[Congressional Record Volume 151, Number 132 (Tuesday, October 18, 2005)]
[House]
[Pages H8902-H8907]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 2000
MEDICARE PART D
The SPEAKER pro tempore (Mr. Jindal). Under the Speaker's announced
policy of January 4, 2005, the gentleman from Georgia (Mr. Gingrey) is
recognized for 60 minutes as the designee of the majority leader.
Mr. GINGREY. Mr. Speaker, we just heard from the other side, the 30-
Something Democrats. I have been listening, as I know my colleagues
have, to the 30-Something Democrats for about a year and a half now a
couple or three times a week. It is the same old same old. Now they
have pledged to come back tomorrow night with some positive information
voice, and I look forward to that. In fact, I am going to listen very
closely, because all I have heard from my three colleagues on the other
side, the 30-Something Democrats, the two from Florida, the one from
Ohio, very intelligent, very well spoken, very articulate, and very,
very negative.
So before we get into our special hour talking about something
positive, a Medicare prescription drug benefit for our needy seniors, I
just want to suggest to my colleagues who spent the last hour talking
negative we look forward to hearing from them tomorrow night maybe on
something positive for a welcomed, welcomed change.
Mr. Speaker, it kind of reminds me of the fall of 2003, my first year
in the 108th Congress, when we worked so very hard on trying to bring
to our seniors finally, after almost 38 years, a prescription drug
benefit under Medicare. What we heard from our colleagues on the other
side of the aisle was very similar to what we just listened to in this
Chamber over the last hour from the 30-Something Democrats. It was all
negative. There was no plan, there was no alternative. It was just:
Seniors in my Democratic district, you men and women who have supported
me and let me represent you in the Congress, this is what I suggest
that you do, you take out your AARP card and you cut it to shreds
because that is what I, your Congressman or your Congresswoman on the
Democratic side of the aisle, plan to do.
Yet, Mr. Speaker, what we did was an historic benefit. In fact, for 2
years now, and it will continue until January 1 of 2006 when the
official Medicare Part D prescription benefit plan is available, we had
an almost a 2-year transition plan of a Medicare prescription drug
discount card which would allow our neediest seniors actually to have
$600, a debit card if you will, not a credit card, but $600 each of
those 2 years if they were at or near Federal
[[Page H8903]]
poverty level low income, below about $11,000 a year for an individual
or below $14,000, $15,000 a year for a couple, basically men and women,
our seniors who are on Medicare and essentially living off of their
Social Security benefit and very, very little else.
I think it was a tremendously compassionate thing for this Congress,
this leadership, this Republican majority and this President, George W.
Bush, to finally deliver on a promise that had been made by prior
Congresses, prior Presidents. I will not get into naming names or
saying who was in charge at what period of time.
The fact is Medicare was first passed in 1965. Medicare was a very
good program then, it is a very good program now, but it desperately
needed modernization when we have come to realize, especially over
these last few years, how important it is to have an opportunity to
have that prescription drug benefit to go along with Part A and Part B.
Part A of course, Mr. Speaker, you understand is a hospital part and
the nursing home part. There is a pretty high deductible for that as
well, today something like $850 out of pocket before there is any
coverage for Part A. And Part B, if God forbid a person end up in a
nursing home after 100 days, there are no benefits in any period or
episode of illness. Everything else is out of pocket, and that is why
so many of our seniors who do end up in a nursing home pretty quickly
become dependent, wards of the State almost, and Medicaid, which is
strapping our States so badly now across this country, pays about 85,
90 percent of all skilled nursing home bills, is paid by Medicaid
because people literally are going broke and they cannot afford it.
So here again, as I waited of course to have this opportunity to
speak on the Republican side, the aisle where we have dedicated, Mr.
Speaker, to explain and talk about something positive. We are a
positive party. We want to do things that are for the benefit of the
people and not just stand around and criticize like we heard over this
last hour.
