[Congressional Record Volume 150, Number 46 (Monday, April 5, 2004)]
[Senate]
[Pages S3624-S3627]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MEDICARE PRESCRIPTION DRUG BENEFIT
Mr. FRIST. Mr. President, last night, I called my mother-in-law in
Fort Worth, TX, just to get her perspective on Medicare and health care
security for seniors, and to ask her what she, a long way from
Washington, DC, understood in terms of the important Medicare
legislation we passed on this floor in a bipartisan way--a Medicare
bill that was signed by the President of the United States on December
8, 4 months ago. We had a good conversation.
I asked a little bit in a personal way about her own experience with
buying prescription drugs. She, like most seniors who are having to buy
prescription drugs on their own--because, remember, until December of
this past year, 4 months ago, prescription drugs were outside of
Medicare. So many seniors are dependent on prescription drugs for a
whole range of illnesses, or to prevent illnesses, whether it is
arthritis, diabetes, heart disease, or cancer. Those prescription drugs
have been out of reach, or at least must be obtained outside of the
Medicare system but indeed no longer.
It was clear to me that there is a lot of confusion by what people
see in the press, what people see on television, comments that are made
by opponents to that legislation. So I want to take a few minutes to
comment on the importance of this legislation, but equally important,
on what this legislation is doing and can do and will do for
individuals with disabilities and seniors. I am speaking about 40
million people who will potentially be touched by this legislation we
passed 4 months ago.
The first point. Already, seniors are benefiting. The legislation was
signed December 8, and already seniors are benefiting because of the
new bill and the reforms in that bill. Health care plans are getting an
extra boost. As a result, seniors who are enrolled in Medicare health
plans, Medicare private health plans, are already receiving better
benefits at lower, what we call out-of-pocket costs. Already, these
seniors are receiving more benefits at lower out-of-pocket costs.
In fact, the Centers for Medicare and Medicaid Services--when you
hear CMMS, that means Centers for Medicare and Medicaid Services, which
is the Government organization, or entity, the center in charge of
managing and administering Medicare. They report that 3.7 million
seniors are already receiving increased benefits, just 4 months after
signing the bill, and 2 million have received lower cost sharing. That
means when they actually have a benefit delivered, they pay less for
that benefit; 1.9 million have seen their premiums go down; and it is
less than 4 months after the President signed the bill. That is, the
monthly premium seniors are paying has already gone down for 1.9
million seniors.
Let me share with you just one specific example. Aetna has eliminated
copayments for a whole broad range of preventive services. That
includes routine physical examinations. It is interesting; until this
Medicare legislation, routine physical examinations were not part of
Medicare. They eliminated copayments for routine physical exams; they
eliminated copayments for bone mass measurements; they eliminated
copayments for colorectal screening exams, prostate screening exams,
mammograms, pelvic exams, and for routine hearing and vision exams for
seniors enrolled in their Medicare Advantage plans.
Aetna has also slashed copayments for inpatient hospitalizations--
that is
[[Page S3625]]
when you are admitted to the hospital--by 50 percent. They added
coverage for generic drugs in every market and for brand-name drugs in
many of its larger markets.
In less than a month from now, seniors are going to also be able to
take advantage of a new Medicare-endorsed prescription drug discount
card. In less than 2 months, all Medicare beneficiaries, whether they
are enrolled in private plans or whether they are enrolled in the
traditional Medicare Program, are going to be able to use these
discount cards, endorsed by Medicare, in order to get a 10- to 25-
percent discount off the cost of their prescription drugs. These cards,
in 2 months, are going to be available. You will be able to take them
in, and however you are getting prescription drugs today, you will be
able to get an additional 10- to 25-percent discount.
There is even better news for those 8 million lower income seniors--
those who have the hardest time affording prescription drugs, or
additional costs of health care. They will be eligible for an
additional $600 in subsidies and assistance on top of the discount they
are going to get, that 10- to 25-percent discount. That is, again, 8
million lower income seniors who will have the discount card, 10- to
25-percent discount, but in addition will get $600 in value, subsidies,
to purchase prescription drugs. That is $600 in assistance they didn't
have before the President signed that bill on December 8 of last year.
