[Congressional Record (Bound Edition), Volume 146 (2000), Part 2]
[Senate]
[Pages 2069-2070]
[From the U.S. Government Publishing Office, www.gpo.gov]



                    PRESCRIPTION DRUG AFFORDABILITY

  Mr. WYDEN. Mr. President, since the fall, I, and other Members of the 
Senate, have come to the floor of this body to talk about the need for 
prescription drug coverage for older people under Medicare.
  As we look at this issue, I am especially pleased that Senator 
Daschle has been trying to reconcile the various legislative proposals 
that have been introduced on this issue. I know colleagues on the other 
side of the aisle have good ideas, as well.
  I particularly commend my colleague, Senator Snowe of Maine. She and 
I have teamed up, on a bipartisan basis, for more than a year now. 
Senator Daschle is trying to bring these bills together and make it 
possible for us to go forward and address this vital issue for seniors 
in a bipartisan way.
  What I am struck by, and what I want to touch on for a moment or two 
this morning, is how significant the

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ramifications are with respect to this prescription drug issue.
  For example, one issue I have not talked about in connection with 
this prescription drug matter is how it is directly and integrally tied 
to the matter of medical errors. Many of our colleagues were astounded 
at the end of last year when the Institute of Medicine produced a 
landmark study--a truly landmark study--documenting the problem of 
medical errors today in American health care.
  These medical errors end up injuring many of our citizens, of course. 
They cost vast amounts of money. What is striking is how many of them 
are tied to problems connected with prescriptions. For example, we know 
when a senior cannot afford to take their prescription or ends up only 
taking two pills, when three of them are essentially recommended by 
their physician, that can constitute a breakdown in our health system 
or, in fact, what amounts to a medical error.
  I think I have been coming to the floor of the Senate and talked on 
the issue of prescription drugs something like 26 times in the last few 
months, for example, talking about instances where folks at home in 
Oregon are actually breaking up their pills, their cholesterol-lowering 
pills, because they cannot afford to take the entire pill. They believe 
if they break up the pill they can stretch it.
  These are the kinds of medical tragedies we are seeing across this 
country. They are errors that we can correct if we go forward and 
address this issue--prescription drug coverage--in a bipartisan way.
  It seems unconscionable to think that, in a Nation as rich and good 
and powerful as ours, with all of these older people walking on an 
economic tightrope, balancing their food costs against their fuel 
costs, fuel costs against their medical bills, we can't go forward, as 
Senator Daschle has suggested, and reconcile these various bills that 
have been introduced on this issue and enact a comprehensive program to 
help older people with their prescription drug bills, reduce the kinds 
of errors the Institute of Medicine found, and help a lot of families 
in our country.
  I think there really are three principles we ought to zero in on in 
terms of trying to address this issue. First, I think there is general 
agreement now that this program be voluntary. I think many Members of 
Congress remember the ill-fated catastrophic care legislation, with a 
lot of older people believing at that time that they were being forced 
to pay for catastrophic benefits they were already receiving under 
their existing private health coverage.
  Now I believe there already is a bipartisan consensus--Senator 
Daschle has touched on this a couple of times recently--that a 
prescription drug program ought to be voluntary for older people and 
voluntary for the various providers, insurers, and pharmaceutical 
benefit managers who might decide to participate in the program. I 
think that minimizes the possibility that older people and families 
will believe they are being coerced by Government to pay for something 
they are already receiving. That voluntary aspect of such a program is 
one area where there already is bipartisan agreement.
  Second, I think there is a general belief that rather than inventing 
an entirely new structure for this program, it must be integrally tied 
to the existing Medicare program and, in particular, fit with an agenda 
for Medicare reform.
  What the legislation I have worked on--the Snowe-Wyden legislation--
does is allow the administrative body--called the SPICE board, because 
our bill stands for Senior Prescription Insurance Coverage Equity or 
SPICE--to contract with a variety of entities, insurance companies or 
pharmaceutical benefit managers or nonprofit agencies--anybody who was 
authorized under State law to administer a program. That way, we are 
not creating a whole new structure for dealing with this program; we 
are building on Medicare as it exists today. At the same time, we are 
doing something else which is critical; that is, adding more choice to 
the Medicare program.
  I personally think the effort to make this program voluntary, to 
build on existing Medicare coverage, which makes the benefits available 
to all seniors--universal coverage for those eligible for the program--
and then, in addition to those principles, add new choices to the 
Medicare program. The reason that is so important is, providing choices 
is what is going to generate the competition that can help hold down 
the prices of medicines for our older people.
  We see so many seniors who can't afford their medicine. There is a 
great debate going on in the country now about whether it is the 
research costs of these drugs that have contributed to it. There are a 
variety of reasons being offered for why older people cannot afford 
their prescription drugs. I am interested in debating those.
  What I am most interested in is making sure older people have the 
kind of bargaining power necessary to drive down the costs of their 
medicine. It seems to me they can get that bargaining power through an 
approach based on choice, such as we have, as Members of Congress, 
through the Federal Employees Health Benefits system. I am very hopeful 
that that expanded array of choices will be a key invisible part of a 
bipartisan effort to go forward and address this issue in the Senate.
  As we head to a period of town meetings and discussions with folks at 
home, I know my colleagues are going to hear accounts from older people 
and families about horrible, tragic instances where older people cannot 
afford medicine and often end up getting sicker and needing much more 
expensive care when they cannot get those essential prescriptions. I 
think we have made a lot of progress in the last 2 or 3 months, with 
Senator Daschle having taken the lead, many colleagues on the other 
side of the aisle trying to bring the Senate together to find the 
common ground. I think we made a lot of progress.
  I am hopeful that when the Senate reconvenes after this break to 
visit with folks at home, when the Budget Committee goes forward--and 
Senator Snowe and I both sit on the Budget Committee--that with the 
bipartisan leadership of Senator Domenici and Senator Lautenberg, we 
can get a generous earmark in the budget to cover prescription drugs 
and, in effect, continue the progress we have made towards getting a 
bipartisan prescription drug program enacted in this session of the 
Senate.
  I have talked with Senator Lautenberg, ranking Democrat, Senator 
Conrad, others who have been involved in this issue on our side, and 
with Senator Domenici on the other side of the aisle. I think there is 
a real openness to making sure there is a generous earmark in that 
budget for a prescription drug program we would enact this year. After 
we get over that hurdle, the challenge will be, as Senator Daschle has 
outlined, to reconcile the various approaches that have been offered. 
As I mentioned, Senator Snowe and I have one we think makes sense, but 
we do not believe we have the last word.
  We think the last word ought to belong to the American people. The 
American people are saying: We want you to deliver on this prescription 
drug issue. We want it done this session. We do not want it to go 
through yet another campaign season as campaign fodder through the 
fall. We want you to get it done this year. Take the steps necessary to 
provide older people the relief they need and deserve.
  I look forward to being part of that effort in a bipartisan fashion.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New Mexico.
  (The remarks of Mr. Bingaman pertaining to the introduction of S. 
2181 are printed in today's Record under ``Statements on Introduced 
Bills and Joint Resolutions.'')
  Mr. BINGAMAN. Mr. President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. MURKOWSKI. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.




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