[Congressional Record (Bound Edition), Volume 146 (2000), Part 9]
[Senate]
[Pages 12245-12246]
[From the U.S. Government Publishing Office, www.gpo.gov]



                A PRESCRIPTION DRUG BENEFIT IN MEDICARE

  Mr. DORGAN. Madam President, I want to talk about the subject that is 
going to be front and center in the Congress this week, the issue of a 
prescription drug benefit and Medicare. There are stories in today's 
papers--the Washington Post, the New York Times, and others--in which 
the chairman of the National Republican Congressional Committee is 
quoted as saying that there is a belief that his party, meaning 
Congressional Republicans, need to do something on the issue of 
prescription drugs. He says, ``It's a great issue--no question it polls 
well.''
  Another member from the other side of the aisle said: ``We're going 
to use the marketplace pressure to solve the problem, which is much 
better than the government program.''
  In other words, the majority party feels they have to bring a bill to 
the floor addressing the need for prescription drug coverage because 
the issue polls well. So they are going to bring an illusory bill to 
the floor of the House this week that requires private insurance 
companies to offer an insurance policy that helps people pay for their 
prescription drugs. The catch is that the insurance companies say they 
cannot offer such a policy. Officials from two companies have come to 
my office and told me that, to offer a policy with $1,000 in benefits, 
it would cost $1,200.
  I come from a rural State. In rural States, a recent study shows that 
rural Medicare beneficiaries pay 25 percent more out-of-their own 
pockets for prescription drugs than do urban beneficiaries. Of course, 
rural areas are shrinking. Many have seen the movie ``Four Weddings and 
a Funeral.'' In rural areas of my State, ministers tell me they have 
four funerals for every wedding because the population is getting older 
and the younger people are moving out.
  And those senior citizens living in rural areas are the ones who are 
paying the highest prices for prescription drugs.
  And many of them cannot afford the drugs they need. They have heart 
trouble, diabetes, and a range of other problems. Their doctors say: 
You need to take this miracle medicine, this life-saving drug, to help 
you live a better life. And they say to their doctors: I can't afford 
it.
  We need to do two things. First, we need to add a prescription drug 
benefit to the Medicare program, and second, we need to put downward 
pressure on drug prices.
  I thought I might, with my colleagues' consent, show on the floor of 
the Senate a couple of pill bottles that illustrate part of the 
problem. Here are two bottles for a prescription drug called Zocor used 
to lower cholesterol. This is the same tablet, in the same strength, 
made by the same company, probably made in the same manufacturing 
plant. If you buy Zocor in Canada, it costs $1.82 per pill. But if you 
buy the same drug--the same pill, made by the same company--in the 
United States, it costs $3.82 per pill.
  Let me say that again. If you are a Canadian, you pay $1.82 for 
Zocor; if you are an American, you pay $3.82, more than twice as much. 
Why? Because the big drug manufacturers have decided they want to 
charge the American consumer more than twice as much.
  One other example, if I might. Here are bottles of Zoloft. Zoloft is 
a common prescription drug used to fight depression. If you buy this 
medication in Canada--the same pill, in the same strength, by the same 
drug company--it costs $1.28 per pill. But if you buy it in North 
Dakota, it costs $2.34 per pill. The Canadian pays $1.28; the American 
pays $2.34, 83 percent more.
  I have other examples, but I think you get the point: American 
consumers pay the highest prices in the world for their prescription 
drugs. These are the prices that our current marketplace have achieved. 
Why should an American citizen have to go to Canada to buy a drug that 
was produced in the United States in order to pay half the price that 
is charged in the United States? The answer is that they should not 
have to do that.
  I think these examples illustrate why, when those on the other side 
of the aisle say ``we're going to use the marketplace pressure to solve 
the problem,'' this marketplace approach just is not going to work. We 
need a real prescription drug benefit added to the Medicare program. 
What we do not

[[Page 12246]]

need is an illusion of a benefit where we tell private insurance 
companies to sell a policy they say they can't underwrite and won't 
sell.
  That is not good public policy. Maybe the polls show that Medicare 
prescription drug coverage is a popular issue, but you do not solve a 
problem, no matter how popular an issue, by coming up with a solution 
that does not work.
  We need to add a prescription drug benefit to the Medicare program in 
a way that is sensible and thoughtful and workable. And, second, as we 
do that, we need to put some downward pressure on prescription drug 
prices.
  It is not fair, right, or reasonable that the American consumer ought 
to pay double the price for the same drug, put in the same bottle, 
manufactured by the same company. That is not fair. The common 
medications that senior citizens so often need--to treat their heart 
problems, diabetes, arthritis, and so many other difficulties--have 
been increasing in cost at a dramatic rate.
  I am not talking about creating price controls, but we need to do 
something to put some downward pressure on prices. One thing we should 
do is pass legislation that I have introduced, along with Senator 
Snowe, Senator Wellstone and others, that will allow American consumers 
to have access to these drugs from anywhere in the world, as long as 
they are FDA-approved with safe manufacturing standards. This 
legislation, the International Prescription Drug Parity Act, will allow 
Americans to access these drugs from anywhere in the world at a lower 
price.
  If we eliminate the legal obstacles that currently exist and allow 
pharmacists to purchase these medications from other countries on 
behalf of their American customers, the pharmaceutical industry will be 
forced to re-price their drugs in this country.
  In short, I wanted to come to the floor to make the point that we 
must put a prescription drug benefit in the Medicare program, but we 
must do it in a way that works. We should not do this just so some will 
be able to go home to their states and say: We passed prescription drug 
coverage, didn't we? That might provide some self-satisfaction but it 
does nothing for the millions of Medicare beneficiaries who need 
prescription drug coverage. And finally, as we develop this 
legislation, we need to acknowledge that drug pricing is unfair in this 
country and do something to put some downward pressure on prescription 
drug prices.

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