[Congressional Record Volume 153, Number 62 (Wednesday, April 18, 2007)]
[Senate]
[Pages S4625-S4633]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           PRESCRIPTION DRUGS

  Ms. STABENOW. Mr. President, we have a very important vote we are 
going to take in a few minutes about whether we are going to be allowed 
to proceed--even to proceed--to a bill that would give the Secretary of 
Health and Human Services a very important tool to lower prices for 
prescription drugs.
  With all due respect to my friends on the other side of the aisle, I 
hear very differently from seniors. First of all, they don't like, in 
Michigan, wading through 50, 60, 70 different insurance plans and all 
the paperwork to figure out what plan they are going to sign up for. 
They wanted us to go directly to Medicare which is, by the way, a 
Government-run program, one of the most successful in the U.S. 
Government.
  They wanted us to be able to set up prescription drug coverage 
through Medicare. That wasn't done. Instead, we have this privatized 
system that was geared to making sure the industry would have the 
maximum amount of profit. That has been the focus, unfortunately, of 
this legislation, which

[[Page S4626]]

is why we would see, in the middle of a prescription drug bill for 
seniors, actual language that says: You cannot negotiate for lower 
prices.
  Now, we have an opportunity to change that, to take that language 
away. What are we hearing? Well, we are hearing all kinds of things, 
all kinds of things. On the one hand we hear: This will do nothing for 
seniors. It will not help seniors. It will not lower prices. On the 
other hand we hear: It is going to do all kinds of things that are very 
terrible for people.
  Well, it can't be both. What we have going on is an orchestrated 
effort by the industry to keep things the way they are.
  If we were able to get better prices for seniors, there would not be 
that big gap in coverage that I guess some folks think the seniors 
like. Seniors in Michigan do not like that. After they have paid some 
$2,100 in drug costs, going into a gap where the average price has 
actually gone up, they have no help. This is a very different world I 
am hearing from, the people in Michigan, rather than what we are 
hearing from the industry and from others who support this plan the way 
it is.
  We can do better than this Medicare prescription drug benefit. Today 
is the opportunity to decide whose side you are on, either on the side 
of the industry that is doing great under this bill, record profits, or 
you are going to be on the side of the seniors who are asking us to 
help them, whatever way we can, get the best deal for them by lowering 
their prices.
  I wish to go through a few of the myths and the scare tactics that 
have been out there, and there have been many, there is no question 
about it. First of all, we are hearing from the industry now in big 
ads--by the way, I should say, $135,000 an ad a day--by folks who say 
this bill would not do anything. It is the Washington Post and another 
Washington Post. We go on and we can see all of the papers that we 
read. We have seen these ads in the Congressional Daily--daily, 
millions and millions of dollars.
  I woke up this morning to an ad on television I have seen many times: 
The Medicare prescription drug benefit, yes, it is doing great for 
them. It is not doing great for our seniors.
  Here is one of the things they are saying: that 89 percent of the 
folks oppose negotiation, if it could limit access to new prescription 
drugs. What they are saying is, they are telling people they are going 
to limit access to new drugs, they are not going to be able to do 
research anymore.
  In fact, this bill would not limit access to prescription medication. 
I have to say, with all due respect, the industry spends about 2\1/2\ 
times more on advertising and marketing than they do on research. We 
have a long way to go. We could cut out a couple of ads. One ad for 
$135,000, if it was not done, I wonder how much medicine that would buy 
for people? This is not about doing away with research. We know that. 
CBO says that. We know that as a fact. This is not about taking away 
access to medicine for people.
  We are being told it will have an effect on other purchasers. The 
Congressional Budget Office, I asked them to put in writing, after our 
Finance hearing, whether this bill would do that. CBO anticipates that 
S. 3--the bill in front of us, the Medicare Prescription Drug Price 
Negotiation Act of 2007 as reported by the Finance Committee--would not 
have an effect on drug prices for other purchasers.
  Unfortunately, my good friends, the veterans for whom we work hard, 
whom we have raised health care dollars for, have been told something 
different. That is very unfortunate. It is not true. It is a 
scare tactic. This bill does not do that. CBO, in fact, has indicated 
it does not do that.

  We hear something else that I think is very important. We hear: Well, 
we should not compare this to the VA; the Veterans' Administration 
negotiates group prices for our veterans. In fact, the average 
difference in price is 58 percent.
  Now, some go up to as high as 1,000 percent, a 1,000-percent 
difference. On Zocor, there is a 1,000-percent difference. It seems to 
me there is a little room for us to negotiate for those on Medicare 
within that 1,000 percent.
  But we are told no. The problem is that the VA, first of all, gets 
lower prices because they do not offer as many drugs; you cannot go to 
the VA and get the drugs you need, which is also not true.
  From a presentation overview of the VA pharmacy benefit, in a 
presentation that was made, comparing apples to apples, now they have 
compared on the other side of this argument chemical compounds as 
opposed to actual drugs.
  But the fact is, under Medicare there are 4,300 different drugs 
available, 4,300. Under the VA, they dispense 4,700--not 4,300--4,778 
specific drug products, specific drug products which represent the 
chemical compounds that have been used on the other side of the 
argument.
  In fact, in addition to that, if you go to the VA and if on the list, 
the approved list, there is not the medicine you need, you can ask for 
an exception to get the medicine you need. In addition to the 4,778 
different medicines available from the VA, last year they dispensed 
prescriptions for an additional 1,416 different drugs so our seniors, 
our veterans were able to get what they needed from the VA.
  When we hear concerns about veterans health care, with all due 
respect--I hear a lot about driving too far to get tests, waiting too 
long to see a doctor--I do not hear about not being able to get 
medicine.
  The fact is, the VA dispenses more different prescriptions at a lower 
price than this privatized system, what I view as a dismantling of 
Medicare that has taken place through the prescription drug benefit 
that is before us.
  What we have is the ability today to take a vote on proceeding to a 
bill that 87 percent of the American public wants to see us pass. And 
this is the AARP. Now, I find it very interesting, on the one hand, we 
have got all the folks representing the industry doing well under this 
bill, putting in ads, doing surveys, talking to us through the 
television and the radio saying that seniors do not want to negotiate 
the best price because of all these scare tactics.
  But when the group who represents seniors, the AARP, speaks, they 
tell us 87 percent of voters want us to move ahead. This is a tool. 
This is giving the Secretary the ability to use that tool in a way that 
is responsible and will lower prices for our seniors. This is a motion 
to proceed.
  I hope we are not going to see what we have seen, unfortunately, too 
many times this year, as we have--in the new majority--worked hard to 
change the direction of this country. I hope we do not see our efforts 
stopped from even moving forward to debate this critical piece of 
legislation. Eighty seven percent of the American public has some 
common sense. They are saying: What are you doing? What are you doing 
that you would not give the Secretary the ability to negotiate the best 
price?
  I hope we will join together overwhelmingly and vote to give us the 
opportunity to consider this bill, to be able to move forward on a 
basic policy of common sense to help our seniors, people on Medicare, 
get the lowest possible price for their medicine.
  The ACTING PRESIDENT pro tempore. The Senator from Texas.
  Mr. CORNYN. May I inquire how much time this side of the aisle has 
remaining in morning business?
  The ACTING PRESIDENT pro tempore. The Senator has a little over 20 
minutes.
  Mr. CORNYN. I see the distinguished ranking member of the Finance 
Committee here. I will speak briefly and then certainly yield the rest 
of our time to him.
  There is a much larger question than has been addressed so far before 
the Senate this morning on this particular motion to proceed; that is, 
whether we are going to see the incremental growth of Government 
involved in intervening between decisions that should be made by 
patients in consultation with their doctors as a matter of individual 
choice. If, in fact, the advocates of this particular legislation are 
successful, it will be one step further down the road toward a single-
payer system where the Government will decide what kind of health care 
we get and our family members receive rather than we as a matter of 
individual choice in consultation with our personal family doctor. That 
is a dangerous trend.
  As my colleagues know, the Federal Government and Federal taxpayers 
pay for 50 percent of health care today. I am staggered by the 
suggestion that

