[Congressional Record (Bound Edition), Volume 146 (2000), Part 15]
[House]
[Page 21763]
[From the U.S. Government Publishing Office, www.gpo.gov]



WHAT IS BEHIND OPPOSITION TO THE DEMOCRATS' MEDICARE PRESCRIPTION DRUG 
                                  PLAN

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Ohio (Mr. Brown) is recognized for 5 minutes.
  Mr. BROWN of Ohio. Mr. Speaker, earlier this year a confidential 
document prepared for House Republicans somehow found its way into the 
public realm.
  It was not big news at the time, just some talking points prepared by 
Republican polling firms on the Democrats' Medicare prescription drug 
plan.
  According to their analysis, one way to create opposition to the 
Democratic plan is to call it a one-size-fits-all plan or a big 
government plan.

                              {time}  1445

  One cannot blame the public for bristling at those phrases. I do not 
know anyone who likes big government for big government's sake. 
However, one can blame politicians for exploiting those terms instead 
of confronting the fundamental differences between the Democratic and 
Republican prescription drug plans. One can blame the drug companies 
and the chamber of commerce for spending $40 million already and 
promises of another $40 million on phony groups on television such as 
Citizens for Better Medicare.
  The Democrats plan would add an optional drug benefit to Medicare. 
The Republican plan, the drug company plan, would bypass Medicare and 
subsidize private, stand-alone insurance plans.
  So is the Democrats' Medicare prescription drug coverage a one-size-
fits-all program as the Republicans and the prescription drug companies 
tell us? I do not think so.
  It is difficult to conceive of a program offering more choice than 
Medicare. The Medicare program covers medically necessary care and 
services. Beneficiaries can see the health care professional and go to 
the facility of their choice.
  Similarly, under the proposed drug benefit, enrollees can go to the 
pharmacy of their choice. FDA-approved medications prescribed by a 
physician would be covered under the Democrats' Medicare prescription 
drug plan.
  Given this level of flexibility, how would a legion of new private 
health plans enhance the beneficiary's choice in any way that matters? 
It is more likely that the Republican plan, the prescription drug 
company plan, like any other managed care product, would restrict 
choice and add to the insurance and drug company's bottom lines.
  Medicare is a single plan that treats all beneficiaries equally, 
provides maximum choice and maximum access for patients and doctors.
  The Democrats' prescription drug coverage proposal embraces the same 
principle. Is that a one-size-fits-all program?
  Under the Republican prescription drug proposal, under the drug 
companies' plan, Medicare beneficiaries would have to choose among 
private stand-alone insurance company prescription drug plans. They say 
that enables seniors to tailor their prescription drug coverage to 
their particular needs.
  None of these private plans, however, will provide more choice to the 
Democrats' plan than the Medicare plan in terms of which medications 
are covered since the Democrats' plan covers all Medicare doctor-
prescribed medications. None of these private plans could provide a 
broader choice of pharmacy since the Democrats' plan does not restrict 
access to pharmacies.
  Under the Republican plan, under the prescription drug company plan, 
it appears that choice is actually code for ``wealth.'' Higher-income 
seniors could, in fact, afford a decent prescription drug plan, one 
with the same level of coverage as would be available to all 
beneficiaries under the Democrats' Medicare plan. Lower-income 
enrollees, however, would be relegated to restrictive alternatives. 
Some choice.
  Is the Democrats' prescription drug coverage plan a big government 
program as the Republicans and the prescription drug companies' 
executives tell us? Hardly.
  Medicare is a Federal Government program with the beneficiary 
population of 39 million. It is definitely big. But Medicare is also 
one of the most enduring popular public programs in the Nation's 
history. Medicare far outranks both employer-sponsored and individually 
purchased private insurance as a trusted source of health care 
coverage.
  So when opponents of the Democrats' prescription coverage plan berate 
it for being one size fits all or big government, they, in fact, are 
berating Medicare itself.
  In fact, the Republican prescription drug proposal, the plan from the 
big drug companies, which ignore Medicare to establish new private 
insurance policies, is an insult to the Medicare program. Their plan 
pays homage to those Members of Congress who favor privatizing 
Medicare. Parenthetically, I have to say I have not yet met anyone 
outside of Washington who wants to privatize Medicare.
  It is no coincidence that the only way a Medicare beneficiary could 
avoid carrying multiple health insurance policies under the Republican 
plan, under the prescription drug company plan, is to join a private-
managed Medicare-managed care plan.
  As Congress and the presidential candidates debate the merits of 
competing prescription drug coverage proposals, watch for allegations 
to be thrown around like one size fits all and big government program. 
Because when applied to insurance coverage offering maximum choice in 
matters that matter, choice of provider access to medically-necessary 
care, which is what Medicare is all about, those, those threats, those 
accusations of one size fits all and big government program, those 
terms simply fall flat.
  Bear in mind that more than the structure of prescription drug 
benefit is at stake. The future of Medicare hangs in the balance.




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