[Congressional Record Volume 168, Number 26 (Wednesday, February 9, 2022)]
[Senate]
[Pages S604-S607]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



                   Unanimous Consent Request--S. 3615

  Mr. SANDERS. Madam President, let us be as clear as we can be, and 
that is, there is significant discontent throughout our country today, 
from Vermont to California and in all 50 States. The American people 
are worried about COVID. We are all worried about COVID. We are all 
tired of COVID. But the American people are worried about much more. 
They are worried about inflation, the price of food and gas, and other 
products going up. They are worried about climate change and whether or 
not the planet they will be leaving to their kids and grandchildren 
will be healthy and habitable. They are worried about a middle class 
whose real, inflation-accounted-for wages have not risen in almost 50 
years, have been stagnant, and the reality that today, half of our 
workforce is living paycheck to paycheck.
  The American people are worried about the massive level of income and 
wealth inequality which we are experiencing in which, during this 
pandemic alone, just the last few years, the billionaire class saw an 
increase in their wealth by some $2 trillion while at the same time, 
thousands of workers died as they went to their jobs. They didn't have 
a choice about it; they went to work, and they died.
  The American people are worried that their kids are not getting the 
quality childcare that they need or that the family can afford. They 
are worried about the outrageous levels of student debt that their kids 
acquired because they chose to get a higher education.
  Above all else, the American people, in my view, are outraged that in 
the midst of all of these crises and more, their elected officials are 
simply not responding.
  In my view, now is the time to tell the American people that we in 
Congress do understand their pain, that we do know what they are going 
through, and that we are prepared to stand up for the working families 
of this country and take on the greed of powerful special interests who 
wield so much influence over the economic and political life of our 
Nation.
  Today, Senator Klobuchar and I are going to focus on one--just one--
of the many issues that this Congress must address. The American people 
want action, and that is what we have to give them. We have to respond 
to the crises.
  Today, we are going to be talking about prescription drugs. For 
decades, literally decades--20, 30, 40 years--

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Members of both political parties have come to the floor of the Senate, 
come to the floor of the House, and they have bemoaned the high cost of 
prescription drugs in this country. They promised the American people 
they would lower those outrageous prices. Republicans have come to the 
floor, Democrats have come to the floor, and speech after speech has 
been made. And not only speeches--Members of both political parties put 
30-second ads on television when they ran for office: Hey, vote for me. 
I am going to lower the cost of prescription drugs.

  For decades now, Members of Congress have been talking about lowering 
the cost of prescription drugs, and for decades, they have failed to 
deliver. Talk, talk, talk--nothing happens. The cost of prescription 
drugs goes up.
  Congress has failed to deliver under Democratic leadership. It has 
failed to deliver under Republican leadership. It failed to deliver 
under Democratic Presidents and failed to deliver under Republican 
Presidents. We have failed to deliver because of the greed of the 
pharmaceutical industry, which today is likely the most powerful 
corporate interest in America and is certainly the dominant political 
force here in Washington, DC.
  So I ask my fellow Americans today: Do you want to know why you are 
paying the highest prices in the world for prescription drugs? Simple 
question. Why is it that we are paying in some cases 10 times more for 
the same exact prescription drugs that are sold in Canada or in Europe?
  Do you want to know why one out of four Americans--this is really 
quite crazy, that in the midst of a dysfunctional healthcare system, we 
have one out of four Americans who cannot afford to fill the 
prescriptions that their doctor writes. Think about that for one-half a 
second. People are sick. They go to the doctor. The doctor writes out a 
prescription. People can't afford to fill it. They end up in the 
emergency room. They end up in the hospital. They get sicker because 
they simply cannot afford the outrageous cost of medicine.
  Do you know why millions of diabetic Americans actually ration their 
insulin? I have talked to diabetics and parents of diabetics. Their 
kids get sick because they cannot afford the cost of insulin. 
Obviously, diabetes today is a terrible, terrible illness impacting 
many millions of Americans.
