[Congressional Record Volume 151, Number 89 (Wednesday, June 29, 2005)]
[Senate]
[Pages S7608-S7609]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
INDIAN HEALTH CARE IMPROVEMENT ACT
Mr. GRASSLEY. Mr. President, I want to take a few minutes to explain
my action today related to S. 1239, a bill to amend the Indian Health
Care Improvement Act. Today, with great reluctance, I asked Leader
Frist to inform me before entering any unanimous consent agreements
related to consideration of this bill, which the Indian Affairs
Committee reported by voice vote this morning.
S. 1239 would pencil the Indian Health Service, IHS, an Indian tribe,
a tribal organization, or urban Indian organization to pay the monthly
part D premium of eligible Medicare beneficiaries. The bill defines
eligible beneficiaries as individuals who are Indian and who are
eligible for the part D prescription drug benefit, but who do not
receive any additional financial assistance made available under the
Medicare Modernization Act of 2003, MMA, to beneficiaries with limited
incomes.
I am all for providing assistance in paying premiums for
beneficiaries in financial need. We devoted a lot of time to those
provisions in the MMA. I am troubled, however, that as currently
drafted, S. 1239 would permit the IHS, an Indian tribe, tribal
organization, or urban Indian organization to pick and choose who will
get premium assistance. Specifically, the bill would allow them to
consider an eligible beneficiary's ``expected drug utilization'' and
any other factors to determine the cost-effectiveness of paying the
beneficiary's premium.
This provision might be an attempt to reflect that the IHS, tribes,
and tribal organizations have limited resources. The bill language,
however, raises a number of questions. First, how would the IHS and
tribes determine expected drug utilization or cost-effectiveness? Would
it be based on the number of drugs a person takes or the severity of
illness? Second, how would they account for the fact that a
beneficiary's drug needs could change dramatically with just one
illness? That is the point of having insurance.
When we crafted the MMA, we were keenly aware of the potential for
adverse selection--meaning that beneficiaries might wait until they
need part D coverage to enroll in part D. This would have the effect of
driving up the cost of the part D premium for all beneficiaries. The
additional considerations currently included S. 1239 set a dangerous
precedent by seemingly promoting adverse selection in the part D
program. This is exactly opposite to what we sought to achieve in the
MMA.
Mr. President, I welcome the opportunity to work with the sponsors of
S. 1239, Senators McCain, Dorgan, and Baucus, and with members of the
Indian Affairs Committee on this matter. I had hoped to accomplish that
before the bill was reported out of committee. Unfortunately, that did
not happen. I do not take actions such as these lightly. But I am
deeply troubled that as currently drafted, S. 1239 could end up having
unintended consequences for the very people it is intended to assist
and for all Medicare beneficiaries.
COMBAT METH ACT OF 2005
Mr. FEINGOLD. Mr. President, I am proud to add my name today as a
cosponsor of the Combat Meth Act of 2005, S. 103. I want to thank
Senator Talent and Senator Feinstein for their leadership on this
issue. I have had the opportunity to work with my colleagues on a new
version of the bill that I understand will be offered in the Judiciary
Committee as a substitute when the bill is marked up, and I am very
pleased to support this new version of the Combat Meth Act.
Meth is a highly addictive and particularly destructive drug that can
be manufactured from widely available household items. In the last 5
years, the use of this terrible drug has skyrocketed, both nationally
and in my home State of Wisconsin. When I talk to prosecutors and
police officers from Wisconsin, they consistently tell me that meth use
is the most daunting problem they are facing. They tell me that meth is
the single most harmful drug--to addicts, families, children,
communities, and the environment--that they have ever dealt with. This
bill gives law enforcement officials a chance to stem the growing tide
of meth use by restricting access to the cold medicines that are
commonly used to make meth and by providing funds for programs that
have been shown to combat the meth problem. The bill targets those who
purchase over-the-counter drugs for the purpose of manufacturing meth,
while still allowing law-abiding Americans to have adequate access to
the cold medicines they need.
Methamphetamine is derived from pseudoephedrine, a chemical that is
found in most common cold medicines. Meth ``chefs'' can manufacture the
drug by buying large quantities of cold medicine, mixing it with other
common chemicals, and heating it. This process can occur nearly
anywhere and requires only limited knowledge and experience. Even
beginners can easily manufacture this drug.
Given how easy it is it make, it is not surprising that meth use has
been increasing rapidly. A recent report from the National Institute on
Drug Abuse finds that meth use has swept across the country, starting
in Southern California and moving steadily eastward. The situation has
become particularly dire in the Midwest, where meth use accounts for
more than 90 percent of all drug prosecutions. Literally millions and
millions of individuals have reported using meth--and this trend shows
no signs of slowing. Meth cases in my home State of Wisconsin have gone
up 500 percent in just the last 4 years, from 101 prosecutions in 2000
to 545 in 2004. And Wisconsin is doing much better than many other
Midwestern States thanks to proactive efforts by state officials in the
late 1990s, before meth had taken hold, to educate communities about
the dangers of meth and the need for prevention. These education and
prevention efforts paid off, keeping the number of meth labs relatively
low in Wisconsin compared to neighboring States, but the problem
remains a very serious one.
