this Congress deserve having all of
us go into this with our eyes wide open.
I read to you before, I say to my colleague from Texas, a letter
signed by 41 of some of the most conservative Republicans in this House
who asked your leadership, made one simple request of your leadership,
and that is that they respect the rules of this House and give them and
the entire House 3 days to review the contents of this bill. That is
not too much to ask for. I think people on both sides of the aisle,
even those who are going to support this bill, want to know exactly
what is in it. They do not.
The fact of the matter is we are about to go up to the Committee on
Rules, we are going to waive all the rules, disregard them once again
as has become a habit in this place, and I think it is sad, especially
on a bill this important. Our constituents deserve better.
Mr. Speaker, I would hope that maybe between the time the gentleman
from Texas and I leave the House floor to go up to the Committee on
Rules that there might be a change of mind and the leadership might
actually respect the rules of this House, but I doubt it. Having said
that, I think it is unfortunate. I think the losers are the American
people.
Mr. Speaker, I yield back the balance of my time.
Mr. SESSIONS. Mr. Speaker, I yield myself the balance of my time. I
thank the time that the Speaker has given us this morning to debate
this rule. I believe it is a fair rule. I have not heard much debate
about it.
Mr. Speaker, I yield back the balance of my time, and I move the
previous question on the resolution.
The previous question was ordered.
The resolution was agreed to.
A motion to reconsider was laid on the table.
____________________