I do not hear a plan from the other side, yet they voted almost
overwhelmingly, thank goodness there were a few in a bipartisan fashion
did vote in favor of the Medicare prescription drug modernization plan
Part D, and it should not have been a partisan issue. It should have
been not about the next election, but doing something that is going to
help the most treasured part of our society, really, that being our
senior citizens, and particularly those who are in greatest need. So,
Mr. Speaker, it is a pleasure to be asked by the leadership tonight to
lead this hour as a physician Member of the body.
There are actually 10 M.D. physicians in this congressional body of
435 Members. There are other Members who are health care professionals,
be they psychologists or pharmacists or registered nurses and physical
therapists, veterinarians, people that have worked in health care, and
I think we all owe it to our colleagues and to the American people to
get behind and to support this legislation which will in fact go into
effect January 1, 2006.
Mr. Speaker, it is important for each one of us on both sides of the
aisle not to discourage our constituents, our seniors from signing up
for this prescription drug benefit, but to explain it to them and let
them know and to particularly let those know who are at a low income
level.
We mentioned just a few seconds ago about that amount, about $11,800
for an individual, a single person, a widow or a widower, or about
$15,000, $16,000 for a couple, that they are eligible for supplemental
help. We anticipate, Mr. Speaker, that the deductible for the Medicare
Part D prescription drug benefit would be about $250 a year and that
the monthly premium would be about $35 a year, $32 to $35 a year. That
is what we predicted a year and a half ago. Now that these plans are
rolling out and are being offered to our seniors, the marketplace is
working. Competition, that competitive entrepreneurial spirit is
working without government price controls, and many of these plans are
going to be offered or are being offered right now to our seniors at as
low as $20 a month premium, not $32, not $35, but $20 a month. So
already the predicted cost is coming down, and as a result of that I
think the number of seniors who sign up and take advantage, sure, there
will be, Mr. Speaker, some seniors who will realize that they already
have coverage. Maybe they are a retired State employee, possibly a
teacher, maybe they are a retired Federal employee, possibly they work
for a company like in the State of Georgia, Lockheed Martin or Coca-
Cola or Home Depot, some of these strong companies that seniors have
worked for 30 or 40 years, and that was not atypical with the great
generation, they stuck with the job and with the company and they have
been promised health care benefits and benefits that do include
prescription drug coverage.
In this bill, by the way, we have done everything we could to make
sure that companies do not drop those plans, that those promises made
are promises kept. That is in addition part of this Medicare
modernization. So some people, Mr. Speaker, some seniors will decline
to sign up for Medicare Part D because they already have a plan and
they have a good plan and they stick with it, and that is perfectly
understandable. But for those seniors who do not have anything, who get
to go to their doctor, maybe their family practitioner, their general
internist for that annual physical, and lo and behold they find out
that their cholesterol is elevated, their blood sugar is elevated,
their blood pressure is elevated and they have that need to be on
medication and they go to the drug store with a fistful, literally a
fistful of prescriptions, maybe four or five. You talk about sticker
shock. Currently our seniors in that situation, they are maybe not part
of an HMO and they do not get any discount because of volume, it is
just them trying to fill a prescription.
I know that recently I went to the drugstore and happen to be on a
statin to lower my cholesterol and ordered a 3-month supply, and only
to find out that my part of the prescription, I think 25 percent of the
true cost, was going to be $110. When I asked the pharmacist what it
really cost, the cost per pill, and I will not mention the pill in
fairness to the company, but it was something like $5.25 for each pill,
and it is necessary that I take that every day, and my health is pretty
good. But you take a lot of our seniors, Mr. Speaker, they do not have
one thing wrong, a lot of times it just almost like you might say is
multi-system diseases. They may have three things that impact each
other. What has happened in the past of course is this: They maybe were
too embarrassed to say they could not afford the prescription, and
maybe they turned around and walked out and said they would be back but
never came back. Or possibly they asked the pharmacist, instead of a
month's supply, just give me a 2-week supply, and then they would go
home and they start breaking those pills and trying to stretch it just
like we oftentimes have to stretch the budget when things are tight.
But the problem is, of course, that is when these diseases get out of
control. That is when the elevated cholesterol results in plaque
formation in the coronary arteries, or the blood sugar gets elevated
and all of a sudden there is a problem with blindness and loss of limb
or a patient ending up on renal dialysis.