[[Page S4627]]

the Federal Government can somehow do a better job than the private 
sector through choice and competition in setting drug prices. Rather 
than a negotiation, this is like a take-it-or-leave-it offer with a gun 
to your head. The consequences, if this legislation is successful, will 
be that seniors will have fewer choices, Government will have grown 
that much bigger and interfered much more in the private choices we 
should all make as a matter of personal choice. The irony is, this is 
one of the Government programs--I would say rare Government programs--
that actually works better than we thought it would. As a matter of 
fact, I voted for the Medicare prescription drug bill in 2003, but I 
was concerned when some of the estimates that came out of the 
Congressional Budget Office indicated it would actually cost a lot more 
than we originally thought. But this is a good news story.
  What I don't understand is why our Democratic friends want to ruin a 
good thing that 80 percent of seniors who have access to this 
prescription drug plan say they like and 90 percent of seniors eligible 
have signed up for, saving on average $1,200 a year. Why in the world 
would we want to mess up a good thing? I don't understand it, unless it 
is that incremental step toward a single-payer, Government-run health 
care system that would be a bad direction, rather than leaving the 
private sector to provide choices and competition, which improves 
services and lowers price.
  Listening to some of my colleagues on the other side of the aisle, to 
paraphrase H.L. Mencken, they live in dread that somebody somewhere is 
actually making a profit in a private enterprise. I don't particularly 
care if shareholders in a company decide they want to risk their money 
to invest in a competitive enterprise to provide me and my family a 
service that I want and like and need and do it at a price that is 
lower and a service quality that is better than the Federal Government. 
The fact that they make a profit, good for them. That is what this 
country is built on. That is why our economy is the envy of the world.
  Competition provided in the prescription drug benefit has forced 
costs down far below what was anticipated. In 2007, the average premium 
for the benefit is $22 a month--40 percent less than projected. We have 
heard the statistics before, but they bear repeating. The Congressional 
Budget Office new budget estimates that for the next 10 years, the net 
Medicare cost for the prescription drug benefit will be more than 30 
percent lower than originally forecast, $265 billion. I have only been 
in the Senate for 4\1/2\ years, but I don't think I have ever seen or 
even read about a Government program that actually came in under budget 
at a lower cost than originally projected. For some reason--and it 
escapes me--some of our colleagues here want to change that, and that 
is a mistake.
  One of the editorials in one of my newspapers back in Texas, the 
Austin American Statesman, writes:

       The incoming majority of Congressional Democrats, it seems, 
     has a problem: a promise to fix something--the new Medicare 
     drug program--that might not need fixing.

  The basic point is this: We passed a prescription drug benefit that 
uses market competition to provide critical medications to seniors at 
costs much lower than projected. The results so far demonstrate the 
familiar principle that competition and choice could bring lower 
prices, something that should not surprise any of us. I must say, I am 
surprised at the magnitude of the benefit and the magnitude of the 
savings and the way this has lived up or, I should say, even exceeded 
expectations.
  Today in the Wall Street Journal there is an article entitled 
``Bitter Pills'' which I ask unanimous consent to have printed in the 
Record following my remarks.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  (See exhibit 1.)
  Mr. CORNYN. This speaks directly to the comments made by the Senator 
from Michigan about the Veterans' Administration. Let me briefly read 
this paragraph:

       Supporters of federal price ``negotiations''--really, an 
     imposed price--also like to point to the example of the 
     Veterans Health Administration which negotiates prices 
     directly with drug companies. But it turns out that the 
     vaunted VHA program has a few holes of its own. The LEWIN 
     study--

Which it alludes to earlier, a health policy consulting firm

     examined the availability of the 300 drugs most commonly 
     prescribed for seniors. It found that one in three--including 
     [the most] popular medicines as Lipitor, Crestor, Nexium and 
     Celebrex--are not covered by the VHA.

  Not covered. That is what the advocates of this legislation, I guess, 
believe is the ideal, to cover less drugs, and that is what the 
consequences of this legislation would be.
  Let me read the last sentence:

       However, 94 percent of these drugs are covered under the 
     private competition model of Medicare Part D. Fewer than one 
     of five new drugs approved by the FDA since 2000 are 
     available under the VHA plan.

  If the right vote on this upcoming motion to proceed is to end the 
debate, it is not true that we haven't had debate. We are having the 
debate right now. But I believe the country would be better off, 
seniors would be better off, and choice and competition would remain 
available if we voted against the motion to proceed. That is how I 
intend to vote and urge my colleagues to do the same.
  I yield the floor.

                               Exhibit 1

             [From the Wall Street Journal, Apr. 18, 2007]