At the end of April, in about 3, 3\1/2\ weeks, all Medicare
beneficiaries will be receiving a letter from the Secretary of Health
and Human Services, Tommy Thompson. In that letter, there will be a
four-page guide with information on this discount card.
When I talked to my mother-in-law last night, she said she faintly
heard about this card but didn't have too much information on that. I
told her in a few weeks this information will come to you in a letter.
Read that four-page guide. More detailed information will be available
from the Department of Health and Human Services. It will placed on the
Department of Health and Human Services Web site and, as most people
are beginning to hear, you can call 1-800-medicare and obtain even
further information. If you call that number, they will also send you a
32-page booklet called Guide to Choosing a Medicare-Approved Drug
Discount Card.
I mention all this now because people say they don't know very much
about the card, but I point out that information will be made available
on a timely basis so you will be able to understand what these cards
provide, what they don't provide, and also what is the best card for
you to choose given what drugs you may be on.
In fact, the Health and Human Services Web site will contain a
fantastic new analysis, or Web page, that is easy to use called Price
Compare. It is a price-compare tool that will allow seniors to choose
the drug card that is best for them and their individual needs by
offering a comparison of the cards available in that area for them. It
will be specific, where you can put on that Web page what drugs you are
on, and there will be a comparative analysis that is placed on the Web
site where you can say this card looks like it would benefit me better
than the other card, as well as a listing of all the cards available in
your area. This site will be live and up and running at the end of this
month, on April 29. It will have information as to how individuals with
their individual needs will be able to benefit. Actually, an individual
or specific pharmacies in one's community will be listed as well. So I
am looking forward to that site. It will be a fantastic new Web site.
Right now, seniors and their families can go to a Web site, if you
want to, www.medicare.gov. On the Web site you would look for a site
called ``Prescription Drugs and Other Assistance Programs.'' There is a
section on that Web site. There you can enter your ZIP Code, where you
live, and you can enter your income and your current medications to
find out which cards will be available in your area.
This is a wonderful and easy way to get prepared once the final Web
site comes out, and those benefits are made available. Again, we will
keep you posted on when the benefits specifically become available. It
is clear that seniors and individuals with disabilities need and
deserve relief from these high costs of prescription drugs.
Seniors need and deserve a Medicare Program that provides them with
what they want, and that is health care security. In the event one
needs medicine to prevent a disease or illness, or when one is a senior
or an individual with a disability and an illness strikes, they will
have access to appropriate treatment. When I say health care security,
that is what I mean.
Now that prescription drugs are brought into Medicare, we can say
seniors will have affordable access with this legislation, much better
than in the past.
I do want to tell the seniors of America that the President of the
United States has heard them in that it is difficult to receive and
purchase these skyrocketing prescription drugs because of the cost. The
leadership in Congress has responded with this bipartisan plan and,
indeed, help is on the way, and more help will be on the way in the
coming weeks. That is the positive side.
I also want to take this opportunity to comment on the fact that
despite this landmark and new commitment--and, yes, it does mean more
Government resources are directed at seniors who need those resources
in terms of help obtaining prescription drugs--hardly a day goes by
that opponents to this legislation do not level a new attack or a new
accusation or seek a new investigation trying to tear apart this
tremendous accomplishment for our seniors and for our individuals with
disabilities.
I want to thank and commend Secretary Tommy Thompson for initiating
an investigation that is being conducted by the inspector general of
the Department of Health and Human Services in response to some of
these accusations. I look forward to the inspector general's findings.
If a law has in any way been broken, or if information was
inappropriately withheld from Congress, clearly appropriate actions
ought to and will be taken. However, the number of the attacks and the
vehemence of the attacks coming from the other side, from those people
who opposed this landmark legislation for seniors, suggests there is a
lot more at work and a lot more is going on than just wanting strong
congressional oversight or good government. Unfortunately, what we are
seeing is an orchestrated scheme to discredit the progress that has
been made to date to get prescription drugs to seniors in an affordable
way; to dismantle the prescription drug coverage that for the first
time in history we have put into the Medicare system. The opponents to
the original legislation seem to want to dismantle that. It is
political gamesmanship.