I hope my colleagues would listen carefully to this. We heard at the
outset a lot of Members, and very legitimately and honestly and
sincerely, oppose this bill and the vote was a very close vote, and
indeed it was. I am very proud that I voted yes, and I think most if
not all of the physician Members as a body also voted yes on both sides
of the aisle. But there were men and women of good faith who voted no.
In some instances they were voting no because they did not think that
we were doing enough. You even hear that today, the hole in the
doughnut is too big and the plan is not good enough. It might be okay
for some people, but for the typical average senior who is a Medicare
beneficiary or someone who is on Medicare because of a disability, it
is just not good enough. We want to do more, we want to close down,
shrink down that hole in the doughnut, so they voted no. And I can
understand that line of reasoning.
There were Members mostly on this side of the aisle who felt that we
cannot do this because we cannot afford to do it. We have got a
deficit, we have got a debt that is far too big by everybody's
admission. Although we
[[Page H8904]]
would like to do this, we cannot do it because we cannot afford really
to do anything. We are in a war in the Middle East trying to bring
democracy. I think we are succeeding there. I think the light at the
end of the tunnel is beginning to shine brighter and brighter with the
success and the 60 percent plus turnout here recently in the new
constitution and then hopefully parliamentary elections a month from
now.
{time} 2015
The point I wanted to make, Mr. Speaker, in regard to the cost, the
cost was calculated based on the fact that you would continue to spend
in the Medicare program in this country the same amount, maybe
increasing depending on, as the population of seniors increased for
part A, you would have the same situation for part B; it would increase
because of an increase in population of seniors.
And then you would have this added expense. We were told initially
that that was about $400 billion over 10 years, and then there was a
recalculation and maybe it was going to be as much as $600 billion. The
fact, Mr. Speaker and my colleagues, is this. We get no credit for the
fact that taking prescription medications, when our seniors can go to
the drug store and get those prescriptions filled, and they can in a
very timely fashion lower that blood pressure, lower that blood sugar,
lower that cholesterol, and guess what, we do not end up spending money
on them for part A or part B, do we except maybe for an annual check-up
on an outpatient basis by one of our wonderful primary care physicians
who work so hard and such long hours? No. We keep them out of the
hospital.
Before the Medicare modernization, before December of 2003, you could
not even go to your doctor and get a routine thorough physical and have
it paid for under Medicare. You could not get a blood test for
cholesterol, you could not get a mammogram, you could not get a PSA
blood test screening for prostate cancer, you could not get a
colonoscopy.
In this bill, in addition to the prescription drug benefit, all of
those things are now available and paid for. This is what we call, Mr.
Speaker, preventative medicine. Not waiting until somebody is eligible
for coverage under part B because they show up in the emergency room
having had a stroke because their blood pressure could not be treated,
or they ended up on the operating table getting the coronary bypass or
even worse, having a leg amputated because they never had the money to
treat their diabetes.
We save money, Mr. Speaker, on part B because of part B. And even if
we did not, it is the compassionate thing to do. It is the
compassionate thing to do. Who wants to end up spending the rest of
their life in a nursing home after a stroke no matter who is paying for
it?
But as I said earlier, those days are limited to 100, and then after
that, mom or dad or grandmom or granddad exhausts every bit of their
savings, everything that they have worked their whole lives for, maybe
they wanted to send a grandchild to college, an opportunity that they
never had when times were tougher, and all of a sudden they lose it all
simply because we did not, Congress did not, give them this coverage,
this Medicare prescription drug benefit.
So I say, Mr. Speaker, to my colleagues, to anybody who will listen,
that this was the right thing to do. This is not something that we can
afford to put off. You cannot. I have heard people say, well, gee, you
know, the seniors have waited 3 years, surely because now we are in a
bind, and we are trying to figure out a way to pay for the restoration
of the gulf coast and rebuild that infrastructure, certainly we need to
do that and we need to look for so-called offsets. And they are there.
We talk about maybe taking a little haircut and cutting 1 to 2
percent of the growth in every Department. I think we can find those
cuts, and I think we can do that. But to ask the seniors to wait
another year or two or three, that would be the cruelest of ironies on
our part.