  Let me tell you why we pay the highest prices in the world, why 
people in America die because they can't afford prescription drugs. The 
answer has everything to do with the corrupt political system in which 
over the past 20 years the pharmaceutical industry has spent over $4.5 
billion--not million; $4.5 billion--on lobbying and hundreds of 
millions of dollars on campaign contributions. Yes, you heard that 
correctly--$4.5 billion over 20 years on lobbying and God knows how 
many hundreds of millions of dollars on campaign contributions. These 
are campaign contributions that go to Republicans. These are campaign 
contributions that go to Democrats. And I am talking about many 
hundreds of Members of the House and Senate who receive funding from 
the pharmaceutical industry.
  Further, the pharmaceutical industry has over the years mounted an 
unprecedented lobbying effort in Washington, here in the Nation's 
Capital, and in States all over the country. I hope everybody hears 
this because this is what power is about. This is why you pay the 
highest prices in the world for prescription drugs.
  Last year alone, the pharmaceutical industry hired more than 1,700 
well-paid lobbyists to come to Capitol Hill to protect their interests, 
including the former congressional leaders of both major political 
parties. Got that? Seventeen hundred well-paid lobbyists protecting the 
interests of the pharmaceutical industry--get out your calculator 
because what that amounts to is three pharmaceutical industry lobbyists 
for every Member of Congress. There are 435 Members in the House and 
100 in the Senate and 1,700 well-paid lobbyists making sure that you 
pay the highest prices in the world for prescription drugs.
  What is the result of all of that lobbying and all of those campaign 
contributions? Well, I think the American people know it every time 
they walk into a drugstore. The pharmaceutical industry, uniquely in 
the entire world, is able to raise their prices anytime they want, to 
any level they want.
  How many people out there walked into a drugstore, refilled their 
prescription, and the pharmacist said: Well, I am sorry to tell you the 
cost of your medicine has gone up 20 percent.
  Why? Because they can. They can do anything they want. If they want 
to double prices, triple prices, there is no law stopping them. That is 
what you get when you spend billions of dollars on lobbyists and 
campaign contributions. You get what you pay for, and they have gotten 
what they paid for.
  Not only do we pay the highest prices in the world for prescription 
drugs, but the result of that is that the pharmaceutical industry, year 
after year, makes huge profits. Eight of the largest drug companies in 
America in 2020 made nearly $50 billion in profits, while the CEOs of 
those pharmaceutical companies took home over $350 million in total 
compensation. Eight companies; $350 million in compensation for the 
CEOs of those companies; $50 billion in profits in the last year we 
have information.
  Let's be very clear. The overriding motivation of the pharmaceutical 
industry is greed. Their overriding goal is to make as much money as 
they can by squeezing as much as they can get from the sick, from the 
elderly, and from the desperate.
  I could give you many, many examples of the outrageous greed of the 
pharmaceutical industry, and I am not even going to talk about the 
opiate crisis, which has killed hundreds of thousands of Americans. I 
am not even going to go there today.
  Let me just mention, a couple of years ago, the former CEO of a drug 
company called Gilead became a billionaire by charging $1,000 for the 
hepatitis drug Sovaldi. He became a billionaire. Interestingly enough, 
that drug was developed by taxpayer dollars through the Veterans' 
Administration. While they charge $1,000 a treatment here in the United 
States, it turns out that it costs $1 to manufacture and can be 
purchased in India for all of $4--$1,000 here; $4 there.
  In 2016, the chairman of Mylan received a $164 million compensation 
package after his company jacked up the price of EpiPen--you all 
remember EpiPen--by 550 percent over a 9-year period.
  All over this country, the American people are asking a simple 
question: How many people in our country need to die? How many people 
need to get unnecessarily sicker before Congress is prepared to take on 
the greed and power of the pharmaceutical industry?
  Enough is enough. A lifesaving prescription drug does not mean 
anything if you cannot afford that drug. We have great drugs out there. 
What does it mean if you can't afford that drug or if you are going to 
go bankrupt because you have to buy it for a family member?
  We cannot allow the pharmaceutical industry to charge the American 
people, by far, the highest prices in the world for prescription drugs. 
And that is why I have introduced today, along with Senator Klobuchar, 
legislation that would cut the cost of prescription drugs under 
Medicare in half--not by 10 percent, not 30 percent--cut the cost of 
prescription drugs under Medicare in half. It would do that by making 
sure that Medicare pays the same low prices for prescription drugs as 
the Veterans' Administration does.
