[Congressional Record Volume 153, Number 4 (Tuesday, January 9, 2007)]
[Senate]
[Pages S274-S278]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         MEDICARE DRUG BENEFIT

  Mr. GRASSLEY. Mr. President, I am back again tonight to talk about 
the Medicare drug benefit. As I said yesterday, the 110th Congress will 
consider legislation that would fundamentally change the benefit. The 
public and Medicare beneficiaries need to fully understand the proposed 
changes and how they would affect them.
  When we talk about the public and Medicare beneficiaries, remember, 
for the most part, we are talking about the senior citizens of America 
and people who are on Social Security disability.
  Yesterday I spoke about how the benefit uses prescription drug plans 
in competition to keep costs down and how well that has worked. Today I 
want to get to the crux of this debate, the so-called prohibition on 
Government negotiation with drugmakers.
  Opponents of the Medicare drug benefit have twisted the law to come 
up with their absurd claim that Medicare will not be negotiating with 
drugmakers. They misrepresented the noninterference clause. The 
language does not prohibit Medicare from negotiating with drugmakers; 
it prohibits the Government from interfering in negotiations that are 
ongoing all the time.
  So it is a prohibition on Government negotiating. It is not a 
prohibition on negotiation. It is very important because it is not the 
Government agency itself that is doing the negotiating. It is the 
private prescription drug plans that are doing the negotiation.
  That may surprise some people who have heard about the so-called 
prohibition on negotiations. Of course, price negotiations occur on 
drugs provided to Medicare beneficiaries. Those negotiations occur 
between the prescription drug plans and the manufacturers. We have a 
precedent for this. The plans are run by organizations experienced in 
negotiation with drug manufacturers. They deliver prescription drug 
benefits to millions and millions of Americans--in other words, meaning 
millions and millions of Americans beyond senior citizens--and 
including this 50-year precedent of it being done for Federal employees 
through the Federal Employees Health Benefit Plans.
  As I said yesterday, competition among the plans to get the best 
price is working. We have lower than expected bids and cost of premiums 
and lower than expected costs for the Government as a result. So not 
only is it saving the senior citizens money, as it has been saving 
Federal employees money for 50 years, but also lowering costs to the 
taxpayers because there is some subsidy for seniors in the Medicare 
prescription drug program.
  Most importantly, we have lowered prices on drugs for beneficiaries. 
For the top 25 drugs used by seniors--so I am just taking the top 25 
drugs used--the Medicare prescription drug plans have been able to 
negotiate prices that on average are 35 percent lower than the average 
cash price at retail pharmacies; 35 percent lower. The purpose of the 
prohibition on Government negotiation--in other words, getting back to 
what is referred to as the noninterference clause--is to keep the 
Government from undermining these negotiations that have been so 
successful and to keep the Government out of the medicine cabinet.
  I have lost count of the number of times I have talked about this so-
called prohibition that is not a prohibition on negotiations, because 
negotiations are going on every day. I am not easily discouraged and 
that is why I am here talking tonight on this subject. I prefer to 
debate more substantive issues, but unfortunately that is not the case. 
The debate that went on during the campaign, the debate that went on in 
some speeches on the floor in the last Congress, and the debate that 
will come here on the Senate floor in the next 3 weeks, is in fact a 
shell game. It is about distortion of the language of the law, it is 
about manipulation of beneficiaries and, in turn, the public, and it 
hinges on the convenient lapse in some people's memory about the 
history of this noninterference clause. What I want to do today is 
remind people about the history.
  We are going to take a little trip down memory lane. For our first 
stop

[[Page S275]]

on memory lane, let me take a second to read something to you. This is 
a quote from someone talking about their own Medicare drug benefit 
proposal.

       Under this proposal, Medicare would not set prices for 
     drugs.

  Let me start over again because that first sentence needs to be 
emphasized:

       Under this proposal, Medicare would not set prices for 
     drugs. Prices would be determined through negotiations 
     between the private benefit administrators and drug 
     manufacturers. . . .

  The person who said this clearly wanted private negotiations with 
drug companies for Medicare benefits. He was proposing, and I want to 
quote again from this person--and I am soon going to tell you who that 
is--

       . . . negotiations between private benefit administrators 
     and drug manufacturers.