Part of it is driven by the success of passage of this wonderful
legislation. Part of it is the fact that it is a political year and we
have 7 months or so going into these elections, and people say this
Medicare legislation, which is a success for the President of the
United States and a success for this body, needs to be discredited in
some way, I would argue, for political purposes.
We know for a fact that attacking Medicare is in part an aspect of
the opponents' game plan for the elections. Why do I say that? Because
we can actually find it in writing in a memo written earlier this year
to Democratic leaders. Party pollsters outlined a game plan for
discrediting this landmark Medicare Modernization Act. The pollsters'
advice in the memo was unequivocal that Democrats were in danger of
surrendering the Medicare issue unless they were willing to totally
discredit the legislation by defining it as, and I draw upon their
words, ``unacceptable.''
We are seeing results. This poll-driven political game is being
followed. For some, voting against the legislation was not enough. They
have also tried to prevent seniors from learning about the new benefits
to which they are entitled, some of which I just outlined. They have
leveled charges intended to frighten seniors and to undermine the
legislation itself.
We simply will not let it happen. We cannot let it happen. I want
seniors to know we will not turn back the clock on the progress we have
made, under the leadership of the President of the United States and
this body. We will make sure seniors and individuals with
[[Page S3626]]
disabilities get these new benefits they need and deserve.
When this law is fully implemented, the bottom line is that seniors
will have better access to more affordable medicines and prescription
drugs they need.
There are several examples. Sixteen million lower income seniors--
there are 40 million seniors today and 16 million lower income seniors
are going to be paying little or no monthly premium, and no more than
$5 for each prescription. That is a huge benefit to those people who
are most vulnerable to not being able to obtain prescription drugs.
If we look at the 40 million seniors today, there will be 10 million
seniors who have no current prescription drug coverage who will get
relief from the high cost of prescription drugs by this legislation.
All 40 million seniors today, and the 80 million baby boomers who will
be coming through the system over the next 30 years, will have access
to more preventive care because of this legislation. By that I mean
simple things such as cholesterol screenings that were not a part of
Medicare but are a part of Medicare today.
I mentioned baseline physical examinations. For the first time in
Medicare--and it is through those baseline physical examinations that
the diagnosis of hypertension or possibly diabetes is made. For the
first time, these baseline physical examinations will be a part of
Medicare. The purpose is to diagnose the potential for having a stroke
by figuring out whether or not one has hypertension, or one is at a
risk for heart disease, diabetes, or cancer.
We talk about chronic care coordination and disease management. Those
are terms that are misunderstood, but they are very important. As a
physician, it is important because with an aging population we see more
chronic disease. As people live longer and we are able to treat acute
and chronic disease such as heart disease, rheumatoid arthritis, or
other debilitating arthritis, diabetes, or stroke, after one has had a
stroke, it is very important. Couple that with diseases such as
Alzheimer's or Parkinson's disease, how those chronic diseases are
managed, especially when there is one, two, or three of the diseases
with overlapping care, it is absolutely critical.
Our system historically has not been set up very well. Especially in
Medicare it has not been set up at all until recently, until this bill,
to manage this complex overlap of diabetes with heart disease, with
arthritis, with Parkinson's disease. For the first time in this
Medicare bill there is an appropriate system set up for disease
management and chronic disease coordination. Physicians will be able to
continue treating Medicare patients because in the new law there was $7
billion included to help safeguard medical services to seniors. Seniors
in rural areas will benefit from the legislation's historic $25 billion
investment in improving health care in rural America, to provide
services that may not be there today, to set up a system that will
attract or keep nurses and physicians in rural areas, $25 billion
injected into the system to better accomplish taking care of and
managing the care of seniors in rural America.
For the whole category of retirees today who get health coverage from
their former employer, the cost of this bill will be more secure,
thanks to the bill's $89 billion in increased Government assistance to
retirees.
I mentioned last night that my conversation with my mother-in-law
very quickly came to the cost of a particular medicine she was taking
and how, over the last three billing periods, I think she said, each
time the cost of that one medicine has gone up. Was it addressed in the
Medicare bill?
As a first step, it was addressed. We still have a lot more to do.
This Medicare bill was never intended to solve all of the challenges we
have in Medicare today, but we did take a first step in controlling
those prescription drug costs.
