[Congressional Record (Bound Edition), Volume 145 (1999), Part 19]
[Senate]
[Pages 27416-27418]
[From the U.S. Government Publishing Office, www.gpo.gov]



                        PRESCRIPTION DRUG COSTS

  Mr. WYDEN. Mr. President, this is the eighth time in recent days I 
have come to the floor to talk about the issue of prescription drugs 
because, frankly, I think this is a priority for this session of the 
Congress and one we can tackle in a bipartisan way.
  Senator Olympia Snowe and I have teamed up on a bipartisan bill. We 
were able to get 54 votes on the floor of the Senate for a concrete 
funding plan for our approach.
  What I have been doing, as folks can see in the poster right next to 
me, is urging seniors to send in copies of their prescription drug 
bills. The poster is very clear. We would like seniors to send copies 
of their prescription drug bills directly to each of us in the Senate 
so we can emphasize how important it is that this be tackled in a 
bipartisan way.
  Senator Snowe and I have heard again and again that this is an issue 
that just has to be put off until after the 2000 election. The 
Republicans and Democrats are going to just bicker about it and sort of 
have an ongoing finger-pointing exercise and nothing will get done.
  I happen to think there are a lot of Members of the Senate who want 
to tackle this issue and want to tackle it in this session of Congress.
  Since I have come to the floor of the Senate and brought this poster 
urging seniors to send their prescription drug bills in, I have heard 
from a number of our colleagues in the Senate. They have said we need 
bipartisan action. A number of them have asked for copies of the 
bipartisan Snowe-Wyden bill. They want to know more about it.
  I am going to continue tonight to read from some of these letters, 
particularly from folks I am hearing from in Oregon. But I want to take 
a few minutes tonight to talk about some important issues relating to 
this question of prescription drug coverage for senior citizens and 
particularly ask about this issue of whether we can afford, as a 
nation, to cover prescription medicine.
  Mr. President and colleagues, I believe America cannot afford to not 
cover prescription drugs. The reason that is the case is that drugs in 
the 21st century are going to be preventive. They are going to allow 
for patients to be treated on an outpatient basis and it will make part 
A of Medicare, the hospitalization part of Medicare, less expensive.
  I mentioned a drug the other night, an important anticoagulant that 
helps to prevent strokes. It is a drug that would cost perhaps $1,000 a 
year to assist seniors. If we can prevent those strokes through the 
anticoagulant drugs, we can save $100,000 that might be incurred as a 
result of expenses associated with a disability.
  There is one bipartisan bill before the Senate dealing with this 
prescription drug issue. It is the Snowe-Wyden legislation. My view is 
we can't afford to continue to pass up the opportunity to address these 
health care issues in a preventive way rather than incurring the 
extraordinary expenses for more institutional care.
  I will mention a few of the drugs that will be particularly important 
to older people. One is Neupogen, which helps cancer patients and 
others with compromised immune systems boost their white blood cell 
counts and avoid hospital stays. Another is Glucophage, which is now 
being used to help those at risk for diabetes from getting that disease 
which causes so many other serious health problems.
  My mom has had diabetes for a long time. I have seen the costs of 
these medicines. To think there is an opportunity with a particular 
drug to cover these seniors with their prescription drug bills seems to 
me to be an option as a nation we cannot afford to pass up.
  Another drug is Vasotec, which treats high blood pressure and helps 
to stave off strokes and heart disease and other major problems.
  These are all important medications. They do cost money, but the 
bottom line is we can use these medicines.

[[Page 27417]]