  So I am taking that quote out of the previous quote for a way of 
emphasis.

       Negotiations would go on between private benefit 
     administrators and drug manufacturers.

  In other words, not involving the Government. So it could not be more 
clear what this person had in mind when he was proposing legislation a 
few years ago. You are going to be shocked to hear who said this. For 
those who thought President Bush said it, they are wrong. The quote is 
from none other than President Clinton. President Clinton made that 
comment as part of his June 1999 plan for strengthening and modernizing 
Medicare. President Clinton had in his idea, when we were going to 
strengthen and modernize Medicare with a prescription drug program, 
that we ought to have negotiations done by the private sector, not by 
the Government.
  President Clinton went on to say that under his plan:

       Prices would be determined through negotiations between the 
     private benefit administrators and drug manufacturers.

  Quoting further:

       The competitive bidding process would be used to yield the 
     best possible drug prices and coverage. . . .

  And following the 50-year precedent I have been referring to, he went 
on to say:

       . . . just as it is used by large private employers and the 
     Federal Employee Health Benefit Plans today.

  That is the end of the quote from President Clinton.
  President Clinton also described his plan as using private 
negotiators because:

       These organizations have experience managing drug 
     utilization and have developed numerous tools for cost 
     containment and utilization management.

  This is a President whom a lot of people would believe, because he 
comes from the Democratic Party, has great faith in big Government, 
that he would not be suggesting these things. But when you have a 
precedent of 50 years of it working for Federal employees, he believed 
it was good enough to use when you offer prescription drugs to the 
senior citizens of America.
  Does this ring any bells? It should, because it is the same framework 
used in today's Medicare prescription drug benefit--and I had a hand, 
as a conferee, in writing that. Private negotiations with drug 
companies--and it is based on a nearly 50-year history of the Federal 
Employees Health Benefit Plan.
  Here is another interesting spot on memory lane--if I could digress 
for a minute for the benefit of Members who keep ringing up about a 
doughnut hole--separate from the issue of pricing drugs and 
negotiating. I thought it would be good to remind people. The Clinton 
plan had a coverage gap as well. It had a doughnut hole, as we refer to 
it, like the bill eventually signed by President Bush in 2003. Like 
many others, the new Speaker of the House has questioned why one would 
pay premiums at a point in time when you are not receiving benefits. In 
other words, when you are in the doughnut hole. It happens in the 
private sector, in a lot of different insurances. That is how insurance 
works. Go look at any homeowner's policy and auto policy or even the 
Part B of Medicare. You pay premiums to have coverage, and that is also 
how President Clinton's plan would have worked if it had been passed in 
1999 instead of 2003.
  In Sunday's Washington Post, Speaker Pelosi was quoted on her 
thoughts about having a doughnut hole. She said:

       How could that be a good idea unless you're writing a bill 
     for the HMOs and the pharmaceutical companies and not for 
     America's seniors?

  Maybe she was referring to President Clinton's plan. As I said, 
President Clinton proposed this plan in June of 1999. On April 4, 2000, 
in a bill that is listed as S. 2342, the Medicare Modernization Act 
introduced here in the Senate, S. 2342 from that year, 2000, would have 
created a drug benefit administered through benefit managers. It even 
had the same title as the Medicare law that is now law. The Medicare 
Modernization Act is the title in 2000. It is the title of a bipartisan 
bill that is now law. So, here again, we have private negotiations with 
drug companies. It sounds familiar. It is like today's Medicare drug 
benefit.
  Here is another important stop down our memory lane. This bill, which 
I referred to as S. 2342 previously, included the following language. 
``Noninterference,'' nothing in this section or in this part shall be 
construed as authorizing the Secretary to:

     require a particular formulary or to institute a price 
     structure for benefits; (2) interfere in any way with 
     negotiations . . . or (3) otherwise interfere with the 
     competitive nature of providing a prescription drug benefit 
     through private entities.

