[Congressional Record (Bound Edition), Volume 146 (2000), Part 2]
[Senate]
[Pages 1502-1503]
[From the U.S. Government Publishing Office, www.gpo.gov]



                    PRESCRIPTION DRUGS AFFORDABILITY

  Mr. WYDEN. Mr. President, for many months now, I and other Members of 
this body have been coming to the floor to talk about the need for 
prescription drug coverage for our older people under Medicare. I have 
brought to the floor on more than 20 occasions specific cases of older 
people who, in so many instances, are walking an economic tightrope, 
trying to balance their food costs against their prescription drug 
bill, their prescription drug bill against some other necessity. More 
and more of these older people and their families simply cannot make 
ends meet.
  I wish to address the question of whether this country can afford to 
cover prescription drugs for older people under Medicare. I submit this 
Nation cannot afford not to cover these essential health care services.
  We talked on the floor about the important drugs such as Lipitor, a 
cholesterol-lowering drug used by many older people. These drugs are 
absolutely key to keeping older people well. There is no question that 
right now if the Government were to pick up the costs of these 
medicines there would be additional costs, but the savings generated as 
a result of extending prescription drug coverage to older people, in my 
view, would be staggering.
  I continually cite the exciting contributions made by these new 
medicines that prevent strokes. They are known as anticoagulant drugs. 
For an older person, it might cost perhaps $1,000 a year to pay for the 
drugs, anticoagulant drugs that prevent these strokes, but if you 
prevent a stroke you could save upwards of $100,000 through an 
investment that is just a small fraction of those costs.
  I am very hopeful it will now be possible to reconcile the various 
bills that cover prescription drugs for older people. Senator Daschle 
has talked to me on a number of occasions, even a few hours ago, 
indicating he is very interested in seeing the Congress come together 
on a bipartisan basis and enact this legislation to meet the needs of 
older people and better utilize the dollars that are available for 
health care in this country.
  The stories we have accumulated from home are tragic. I heard 
yesterday from an older woman in Tillamook, OR. She recently took 
another senior, an 80-year-old woman, to the emergency room. This 80-
year-old woman said she could not afford the one medication she needed 
to control her high blood pressure. As a result, she almost died.
  From what we are seeing across this country, we either now go forward 
and make a well-targeted investment to make sure vulnerable seniors get 
help with prescription drugs or we end up with vastly more people 
suffering and much increased costs.
  I have received scores of letters from across rural Oregon. These are 
from people who have to drive 40 miles, 50 miles to a pharmacy. They 
don't have big health plans that negotiate discounts for them.
  In Baker City, OR, I have been told by an older couple they are 
getting by on $200, the two of them, for their entire month after they 
are done paying their prescription drug bills. There is not a one of us 
in the Senate who could live in that kind of arrangement where they 
essentially had only a couple of hundred dollars a month to pay for 
their food and shelter and other essentials. A country as good and rich 
and strong as ours is capable of addressing this need. I think it can 
be done using an approach that relies on marketplace forces.
  I particularly wish to praise my colleague from Maine, Senator Snowe. 
I have been able to team up with her on this prescription drug issue 
for 14 months. When we started in the Budget Committee, I think a lot 
of folks looked at us and said, Senator Snowe, Senator Wyden, they are 
well meaning but there is no chance this prescription drug issue is 
going to be addressed.
  We have seen over the last few months tremendous progress. There is 
not a Member of Congress, Democrat or Republican, who goes home and 
doesn't get asked about this issue. We have a chance to bring the 
various bills together. Senator Daschle wishes to do so, and I know a 
number of Republicans want to do so as well. Our colleagues in the 
Senate recognize this ought to be a voluntary program. A lot of lessons 
have been learned since the catastrophic care issue came before the 
Congress. This is not going to be a mandatory program. This is not 
going to be a one-size-fits-all program from Washington. This is going 
to be based on voluntary choice. We are going to use the dollars that 
are raised for this program to pick up the prescription drug portion of 
a senior citizen's private health insurance.

[[Page 1503]]

  I am not talking about a federalized health care system. We are 
talking about using private health insurance, making sure older people 
have a variety of choices and offerings. As a result of those choices 
and offerings, they can have some big bargaining power.
  What happens right now is the health plans, the HMOs, big buyers, go 
out and negotiate a discount. If you are an older person in rural 
Nebraska or rural Oregon and you don't have prescription drug coverage, 
you walk into the Rite Aid or a Fred Meyer or one of your drugstores 
and you, in effect, have to subsidize the big buyers who are in a 
position to negotiate discounts. We can use private marketplace forces, 
the way the Snowe-Wyden legislation does, and the way several of the 
other bills do, to make sure older people have the kind of bargaining 
power that makes these prescription drugs more affordable.
  I am very pleased that this issue has become a bigger priority in the 
Congress in the last few weeks. I think now is going to be a test of 
whether we can, as Senator Daschle and others have suggested, reconcile 
the various bills that have been introduced on this issue. I do not 
expect to have the last word on this matter.
  Senator Snowe and I are very proud the financing of our legislation 
received 54 votes in the Senate when it came up last year. On the 
Snowe-Wyden amendment, we saw Senator Wellstone vote for it, Senator 
Santorum vote for it, Senator Kennedy vote for it, and Senator Abraham 
vote for it. That is a pretty good coalition. That is the kind of 
coalition we can build if we pick up on the counsel of Senator Daschle, 
and I know a number of Republican leaders, to come together and 
reconcile these various bills.
  I intend to keep coming to the floor and reading these cases. Our 
friend, Senator Kerrey, is here. I know he is going to be speaking on 
an important issue, and I do not want to detain him. I think in this 
country we are now seeing older people break their pills in half 
because they cannot afford to pick up the cost of medicine when we 
have, as we saw in Tillamook, OR, 80-year-old women being taken to 
emergency rooms and not able to afford their medicine. It is wrong. It 
is just wrong for this Congress to not address this issue in a 
bipartisan way this year.
  This is not one we ought to put off until after the election and see 
it used as a political football. It should not be used as fodder for 
the campaign trail because if it is, too many older people who cannot 
afford their medicine are going to suffer.
  We have a chance to move on a bipartisan basis to reconcile these 
various bills. I intend to keep coming to the floor of this body again 
and again to describe these cases, to show how urgent the need is. The 
President at the State of the Union Address made it clear he was 
extending the olive branch to both political parties to work with him 
on this issue. We ought to seize, on a bipartisan basis, the 
opportunity to use private health insurance, not some federalized 
Government program, to make sure we meet the needs of older people for 
prescription medicine.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The distinguished Senator from Nebraska is 
recognized.

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