  Why is it that the VA pays so much less for prescription drugs than 
Medicare? The answer is pretty simple. While the VA has been able to 
negotiate with the pharmaceutical industry for the past 30 years, 
Congress banned Medicare by law from doing anything to lower 
prescription drug prices. And the result is that, according to the 
nonpartisan Government Accountability Office, Medicare pays twice as 
much for the exact same prescription drugs as the VA.
  All right. You talk about dysfunctionality. You talk about crazy. You 
have two branches of government. VA pays X, Medicare pays 2X. How in 
God's name does that make sense to anybody other than the 
pharmaceutical industry? This is totally absurd. And if the VA can 
negotiate with the drug companies, so can Medicare.
  By the way, for all of the great deficit hawks here staying up nights 
worrying about the deficit, let me tell you,

[[Page S606]]

if we do that, we will save Medicare some $900 billion over the next 
decade. I would like to see where the deficit hawks are on this issue--
$900 billion, 10 years. That is real money.
  The VA, obviously, is not the only Agency that negotiates for lower 
drug prices. That is something that takes place in every other major 
country on Earth. There is no rational reason for the pharmaceutical 
industry to charge the American people $98.70 for a standard unit of 
insulin that can be purchased in the UK for just $7.52, and on and on 
it goes.
  The American people are being played for suckers. They have bought 
the U.S. Congress, and it is time now for Congress to stand up to these 
people.
  With that, I would mention that what we are talking about--what 
Senator Klobuchar and I are talking about is not some radical far-left 
idea. I get that. I don't know if Senator Klobuchar gets that, but it 
is not some radical, far-left idea; it is a fairly popular idea.
  According to an October 2021 poll by the Kaiser Family Foundation, 83 
percent of the American people want Medicare to negotiate with the 
pharmaceutical industry to lower the cost of prescription drugs, and 
poll after poll shows the same thing. Maybe, just maybe--ready for a 
radical idea, Madam President? Maybe, just maybe, instead of doing the 
work of the lobbyists and the pharmaceutical industry, we might just 
want to represent the American people.
  I yield the floor.
  Ms. KLOBUCHAR. Madam President, I think you know Senator Sanders and 
I debated a number of issues before, but from the beginning, we have 
been strongly united on one thing, and that is bringing down costs for 
the American people. And that is, as he just said, not one bit radical.
  We have joined together to introduce the Cutting Medicare 
Prescription Drug Prices in Half Act because that is what we should be 
doing. America pays more. The people of this country pay more for their 
prescription drugs than any other country in the world. How can that 
be, as Senator Sanders has noted, when it is our country, our taxpayers 
who are investing in all this research? How can we come up short when 
it comes to what our people are paying for drugs?
  The examples: In the past 5 years, the cost of Lyrica--a drug that 
you see advertised on TV, millions of dollars in ads--a drug that 
treats nerve pain or Symbicort, an asthma medication, increased almost 
50 percent. What is the result of these kinds of increases? Nearly 20 
percent of older adults have reported not taking their medicines as 
prescribed because of the cost.
  Last month alone, drug companies hiked the price of 742 drugs in 
America. What do we do? We sit. We sit; we talk about it; and we are 
not taking action.
  That is why Senator Sanders and I are putting our bill in today. We 
would love to spend the week debating it. We would like to move to this 
bill so we can get this done. We know that prescription drug prices in 
the United States are more than 250-percent higher than other 
industrialized nations.
  What is our simple solution? The VA, the U.S. Department of Veterans 
Affairs, that we empower with the lives of our veterans and their 
healthcare--they negotiate the prices of the drugs they purchase and 
dispense for our Nation's veterans. One report found that the VA price 
is often half as much as what Medicare pays. Why? It is simple. The VA 
negotiates for prices; Medicare doesn't.
  I kind of think--and Senator Sanders and I know this well--that 46 
million seniors in America could get a pretty good deal if you allow 
the government to negotiate on their behalf, a good deal for the 
taxpayers of this country, for people who care about deficits, for 
people who care about the bottom-line budget, and a good deal for 
customers.
  Guess what. It wouldn't just help seniors because that is such a 
large block of customers in this country that it would bring down the 
drug costs for everyone.
  The stories in my State--people like Claire from St. Paul. When the 
cost of the prescription drug she relied on to manage her rheumatoid 
arthritis jumped from $60 a month to $1,400 per month, she could no 
longer afford it. In her words, her arthritis became so bad that she 
could barely handle a fork and a knife or the young man who is the 
manager of a restaurant, a full-time job. When he aged off his parents' 
insurance, what happened to him? You know this story, Madam President. 