Drug costs will be held more firmly in check for all Americans, not
just seniors but for all Americans. That is because the Medicare bill
had a whole part which speeds the cheaper generic drugs that are just
as good, with just as much what we call efficacy--they are equal in
efficacy, but it speeds those generic drugs to market, and by market I
mean consumers; by consumers I mean patients; by patients I mean people
such as my relatives, my mother-in-law, seniors who are out there
today. Also, the Medicare bill helps close many of those loopholes in
our Nation's patent laws that prevented prescription drug price
competition.
Again, it is a first step. It doesn't attempt to solve all of the
prescription costs, the skyrocketing costs we see for prescription
drugs, but takes a very definite first step.
There is a lot of confusion about what health savings accounts are,
but when you look at the Medicare bill, for the first time we have
offered a health savings account or medical savings account that an
individual can own. It does not apply just to seniors; it can start
with a 20-year-old or 25- or 30- or 35- or 40-year-old. But it is an
account that you yourself pay into, tax free. For health benefits that
you want to pay for, you take it out tax free. So it is a tax favored
savings account that you own and you can take with you through life. If
you pay into it when you are 25 years of age or 30 years of age or 35
years of age, but say you have a high deductible insurance policy, and
you don't have any health expenses that year, the money that you put in
or that your employer put in or somebody from your family put in, rolls
over to the next year and grows. If you don't need it the next year, it
grows again. If you don't need it when you are 33, it grows again, or
35 or 40 or 45. You take it. You draw down on it, but you take it with
you.
When you get to be a senior, you can use it to pay for some of those
copayments for a prescription drug or you can use it to pay for your
long-term care if you need long-term care.
It is a fantastic new entity that gives the individual real
ownership--control over health care decisionmaking, control over that
health care dollar. It is called a health savings account. It will be
coming on line very soon. It was part of this Medicare bill signed by
the President 4 months ago.
In closing, this Medicare Modernization Act is helping millions of
seniors in countless ways. Millions are being helped right now because
of the passage of this bill. We are getting results. It is a major
first step. I say it is a first step, a major first step, because,
although it is a big bill, an important bill, a significant piece of
legislation, because clearly there are things we will have to do about
the cost of health care, affordability to our seniors, access to health
care, addressing the issues of the trust fund itself, addressing the
doubling of the number of seniors who will come into the system over
the next 30 years with a diminishing number of the workforce actually
paying into the system. These are all issues we will have to address.
But this bill is a major first step that is to the benefit of every
senior listening to me today and those 78 million people who will be
new seniors over the next 30 years.
We worked hard on this in this body, the Senate. We worked with the
House. We worked in a bipartisan way to provide these benefits to
America's seniors. We have worked hard to give seniors today the
coverage they need and to give them the Medicare coverage they deserve.
We simply cannot, we will not let election politics get in the way of
health care for millions of America's seniors.
I will close and review again very quickly those benefits on the
chart next to me that outline how important this particular bill is
that was not law on December 1 but on December 8 was signed by the
President of the United States. Those benefits include a drug card with
10-25 percent immediate prescription drug discounts and additional
relief for 8 million low-income seniors. That is now a reality.
Comprehensive prescription drug coverage for 16 million low-income
seniors is now a reality. Protection against high--catastrophic
prescription drug costs, something that all seniors fear, not knowing
what might happen to them 5 years from now or 10 years from now. There
are new preventive benefits, including that annual physical examination
where, for the first time, when that blood pressure cuff may be put
around your arm and the diagnosis of high blood pressure is made, for
the first time in the cost of the Medicare bill you can get help
getting a drug,
[[Page S3627]]
through Medicare, to prevent that hypertension causing a heart attack
which otherwise would put you into the hospital--very expensive--or
cause a stroke--very expensive. Now that can be preventative.
There is $7 billion in improved physician payments which physicians
deserve; $25 billion in rural health improvements in order that our
rural communities will be able to access the appropriate health care
they need today; $26 billion in State Medicaid relief and affordable
health care through tax deductible health savings accounts. All of it
is a first step, a start.
I wish to comment this has been accomplished in a bipartisan way. We
need to continue working in a bipartisan way. I look forward to doing
that. I look forward to working with both sides of the aisle to the
benefit of America's seniors.
I yield the floor.
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