And I, Mr. Speaker, am not willing to do that. And I would beg my
colleagues, let us not go down that road. We are about to do something
that is really good for our seniors. It may be not unlike what we have
done in the Middle East. We hear, whether it is from the 30-something
Democrats or in the editorial pages from our liberal newspapers in this
country, the constant, constant negative criticism and naysayers, and
this talk about what is your exit strategy.
I have been hearing that, Mr. Speaker, for 2 years. What is your exit
strategy? I mean, you know, you are in the early part of the fourth
quarter of a football game, and you are winning, but the going is
getting a little tough. If you pull your team off the field, you do not
win; you forfeit.
And all of those lives, 2,000 dead, and four times that many injured,
are for naught. What a disgraceful thing that would be if we did not
follow through. So the analogy then is the light is at the end of the
tunnel, it is shining brightly, I think, as I stand here tonight, Mr.
Speaker, in the Middle East.
And I think that is absolutely true in regard to health care for our
seniors as we go forward. And to all of a sudden snuff out that light
because we have this natural disaster, this catastrophe which nobody
could prevent or predict, and we have to respond to it, but as Thomas
Payne once said, when he was serving at Valley Forge with George
Washington, these are the times that try men's souls.
But we, thank God, Mr. Speaker, can walk and chew gum at the same
time. This Republican leadership can deal with both of these issues,
and it would be a terrible mistake to turn our backs on our seniors at
this critical time where we are seeing light at the end of the tunnel
and providing for them a benefit that they well, well deserve and have
needed for so long.
The thing about this bill that excites me, Mr. Speaker, I guess one
of the things that I am the most excited about, is the fact that the
benefit is the greatest for those with the greatest need. Yes, there is
a hole in the donut, and it is true that for some people the benefit
would not be great if they were not spending anything on prescription
drugs.
And there are those in our society who are very fortunate. Sometimes
in medical parlance we refer to this as having the Methuselah gene:
they enjoy long life and good health, and other members of their family
the same. And, you know, maybe they will go see the doctor every year
or two; but everything is always fine, and so they are not spending any
money on prescription drugs.
So they may look at it and say, gee, $250 deductible if I have to
spend anything, that is out of my pocket. And if I am spending $30 a
month, you know, that is another almost $400, and I am not currently
spending that. So, you know, I look at that and I have spent $700 the
first year of the prescription drug benefit that I have got, and last
year I did not spend anything on prescription drugs, so I have lost
$700. Well, that is true. That is true.
But what that individual needs to realize, and I hope that my
colleagues in the Congress on both sides of the aisle will make sure
that they in a very fair way explain this to their constituents, you
beware that next year or next month or next week or even tomorrow, do
not all of a sudden have a little chest pain and end up being that
person that needs to be on four or five prescription drugs, and then
your bill could be 3 or $4,000 or $6,000 or $8,000 dollars a year.
And it does not take long for that to put one in the poor house, if
they can afford it at all. So for everybody, for every senior there is
something that we call catastrophic coverage. So if they spend, an
individual on Medicare, spends in any year up to $3,600 on prescription
drugs out of their own pocket, that of course would include the
deductible and the copay and then, yes, the gap or the hole in the
doughnut; but beyond that, if there are still costs for prescription
drugs, the Medicare part D insurance program pays 95 percent of
everything above that.
That is a wonderful benefit, what we call catastrophic coverage. I
hope most people will not get into that situation. But clearly they
could. They could get into that situation. So what I am saying, Mr.
Speaker, is this is a good benefit for everybody; and everybody is
eligible, from the lowest income to the highest income. If they do not
have coverage in some other way for prescription drugs, then they are
eligible for this benefit.
[[Page H8905]]
Of course, those who are living off of Social Security and they have
very little assets, not much stuff, we all, I think, Mr. Speaker, have
too much of a desire for stuff, stuff that really in some instances is
not very important. Certainly more stuff does not necessarily make you
happier.
But a person can own their home, they can own it free and clear. They
can own up to 50 acres of land that may have been in the family for
some time and they do not want to sell. They can certainly own an
automobile. But they cannot have much stuff beyond that. Much assets.
