[Congressional Record Volume 153, Number 7 (Friday, January 12, 2007)]
[House]
[Page H497]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    MEDICARE PRESCRIPTION DRUG BILL

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Pennsylvania (Mr. English) is recognized for 5 minutes.
  Mr. ENGLISH. Mr. Speaker, I first want to congratulate the Speaker 
for the opportunity he has to preside today. Congratulations.
  Mr. Speaker, 3 years ago, Congress passed a Medicare bill that for 
the first time created an opportunity for many seniors to have access 
to strong, valuable and persistent prescription drug coverage. Although 
the legislation was a compromise, and in places an imperfect one, this 
program has proven to be a success, working for seniors with a range of 
circumstances and particularly valuable resource for seniors of the 
most limited means, many of whom are in my district.
  It falls on us in this Congress to consider ways that we can further 
strengthen this benefit. Unfortunately, the legislation that we have 
debated today, H.R. 4, is a huge and real step back and is less of a 
policy than a bumper sticker.
  As a member of the Ways and Means Health Subcommittee, which has 
jurisdiction over this program, I am deeply disappointed that we had no 
hearings, no discussion and no opportunity for amendments to produce a 
real pricing reform bill with teeth and with nuance. While part D is 
not perfect and can be improved, it is our fundamental responsibility 
to put in place a policy that might build on the successes of the 
program, and they are substantial.
  Independent estimates for the Medicare part D prescription drug 
benefit for the fiscal year 2008 budget cycle show that net Medicare 
costs are 30 percent less, about $190 billion lower than were 
originally predicted when the benefit was created in 2003.

                              {time}  1515

  In addition, based on strong competitive bidding by health care plans 
for 2007, average monthly premiums will be approximately $22 for 
beneficiaries, down from $23 in 2006 if enrollees remain in their 
current plans. The initial estimate for 2006 premiums was $37. CMS has 
indicated that beneficiaries are saving on the average of $1,200 
annually on their drugs, and these are achievements that must be 
preserved.
  Many people in my district like the idea of the legislation which the 
House Democrats put forward today. I understand how they feel. I have 
long felt that we could improve on the existing policy and the existing 
process. But what I found was that the Democrats' plan is more of a 
political stunt than a solution. And it isn't at all a prescription for 
real reform, and it is, at best, a placebo, but one that could actually 
reduce the benefits and the coverage for many individual seniors. To 
understand why, we need to recognize how much this proposal has been 
criticized. Even leading liberals like Urban Institute president Robert 
Reischauer and Brookings Institution senior fellow Alice Rivlin have 
expressed real qualms about an initiative that limits choices for 
seniors by putting government bureaucrats in charge of setting prices 
for prescription drugs. Reischauer recently said to The Washington 
Post: ``People were worried no private plans would participate. Then, 
too many plans came forward. Then people said it's going to cost a 
fortune and the price came in lower than anyone thought. Then people 
like me said that they are low-balling the prices the first year. They 
will jack up the rates down the line. And lo and behold, the prices 
fell again. And the reaction was, we have got to have the government 
negotiate lower prices. At some point you have to ask, what are we 
looking for here?''
  Rivlin stated: ``It's not clear that a government, particularly this 
government, would get a better deal from the drug companies by direct 
negotiations than the drug plans can get on their own, and it might 
have some negative consequences.''
  We also want to recognize that the new majority has claimed that 
their proposal will provide significant savings, when, in fact, the 
CBO, nonpartisan, has announced that H.R. 4 would in their view have no 
budget savings and a negligible effect on Federal spending.
  The reasons why I felt, as an advocate and caretaker for this 
program, obliged to oppose H.R. 4 are clear: one, this measure is not 
going to generate savings for the consumer; two, government price-
setting will only drive drugs out of the program and reduce seniors' 
access to critical drugs that may be central to their treatment as 
individuals.
  This plan could potentially, three, limit seniors' access to their 
community pharmacies. For many seniors, advice from their pharmacist is 
a critical service that they need to have access to to coordinate their 
drug uses and find the best coverage.
  And, four, finally, this plan could lead to increased drug prices for 
America's vets.
  Mr. Speaker, I believe we could improve on this legislation, and I 
will speak next week about some further ideas. I believe that there is 
a significant difference between the plan we have and the VA plan; and 
if we don't recognize those differences, we are going to shortchange 
seniors, and this bill that we voted on today will generate no savings. 
And I hope when it comes back from the Senate, that there will be an 
opportunity to substantially correct it, put teeth into it and create a 
real nuanced policy that will add to the successes of our part D 
program.

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