                              Bitter Pills

       The Senate is scheduled to vote today on legislation to 
     allow the government to negotiate drug prices under the 2003 
     Medicare prescription drug bill. Democrats and such liberal 
     interest groups as AARP claim this would save money for 
     seniors and taxpayers, but the more likely result is that 
     seniors would find that fewer of their therapies are covered.
       We opposed the prescription drug bill as a vast new 
     entitlement, but there's no denying the program's innovation 
     of using private-sector competition has worked far better 
     than critics predicted. In the first year alone, the cost of 
     Medicare Part D came in 30 percent below projections. The 
     Congressional Budget Office calculates the 10-year cost of 
     Medicare Part will be a whopping $265 billion below original 
     estimates.
       Seniors are also saving money under this private 
     competition model. Premiums for the drug benefit were 
     expected to average $37 a month. Instead, premiums this year 
     are averaging $22 a month--a more than 40 percent saving, 
     Democrats don't like to be reminded that many of them wanted 
     to lock in premiums at $35 a month back in 2003. No wonder 
     recent polls find that about 80 percent of seniors say 
     they're satisfied with their new Medicare drug benefits.
       Democrats who opposed all of this private competition now 
     say that government-negotiated prices will do even better. 
     They must have missed the new study by the Lewin Group, the 
     health policy consulting firm, which found that federal 
     insurance programs that impose price controls typically hold 
     down costs by refusing to cover some of the most routinely 
     prescribed medicines for seniors. These include treatments 
     for high cholesterol, arthritis, heartburn and glaucoma.
       Supporters of federal price ``negotiations''--really, an 
     imposed price--also like to point to the example of the 
     Veterans Health Administration, which negotiates prices 
     directly with drug companies. But it turns out that the 
     vaunted VHA drug program has a few holes of its own. The 
     Lewin study examined the availability of the 300 drugs most 
     commonly prescribed for seniors. It found that one in three--
     including such popular medicines as Lipitor, Crestor, Nexium 
     and Celebrex--are not covered under VHA. However, 94 percent 
     are covered under the private competition model of Medicare 
     Part D. Fewer than one of five new drugs approved by the FDA 
     since 2000 are available under VHA.
       Here's the real kicker: Statistics released March 22 by the 
     VHA and Department of Health and Human Services show that 
     1.16 million seniors who are already enrolled in the VHA drug 
     program have nonetheless signed up for Medicare Part D. 
     That's about one-third of the entire VHA case load. Why? 
     Because these seniors have figured out that Medicare Part D 
     offers more convenience, often lower prices, and better 
     insurance coverage for their prescription drugs. In short, 
     seniors are voting with their feet against the very price 
     control system that Democratic leaders Harry Reid and Nancy 
     Pelosi want to push them into.
       Of course, the greatest threat from drug price controls is 
     not to our wallets, but to public health. Price controls 
     reduce the incentive for biotech and pharmaceutical companies 
     to invest the $500 million to $1 billion that is often now 
     required to bring a new drug to market. If government price 
     controls erode the profits these companies can earn to 
     produce these often life-saving medications, the pace of new 
     drug development will almost certainly delay treatments for 
     AIDS, cancer, heart disease and the like. Congress is 
     proposing dangerous medicine, and if it becomes law seniors 
     may be the first victims.

  The ACTING PRESIDENT pro tempore. The Senator from Oregon is 
recognized.

[[Page S4628]]

  Mr. WYDEN. Parliamentary inquiry: How much time remains on our side?
  The ACTING PRESIDENT pro tempore. The Senator has 20 minutes.
  Mr. WYDEN. It is my intention to go a little less than 10 minutes. I 
know the distinguished chairman of the committee is here as well, and I 
want him to be able to speak for our side.
  Mr. President, I have always tried to work in a bipartisan way on 
health care. I voted in favor of creating the Medicare prescription 
drug program. I do not favor the Government running everything in 
health care. In fact, I have introduced legislation that would ensure 
that the government would not run everything. I believe it is important 
that pharmaceutical companies be successful in developing new products 
and therapies for America's seniors and for patients who are suffering. 
I believe it is time for the Senate to right a wrong. Outlawing the 
Government from any and every opportunity to negotiate lower drug 
prices for millions of seniors and taxpayers is an instance of special 
interest overreaching. Everybody else in America negotiates. Employers 
negotiate. Labor unions negotiate. Individuals negotiate. Everybody 
tries to be a smart shopper. Certainly Medicare, with 43 million 
people's interest on the line, ought to do everything it possibly can 
to be a savvy shopper.
  It is especially important that the Government not give up the right 
to negotiate when single-source drugs are involved. These are drugs 
where there is no competition and no therapeutic equivalent. For many 
patients, a single-source drug is essentially the only drug available. 
Cancer drugs often fall into this particular category. What this means 
is, seniors who depend on these cancer drugs for their very survival 
often face bills of thousands and thousands of dollars. In my hometown, 
it can often cost something like $400 for a particular injection. We 
are talking about treatment with these single-source drugs for those 
who are suffering, say, from leukemia, from kidney disease. For the 
life of me, I don't see how it is common sense to say that we are going 
to give up every single opportunity for all time for the Secretary of 
Health and Human Services to try to negotiate a better deal for those 
seniors on drugs where there is no competition.
  Senator Snowe and I have worked for more than 3 years in a bipartisan 
way to address the most important concerns of our colleagues who have 
questioned this proposal. We believe strongly that we should not have 
price controls in any shape or form. Price controls clearly impede 
innovation and the development of new therapies. We should not do that. 
Chairman Baucus has ensured that price controls would not be allowed 
under the measure before the Senate today.
  Senator Snowe and I also believe strongly that there should not be 
restrictive formularies. These form-
ularies--to use technical health care lingo--essentially involve a list 
of drugs to which seniors could get access. We should not restrict the 
access of seniors to medicines. Senator Snowe and I have made that a 
priority for more than 3 years. Chairman Baucus has addressed that as 
well.
  We don't have any one-size-fits-all, run-from-Washington kind of 
pricing regimes. All we have said is: Let's make sure we can negotiate 
when it is critically important. I submit, in every one of these budget 
letters--I know the history has been hard to follow; one said this, one 
said that--every one has indicated that there can be savings when there 
are single-source drugs involved in negotiation. I emphasize that. For 
certain cancer drugs, where seniors can be spending thousands and 
thousands of dollars, there is the potential for savings when the 
Secretary has a role there.
  Not a single person in the Congress today can imagine all of the 
scenarios possible that may come up in 10 or 20 years, what new drugs 
there may be that could cure or treat health problems. There can be 
situations in the future where, for example, a different Secretary of 
Health and Human Services would use negotiating authority to get 
savings that can't be anticipated for drugs that haven't even been 
contemplated today. It doesn't make sense for the Congress to 
preemptively outlaw future savings. It especially doesn't make sense 
when the American Association of Retired Persons, in an RX Watchdog 
Report that looked at nearly 200 drugs including the most commonly used 
brand-name medications, has found that seniors very often need 
medicines that carry price tags that have gone up twice the rate of 
inflation. So we have older people getting hit--almost clobbered--with 
these costs which are going up more than twice the rate of inflation.

  I and others have said we want to be sensitive to the question of 
innovation. That is why we have not supported price controls. But when 
you are talking about drugs, such as certain cancer drugs, and the 
interests of older people, let us not say, for all time, and in every 
instance, we are going to forsake the opportunity to negotiate.
  Given that is possible to negotiate savings for seniors, if you stand 
up at a town meeting anywhere in this country and say, well, gosh, that 
is no big deal, I think seniors and taxpayers would say, try to get us 
the most value out of this program. This is a program I voted for and 
that I have always tried to look at ways to improve. I think there are 
plenty of ways under the leadership of Chairman Baucus and Senator 
Grassley we can improve this program.
  Certainly, it is still far too complicated. You almost have to be a 
legal wizard to sort through some of these forms and to be able to 
compare the possibilities you might have for your coverage. So there 
are other steps that can be taken in a bipartisan way. But we ought to 
have a real debate in the Senate on one of the most important 
pocketbook issues of our time. This is what people talk about in coffee 
shops, in senior centers, and in community halls all across the 
country.
  I think the proposal Chairman Baucus has developed in this area makes 
sense. It does not go over the line and impede pharmaceutical 
innovation. It ensures we are going to be on the side of trying to 
stand up for seniors when it comes to those drugs, such as the cancer 
drugs I have discussed this morning, when they have trouble affording 
them.
  I hope our colleagues will vote for the motion to proceed and a 
chance for the Senate to have a real debate rather than this abridged 
kind of discussion where only a handful of Senators can participate.
  I thank the chairman of the Finance Committee for making sure this 
gets to the floor and, particularly, my colleague, Senator Snowe, who 
has worked with me on this issue in a bipartisan way for more than 3 
years. If we get a chance to proceed, she and I will be offering an 
amendment to strengthen the proposal still further.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Montana.
  Mr. BAUCUS. Mr. President, in Shakespeare's time, the poor had little 
access to medicine. In ``Measure for Measure,'' one of Shakespeare's 
plays, he wrote:

       The miserable have no other medicine, but only hope.