  This is the first bill, the very first one where the noninterference 
clause appeared. You could say it is the second time it appeared 
because it appeared as a suggestion of President Clinton, but it was 
introduced the first time, and this was the language. But S. 2342 was 
not introduced by Republicans. It was introduced by my esteemed 
colleague and friend, the late Senator Moynihan. One month later there 
was S. 2541 introduced. I will read some language of that bill. Here I 
go to the first chart I have. I have four charts coming up.
       (B) Noninterference . . . The Secretary may not--
       (1) require a particular formulary, institute a price 
     structure for benefits;
       (2) interfere in any way with negotiations between private 
     entities and drug manufacturers or wholesalers; or
       (3) interfere with the competitive nature of providing a 
     prescription drug benefit through private entities.

  That wasn't a Republican bill, either. It was introduced by Senator 
Daschle, who was joined by 33 other Democrats, including Senators Reid, 
Durbin, and Kennedy. For instance, 33 Senate Democrats cosponsored 
language for a bill that they now find not to their liking. I don't 
understand it. It turns out that the Democrats did not want Government 
interfering in the private sector negotiations, either. They recognized 
then that the private sector would do a better job. They recognized 
then what President Clinton recognized: something that had worked 50 
years for Federal employees could be allied to senior citizens and 
Medicare as well and maybe do it better. And they didn't want the 
Government, some bureaucrat, messing it all up. At that time, they 
didn't want the Government in their medicine Cabinet, either.
  In June 2000, two Democratic bills were introduced in the House of 
Representatives that also included the noninterference language. One 
was introduced by Dick Gephardt. That bill had more than 100 
cosponsors, including then-Representative Pelosi, now Speaker of the 
House, but it also included Representatives Rangel, Dingell, and Stark. 
I want Members to know I worked very closely on some health issues with 
Dingell and Stark, and I worked very closely with Congressman Rangel on 
trade and tax issues.
  That language included in H.R. 4770, introduced by Representative 
Gephardt and supported by more than 100 House Democrats, was almost 
identical to the language in Senator Daschle's bill. So we have 33 
Senate Democrats, we have 100 House Democrats supporting the 
noninterference language.
  Here is a chart with the text of the noninterference clause included 
in what is now Part D, the prescription drug part of Medicare, 
referring to it again under its official title, the Medicare 
Modernization Act.
  It says:

       (B) Noninterference--in order to promote competition under 
     this part and in carrying out this part, the Secretary--
       (1) may not interfere with the negotiations between the 
     drug manufacturers and pharmacies and PDP sponsors; and

[[Page S276]]

       (2) may not require a particular formulary or institute a 
     price structure for the reimbursement of covered Part D 
     drugs.

