[Congressional Record (Bound Edition), Volume 146 (2000), Part 9]
[House]
[Page 12146]
[From the U.S. Government Publishing Office, www.gpo.gov]



          DEMOCRATIC VS. REPUBLICAN PRESCRIPTION MEDICINE PLAN

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Washington (Mr. McDermott) is recognized for 5 minutes.
  Mr. McDERMOTT. Mr. Speaker, the majority leader said it on Wednesday, 
we will embark upon a very important bill, that is, giving prescription 
medications for seniors in this country. There is an enormous 
difference between the Republican and the Democratic plan, and I would 
like to lay out the differences.
  The Democratic prescription medication plan is part of Medicare. It 
is a core benefit. The Republican plan is not a part of Medicare; it is 
simply a chance to buy a private insurance policy or join an HMO.
  The Democratic plan is secure. Seniors can count on it, just like 
they count on Medicare. Under the Republican plan, your insurance 
company or your HMO could leave your area, disrupt your life, as they 
are doing today with regular benefits, while you look for another 
company. This is just one more example of the HMO in pharmaceuticals.
  Now, the Democratic prescription plan is simple and easy. It is a 
part of Medicare. Under the Democratic prescription medicine plan, you 
will not have to change anything that you now do to get your 
prescriptions. You can continue to get your prescriptions from your 
local pharmacist, just as you do now.
  On the other hand, the Republican plan is complex and difficult. The 
Republican plan would require you to find an insurance company or an 
HMO and sign up. Then you would get your prescriptions by mail order. 
The chairman of the committee came before the Committee on Ways and 
Means and held up a letter from a mail order house in Florida. All your 
drugs would come from Florida, and you would have to wait 8 to 10 days.
  Under the Democratic plan, you would pay $25. The one that will be 
brought to the floor has a guarantee of a $25 premium. Under the 
Republican plan, your premium would be set by the insurance company, 
which would have to be high enough to cover the marketing costs and 
profits.
  There is no guaranteed premium in the Republican plan. Seniors have 
already been through this with HMOs. They joined an HMO, they were 
going to get all these benefits. Then they took away the benefits. Then 
they said we have taken away the benefits, but we are going to charge 
you a policy premium. That is what will happen under the pharmaceutical 
plan of the Republicans.
  The Republicans say we are going to give you choice. They really take 
away choice. The only choice that a senior will have is which plan do 
they go into, which insurance company do they sign up with.
  The HMO, or the private insurance company, will limit the choice of 
what pharmaceuticals they receive. Now, when I am a physician and I 
write a prescription and I hand it to a patient and they go to the 
pharmacy, I know what the patient got. But when it goes through this 
HMO, they could say, well, that is not on our formula. We will give you 
something that is close, or we will give you something that we think is 
just as good, and that choice of the physician and the patient will be 
interrupted. We will have to put an amendment on the Patient's Bill of 
Rights on this issue.
  The other thing they take away is your choice of pharmacy. If they 
are a mail order house in Florida, they do not care about your local 
pharmacy. Your local pharmacist is out of business as far as your being 
able to do down there and get your medicine with the discount. You will 
have to pay the old high prices. In my view, the Republican plan really 
guarantees a benefit to insurance companies or HMOs, not to seniors.
  There is no guarantee that the insurance companies will offer an 
affordable, and I emphasize, affordable prescription drug plan to 
seniors.
  Now, you ask me, why is that? Well, let me tell you the specifics of 
the bill. Ordinarily a lot of people do not read the bill, but I do. 
The Republican plan guarantees profits to insurance companies and HMOs 
by letting them hold the Government hostage.
  Page 56 of the Republican plan says that the Government will pay 
private plans not more than 35 percent of the cost of those medicines. 
So you have paid your premium through Social Security, and the 35 
percent for the Government that has to cover it. But the Congressional 
Budget Office and the insurance companies say the plan will not work; 
we will not offer a plan if the Government pays only 35 percent.
  So the Republicans answer that. They go around on page 40 and they 
say the Government may provide financial incentives, including partial 
underwriting of the risk to get the insurance companies to sell 
policies to seniors. During the markup in the committee, the chairman 
of the health subcommittee said that they could cover up to 99 percent. 
Now, if you are an insurance company out there and they offer you 35 
percent, you say, I do not want that. I am going to wait until they 
offer me 100 percent.
  It is a bad bill, and we have to pass the Democratic alternative.

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