  With the Medicare Modernization Act of 2003, we sought to give 
America's seniors, especially America's poorest seniors, something more 
than only hope. We sought to ensure that seniors had access to the 
affordable medicine they need.
  When we crafted the Medicare drug benefit, we could only imagine how 
it would work. We really did not know. In some respects, our work was 
theoretical. We established a market-based approach in which any number 
of private insurers would compete to offer drug coverage. That was the 
foundation.
  Even with a market-based design, we had tremendous concern that the 
market would not be able to offer drug coverage. As the former CMS 
Administrator said at the time:

       Private drug plans do not yet exist in nature.

  We were starting from scratch.
  In an abundance of caution, we went a step further than merely 
creating a market for drug coverage. We took what I am now convinced 
was a step too far: We tied the hands of the Secretary of Health and 
Human Services with what has come to be known as the ``noninterference 
clause.'' We eliminated the Government's ability to intervene to get 
fair drug prices for seniors. Today, we consider a bill to repeal a 
portion of that noninterference clause created by the Medicare 
prescription drug program.

[[Page S4629]]

  What is the noninterference clause? The noninterference clause 
prohibits the Secretary of Health and Human Services from 
``interfering'' with the negotiations between drug manufacturers and 
pharmacies and drug plan sponsors. Essentially, this provision bans the 
Secretary from doing anything that would affect the prices Medicare 
pays for drugs. Another prong of this noninterference clause prohibits 
the Secretary from creating a single, national formulary and from 
setting prices under the Medicare drug benefit. The legislation before 
us today, however, leaves that part alone. Those prohibitions remain.
  Now the Medicare drug benefit is in its second year. Our theory that 
private plans would offer and deliver Medicare drug coverage proved 
accurate. It is working for millions of Americans. It is giving them 
more than just hope. But it is not perfect, and in some cases it still 
may not be giving seniors affordable drugs. We are here today because 
we need to do all we can to make sure it works well for everyone. 
Looking at the program today, the noninterference clause is an 
unnecessary hindrance. It ties the Secretary's hands.
  Free markets are usually the best solution. But markets sometimes 
fail. In this program, American taxpayers are spending more than $50 
billion a year to deliver a prescription drug benefit to seniors. We 
may on occasion need the Secretary to roll up his sleeves and get more 
involved in the program. We want Secretaries of HHS to be able to use 
the tools at their disposal. We want them to help shape the drug 
benefit into a strong and thriving program. It is time to untie the 
Secretary's hands.
  The bill before us today does not change the market-based approach of 
the drug benefit. It does not change that at all. This bill is not the 
first step toward Government-run health care, nothing close to it. This 
bill is not the first step toward a single-payer health care system. No 
way. Rather, the bill before us today aims simply to improve and 
strengthen the drug benefit. It is our way of fulfilling our promise to 
provide Medicare beneficiaries with access to affordable medicines. We 
should not allow the Government to sit idly by while seniors continue 
to pay high prices or even go without their medicine. That would be a 
dereliction of duty. Congress created this benefit to give seniors 
access to affordable drug coverage. Now we need to make sure the prices 
seniors pay at the pharmacy are low, too. That is the goal of this 
legislation.
  So let us build on the Medicare Modernization Act of 2003. Let us 
seek to give America's seniors something more than only hope. Let us 
ensure that seniors truly have access to the affordable medicine they 
need.
  Mr. President, I yield the floor and reserve the remainder of our 
time.
  The ACTING PRESIDENT pro tempore. The Senator from Iowa is 
recognized.
  Mr. GRASSLEY. Mr. President, I have 12 minutes left; is that right?
  The ACTING PRESIDENT pro tempore. That is correct.
  Mr. GRASSLEY. Mr. President, I ask the Chair to please inform me when 
I have used 11 minutes.
  Mr. President, we have a situation here where the latest argument has 
been that when we wrote the bill 4 years ago, providing pharmaceuticals 
for seniors under Medicare, we went one step too far by saying the 
Secretary of Health and Human Services should not interfere in plans 
negotiating drug prices.
  Well, I want everybody to understand that we took this language from 
several different Democratic bills which had been introduced because I 
wanted this program to be as bipartisan as we could make it. So we had 
Senator Moynihan introducing President Clinton's bill in 1999 which had 
that language in it. We had a Daschle-Reid bill in the year 2001 which 
included that language. We had a House bill in 2001 which
included that language. We had a
Gephardt-Pelosi-Rangel-Stark-Dingell-Stabenow bill--Senator Stabenow 
now--which had this language in it.
  So I want people to know that as to this language which they now 
think should not be in this legislation--the bipartisan approach--we 
took this language because we thought this would be one step further 
toward making this whole program bipartisan because we do not have 
enough bipartisanship in the Congress now. All of a sudden, everybody 
who thought this language was perfect language thinks this language--
from Democratic pieces of legislation--ought to be struck out of this 
bipartisan bill. Obviously, as I said yesterday, and I say today, we 
have plans that are working. And if it ain't broke, don't fix it.
  Mr. President, I have always been fond of jigsaw puzzles--spinning 
the pieces around, figuring out how the pieces of a puzzle all fit 
together, until you finally see the whole picture. This debate is a lot 
like working a jigsaw puzzle. I would like to have you take a look at a 
few of the pieces.
  One piece is the House bill, H. 4, passed by the House. The House 
bill requires the Secretary to negotiate prices with drug 
manufacturers. The House bill also strikes the ban on Government price-
setting. To date, the House authors have not explained why they wanted 
to authorize the Government to set prices.
  The Congressional Budget Office said the House bill would not achieve 
any savings unless the Secretary was given the authority to establish a 
formulary or use some other tools to negotiate lower prices.
  Let's look at another piece of the puzzle; that is, the bill before 
us, S. 3. The Senate bill authorizes the Government to take over 
Medicare's negotiations. It strikes the prohibition on Government 
interference in negotiations the prescription drug plans are doing 
today, negotiating with the drug companies to get drug prices down. The 
average cost of the 25 most used drugs by seniors is down 35 percent.
  The Senate sponsors keep saying their bill ``begins the process'' for 
negotiation. But what about the negotiation that has been going on for 
4 years under this bill? They say their language, by striking, is a 
step toward what they want.
  As was the case in the House bill, H.R. 4, the Congressional Budget 
Office also says the Senate bill, S. 3, will not achieve any savings 
unless the Secretary establishes a national formulary or uses other 
tools to reduce drug prices.
  So we have two bills, two pieces to our puzzle. But on Thursday 
night, in our Finance Committee markup of S. 3, we found a missing 
piece that helps us bridge the bills together and finally see the full 
picture of the puzzle.
  On Thursday night, I offered an amendment that would prevent the 
Secretary from using preferred drug lists to limit access to approved 
prescription drugs. We have heard over and over again from our 
colleagues that neither H.R. 4 nor the Senate bill, S. 3, allows for a 
national formulary. But as all observers of the Medicaid Program know, 
States are not allowed to use formularies, but the courts have said 
States can use preferred drug lists. A preferred drug list is just like 
a formulary, only in sheep's clothing. It is a Government-controlled 
list of drugs a beneficiary can and cannot have; in other words, the 
Government saying what drugs you can use, not your doctor, or at least 
what drugs we are going to pay for. A national preferred drug list 
would have the same effect, then, as a national formulary.
  So I thought: For all the talk about not allowing Government 
formularies, the proponents of S. 3 would embrace a provision banning 
preferred drug lists. If they really do not want to limit beneficiary 
access to drugs, it should have been an easy thing for them to support. 
So I offered that amendment to prohibit the Secretary from imposing a 
national preferred drug list. Much to my surprise, every Democrat in 
the committee voted against my amendment. When the proponents of 
Government negotiations defeated my amendment, they were, in fact, 
voting in favor of having the Government limit access to drugs. They 
voted for Government limits on access to drugs. They voted to have the 
Government tell beneficiaries which drugs they can have and which they 
cannot have, which is an intervention of Government between a doctor 
and a patient--that relationship we were working so hard to preserve 
when we wrote the bill in 2003.
  We have the final piece of the puzzle allowing everything to fall 
into place.
  What would H.R. 4 and S. 3 look like after they merged them together 
in conference between the House and Senate? Well, you can put two and 
two together and get an answer.

