[Congressional Record Volume 150, Number 60 (Tuesday, May 4, 2004)]
[Senate]
[Pages S4780-S4781]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               FIRST DAY OF MEDICARE DRUG CARD ENROLLMENT

  Mr. DASCHLE. Mr. President, I want to use the remainder of my leader 
time to comment on the Medicare temporary drug discount card.
  For nearly a decade, Congress has been debating how to provide 
seniors with meaningful help when it comes to the skyrocketing cost of 
prescription drugs.
  This temporary program represents the first tangible result of that 
long debate. Until the Medicare prescription drug benefit takes effect 
in 2006, this is the only assistance seniors will receive.
  The administration has introduced this program with great fanfare. 
Unfortunately, the hype masks the disappointing truth. This program 
provides far more confusion than real savings. As a result, it 
represents yet another missed opportunity in our longstanding effort to 
bring the cost of medicine within the reach of seniors who need it.
  Among the many shortcomings in the program are three critical flaws. 
First, the discount program forces seniors to go through a baffling 
number of calculations and decisions.
  In order to decide whether the discount program is right for them 
and, if so, which card to choose, seniors need to ask themselves: 
First, will the card offer discounts on the drugs I need? Second, is my 
neighborhood among those where this card is available? Third, does my 
pharmacist accept the card? Fourth, which of the several cards offered 
will provide the best discount on the drugs I am personally taking? Are 
the discounts offered worth the enrollment fee? Could I get a better 
deal through a separate discount plan offered outside of Medicare? Will 
I qualify if I am in Medicaid?
  The questions go on and on and on. The dizzying array of 
possibilities and permutations are shown in a number of the pieces of 
material that have been offered by CMS. I must say the charts and 
information provided are equally as confusing.
  One reason it is so confusing today is that seniors have nowhere to 
turn for reliable information. The Center for Medicare and Medicaid 
Services has built a Web site, but it has already been found to have 
incorrect prices on many of the drugs Medicare recipients rely upon the 
most.
  Unless seniors have faith in the information on which they are basing 
their decisions, the fact they are given options will mean absolutely 
nothing.
  Second, the program unfairly locks seniors into their choices until 
the end of the year, even though the card sponsors can change the rules 
anytime they wish.
  Assuming that a Medicare recipient is able to get the information he 
or she needs to make a smart choice on a plan that could help, it may 
not matter. At any time, card sponsors can withdraw the discount they 
were offering on any drug. Meanwhile, even though the rules could 
change at any minute, Medicare recipients are actually locked into the 
choice they made until the next enrollment period comes. So they make 
their decision based on facts provided to them, and they are locked 
into that decision for the coming year. But those facts can change at 
any time--the day after, for example--and the Medicare recipient is now 
committed. Those facts for that recipient could change. This is an 
extraordinary invitation for abuse. It puts seniors, especially those 
with serious health conditions, in a very vulnerable position.
  Last week, the Secretary of Health and Human Services suggested that 
seniors wait before enrolling because more information will soon be 
available.
  Because enrollment begins today and the administration has not 
included this warning in its widespread advertising, I have urged 
Secretary Thompson to allow Medicare recipients at least a 30-day grace 
period to enable them to change their decisions should it turn out that 
another plan could offer a better discount.