  It sounds exactly like what was introduced in the Democratic bill. If 
we compare this language to the Gephardt-Pelosi language, the Medicare 
Modernization Act provisions have 26 fewer words. Compare it to the 
Daschle-Kennedy noninterference clause--the Medicare Modernization Act 
has 10 fewer words. It sounds as if sponsors of those bills were pretty 
concerned about the potential of Government interference.
  Last week, the senior Senator from Illinois described the Medicare 
law enacted in 2003 as being written by the pharmaceutical industry. 
But the noninterference clause first appeared in legislation introduced 
by Democrats who now oppose the same provision that is law.
  Since the opponents of the Medicare drug benefit always say that the 
noninterference clause is proof that the drug industry wrote the law, 
my question is, If that is what you think, did the pharmaceutical 
industry also write the bills that you had put in over the previous 
years going back to the bills I have referred to that were introduced 
by Democrats? I bet you wonder just how many Democratic bills contain 
that now infamous ``noninterference clause''--the prohibition, in other 
words, on Government negotiating.
  I have a timeline. As this chart shows, the prohibition on Government 
negotiation--the noninterference clause--has been in seven bills by 
Democrats between 1999 and 2003. That is in addition to the point I 
make clear of where the last Democratic President was on this subject: 
right where the law is today. Seven bills, including the bill 
introduced in the House on the same day as H.R. 1, which is now the 
law.
  First it was in the Moynihan bill in 2000. There was a Daschle-Reid-
Kennedy bill. That was followed in the House by a bill introduced by 
Representative Eshoo and then the Gephardt-Pelosi bill which has 
Representatives Rangel, Dingell, Stark, and our colleague who then was 
in the House, Senator Stabenow now, as a cosponsor. Representative 
Stark then had his own bill, and the senior Senator from Oregon 
introduced his bill in the Senate.
  Finally, in the House, Representative Thomas introduced a bill. I 
know what the response will be. It will be that even though Democratic 
bills had nearly exactly the same noninterference language, practically 
word for word in seven bills over a long period of time, opponents now 
think that approach is no longer best for Medicare. It is sort of like 
we supported it before we opposed it.
  Mr. DURBIN. Will the Senator yield?
  Mr. GRASSLEY. Of course I yield for a question. We very seldom get a 
chance to debate. That is a welcome opportunity.
  Mr. DURBIN. I notice that my friend and colleague from Iowa has been 
in the Senate for the last several days talking about Medicare 
prescription Part D, which he played a major role in creating. I know 
he feels the program as passed into law should not be changed--or at 
least not along the lines many suggest. However, I ask this question: 
Does the Senator believe that the current program at the Veterans' 
Administration which allows that agency to bargain for bulk discounts 
on behalf of our veterans to reduce the prices of the drugs they buy 
for our veterans is a good policy?
  Mr. GRASSLEY. In the sense of what we can afford for veterans, we 
ought to think in terms of that we cannot afford enough for veterans 
who put their lives on the line.
  When we have appropriated accounts, there are some limits, as opposed 
to an entitlement such as Medicare, but it is not as good as what 
seniors have under this because there are several therapies the 
Government will not pay for under the veterans program we pay for under 
Medicare. From that standpoint of the quality of the program, based 
upon the therapies that are available, it is not as good as what we 
have in Medicare.
  Mr. DURBIN. Would the Senator acknowledge the fact, though, that the 
Veterans' Administration, because it can bargain on behalf of all 
veterans and obtain bulk discounts, saves money not only for the 
veterans who are provided with these drugs but also for our Government; 
that the pharmaceutical companies, anxious to provide drugs to millions 
of veterans, will give bulk discounts that will benefit both the 
Veterans' Administration and the veterans?

  Mr. GRASSLEY. The answer is yes. But you get back to the person who 
came to one of my town meetings and said: The doctor said I ought to 
have this prescription. Why won't the Veterans' Administration pay for 
it? I have to have this one, according to the Veterans' Administration, 
and there is some way it affects me that the other one wouldn't.
  We have to take that into consideration as well. Yes, bulk discount 
gets drugs cheaper, but the Government is not going to pay for every 
drug. You are going to have the bureaucrat in the medicine cabinet of 
the veteran, and the bureaucrat is not today in the medicine cabinet of 
the senior citizen.
  You also have to realize that, in addition to the VA having a limited 
formula, they also do not have the availability of the drug in the 
pharmacies the way we provide in this Medicare Program.
  Mr. DURBIN. Would the Senator from Iowa acknowledge the fact that 
under the current Medicare prescription Part D, if a senior citizen in 
Iowa or Illinois signed up for a specific program, there is no 
guarantee the formulary they signed up for today will be available to 
that senior next month or even next year? So if the Senator from Iowa 
is concerned that the VA can't guarantee all drugs, the current 
Medicare prescription drug Part D Program does not guarantee the 
formulary. The formulary can literally change by the month, and a 
senior can find that a valuable and important drug they signed up for 
is no longer covered.
  Mr. GRASSLEY. If you want to say for a period of a year or beyond a 
year, the answer is yes, but for 12 months, no. But also remember that 
every year the Secretary of Health and Human Services has to approve 
these plans, and there are certain basic needs they have to meet. One 
of those basic needs that is in the law that is not in the VA program 
is a requirement that every therapy be available.
  Mr. DURBIN. I say to the Senator from Iowa, it has been my 
experience, working with my seniors, that every plan does not offer 
every drug.
  Mr. GRASSLEY. That is true, but every therapy is available.
  Mr. DURBIN. That is the same situation the VA faces. The VA may say 
to that veteran: We believe you should have a generic drug. The veteran 
may prefer a brand-name drug which is more expensive, but the plan 
provides the therapy through a generic drug. So in that way, it 
parallels what the Senator is describing under Medicare prescription 
Part D.
  What I am suggesting, what we are suggesting on this side of the 
aisle, is not to foreclose the possibility that private plans will 
continue to offer options under Medicare prescription Part D. What we 
are trying to add is something that was debated at length and rejected 
when the bill was written; that is, to allow Medicare as an agency, as 
a program, to offer its own prescription drug program for seniors, to 
bargain with pharmaceutical companies to find the lowest prices 
possible and then allow the seniors to make the choice: either take the 
Medicare approach or take a private approach. It gives more choices, 
not fewer.