[[Page S4630]]

  H.R. 4 requires the Secretary to negotiate drug prices and eliminate 
the ban on price setting. It is clear now that supporters of the Senate 
bill want the Government to set preferred drug lists because they voted 
against it when I offered that in committee, that the Secretary 
couldn't do that, preferred drug lists, which are just like 
formularies. They want the Government to determine what drugs seniors 
will be allowed to get coverage for. We have heard all this hooray 
about the VA and how they do things. Remember, the VA only pays for 23 
percent of the drugs that seniors can get now under Part D.
  The puzzle is complete. If we let S. 3 go to conference, we will have 
returned to us a bill that requires the Secretary to negotiate with 
drug manufacturers using price controls and a national preferred drug 
list. It couldn't be more clear.
  We must not let that happen. We must put a stop to it and do it right 
here. Price control and a national preferred drug list are the tools 
they want the Government to have. They want to have the Federal 
Government take over Medicare prescription drug marketing, and that is 
absolutely the wrong thing to do. The Medicare drug benefit is working. 
``If it ain't broke, don't fix it.'' It is a testimony to the idea that 
the private market works, that Government-run health care is not the 
answer.
  They say Medicare doesn't negotiate. That is not true. Medicare is 
negotiating today, just the way we set it up 4 years ago to negotiate. 
Medicare is negotiating through the market clout of its prescription 
drug plans, and the market-based model for Part D is working. Costs are 
far lower than expected. CBO projections for Part D dropped by $308 
billion--32 percent lower. That is the 2007 baseline compared to the 
2006 baseline. Premiums for beneficiaries are 40 percent lower. Seniors 
overwhelmingly approve of the benefit.
  So why do supporters of this legislation hate the Medicare drug 
benefit so much? They hate it because nothing could be more damaging to 
the idea of Government-run health care than Part D, the way we wrote it 
4 years ago. It is a free market plan, and it is a market that is 
working, and that is not their plan for how health care should work. 
Their view is that Government knows best.
  So what do seniors and all Americans have to look forward to if this 
Trojan horse attack succeeds in a Government takeover of prescription 
drugs? Seniors can look forward to fewer choices. Gone will be the days 
when seniors can select from various plans to find one that suits them. 
If this bill passes, seniors will get only the drugs the Government 
selects for them.
  Do you want a Government bureaucrat in your medicine cabinet? All 
other Americans will see higher prices for their prescription drugs, 
experts testified before the Finance Committee.
  I will go ahead and use up the remaining minute.
  CBO has said that everybody else's prices will go up. We have reams 
of evidence showing that price controls and Medicare will lead to 
higher drug costs for everybody else. That means higher prices for 
veterans. That means higher prices for the disabled, pregnant women, 
and children on Medicaid. That means higher prices for small business 
owners and families. If we don't stop this bill right now, that is what 
we have to look forward to.
  We can and should stop this bill in its tracks. Vote against 
Government-controlled drug lists, vote against Government setting 
prices, vote against Government restriction on seniors' access to 
drugs.
  Mr. President, everyone should move beyond the simpleminded rhetoric 
of sound bites and see the full picture because sound bites don't make 
sound policy.
  I yield the floor.
  Mr. WYDEN. Mr. President, parliamentary inquiry: How much time does 
our side have remaining?
  The ACTING PRESIDENT pro tempore. The Senator has 6\1/2\ minutes.
  Mr. WYDEN. Mr. President, I have great respect for the Senator from 
Iowa, but I simply want to set the record straight with respect to a 
couple of points. The distinguished Senator from Iowa was talking about 
the House bill to a great extent. We are not dealing with the House 
bill. I want to be very clear what the Senate bill does.
  All the Senate bill does is lift this restriction which bars the 
Secretary from ever having a role in negotiation. This bill--the 
measure that is before the Senate--does not take over the role of the 
private plans. The private plans would continue as they have since the 
program's inception: to sign the contracts, to conduct the various 
activities to make sure that seniors can purchase that coverage. There 
is no takeover of private plans, despite what has been suggested.
  Point No. 2: In no way does the measure now before the Senate limit 
access to drugs for seniors. We have been told that under this 
particular measure, there would be huge restrictions with respect to 
seniors being able to get drugs, that there would be formularies 
established, a variety of prescriptive arrangements that would deny 
choice. That is not the case in this legislation.
  Let's be clear. One, this is not the bill that is before the House. 
It is not the bill the House has acted on. Two, it simply lifts the 
restriction. Three, it doesn't take over the role of the private plans. 
The Secretary is simply complementing the role of the private plans. 
Four, under this particular measure, the Government would not limit 
access to drugs. There would be no restriction on drugs that seniors 
could get under this bill.
  I only come back to the point I made earlier. This is about patients 
who are hurting. This is about those cancer patients, for example, who 
are taking drugs for which there is no competitive alternative, where 
there is no therapeutic alternative. Should we simply sit by and say 
that when they have to spend thousands and thousands for those cancer 
drugs--cancer drugs that are essential to their survival--are we going 
to say that we should give up any and every opportunity for the 
Secretary to try to negotiate a good price? I think we understand this 
is a straightforward issue. This is about whether we are going to have 
a real debate on one of the most important consumer issues of our time.
  There are groups such as the AARP that have brought to the attention 
of every Senator what this means for their members. This is what people 
are talking about in coffee shops. They are talking about it in 
community centers. They are talking about it all across the country 
because they think when you have a program that has 43 million people, 
be the smartest shopper you possibly can.
  We have the private plans out there already. The Baucus proposal--and 
I want to emphasize this--does not restrict the role of those private 
plans. It is going to go forward.
  The question is, Should we make it possible for the Secretary of 
Health and Human Services to complement that role, to go beyond it and 
to say there may be some instances where we ought to negotiate? I voted 
for the Medicare prescription drug program. I do not support the idea 
of Government running everything in American health care, but it is 
time to right a wrong. This particular provision, which restricts the 
Secretary from ever negotiating, is an example of special interest 
overreaching.
  The Senate ought to say today: We want to proceed to a real debate, 
not this abridged version where only a handful of Senators could 
participate. I am glad I could correct the record so that as we go to 
the vote, Senators understand that this bill is not the House bill, 
that this bill will not restrict the private plans, and it will not 
restrict access for seniors to medications. I urge our colleagues to 
vote for the motion to proceed.
  Mr. FEINGOLD. Mr. President, one of the biggest flaws in the Medicare 
prescription drug benefit is that it does not adequately address the 
skyrocketing prices of prescription drugs. By denying the Government 
the ability to negotiate price discounts, the benefit actually takes 
away one of the best tools the Medicare Program could use in bringing 
down prescription drug prices.
  That is why I am a cosponsor of legislation that would help address 
this fundamental flaw. The Medicare Prescription Drug Price Negotiation 
Act, S. 3, will remove language included in the Medicare Modernization 
Act that prohibits the Secretary of Health and