  In the wake of the confusing and contradicting information seniors 
are receiving about these cards, the very least HHS can do is to offer 
them the flexibility to make the right choice once the right 
information becomes available.
  Finally, and most importantly, the program simply doesn't provide 
much of a discount. A recent analysis found that prices under the new 
drug cards would be no lower than prices currently available to 
Medicare beneficiaries.
  Furthermore, whatever discounts the cards may provide have already 
been factored into drug company pricing strategies.
  The Wall Street Journal recently reported that several of the drugs 
seniors use the most have actually seen prices increase more than three 
times the rate of inflation since this program was announced.
  In fact, drugmakers have already raised prices so much that the so-
called discounts offered by this program will do little more than 
return the drugs to their original price.
  To add insult to injury, the new law only requires the card sponsors 
to pass along to beneficiaries a share of the discount that they do 
negotiate.
  That is not good enough, so I have introduced legislation that would 
require them to pass along at least 90 percent of the savings to 
seniors. Medicare should not be in the business of propping up profits 
at the expense of seniors.
  After wading through the stupefying process, with its myriad 
questions and calculations, the fact of the matter is many seniors will 
not see their drug costs go down 1 penny.
  Regrettably, this was entirely predictable. Instead of relying on 
commonsense solutions we know could bring down the cost of drugs for 
every senior, Congress created a mystifying maze of computations, 
replete with new vendors, changing rules, shifting prices, and 
unreliable information. There is a better way.
  Not long ago, I was contacted by a couple from Trent, SD, who, until 
January, spent $525 every month to pay for 17 different pills the wife 
had to take for her diabetes and high blood pressure.
  As the cost of the drugs rose higher and higher, it became more 
difficult to pay their monthly bills, much less enjoy the retirement 
they worked and saved for. So in order to make ends meet, the husband, 
at the age of 84--at the age of 84--started a paper route. Once a week, 
he spent a day delivering a weekly magazine to a number of small towns 
around Trent. He does not make much, certainly not enough to cover the 
cost of his wife's prescription drugs, but the added income relieved a 
little of the sting, and most of the urgent bills could be paid.
  In January, the couple called a pharmacy in Canada. They had heard 
drugs cost less on the other side of the border, and he was curious if 
they could save a little money.

[[Page S4781]]

  What they learned stunned them. The same drugs that cost $525 per 
month at their local pharmacy cost less than $100 in Canada. Over the 
course of the year, the couple will save over $5,000.
  This couple's experience points the way to two commonsense steps 
Congress could take to guarantee lower drug prices for all Americans.

  First, we must make it possible to safely and legally reimport drugs 
from countries with lower drug prices. Pharmaceutical companies charge 
American consumers the highest prices in the world. Some medicines cost 
American patients five times more than they cost patients in other 
countries.
  In effect, our citizens are charged a tax simply for being American. 
As a result, millions of Americans are having trouble affording 
lifesaving medication.
  Last month, Senators reached a bipartisan agreement to introduce a 
bill that would allow reimportation of prescription drugs. I want to 
thank Senators Dorgan and McCain for their extraordinary leadership, 
and also those who joined with us--Senators Snowe, Kennedy, and Lott, 
and others on both sides of the aisle.
  This is the same medication, manufactured at the same facilities, and 
inspected by the same rigorous safety standards. It is absurd, even 
cruel, to force Americans to pay wildly inflated costs, driving 
hundreds of thousands of Americans into poverty, just to pad the 
profits of pharmaceutical companies.
  Second, it is time to give the Government the same negotiating 
leverage it has on every other product it buys. When the Government 
buys computers or automobiles or equipment for our soldiers in uniform, 
it uses its purchasing power to get the taxpayer a better deal. We 
should have the same ability to negotiate for drugs on behalf of 41 
million Medicare beneficiaries.
  The administration has repeatedly opposed this commonsense price-
reducing measure and insisted on a provision in the Medicare law that 
expressly prohibits the Federal Government from using leverage to 
bargain for lower drug prices.
  Let's be clear, if we have the power to save taxpayers money and 
choose not to use it, we are, in effect, throwing taxpayers' money 
away. This is foolish and irresponsible. It helps no one but the drug 
companies who can count on their bloated profits. By defending the 
system, the administration is merely showing whose side they are truly 
on.
  America's seniors deserve better. The question isn't how we bring 
down drug costs for seniors. We know how. Rather the question we face 
is whether we truly want to bring down costs for seniors. The 
administration and many of our Republican colleagues have given their 
answer. Over the next several months, seniors are going to see this 
drug card program is not up to the task of controlling the spiraling 
drug costs.
  Instead of helping seniors afford the drugs they need, it is designed 
to help drug companies reap the profits to which they are accustomed. 
Seniors need a real Medicare prescription drug benefit that puts their 
needs first.
  We are going to try to continue to work across the aisle, as we did 
with the reimportation bill, to find a way to bring down these costs, 
to find a way to empower the Government to work on behalf of all 
seniors to negotiate better prices.
  There is an answer to the high cost of prescription drugs. The 
program being introduced today and unveiled this week is not it. We can 
do better than this, and I hope we will.
  I yield the floor.

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