[Congressional Record (Bound Edition), Volume 148 (2002), Part 10]
[Senate]
[Pages 14158-14160]
[From the U.S. Government Publishing Office, www.gpo.gov]




                       PRESCRIPTION DRUG BENEFIT

  Ms. STABENOW. Mr. President, I rise today, as I have now for many 
weeks, and in particular in the last 2 weeks, focusing on prescription 
drugs, which is another disaster, quite frankly, that has been facing 
our seniors, our families, our farmers who are trying to find health 
insurance for their families, our small businesses that are seeing 
their health care premiums double in some cases, trying to afford 
health care for themselves and their employees.
  I rise on behalf of those workers who have had their employer say: 
You are going to have to take a pay freeze this year because we have to 
have money to pay for health care benefits.
  I rise for those manufacturers that are seeing an explosion as well, 
and basically for everyone who is paying the price for the explosion in 
prescription prices, and the system that is basically out of control.
  We have been working hard in the last week and a half. I think we are 
making some progress, but we are not there yet.
  Yesterday, we had an opportunity to vote on two different plans 
before the Senate. One was a plan to strengthen Medicare, to put a 
system in place that was promised in 1965 with the advent of Medicare: 
That once you are 65 or you are disabled, you will know that health 
care is available for you. We all pay into the system. The promise was 
made, and we have been trying to update and modernize that system to 
reflect the way health care is provided today, which is primarily on an 
outpatient basis with prescription drugs.

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Yesterday, we had that plan that would pay the majority of the bill and 
would do it within Medicare, which we know works.
  Then we had another plan much more focused on private insurance, 
HMOs, and I believe a step in privatizing the system. Quite frankly, 
that is supported by the drug industry, the pharmaceutical industry 
that has a situation right now for them that is too good to give up 
voluntarily. They fight everything. They fight any effort to modernize 
Medicare, to put 40 million people, seniors and disabled persons, in 
one insurance system because they know that if 40 million seniors and 
disabled persons are in a system together, they will be able to get a 
group discount, like all the other insurance companies. They are 
fighting that. They know when the Federal Government goes to buy for 
veterans in the VA hospitals, we do not pay retail, we get a discount 
on behalf of the veterans.
  The outrageous part of the system today is that the only people who 
pay retail, the only people who walk into the pharmacy and have nobody 
negotiating on their behalf, are the seniors of this country and those 
who are disabled and need help with health care.
  Everybody else gets a discount. So we are trying to change that. The 
companies are fighting us every step of the way.
  I think we did something historic yesterday. We did not get all the 
way to where we need to be, but for the first time in the Senate--52 
people, a majority of our colleagues--voted for a Medicare prescription 
drug benefit. Unfortunately, in this process we need to get to 60 
votes, but I believe we sent a very strong message with 52 people--and 
the other plan, in fact, had fewer; I believe it was 48 people that 
voted for that plan. So fewer than the majority voted to move in the 
direction of privatizing, to set up a system that is much more 
favorable to the drug companies.
  A majority of us, in fact, said we want to do this under Medicare; we 
want to pay the majority of the bill for our seniors. I am very hopeful 
that now we will be able to bring enough of our colleagues together, on 
both sides of the aisle, to be able to get those eight extra votes for 
something that moves us in the right direction. We know it is not going 
to be all that we had originally hoped, but I desperately hope the drug 
companies are not successful again in stopping anything real from 
happening.
  I believe this is a point in history that people will look to just as 
they will look to 1965, and it is up to us to show that we will do the 
right thing.
  Mr. DORGAN. Mr. President, will the Senator from Michigan yield for a 
question?
  Ms. STABENOW. I would be honored to yield to my friend from North 
Dakota, who has been such a leader in this effort.
  Mr. DORGAN. I would like to ask a question of the Senator from 
Michigan. It is true that yesterday we had 52 votes for a prescription 
drug plan in the Medicare Program. It is also true that we desperately 
need it. Medicare is now roughly 40 years old. Had we had these 
lifesaving and miracle drugs available when Medicare was created, there 
is no question that we would have had a prescription drug benefit in 
the Medicare Program. Our task now is to put a prescription drug 
benefit in the Medicare Program and do it in a way that does not break 
the bank. Both goals are important.
  Yesterday, we had 52 votes for a prescription drug plan in the 
Medicare Program, but we need 60. It is also true that although a 
majority of the Senate have now expressed themselves that they want 
this prescription drug plan in the Medicare Program, a minority of the 
Senate can block it.
  My hope is we will find a way now to reach 60 votes put a 
prescription drug plan in the Medicare Program in a thoughtful, 
responsible manner, that is helpful to senior citizens. At the same 
time we must put downward pressure on prescription drug prices. Both 
approaches are necessary.
  I ask the Senator from Michigan if it is not the case that although 
we had 52 votes and the Senate has already said, yes, let us do it, a 
minority can block it? The question is, over the next 48 hours, Will a 
minority in the Senate block the majority's efforts to pass this bill? 
Is that not where we stand at this point?
  Ms. STABENOW. That is exactly where we stand. My friend from North 
Dakota is correct. That is exactly where we stand. The question is, 
Will the minority be able to block what the majority of people want to 
have happen?
  Turning back and asking my friend a question as well, I want to say 
for those who are watching today, there is a way to express yourself. 
We certainly hope you will engage with your Senator. You can also go to 
fairdrugprices.org and be part of an online petition drive urging the 
Senate to act, and share your own individual story. We have never had a 
more important time for people to be involved. We need people now to be 
involved. There are six drug company lobbyists for every one Member of 
the Senate, but the majority of the people in this country, regardless 
of where they live, know that we need action for them now, and that is 
what this is about.
  Since my colleague has been a leader in another important effort, 
lowering prices for everyone, which is the other piece of the puzzle, 
we want to make sure Medicare is updated to cover prescriptions for 
those on Medicare, and that is critical. But for everyone else who is 
not on Medicare, they also pay too much, and there are a number of 
efforts we are equally engaged in to get more competition, to lower 
prices for everyone, and I wonder if I might ask my colleague to speak 
to that specifically, since we have joined in efforts to open the 
border to Canada, and other efforts.
  I know that the Senator has been very involved in those efforts to 
create more competition.
  Mr. DORGAN. Mr. President, the Senator from Michigan knows that one 
issue with respect to this bill is adding a prescription drug benefit 
to the Medicare Program, but that is not the only issue concerning 
prescription drugs in this country. The other issue is that all 
Americans who get sick, who have a disease or an illness and who need 
prescription drugs need to be able to afford and have access to these 
medicines. Miracle drugs provide no miracles, lifesaving drugs save no 
lives for those who cannot afford them. So we are trying to find a way 
to put some downward pressure on prescription drug prices.
  The fact is that American people are charged the highest prices in 
the world for prescription drugs. Virtually everyone else in the world 
buys the same pill, put in the same bottle, made by the same company, 
and pays a much lower price. There is no Republican or Democratic way 
to get sick. There is no Republican version of Celebrex, Zocor, or 
tamoxifen, and there is no Democratic version of Celebrex, Zocor, or 
tamoxifen. There is just sickness, medicine, and need.
  I want the drug companies to do well. I want them to invest in 
research, experimentation, and finding drugs. We are doing that in the 
public sector, doubling the amount we are spending on the National 
Institutes of Health searching for cures for these diseases. By the 
same token, I want what we reap from all this research to be affordable 
by the American people who need them when they get sick.
  Regrettably, what has happened is every year the cost of prescription 
drugs is going up--18 percent last year, 16 percent the year before, 17 
percent the year before that. There is this relentless increase in the 
cost of prescription drugs, and the fact is a lot of vulnerable people 
in this country desperately need those drugs and cannot possibly afford 
them.
  Yes, it is important we do a prescription drug benefit in the 
Medicare Program. Fifty-two Senators have already said yes. The 
question is, Will a minority block us in the next day or two from 
getting this done?
  We also need to find a way to put downward pressure on prices. One 
way we have worked on--and the Senator from Michigan has been a 
leader--is the reimportation of prescription drugs from Canada. The 
same drug, put in