But if they meet that means test, then the deductible is covered. The
monthly premium is covered. There is no copay up to the first $2,250 or
25 percent as it is to everybody else, and there are no holes in the
donut, there is no gap in the coverage. Everything is catastrophic
coverage almost from day one, maybe a dollar copay for a generic
prescription, and up to a maximum of $5 for the most expensive.
Remember I talked, Mr. Speaker, earlier about that statin that I was
taking that cost $5 a pill. For our needy seniors, a 3-month supply,
100 pills, you do the math, that is over $500. They might have a $5
copay for a prescription like that.
Mr. Speaker, I see that one of my physician colleagues has joined us,
and I thank him for taking time out of his busy schedule to be with us
during this leadership hour to talk about this Medicare part D
prescription drug benefit that we talked about.
He was very much a part of that, Mr. Speaker, and he was in the
108th, my classmate, my friend. I yield to the gentleman from Texas
(Mr. Burgess).
Mr. BURGESS. Mr. Speaker, I thank the gentleman for yielding to me. I
could not help but see as the leadership hour progressed you were doing
an excellent job of covering all of the things that I think are so
important to tell our constituents and our seniors about this plan.
Of course, it is an optional plan. There is no requirement that
anyone take this plan. But still I think it is worthwhile for families
to sit down, perhaps the day after Thanksgiving, while everyone is at
home and thinking about things, to sit down and look at these plans and
decide if it might not be a good idea for the Medicare beneficiary in
your family.
I would stress that the first date that the benefits will be
available will not be until January 1, but the first day that a senior
can sign up for a plan is November 15. So that Friday after
Thanksgiving or the Saturday after Thanksgiving after you have had
enough leftover turkey and pumpkin pie and football, maybe it would be
a good idea to sit down and decide if this is not worth a little closer
scrutiny.
I took the liberty of going to the Medicare.gov Web site. If anybody
has not been there recently, I would encourage them to do so. If you
are unable to use a computer, ask your son or daughter or your
grandchild to do it for you. I promise you they know how.
But looking on the Medicare.gov Web site for my State, Texas, there
are some interesting figures available there. And perhaps one of the
most interesting there, it is too small to show on the television, but
there are a variety of plans that are available in the State of Texas.
Just going down the list here, we see one that has a monthly premium
of $28, which is lower than the premium that was originally designated
as $37, the premium that we originally designated on Medicare, and
there is no deductible incurred with that expense. So that is a
straight monthly expense.
{time} 2030
Mr. Speaker, I would argue that that is a heck of a deal. And again,
there are several plans like this, and they are all available for you
to see in your State at the Medicare.gov Web site. Furthermore, for
people who want to look into using one of the Medicare HMOs or PPOs,
one of the Medicare advantage plans that will be available, there are
several in my State of Texas; there are several in the counties that I
represent. There is a PPO plan with basically a zero drug premium, and
there is an HMO plan with a zero drug premium and zero drug deductible,
so these are significant savings for people who are on Medicare who do
spend money on drugs.
I would stress, and I have had constituents call me, and they looked
at the plan and they say particularly when looking at the concept of a
$37-a-month premium with a $250 deductible, they will say this is of no
benefit to me. That may be true, in which case do not do it, but look
at some of the plans that are available in your State, in your county
and see if there is not one there.
Have a family discussion. Involve your children or your grandchildren
in the discussion, because doggone it, we take good health for granted.
It is something, though, that can change year by year and that is,
after all, why we buy insurance, not to save us money on our current
expenditures, but to protect us from those very hefty expenditures that
may be incurred in the future.
I must tell the gentleman from Georgia (Mr. Gingrey) he has done a
very thorough job about discussing Medicare. I agree with him
completely about the need for cutting the deficit this year. I think
that is critical that we do so, but this plan is not the place to make
that cut. And for anyone who has heard a story or a rumor that the
Medicare prescription drug part D roll out may be delayed because of
problems with the deficit, that is simply not true. This program will
roll out on time. And as we always like to say, it is on time and under
budget.
With that, I yield back to my good friend from Georgia.