  Mr. GRASSLEY. Mr. President, I say to the Senator, I want to comment 
on the first part of what he recently said; that is, that what you say 
is true in regard to plans changing what drugs can be offered. We 
require that every therapy be available, but you are right, not every 
drug is available. And you want what the VA has because it might be 
better.
  Now, let me point out then why our program is better. In the VA, 30 
percent of drugs are covered, 70 percent not covered. In our program, 
if a senior finds him or herself in a plan where at the end of the year 
it has changed, they have choices of several plans to go to. The VA 
does not have that choice. There is no place a veteran can go. There is 
no place my constituents could go when they came to me and said: Why 
don't you cover this drug? My doctor says I need it because of what it 
does to me that the other one won't--or just the opposite.
  Mr. DURBIN. If I could say to the Senator from Iowa, I have found my 
veterans to be very happy with the VA

[[Page S277]]

program. It is a very affordable program.
  Mr. GRASSLEY. I have, too, so I agree with the Senator.
  Mr. DURBIN. It is growing dramatically in size, which suggests more 
veterans are using it. But going back to Medicare Prescription Part D, 
we are not suggesting that Medicare offering its own program as an 
option is going to be mandatory on seniors. It is still their decision 
whether they want to use the Medicare approach--which we are supporting 
on this side of the aisle, which allows for these discounted drugs--or 
if they feel a private plan is better for them, better for their needs, 
better for their pocketbook. It is just a consumer choice. But that 
choice is not available today.
  Medicare cannot offer to the seniors, under Medicare Prescription 
Part D, an option. What is wrong with Medicare offering that option and 
competing with these private insurance companies?
  Mr. GRASSLEY. Well, can I ask a question without answering the 
Senator's question?
  Mr. DURBIN. Certainly. Of course.
  Mr. GRASSLEY. Because I was very joyful the Senator was coming out 
here. I saw him come out. I probably irritated him or something.
  Here is what I was hoping we would be debating. Because the whole 
point of the last 2 days is: From President Clinton in June 1999, all 
the way through bills that the Senator's party introduced in 2003, we 
had the noninterference clause in it. I want you to know I felt very 
comfortable adopting a Democrat noninterference clause in my bill that 
is now law, and I was hoping the Senator was going to come out and give 
some justification why his party--mostly in his party; there were some 
on our side who would agree--why his party would change its mind after 
President Clinton thought that what we have been doing for 50 years was 
working so well in the Federal Employees Health Benefit Program that he 
wanted to do it. And he said you get lower drug prices by doing it that 
way.
  Several bills--I think I said seven bills--introduced by Democrats 
had the same principle in it. And now you don't like it. I don't 
understand why. I was hoping that was why the Senator came out to 
debate.
  Mr. DURBIN. Mr. President, I would say to my friend from Iowa, that 
is why I was asking the questions because I think the questions get 
beyond the word ``noninterference'' into the reality of the choice we 
are suggesting.
  I do not believe it is an interference to the rights of seniors 
eligible under Medicare Prescription Part D to give them an additional 
choice. And that is all we are asking: Allow Medicare to offer to the 
seniors another choice. They can reject it. They can accept it. I do 
not think that is mandatory or interfering.
  I think, frankly, that a free-market Republican such as my good 
friend from Iowa would grasp that as a good option. It means the 
private insurance companies would then have to do their best to compete 
with Medicare. If Medicare offers a better plan, seniors can take it. 
If it does not, they can take private insurance options that are 
currently available.
  Mr. GRASSLEY. If it is a good idea, I think the Senator from Illinois 
would do the consumers more good by offering a Government program to 
compete with Wal-Mart, maybe.
  Mr. DURBIN. I would say, when it comes to the Medicare program, we 
know this was created by the Senator's committee. And I salute him for 
his leadership. But it is in fact a Government program. In fact, it is 
a program that is subsidized by our Federal Government. It is not just 
allowing little, private entities to compete. We provide a subsidy to 
them. We have constructed a plan which has a doughnut hole where there 
is a period of no coverage. We have constructed an approach that some 
seniors find very hard to understand. But regardless, it is a 
Government creation. What we are suggesting is a Medicare option is not 
unreasonable. It still leaves the final choice in the hands of the 
seniors. They make the final choice what is best for them, what is best 
for their family, and what is best for their budget.