When seniors receive these medicines, they are in a position to stave 
off much more serious and much more expensive problems. It is sensible, 
in my view, to make sure seniors who need these medications--that are 
preventive in nature--can get them. Under the bipartisan Snowe-Wyden 
bill, that would be done.
  As far as I am concerned, in my reading of history, there is pretty 
much nothing that can get accomplished in the Senate that is truly 
important that isn't bipartisan. Our proposal gives each senior a 
chance at affordable prescription medicine. It ought to be recognizable 
to Members of Congress because a version of this model is what ensures 
good health for the families of Members of this body and the Congress.
  Since my days with the Gray Panthers--I have been working on this 
prescription drug issue for many years now--I have seen how many 
seniors have to walk an economic tightrope, balancing their food 
against their fuel costs and their fuel costs against their medical 
bills. We have now more than 20 percent of the Nation's older people 
paying more than $1,000 per year for prescription drugs. The typical 
senior is using 18 prescriptions a year.
  One constituent from Medford, OR, wrote that from a modest income he 
spent more than $1,230 so far this year on prescription medicines.
  The typical senior is taking 18 different prescriptions. I hope, as a 
result of this effort to collect these drug bills from seniors, we can 
actually get some relief for people in this country who are facing such 
serious and urgent health care needs.
  Some have said we ought to wait until after the next election, we 
ought to wait for comprehensive Medicare reform. I know the Presiding 
Officer believes strongly in this. There are a lot of Members who want 
to see broader, more comprehensive Medicare reform. Under the Snowe-
Wyden prescription drug proposal, we are using the kind of principles 
that make sense for Medicare in the 21st century. It is choice-
oriented. It gives a lot of options to older people. We use marketplace 
forces to contain costs.
  It has worked for Members of Congress and their families. I think it 
can work for my constituents at home in Oregon. I think it can work for 
the older people of this country. I am hopeful in the days ahead we can 
make the case for why it is important the Senate Act in this session.
  The question of prescription drugs and will Congress tackle it now--
all of the political prognosticators have said this is an issue the 
Congress is going to punt on. They have said this is an issue that is 
going to have to be put off. I don't see how, when seniors are sending 
copies of their prescription drug bills, a Member of this body, a 
Member of this Congress, can say we ought to put this issue off when 
there is a model that 54 Members of the Senate have voted for, that has 
strong bipartisan support, that uses marketplace forces as a model. 
Let's not say this is something that ought to be put off.
  I think we know what needs to be done. I think we can do it in a 
cost-effective fashion. Our bill doesn't involve price controls. Some 
seem to think that is the way to go. What troubles me about plans to 
deal with prescription drug costs that involve price controls, we will 
have massive cost-shifting. If we have Medicare acting as the buyer for 
all the medicine, it may be possible for the Government to negotiate a 
discount. I have always said that might be possible. What troubles me 
about that approach is we will have the cost passed on to someone else 
who might be 26 or 27--maybe a divorced mom who has a couple of kids--
working as hard as they can, and all of a sudden they find out their 
prescription drug bill shoots up because Congress adopted an approach 
in this area that doesn't use marketplace forces.
  Under the bipartisan Snowe-Wyden plan, the only bipartisan 
prescription drug bill now before the Senate, we reject those cost 
controls. We don't advocate a one-size-fits-all Federal approach. We 
use marketplace forces, the kind of forces that help deliver decent and 
affordable care to Members of this body and our families.
  I want to read briefly from a couple of the other letters I have 
received from Oregon. I will keep coming back to the floor of the 
Senate again and again until we get bipartisan action on this 
prescription drug issue. I think the question of prescription drugs is 
the kind of issue that can leave a legacy for this session. It is the 
kind of important question that will help folks and help families at a 
time when a lot have fallen between the cracks. We know the economy is 
strong. We know a lot of people are doing well. If they happen to be in 
the stock market, most of the time they are doing very well. But there 
are a lot of folks who don't have the stocks in the technology 
companies, a lot of folks are on modest incomes. A lot of the seniors I 
have worked with since my days with the Gray Panthers are telling me 
and telling other Members of the Senate they just can't afford their 
prescriptions. That is what this is about. They can't afford their 
prescriptions.
  There is a right way and a wrong way to deal with that issue. The 
wrong way, in my view, is to have a price control regime and produce 
cost-shifting with intervention by Government. I don't think that will 
work. I think a lot of people will end up getting hurt by that 
approach. I think there would be a lot of unintended consequences.
  The right kind of approach, the one advocated in the bipartisan 
Snowe-Wyden prescription drug bill, uses marketplace forces. It gives 
seniors the kind of bargaining power that health maintenance 
organizations would have. Those big organizations, the health 
maintenance organizations, can go out and negotiate deep discounts. 
They use their bargaining power in the marketplace to get discounts. 
What happens is seniors get shellacked twice. They get hit once because 
Medicare doesn't cover prescription drugs.
  Medicare started out as half a loaf back in 1965. It did not cover 
prescriptions and eyeglasses and hearing aids and a variety of needs 
older people have. But as a result of the escalating costs of health 
care, a lot of seniors are paying more proportionately out of pocket 
today than when Medicare began in 1965.
  So seniors are not able to afford their prescriptions, and that 
senior purchaser, a low-income elderly widow, in effect has to 
subsidize the big purchasers, the health maintenance organizations that 
can negotiate discounts.
  There is a right way and a wrong way to deal with the issue of 
affordable medication. The wrong way is to create a one-size-fits-all 
Federal regime and put the Government in the business of trying to 
orchestrate this entire program. The other is to use a model that we 
know works. Under our proposal--we call it SPICE, the Senior 
Prescription Insurance Coverage Equity Act--Senator Snowe and I, we 
reject this Government model. We use an approach that has private 
sector options and choices and gives seniors bargaining power.
  We hope more older people will send us copies of their prescription 
drug bills. This poster really says it all to seniors and their 
families:

       Send us copies of your prescription drug bills.