Mr. GINGREY. Mr. Speaker, I thank the gentleman from Texas (Mr.
Burgess), and I thank him so much for being with us tonight. I would
welcome, if time would permit, for him to stick around with us and
possibly get into a little bit of a colloquy regarding some other
salient points of this bill. Certainly, I appreciate him being here and
giving us this time this evening.
I was earlier, Mr. Speaker, talking about that statin that I bought a
3-month supply of just last week and that the cost was going to be, the
true cost, I paid 25 percent according to my plan, the prescription
drug plan that I have, but the true cost was over $500. Well, a senior
who maybe has no prescription drug coverage under any plan, they are
not part of an HMO, they are not retired from a company or they are but
the company is not providing prescription drug coverage as part of the
health care benefit, if you multiplied 3 months times four which would
give you 12, if my Georgia Tech math serves me well, then that cost
would be $2,000 for that one prescription.
Well, that is getting pretty darn close, Mr. Speaker, to the $2,250
that we were talking about, that the gentleman from Texas (Mr. Burgess)
was talking about. And the savings on that you would not have to have
too many more prescriptions, maybe an antihistamine or two or an
antibiotic here or there during the course of a year to get up to at
least $250, if you have got one very expensive drug like that statin I
mentioned. The senior who was enrolled in that scenario, they would
actually save about $1,100 a year. That is how much the coverage would
give them.
Of course, if they had prescriptions above that and they got into the
gap or the hole in the doughnut, certainly there would be more out-of-
pocket expenses. But I think it is very important for people to
understand when they hear these naysayers, some of whom we heard from
earlier tonight during their leadership hour, that this is a waste of
time and effort, and it is not any good. And now that you have torn up
your AARP card, and by the way, the reason they made that
recommendation when we came out with the transitional prescription drug
discount card when we first passed this bill, knowing it would take
almost 2 years to get the prescription drug part B insurance program
part up and running, AARP had the audacity to support a Republican
proposal, Mr. Speaker.
I think the other side must have felt that that organization was
always their best friend or, as the saying goes, in their hip pocket.
And they could not stand the fact that AARP, and I am a member, have
been since age 50. I will not tell you how many years I have been a
member. It is a wonderful organization of 37 million seniors in this
country. AARP serves them very well. And AARP as far as partisan
politics, we are blind to whether it was an R or a D proposal. When
they saw a good
[[Page H8906]]
thing they supported it, and that is what they should have done, and
that is what our colleagues on the other side of the aisle should do.
When you see a good thing, do not constantly say no, no, no, just
because you are afraid that the majority party or this President is
going to get credit for a job well done and a promise made and a
promise delivered. Get on board. Join the team for the benefit of our
seniors and to support a good program when you see one.
It is a time now for all of us to work with our seniors to make sure
that they understand the program, that they know how to contact
Medicare, www.Medicare.gov or dial 1-800-Medicare. There are
organizations in every State, the CMS, Committee on Medicare-Medicaid
Services, has contracted with Medicare to explain this benefit.
I know in my own office, Mr. Speaker, we are going to put computer
terminals in the main office and have someone there that can be online
with seniors who just drop in and say, I have gotten the brochures; I
have seen the public service spots on television, but I am still a
little bit confused and would you help us out. I know that I am going
to do that. I know that the gentleman from Texas (Mr. Burgess) is going
to do that.
I know that my physician colleagues and my health care provider
colleagues in this body and hopefully all 435 of us will take that
opportunity, because there is a wonderful program and as the gentleman
said, and I am so glad that he reassured our colleagues and anybody who
might be listening to us this evening during this leadership hour, that
we are not going to delay this program. We cannot afford to do that to
our seniors. They have waited too long. And as I said earlier, this is
a compassionate program, and it would be cruel to pull that rug out
from under them when they have waited so long for this opportunity.
With that, my colleague from Texas (Mr. Burgess), if he would like to
make a few more comments and possibly we can have a little bit of
dialogue back and forth with the remaining time that we have this
evening. And I will turn it back over to the gentleman from Texas at
this point.