He started to ration his insulin. He had severe diabetes, and he died. 
His mother has made her life about getting better drug prices.
  Senator Sanders and I believe you start with the biggest buying 
block. You start with seniors. You get that negotiation going, and it 
will make a big difference.
  For people who believe in free markets and negotiation and 
competition, I don't know how you can say no to this proposal. It is 
time to allow this to be debated to move forward with this bill. Let's 
get it on the floor and call it up for a vote.
  Thank you, Senator Sanders.
  Mr. SANDERS. Senator Klobuchar said it all. I know we are spending 
the week dealing with Assistant Secretaries or something or another--
and that is all terribly important--but the American people want us to 
start acting on their needs.
  At the top of the list, as Senator Klobuchar just said--and what she 
said about folks in Minnesota is exactly the same everywhere. You hear 
the same stories in Vermont. People die and get sick because they can't 
afford prescription drugs.

  I say to my Republican friend, the time is now to have that debate. 
You want to vote against this bill? Hey, that is your right. You go 
home and explain it to the people. That is what democracy is. Some of 
us still believe in democracy, by the way.
  Madam President, as if in legislative session, I ask unanimous 
consent that at a time to be determined today by the majority leader, 
following consultation of the Republican leader, the Senate proceed to 
the consideration of S. 3615, which was introduced earlier today; that 
there be 2 hours for debate, equally divided; that upon the use or 
yielding back of time, the bill be read a third time and the Senate 
vote on passage of the bill without intervening action or debate.
  The PRESIDING OFFICER. Is there objection?
  Mr. CRAPO. Madam President, reserving the right to object.
  The PRESIDING OFFICER. The Senator from Idaho.
  Mr. CRAPO. Madam President, our Nation's seniors deserve meaningful 
solutions that increase prescription drug access and affordability.
  This bill, unfortunately, would double down on the deepest flaws in 
our current healthcare system and usher in a host of new problems from 
fewer treatments to more bureaucracy. And, yes, it is almost certain 
under this legislation we would see launch prices for new drugs 
actually increase. The solution is not to go and double down on a 
failed socialist theory of price-fixing and work to make our market 
better.
  Even setting aside the overwhelming implementation challenges and 
technical issues that this legislation would present from the outset, 
the provisions included would do far more harm than good, particularly 
for the very older Americans they are intended to help.
  I would note from the outset there is talk about wanting to have 
process and a vote. This legislation was just introduced today. It just 
got a bill number today. There has been no vetting of this legislation 
in the committee, which is the regular order of this Senate. There has 
been no public analysis. There has been no public review. There has not 
been any hearing on this legislation. There has been not any 
negotiation on this legislation.
  I heard numbers thrown out here about what a savings this would be. 
CBO has not scored this legislation, and there are serious flaws with 
it.
  Under this proposal, we would see a staggering decline in the game-
changing research and development that our universities, medical 
centers, and entrepreneurs conduct every day, as vital investments in 
the cures of the future would decline.
  As countless studies of price control mandates like the one before us 
today have concluded, these policies would slash new drug discoveries 
in the years to come, jeopardizing some of the highest risk projects, 
in particular.
  Potential treatments targeted at conditions affecting seniors at high

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rates, like certain cancers, would likely suffer the greatest impact, 
as Medicare would become increasingly stagnant and unable to meet the 
evolving needs of rapidly aging populations.
  After coming in under budget with satisfaction rates soaring and 
premiums remaining remarkably stable, Medicare Part D would lose the 
market-driven structure that has made it such a success story for so 
many seniors. Instead, we would move closer to a government-run 
healthcare system--which is the ideal and the goal--where bureaucratic 
price controls like these would become the norm.
  The vast majority of Americans, in my opinion, still reject the 
notion of a government-run healthcare system and price controls in 
place of a free market.
  Meanwhile, our frontline healthcare providers have weathered a truly 
unprecedented 2 years of pandemic, and they would face a sweeping, 
immediate, and drastic payment cut as this legislation aims to advance 
immediate payment reductions under Medicare Part B with direct 
implications for doctors and other healthcare professionals across all 
settings.