  Send them to your Senator. Write to:

       Your Senator, U.S. Senate, Washington, D.C.

  I am going to wrap up tonight--because I know several of our 
colleagues would like to discuss matters important to them--with just a 
couple of other letters.
  From the Oregon coast in the last few days, I received a particularly 
poignant letter. It is from an individual with an income of about 
$1,000 per month. She has to take prescription medicine, a number of 
prescriptions. Over the last few months, out of her $1,000-a-month 
income, she has had to spend almost $700. That is just over the last 
few months, from somebody who is on a very modest income.
  Picture any one of us, or our relatives, trying to get by on an 
income of $1,000 a month and having to spend a significant portion of 
it, around $700 just in recent days, on prescriptions. We know they 
would not be able to do it. But that is the reality of what seniors on 
the Oregon coast are facing. That is the reality of what seniors all

[[Page 27418]]

over this country are facing. That is what the bipartisan Snowe-Wyden 
prescription drug bill seeks to deal with. We want that person to get 
some real relief. We think it is time for the Senate to act on a 
bipartisan basis.
  One other letter I received from the Willamette Valley, not far from 
my hometown, I thought was also particularly poignant. This was from a 
senior who sent me, really, all of his prescriptions. Just as we said 
in our poster, send us copies of your prescription drug bills, I think 
a lot of the seniors are doing it in a pretty detailed fashion. This is 
just an example of what I received from one older person in the 
Willamette Valley. She reports, on a very modest income, she is 
spending $236 a month on her prescription drugs. As she reports, that 
is without the over-the-counter medication she also has to take. She is 
78 years old. She is concerned about whether or not the Senate is going 
to act. She is pretty skeptical, just the way a lot of other seniors 
are in our country. What we need to show is this Senate is willing to 
tackle these issues and do it on a bipartisan basis.
  The time for finger pointing and scapegoating on this issue is over. 
We cannot wait for another year, another full year, for action on this 
matter. We ought to move now. There is one bipartisan bill before the 
Senate, one which I believe can bring Democrats and Republicans 
together. I am going to keep coming back to the floor of the Senate to 
talk about the SPICE Program, the Senior Prescription Insurance 
Coverage Equity Act. It is voluntary in nature. Nobody is required to 
change anything. No senior, no family, would be required to change 
anything in their buying practices should they choose to continue doing 
exactly what they are doing. But for millions of older people, the 
SPICE Program, the Senior Prescription Insurance Coverage Equity Act, 
will be a bargain. It will be a winner because it will give seniors the 
kind of bargaining power the big health maintenance organizations have 
had.
  It is not right, in my view, to give those buyers significant power 
in the marketplace and just say seniors and families do not matter. In 
effect, that is what we are doing. We are telling them: You go on out 
and do your best, walk into a pharmacy, and even though you are 
subsidizing the big buyers, this Senate will not do anything about it.
  I believe it is time for bipartisan action on this. I believe it is 
time to create an approach to cover prescription drugs under Medicare 
that uses the forces of the marketplace, that is bipartisan, and that 
helps hold costs down. I believe a lot of seniors cannot afford their 
prescriptions. There is a right way and a wrong way to deal with it. 
The bipartisan Snowe-Wyden legislation is what we think is the 
appropriate way to go. We are going to continue to come to this floor 
and talk about the need for action on it.
  As this poster says, what will help is if seniors send in copies of 
their prescription drug bills. We urge seniors to send them to us and 
send them to their Senator here in the U.S. Senate, Washington, DC 
20510, because that will help Members of the Senate to see how urgent 
is this need.
  The need was great years ago, but it is getting even greater. Too 
many older people every week are having to make a choice between their 
food costs and their fuel costs and their fuel costs and their medical 
bills. Let us show we can deliver on this important issue. There is a 
bipartisan bill now before the Senate. We hope seniors, as this poster 
says, will be in touch with us to let us know their feelings on this 
important matter.
  I intend to keep coming back to the floor of the Senate until we get 
action on this issue.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Sessions). The majority leader.

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