Mr. BURGESS. Again, I think you have done an excellent job of laying
out the case for the prescription drug benefit. We have a saying back
in Texas when something is a really good deal, we say it does not cost,
it pays. I kind of feel that way about the part B Medicare benefit.
There are three ways that the Medicare part B benefit could, in fact,
result in a costs savings for the Medicare program. One was by
introducing competition. The second was by the more timely treatment of
disease with appropriate medications. And the third way was by
intervening far earlier in the disease process before it gets to the
more costly end-state of the disease.
Well, guess what, we will not know about the latter two for some
time, but we do know about the competition aspect. And competition
works. Competition has driven down the cost of premiums. Competition
has driven down the cost of the deductible for many of the plans that
are going to be available in my State, in my congressional district,
and many other areas across the country.
How soon will we know about whether or not the timely treatment of
disease results in a lowered cost for treating the disease? I cannot
tell you that. But the fact that the emphasis is going to be not only
on the timely treatment of disease but on prevention, identifying those
individuals who are at risk, using the disease management tools that
are available in the Medicare program, how powerful is it that someone
would have the knowledge that a patient's weight had gone up day over
day so that they need to go to their doctor's office and get their
congestive heart failure treated, get their medications adjusted on
Friday morning rather than coming into the emergency room late on
Sunday night and incurring 4 or 5 days in the intensive care unit at
who knows the figure, 6, 7, 8, $9,000 a day.
That is the kind of cost difference we are talking about from the
timely treatment of disease. As far as intervening early in the
processes so perhaps that person never gets to the stage of heart
disease where they develop congestive heart failure, incalculable the
amount of dollars that could be saved. Just by increasing exercise,
modifying the diet to reduce that risk of type 2 diabetes. Disease
management will be a powerful tool for holding down costs in the
future.
Again, the gentleman from Georgia (Mr. Gingrey) has done a great job
in outlining the benefits of this plan, and I certainly thank him for
taking time out of his schedule to come and explain this to his
constituents and the American people at large.
I am happy to enter into a colloquy if there is any time left; but I
honestly think, Mr. Speaker, that the gentleman from Georgia (Mr.
Gingrey) has done a wonderful job, and I will yield to him for whatever
his pleasure is at this point.
Mr. GINGREY. Mr. Speaker, I thank the gentleman so much. I appreciate
his being with us in talking about this issue.
The gentleman and I are not only colleagues of course here in the
Congress, but we are, as I said earlier, fellow physicians; but I think
most of our Members realize we are both OB-GYN specialists so we share
so much in common. And I would guess that the situation in Texas is
very, very similar to the situation in Georgia. Maybe there are some
figures that you would want to mention in regard to Texas; but, Mr.
Speaker, in Georgia we have got a State maybe a little smaller than the
State of Texas population-wise and certainly geography-wise, but we are
a State of almost 9 million people now.
There are approximately 85,500 Medicare beneficiaries; 16,700 of
those live below 135 percent of the Federal poverty level. These are
the folks that are going to benefit the most, and that is why I felt so
strongly and passionately about this compassionate program. It is those
16,710 who are at or below 135 percent of the Federal poverty level,
Mr. Speaker. There are another 7,000 in Georgia, that brings it up to
about 25,000 people in Georgia who are at or below 150 percent of the
Federal poverty level. All of these individuals, all of these
individuals will be eligible to receive supplemental benefit.
Earlier in the discussion in the hour we talked about the numbers,
and I need to correct it a little bit. I think I may have given numbers
that were a little bit on the low side. But you may qualify, listen to
this, seniors may qualify if you are single and have income below
$14,355 and resources are less than $11,500. That does not include your
possibly paid-for home and homestead and your automobile. And married
couples who have income below $19,200 and resources less than $23,000.
Again, excluding their homestead their home and their automobiles.
These individuals and those at or about the Federal poverty level,
again, no deductible, no co-pay, no monthly premium; and you get that
prescription filled for $1 on generic or maybe as much as $3 or
possibly $5 for one of those very expensive drugs that I talked about
earlier.
{time} 2045
And, Mr. Speaker, here again my colleague may want to talk about the
situation in Texas, because I suspect it is very similar.