  In the face of widespread provider burnout, retirements, closures, 
and consolidation, these cuts risk accelerating trends that already 
jeopardize access to healthcare for far too many Americans from all 
walks of life, particularly in rural and underserved communities.
  The VA, which has been referenced here, for its part, would 
inevitably see higher healthcare costs as any discounts or other price 
concessions that lower drug costs for our Nation's veterans would 
disappear.
  Previous payment systems along these lines that have been suggested 
in the past have resulted in a host of unintended consequences, from 
higher launch prices to withheld rebates and discounts.
  Our veterans do not stand to gain from being tied to this unvetted 
and failed new proposal.
  As we confront unprecedented challenges at home and abroad, we must 
look to consensus-driven solutions that meet Americans' everyday needs, 
including prescription drug access and affordability. We can agree on 
that.
  Members across the political spectrum have developed bipartisan drug 
pricing policies that could make a meaningful difference for workers 
and families. I have introduced legislation which is waiting in the 
committee for a vetting rather than coming to the floor here to try to 
get it brought to the floor without even going through Senate regular 
order.
  My legislation is called the Lower Cost, More Cures Act. Here is just 
a quick summary of what it contains: a hard cap on annual out-of-pocket 
spending for all seniors under Medicare Part B, with an installment-
based monthly payment option; reforming of Medicare Part B benefits to 
reduce seniors' cost-sharing burdens and incentivize plans to negotiate 
the best possible deal for enrollees; increasing Part D plan choices; 
increasing options; and reducing prices.
  My bill does have an out-of-pocket monthly insulin cap at $35. That, 
you might remember, is the insulin cap that President Trump put into 
place. That is the kind of approach we need to follow.
  It also includes establishing a chief pharmaceutical negotiator to 
combat foreign freeloading and ensuring the best trade deals that 
achieve American success in dealing with these price discrepancies that 
are driven by terrible behavior from our counterparts in other parts of 
the global economy; strengthening our consumer-oriented oversight 
through our cost-comparison tools and price transparency measures and 
robust reporting requirements in the drug supply chain; facilitating 
value-based arrangements where private and public sector payers can pay 
based on patient outcomes, driving better results for patients; and 
restructuring payments for drugs administered in the doctor's office or 
hospital outpatient department to encourage physicians to deliver cost-
effective treatment options where appropriate clinically.
  My point is, there are a lot of solutions that can work within the 
consistent free market and private sector solutions that we have solved 
here and are working on to make them better.
  We have an opportunity to lower prescription drug costs without 
threatening access to therapies or cures or the future handling of 
giving an advantage, frankly, to our global rivals like the Chinese. 
With a bipartisan and bicameral effort undertaken through regular 
order, we could make a major impact on these issues. This legislation, 
unfortunately, does no such thing. It is thoroughly unvetted, showing 
no signs of technical assistance or practical feasibility. It has not, 
as I said, received a CBO score or even an informal analysis or a 
committee hearing. It did not advance through regular process in the 
Senate.
  I see that our time is running out, and so I will end my comments at 
this point but just ask my colleagues to let us engage in regular order 
in the Finance Committee in the Senate and work these issues through. 
There are a lot of ideas on the table. Let's work them through rather 
than try to cram through one side's idea on the very day the bill was 
introduced in the Senate. I object.
  The PRESIDING OFFICER (Mr. Ossoff). The objection is heard.
  The Senator from Vermont.
  Mr. SANDERS. I say to my friend from Idaho, we have been going 
through regular order dealing with prescription drugs for 40 years. It 
hasn't quite worked.
  Your bill has gone nowhere. My bill has gone nowhere. If you have got 
objections to what Senator Klobuchar and I are doing, let's debate them 
on the floor of the Senate.
  We have heard all the talking points from you that the pharmaceutical 
industry wrote--I got that. They spend a lot of money writing these 
talking points. Let's have that debate right here. The bill that 
Senator Klobuchar and I are proposing is supported by over 80 percent 
of the American people and, I dare say, a vast majority of the people 
of Idaho. You want to oppose it. Go for it.
  Let's have the damn debate right here on the floor, and if it takes 1 
week, great. If it takes 2 weeks, great. You will agree with me that 
this is an issue that the American people care about so I would hope 
that you would reconsider. Let's bring it to the floor. Offer your 
amendments. Let's have the debate.