  Mr. GRASSLEY. Mr. President, I think I have to give a bottom line and 
say it is working. Or if that is not good enough for you--after 2 
years--that it is something that is working, it is something that is 
needed, it is something that Republicans got passed. And we did not get 
it passed without Democratic help, thank God--it was bipartisan--
otherwise we would not have gotten it done. But for 4 years we were 
waiting for something to happen on your side of the aisle. It did not 
happen.
  So could I end by saying one thing? In case my word is not so good, I 
would quote from the LA Times. It is in response to what the Senator 
said about the VA program. And I do not have any problems with the VA 
program. But it says here:

       VA officials can negotiate major price discounts because 
     they restrict the number of drugs on their coverage list. In 
     other words, the VA offers lower drug prices but fewer 
     choices.

  Now, do we want to give the seniors of America fewer choices? I think 
you do. The route you are going, that is where you are going to end up.
  Mr. DURBIN. Mr. President, I would say to the Senator from Iowa, it 
is true that the VA formulary for eligible drugs is a more restrictive 
list. I do not know if that will be the same case when Medicare--if 
they are allowed to--offers an option. But ultimately the choice is in 
the hands of the seniors. If they think the formulary that is offered 
by Medicare is too restrictive, they do not have to choose it. It is 
their ultimate decision. It is the concept of freedom. And I know the 
Senator from Iowa embraces that concept. I hope he will consider our 
approach.
  Mr. GRASSLEY. So I cannot attribute this specifically to the Senator 
from Illinois, but the Senator is talking about choice now, and if 
there is anything people have choice on, it is all the plans that are 
available. But from your side of the aisle, starting in 2004, all I 
heard was there was too much choice, too much choice, too many plans.
  So I do not know for sure if you and your party know where you are 
coming from, whether choice is OK, how much choice is OK. Maybe you are 
leading us down the line where we are going to end up, if you get too 
much Government interference, we will not have choice.
  Mr. DURBIN. I would say to my colleague, when it comes to this issue, 
my experts are pharmacists. Just like so many towns in Iowa, there are 
many towns in Illinois where the drugstore pharmacy is a community 
center, and people come to trust their druggist, trust their 
pharmacist. What I did, as Medicare Prescription Part D came on line, 
was to visit those drugstores and sit down with the pharmacist. And I 
will tell you quite candidly, many times they were dealing with seniors 
who had reached a point in life where a lot of information was 
difficult to evaluate, and they had to work with their pharmacist to 
find the best option.
  So if there was a criticism on our side, it was the fact that there 
was so much information being given to seniors with a limited amount of 
time to make a decision. I think the Senator from Iowa would concede 
that some seniors needed the help of family members or pharmacists or 
counselors at senior centers to help them make this decision.
  But on the final analysis, I hope the Senator will be open to the 
concept that if Medicare offers an option, it is just another choice 
for seniors. Take it or leave it. It is still ultimately their 
decision.
  Mr. GRASSLEY. Mr. President, let me suggest to you that the committee 
that has jurisdiction over it, which I am no longer chairman of, has a 
tradition of trying to work through things. I want you to know I am 
committed to looking if there are better ways of doing it. But I think 
it is pretty difficult to argue with a program that has come in with 
senior citizens, by 80 percent in more than one poll, saying they are 
satisfied and, secondly, a program--what Government program have you 
ever seen come in without big cost overruns?
  This one has come in now with the latest projection by CBO that it is 
going to cost $189 billion less than we anticipated it would cost. And 
we got lower Federal costs. We got lower premiums for the seniors. We 
got 35-percent lower drug prices for the 25 drugs most used by seniors. 
We got lower

[[Page S278]]