[[Page S4631]]

Human Services from negotiating prescription drug prices with 
manufacturers. The legislation goes a step further to require much 
needed data that would set the stage for additional legislation to 
strengthen negotiation in the future. This bill is something that the 
entire Senate should support, and I am disappointed that the Senate is 
being prevented from even debating, let alone voting on, this important 
bill.
  When I talk about the new Medicare prescription drug benefit during 
my travels around my home State of Wisconsin, I continually hear from 
constituents about how they cannot believe that the Federal Government 
cannot negotiate with pharmaceutical companies about the prices of 
prescription drugs.
  We need to help Medicare beneficiaries obtain affordable prescription 
drugs while still ensuring the Federal Government keeps prescription 
drug costs down. By lowering the underlying cost of prescription drugs 
offered through the Medicare Program, we will not only be helping 
beneficiaries save money, but we will also save the Federal Government 
money.
  In a time of mushrooming deficits, skyrocketing prescription drug 
costs and an aging population, we need to be smart about how we use 
taxpayer dollars. If we are going to keep Medicare solvent, we need to 
take strong action to keep health care costs down, especially the 
increasing costs of the prescription drugs the new Medicare Program 
will be providing. This is the fiscally responsible thing to do, and it 
is also the compassionate thing to do as keeping drugs affordable 
ensures access to prescriptions for 43 million seniors.
  I support this legislation, but I also support an even stronger step. 
It makes sense at this time to impose a mandate on the Secretary of HHS 
to negotiate lower prices. The Secretary should also have the right 
tools to negotiate effectively.
  This bill doesn't address formulary or price control authority for 
the Secretary. An ideal bill would at least examine these issues 
closely, yet these are not mentioned. Formulary power and price 
controls in Medicare Part D should be debated in the near future, and 
the reports required in S. 3 will provide needed information for that 
debate.
  So while I would like a stronger bill today, I support today's 
legislation because it is a giant step forward from where we are today. 
I hope my colleagues who are currently blocking this important 
legislation will reconsider their actions.
  Mr. MARTINEZ. Mr. President, today I wish to discuss an issue that is 
on the minds of millions of seniors--prescription drug access and 
pricing. I am here to defend Medicare Part D and the importance of 
competitive drug pricing, because it works.
  Prescription drugs play a vital role in our health care system. 
Thanks to technological and scientific breakthroughs in 
pharmaceuticals, Americans are living longer and more productive lives 
than ever before.
  There has been a remarkable rise in pharmaceutical drug access to our 
Nation's citizens. A generation ago, there were nowhere near as many 
prescription drugs available--today, there are effective drugs on the 
market that help people do just about anything. From drugs that reduce 
blood pressure and fight uncommon bacterial infections, to others that 
lower stress and protect immune systems in the fight against cancer, 
there has never been a time in history like this.
  Members of Congress have--over the last decade or so--made many 
efforts to extend prescription drug access to as many Americans as 
possible, specifically seniors. The expense has been significant, but 
so have the results. This improvement to prescription drug access is 
due in large part to Medicare Part D.
  The Medicare Part D prescription drug program has been successfully 
reducing drug costs for seniors, and as long as we leave it alone and 
let it run as it was intended to, millions of Americans will continue 
to benefit--this was the goal and the goal is being met.
  I strongly oppose any efforts to repeal the noninterference clause, 
and I encourage my colleagues to do the same.
  My colleagues on the other side of the aisle, however, are moving to 
eliminate the noninterference clause--written into the Medicare 
Modernization Act, MMA--which, in layman's terms, means that some 
Members of Congress would like to give the Government the ability to 
negotiate drug prices on behalf of consumers. Proponents of this move 
believe that Government negotiation of drug prices would lead to lower 
prices for the millions of Americans in need of prescription drugs. Yet 
that is not the full picture. The reality is that there is no proof 
that eliminating noninterference would reduce costs for seniors in need 
of low-cost prescription drugs; in fact, there is a chance that this 
approach could limit senior access to certain types of prescription 
drugs--this is because, in Government negotiating of drug prices, 
competition will be eliminated. This is to say that certain drug 
companies will simply back away from the table and choose not to 
participate.
  As you can see, Government negotiation will not benefit the consumer. 
It actually hurts the consumer because it limits what prescription 
drugs are available to them.
  For that reason, I feel strongly that moving in this direction and 
having this debate is not the best use of the Senate's time. Why are we 
debating a program that has been successful in providing drug coverage 
for our seniors and has done so while costing less than anticipated? 
Our seniors have a choice in their plans, and they are pleased with 
those options. We should be using this time to focus on those who lack 
any healthcare options. I am talking about the millions of uninsured 
people in this country.
  My colleagues and I should be talking about ways to give these 
individuals a chance for health care coverage. We need to further 
examine the Tax Code and fix its glaring inequities. The Tax Code needs 
to be unbiased; where you work should not affect how much you pay for 
health care coverage or what kind of health care options you have.
  Why can't all American workers--whether they work for a Fortune 500 
company or the local bakery they started from scratch--have the ability 
to purchase health insurance with pretax dollars?
  My bill, the TEA Act, will allow just that. Why aren't we talking 
about that?
  What about Senator Coburn's Universal Health Care Choice and Access 
Act--why aren't we talking about that? His bill will help transform our 
health care system to one that focuses on prevention and helps to 
reestablish the doctor-patient relationship, while also empowering 
individuals to choose where their care is delivered.
  I encourage us to get past this time-consuming and unnecessary Part D 
debate and turn toward issues that are in need of solutions. From the 
uninsured, to future budget insolvency, to the global war on terror, 
there is plenty--of substance--to discuss.
  Mr. ENZI. Mr. President, today I wish to speak in opposition to the 
bill currently before the Senate.
  First I would like to briefly review the status of the new Medicare 
law that Congress passed in November of 2003. That landmark legislation 
enacted the first major benefit expansion of the program since 1965 and 
placed increased emphasis on the private sector to deliver and manage 
benefits. It created a new voluntary outpatient prescription drug 
benefit to be administered by private entities. The legislation also 
expanded covered preventive services and created a specific process for 
overall program review if general revenue spending exceeded a specified 
threshold.
  I am pleased to be able to report that this new program is working. 
All across the country, seniors are expressing their approval of the 
new benefit. In my State of Wyoming, the new Part D prescription drug 
benefit has been a huge success. Last year, I traveled around Wyoming 
and visited with seniors in Cheyenne, Douglas, Sheridan, Casper, 
Powell, and Rock Springs. I talked to folks all over the State and told 
them about the new program as I encouraged them to sign up for it. I 
also talked to a few of the pharmacists in Wyoming that worked so hard 
to make this program a success. I believe I can speak on behalf of many 
of my colleagues in saying thank you to the thousands of pharmacists 
throughout the country that did so much to implement this great 
program.