Both the manufacture and the use of meth have devastating
consequences for users and those around them. In the short-term, even
occasional meth use leads to a whole host of physical and psychological
problems. It causes inflammation of the heart lining, increasing the
risk of heart attacks and strokes. It causes damage to the nervous
system and creates abscesses on the skin. It also attacks the brain,
leading to bouts of paranoia, anxiety, and insomnia.
Meth's long-term effects are even more destructive. It has highly
addictive properties, quickly turning occasional users into desperate
addicts. Meth addicts often go for days without eating or sleeping.
They suffer from a variety of heart ailments and can sustain permanent
and often irreversible
[[Page S7609]]
brain damage. The drug's effect on the brain also leaves addicts
vulnerable to the entire spectrum of mental health problems, from
paranoia and depression to aggression and psychosis. And the drug's
chemical effects are particularly insidious, meaning that addicts often
require extended detoxification periods before they can begin
treatment.
Sadly, meth's harmful effects are not confined to its users. The
process of manufacturing meth creates unique environmental hazards that
can poison surrounding communities. Cooking the chemicals that create
meth can lead to explosions, fires, and the release of noxious gases.
Remnants from the procedure are often washed down the drain or dumped
in the ground, where they can contaminate local water sources.
Another related danger of significant meth use in a community is an
increased crime rate. Meth addicts often resort to violence to gain
access to the materials they need or to the money they must have to
sustain their addiction. Additionally, people who are high on meth are
disposed to aggressive and violent behavior. The results are apparent.
For example, local news reports indicate that Eau Claire County in
Wisconsin, which has been hard hit by the meth problem, has seen a
significant increase in meth-related crimes as meth use has become more
prevalent. This drug does not just poison users; it can affect entire
communities.
And in the unkindest cut of all, children who are exposed to meth
manufacturing or use can be scarred for life. Children of meth addicts
are exposed to toxic fumes and volatile chemicals, resulting in
potentially serious health problems, and they are often abused or
neglected by those in the throes of addiction.
This problem calls for immediate Federal action. When Oklahoma was
the first State earlier this year to pass a law that successfully
restricted access to pseudoephedrine, the sale of products containing
pseudoephedrine grew noticeably in neighboring States. The Oklahoma
experience shows that States acting alone cannot address what has
become a national meth problem. We need a law that creates national
standards for the sale of products containing pseudoephedrine and puts
the resources of the Federal Government behind the effort to stop meth
use.
The new version of the Combat Meth Act provides the national response
that we need. It attacks the meth problem at all stages of the process:
It gives State and local officials the tools they need to prevent the
sale of products used to make meth, to investigate and prosecute meth
manufacturers, and to treat meth addicts and protect the children they
harm.
This bill helps prevent meth use by restricting the sale of
ingredients needed to manufacture meth. Under the new bill, cold
medicines that contain pseudoephedrine will be placed behind pharmacy
counters and purchasers will only be able to buy 7.5 grams of the
product per month--more than enough for people who really need the
medicine but not enough for those who are buying the medicine to make
meth. It requires people purchasing pseudoephedrine products to sign a
written log, but I am pleased that the new version of the bill ensures
the privacy of this potentially sensitive medical information by
allowing the information to be used only to find individuals who might
be purchasing these products to make meth. The bill also provides
funding to States to monitor the sale of products containing
pseudoephedrine.
The Combat Meth Act gives States the resources they need to bring
meth manufacturers to justice. It provides money for training programs
for State and local law enforcement and expands the scope of currently
effective meth investigation and clean-up programs. Once meth producers
and traffickers are found, this bill helps put them behind bars by
hiring additional Federal prosecutors, training local prosecutors in
Federal and State meth laws, and cross-designating local prosecutors as
Special Assistant U.S. Attorneys, allowing them to bring legal action
in Federal courts.
While this bill strengthens enforcement and prosecution measures, it
also recognizes that most meth addicts require treatment rather than
harsh criminal sanction. To that end, the bill authorizes the creation
of a meth treatment assistance center, which will help states learn how
to effectively treat those who suffer from this awful addiction. And
for this drug's most innocent victims--the children who are exposed to
meth by the users around them--the bill provides a $5 million grant to
allow Federal, State, and local entities to work together to help
assist and educate children who have been harmed by a family member's
meth addiction.
The widespread use of meth, particularly in the Midwest, has become
an unsupportable burden for many families and communities. The new
version of the Combat Meth Act is a common-sense response to a growing
problem one that requires immediate Federal attention. While the bill
does not address the increasing problem of meth imports from overseas,
it will help cut back on domestic meth manufacturing and the many harms
that accompany it. I am proud to support this new version of the bill
and I urge my colleagues to support it.
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