State costs, because the States do not have to pick up the duel 
eligibles as they used to.
  There is something good coming out of the discussion the Senator and 
I are having. If we would have had this discussion 3 years ago, you 
would have said what we were doing was going to bring holy hell and not 
do any good and it would never work. At least now there is some 
acceptance of the program. So maybe with a little bit more dialog we 
will come around to the point where you are saying: Maybe, Senator 
Grassley, you were right.
  Mr. DURBIN. Mr. President, I am always--in fact, I have been quoted 
in your campaign literature sometimes saying nice things about you.
  Mr. GRASSLEY. I noticed you have not said that so I can quote you 
again.
  Mr. DURBIN. I am being very careful this time around. And I would be 
happy to acknowledge you are my friend and a great leader, and you have 
done a great job here. And put it in your next brochure if it will 
help.
  But I want to close by saying thank you for this dialog. It is rare 
on the floor of the Senate, and we need more of it. I would say, when 
it comes to perfect laws, I think aside from the Ten Commandments, most 
laws could stand an amendment or two. So I hope you will be open to the 
possibility of improving Medicare Prescription Part D.
  Mr. GRASSLEY. Remember, the bill you want to amend is a bipartisan 
bill. Remember that.
  Mr. DURBIN. I thank the Senator.
  Mr. GRASSLEY. I thank you.
  Mr. President, I want to finish my remarks. I am not sure finishing 
my remarks can be more valuable than what we just had here in this sort 
of discussion. But I think when the Senator came in, I was kind of 
needling the other party a little bit with a statement like all of this 
business of Democrats introducing this noninterference language, and my 
copying it, thinking that was the right thing to do, was the bipartisan 
thing to do, that now they are backing off of it, as you can see by the 
recent exchange I had with my friend from Illinois, that it is sort of 
for the Democrats like: We supported it before we opposed it.
  But I want to recap. When Democrats controlled the Senate, their 
bills took the same approach and had basically the same noninterference 
language--the same prohibition on government negotiations. Looks like 
my colleagues across the aisle yielded--and perhaps against their own 
better policy judgment--to take the opportunity to make political hay 
by demagoguing what seems like a reasonable proposition. That 
proposition was that Government, with all those Medicare beneficiaries 
in the Medicare program, should negotiate lower prices for drugs. In 
reality, it is nothing but an appealing sound bite.

  After the Medicare law was enacted, opponents distorted the meaning 
of the language and vowed to change it. They have now demagogued on 
this issue for 3 years. They had all that time to prepare their 
proposals. What has been introduced to date? The bill introduced in the 
House to address the so-called prohibition has been described as ``not 
as far-reaching as the new majority indicated before taking power.''
  The Senate bill is a nonbinding sense of the Congress resolution as a 
placeholder with no details. I understand that some bills are 
introduced as markers pending further development. I have done that 
myself. But 3 years of talking about this issue, talking about what is 
wrong with the noninterference clause, and there still is no more 
substance behind the proposal than that?
  One of the questions I should have asked the Senator from Illinois 
is, please describe to me how it is going to work if you take out the 
noninterference clause. I have never had anybody tell me that. 
Something like, let's do it a little bit like the VA, but the HHS is 
not the VA. So how is it going to be done? Somewhere along the line 
they are going to have to tell us.
  In fact, the USA Today editorial page recognized the lack of 
substance when they wrote in November that House Democratic aides 
couldn't provide any details on their party's proposal. This is after 3 
years of their finding fault with what is law.
  It makes me wonder if people who led the charge against the so-called 
prohibition on Government negotiation truly ever did change their minds 
about this provision. There was actually a surprising level of 
agreement among Democrats and Republicans that the private sector would 
be able to do a better job of tough negotiation with drug companies 
than the Government could ever do. We had all seen the same history of 
the poor job Medicare does setting prices on almost anything, whether 
it is hospitals or whether it is wheelchairs. Everyone from President 
Clinton to Mr. Gephardt to Speaker Pelosi to the senior Senator from 
Oregon, recognized that at the time when they put their names on 
legislation.
  The same USA Today editorial referred to opponents' plans to change 
the law as ``more of a campaign pander than a fully baked plan.'' Maybe 
the opponents finally realized that themselves.
  I believe beneficiaries and the public deserve more than that. That 
is what the debate is going to be all about. But they are going to have 
to sell their point.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. REID. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________