[[Page S4632]]

  Today, about 89 percent of Wyoming seniors are receiving prescription 
drug coverage, an increase of 16 percent from last year. They remember 
what it used to be like when they tried to get their prescription 
medications and they don't want to go back. I have received hundreds of 
calls and letters from Wyoming seniors who like the way things are and 
don't want Congress interfering with their prescription drug plan 
because it is working for them. Five separate surveys show that more 
than 75 percent of all beneficiaries are satisfied with the way the 
program works.
  Not only are about 90 percent of seniors now receiving prescription 
drugs, the program is costing less than originally expected. When is 
the last time a government program cost less than was estimated? I came 
to Washington in 1997, 10 years ago, and I don't know that I have ever 
seen a government program that spent less money than we expected. 
Private competition is working better than we envisioned and it is 
saving seniors and the government more and more money every day. Why 
should we change that?
  For some reason my colleagues on the other side of the aisle have 
decided they need to ``fix'' a program that isn't broken. We have 
implemented a plan that is working and before we change it, we need to 
be sure about what we are doing and the effect it will have on the 
program and the impact it will ultimately have on seniors from coast to 
coast.
  The bill now before the Senate would strike the noninterference 
clause from the Medicare law. The ``noninterference'' language in the 
Medicare law prevents the Federal Government from fixing prices on 
Medicare drugs or placing nationwide limits on the drugs that will be 
available to seniors and the disabled. I support this language 
100 percent. Decisions on what drugs should be available should be made 
by seniors and their doctors, not by some central committee in 
Washington.

  Under the Medicare Part D law, each prescription drug plan has its 
own list of preferred drugs. Each plan's list is different--some are 
broader, some are narrower. Each list, however, has at least two drugs 
from each therapeutic class of medications and everyone can find a plan 
that is advantageous to them.
  The ``noninterference'' bill before us is not only unnecessary, but 
it could also prove to be harmful to the health of our nation's 
seniors. The ``noninterference'' language protects seniors and the 
disabled from having the government decide which drugs their doctors 
can prescribe. It maintains the sacred relationships that seniors have 
with their doctors, who know best about what particular drugs are right 
for their patients. Patients support this language, and they want us to 
maintain it.
  I would like to repeat, we have already implemented a plan that is 
working. Yet the majority party wants to ``fix'' the Medicare drug 
benefit. It is ironic to me that they use the word ``fix''--fix is 
exactly what this bill will lead to, the government ``fixing'' prices 
on drugs. It is not a bill about negotiating prices; it is a bill about 
fixing prices. As most Americans know, the Government doesn't negotiate 
in the Medicare program. It sets the prices that the Government will 
pay doctors and hospitals for serving seniors.
  Setting the price is the same as price controls. And we saw what 
happened in the 1970s when we tried to control the price of gasoline. 
Do you remember the long lines at the gas pumps? Trying to control the 
price of gasoline was a complete disaster. Let's not experiment with 
giving government the ability to control the prices of prescription 
drugs.
  Despite what some folks are reporting, the nonpartisan Congressional 
Budget Office has said over and over again that removing this language 
would not save the Government or seniors any money. It wouldn't save 
money because the Medicare prescription drug plans will have strong 
incentives to negotiate drug price discounts that would be as low--or 
lower--than anything the Government could negotiate. Additionally, many 
plans represent more people than Medicare, Medicaid, or the Veterans 
Administration, so the plans have greater purchasing power than the 
Government. To effectively negotiate, you need competing products, or 
you have to be willing to do without one of the products on which you 
are negotiating.
  How many times does the Congressional Budget Office have to say that 
this bill will not save the Government any money before it starts to 
sink in? When will my friends on the other side of the aisle 
acknowledge that this bill will not save any money?
  We do, however, know of something that will save the Federal 
Government and seniors money--competition among private plans. What has 
been proven to reduce costs--especially for seniors with low incomes--
is the new Medicare drug benefit that we passed in 2003.
  The competition among private plans is driving the cost of the 
program down. The average monthly premium has dropped by 42 percent, 
from an estimated $38 to $22--and there is a plan available in every 
state for less than $20 a month. So let me suggest letting competition 
work to drive the prices even lower instead of instituting government 
price controls that have failed in the past.

  Also, because the program has choice, if the price of one plan goes 
up, beneficiaries can switch plans. It is important to remember that 
sometimes the prices will go up, because medical costs will go up as 
long as new technologies are invented that allow people to live longer, 
healthier lives.
  Democrats want to change Part D to resemble the drug benefit program 
of the Veterans Administration. In the VA system, the Government sets a 
price on a drug it can get at the cheapest rate and limits or restricts 
access to those it can not get at cheap rates. As a result, the VA 
benefit excludes three out of four drugs available through Part D. 
Changing the Medicare Program to be as restrictive as the VA system is 
completely illogical.
  Another thing about the VA system is that it can take a long time for 
new drugs to be included on the formulary--sometimes as long as 3 
years. Let me repeat that. It can take as long as 3 years for new, 
life-saving drugs to be included on the VA formulary.
  Lastly, the VA owns the whole system, so you have to order your drugs 
from them or you have to fill your prescriptions at one of 350 
government-run facilities nationwide. In contrast, seniors signing up 
for a Medicare prescription drug plan can choose their plan based on 
the pharmacy they want to use to fill their prescriptions. As a result 
of all of these things, more than 1 million retired veterans have 
signed up for Medicare in the last year. I talked to many veterans in 
Wyoming and they all told me that they signed up for Medicare Part D so 
they could finally get the drugs they needed that they couldn't get 
from the VA.
  Unfortunately, my colleagues on the other side of the aisle want to 
make the Medicare Program more like the VA program. They want to take 
away a senior's ability to choose. The real thing we should be talking 
about is how we can change the VA program to be more like Medicare Part 
D.
  The mark also contains a few other provisions relating to the 
comparative effectiveness of prescription drugs--a study that 
determines whether drug A is better than drug B at treating a disease. 
The mark also contains a provision authorizing consideration of 
comparative clinical effectiveness studies in developing and reviewing 
formularies under the Medicare prescription drug program. No surprise 
here, but the Congressional Budget Office stated no savings will result 
because of this section.
  This is the first step of a dance the Democrats want to do called 
``cutting in on the relationship between doctors and patients.'' 
Decisions about what drugs patients should take should be made by 
doctors and patients. I think we should keep the Government out of the 
exam room.
  To close, I would just like to remind folks of a few key points: (1) 
The Medicare Program is working. More seniors are getting the drugs 
they need at lower costs. (2) The bill before the Senate tries to 
``fix'' something that isn't broken. (3) This bill will take away the 
choices seniors have about the drugs they use. (4) The Congressional 
Budget Office has stated several times that this bill will not produce 
any savings. (5) The bill tries to make the Medicare Program more like 
the Veterans program, but the Veterans program has