Mr. BURGESS. Well, Mr. Speaker, the gentleman has caught me without
having done my homework as well as he has, so I do not have those
figures at hand. But when my colleague was going through that it
reminded me of the times we were on this floor over the last 18 months
talking about the Medicare prescription drug discount card. And of
course in the hour before us there were some individuals who were
fairly negative about anything that might be offered from the
Republican side of the aisle and they spoke very harshly against that
prescription drug discount card for the past 18 months. And that was so
pernicious, so pernicious to people who may have benefited from that
prescription drug discount card; the $600 a year subsidy and the
discount rates that were available on that card.
What a shame. What a shame that their constituents did not get to
participate in that because their representatives came back and told
them, no, this is a bad plan. It is a Republican plan and it is not
good for you.
Well, this is a compassionate plan. This is a bipartisan plan,
because there were Democrats who supported the bill, I am grateful to
say, the night that we took that vote in November of 2003.
[[Page H8907]]
So I urge people, regardless of their party affiliation, to look at
the benefits that are available to you in your State, in your area.
Look at it with your loved ones. Look at it with your children or
grandchildren because there may be some significant savings, some
significant benefit to you.
There is also a benefit to the program at large. If you treat your
disease more effectively, if you prevent disease effectively overall,
that disease process is going to cost less, and that is good for the
country as a whole.
I have to tell the gentleman from Georgia that I just cannot let this
hour go by without asking one additional time for some type of sane
liability reform in this country. We have had good liability reform in
Texas, so why does it matter to me with the rest of the country? Why do
I even care, since Texas is taken care of? The reason I care is because
the cost of defensive medicine in this country in the Medicare program
alone probably approaches $30 billion a year. That is almost the cost
of this prescription drug program.
If we could reform our liability system, this program costs us
nothing. It is the right thing to do and we should do that this year.
And I yield back to the gentleman.
Mr. GINGREY. I thank the gentleman from Texas for his leadership not
only on the Medicare Modernization and Prescription Drug Act, but also
on medical liability. He has been a stalwart supporter of the Health
Act that we have passed in this body so many times over the last few
years.
Mr. Speaker, in the remaining time that we have I wanted to make a
couple of additional comments. We got some good news here recently in
regard to the COLA, the Social Security COLA, which is about a 4.6
percent increase next year because of the Consumer Price Index. That is
good news for our seniors. That is about a $40 per month, typically,
increase in that Social Security paycheck.
Now, it is true that the premium for Medicare part B, even though
that premium only covers 25 percent of the true cost, will also have an
increase next year of about $10. That $10 from $40 leaves $30 still
remaining in that COLA. And even for the seniors who get no
supplemental help, that $30 will pretty much cover the premiums for
Medicare part B. In fact, it may more than cover them, because, as I
said earlier, because of the marketplace, because of competitiveness,
pharmacy benefit managers and companies that are going to offer the
Medicare prescription drug discount program, we are hearing premiums as
low as $20 a month.
And another thing, Mr. Speaker, that we need to say before we
conclude the hour, because we have heard so much negative rhetoric
about this tremendous gap in coverage, the hole in the donut and the
program not being nearly good enough, is that we will have an
opportunity to reduce those costs by some companies now with a slightly
increased premium, maybe as much as $40, possibly $50 a month, so that
there will be no gap in coverage. It will close that hole in the donut
completely. So people will have the option of paying a little bit more
and having coverage without any gap.
Mr. Speaker, in conclusion, I want to again remind our seniors and
ask our colleagues to remind their constituents that beginning November
15 through May 15, 2006, a 6-month window of opportunity will be the
time to sign up for the Medicare part D prescription drug benefit. Look
at the program and compare. If you have something else, make a
comparison, and then make a decision. And make that decision early.
Because if you do, then that coverage starts January 1. If you wait
until after the program starts there may be a month gap before that
coverage kicks in. And if you wait beyond May 15, then there will be a
surcharge. So it is very important to do it in a timely fashion.
I thank my colleagues for their attention, and I thank the leadership
for giving me this opportunity to discuss something as vitally
important as this Medicare prescription drug benefit for our needy
seniors.
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