[[Page S4633]]

fewer choices than the Medicare Program)--that is why over one million 
veterans have signed up for the Medicare Program.
  We don't need meddling for the sake of meddling or a new system 
conjured up for political convenience. Let's stop wasting the time of 
this important body and move to a bill that can actually do some good 
for the American people.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Republican leader is 
recognized.
  Mr. McCONNELL. Mr. President, I am going to proceed in leader time.
  I rise in opposition to the effort to roll back the remarkable 
success of a prescription drug benefit that American seniors have been 
waiting for for decades and which millions of them now enjoy.
  Republicans strongly oppose this effort to tamper with a program that 
is working extraordinarily well by every conceivable measure. In 
standing against those who would end it, we are standing up for the 32 
million seniors in this country who enthusiastically support this 
terrific life-changing benefit.
  But before I explain our reasons, I want to thank Senator Grassley, 
who has been an extraordinarily effective leader on the Finance 
Committee, who has been right in the middle of this issue, going back 
to its formative stages in 2003, and has made a very articulate and 
persuasive case today for not tampering with this extraordinarily 
successful program.
  Having said that, let's get right to the point. Republicans are on 
the side of seniors on this issue. There is simply no doubt about this. 
The only thing in question is why Democrats would even think about 
meddling with a drug benefit that has 92 percent coverage, 80 percent 
satisfaction, and which costs more than 30 percent--more than 30 
percent--less than even the most daring bean counters estimated when we 
passed the bill.
  Seniors who signed up for this benefit are saving an average of 
$1,200 a year on the cost of medicine, and taxpayers are saving 
billions--billions--$265 billion over the next 10 years less than 
anticipated.
  Now, I ask everyone--anyone--in this Chamber: When was the last time 
a Government program came in under budget?
  For those of you who may be watching on C-SPAN, that quietness was 
the sound of crickets and tumbleweed you just heard echoing from the 
Senate Chamber because I doubt a single Government program in modern 
history, let alone one this big and this important, has ever--ever--
come in under budget. So it is a mystery why our Democratic friends 
would want to tamper with this Medicare benefit. If it isn't broke, why 
break it?
  Now, the refrain we keep hearing from the other side is that we need 
competition, that drug prices will be even lower if we allow the 
Government to bargain for lower prices. Unfortunately, that is not 
true. The impartial Congressional Budget Office just sent us a letter 
saying there would be zero--that is zero--savings if Government stepped 
in and interfered with the current system. They sent the same letter to 
a Republican-controlled Congress last year.
  The reason is simple. Prices have plummeted under Part D precisely 
because we have let private drug benefit managers, who already 
negotiate, into a Government drug program for the first time. They do 
the negotiating for us, and it is a good thing because they have much 
more leverage than we do. The three biggest drug negotiators, in fact, 
have four times as many members as the entire Medicare population.
  Let me say that again. The three biggest drug negotiators have four 
times as many members as the entire Medicare population.
  Look, you don't have to be a Milton Friedman to see that bigger 
negotiators are going to get better prices, and that is what we have 
right now with these drug benefit managers. Yet the other side wants to 
send a Medicare team to the negotiating table--a population with one-
fourth the negotiating power. That is like sending a Little League 
pitcher up to the big leagues and handing him the ball for the big 
game. We already have aces on the mound, and they don't need any 
relief.
  The point is, Republicans favor negotiation and competition, and our 
Democratic friends oppose it. Just look at the numbers. They speak for 
themselves. There is no way we could have achieved these savings if 
market competition and negotiation weren't at play. Secretary Leavitt 
said it pretty clearly just yesterday:

       There is rigorous, aggressive negotiation taking place 
     right now.

  That is why we are seeing such success and satisfaction with this 
program. But let's assume just for the sake of argument that price 
isn't an issue. Let's take price off the table for a moment. What about 
choice? What about choice? Here, too, Republicans are on the side of 
seniors. The VA model the Democrats are for some reason enamored with 
is inflexible and restrictive. It excludes three out of four drugs 
available through Part D, including some of the most innovative 
treatments for arthritis, high cholesterol, breast cancer, and other 
ailments. Veterans who want cutting-edge drugs like Crestor or Revlimid 
have to go elsewhere or they have to go without. The choice that 1 
million of them have already made is to join the Part D Program--more 
than a third of them have signed up for the program over the last few 
years.
  So let's sum it up. This seniors prescription drug benefit is 
popular. It is reaching millions of seniors. It is saving us billions 
of dollars. Veterans who have been using the program that our friends 
on the other side want us to imitate are signing up for this one in 
droves.
  No wonder the former Democratic majority leader, Senator Daschle, and 
President Clinton's Health Secretary were all for creating a program 
such as Part D before suddenly our friends on the other side decided to 
oppose it.
  This debate is hardly worth having. The facts are plain. Tens of 
millions of seniors in this country have a great drug benefit program--
cheap, comprehensive, and easy to use. Republicans aren't going to let 
anybody fool with them.
  I strongly oppose cloture on the motion to proceed and urge my 
colleagues to vote likewise.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Oregon is 
recognized.
  Mr. WYDEN. Mr. President, I have a parliamentary inquiry: Our side 
has 2 minutes to close; am I correct?
  The ACTING PRESIDENT pro tempore. The Senator is correct.
  Mr. WYDEN. As one who voted to establish the Medicare prescription 
drug program and believes in bipartisanship, my message today to 
colleagues on the other side and on this side is this: We can do 
better.
  There are patients who are enrolled in this program--enrolled right 
now--who are heart transplant patients and patients suffering from 
cancer, who, while enrolled in the program, are seeing their medicines 
go up hundreds of dollars--hundreds and hundreds of dollars in 1 month. 
They are enrolled in this program that I have voted for.
  I say to my colleagues, let us look at ways to do better. The private 
plans are going to continue to take the lead. This measure does not 
preempt the work of those private plans. But in the name of those 
seniors who are enrolled in this program, who are seeing their bills go 
up hundreds of dollars a month right now, let us not pass up the 
opportunity to do better.
  If we don't vote for cloture and go to this bill, we will not even 
have a debate in the Senate on an issue with such immediate life-and-
death implications for our people, and I simply think that is wrong. I 
wish to make this program better. I wish to make sure we take advantage 
of every opportunity to do that.
  I urge our colleagues, in the name of seniors who are enrolled in the 
program today and are having difficulty paying their bills, to vote for 
cloture. Let us have a real debate on this legislation.
  I yield the floor.

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