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the same bottle, made by the same company, is sold in Canada at a 
fraction of the cost that the American consumer is charged.
  To use one example, someone suffering from breast cancer who needs to 
take the drug tamoxifen is going to pay $100 for that which they could 
buy for $10 in Canada, the same medicine made by the same company, FDA 
approved, similar bottle, different price. The U.S. consumer is charged 
10 times more than the Canadian consumer. It is wrong, it is unfair, 
and it ought to stop. These are the things on which we are working.
  Ms. STABENOW. Absolutely.
  Mr. DORGAN. We do not have perfect solutions, but we must in the next 
day or two make progress to get this bill completed so that we can go 
to conference with the House and make prescription drugs available to 
senior citizens, especially in the Medicare Program, and also begin to 
find a way to bring prescription drug prices down for all of us.
  I appreciate the work the Senator from Michigan has done. She has 
done in her leadership position a lot of work on this issue, and I 
deeply appreciate it.
  Ms. STABENOW. I thank my colleague from North Dakota.
  To support the comments of the Senator from North Dakota, it is so 
frustrating to look at what is happening, and I think so unfair for 
consumers in the United States, taxpayers, and ratepayers. People say: 
How can this happen?
  The reality is that today, while the companies say, oh, no, they 
cannot possibly lower prices at all because they would have to cut 
research, we know today that they spend two and a half times more on 
advertising, marketing, and administration than they do on research. 
When we look at the numbers for last year, the top companies' profits 
were three times more than they spent on research. This is not about 
research. We all are for research and, as my friend from North Dakota 
indicated, we as taxpayers fund research. This year we will contribute 
over $23 billion to basic research. I support that. I support doing 
more than that. It is an important investment.
  After we do that, the companies take the basic information and see if 
they can develop new lifesaving medicine. That is great. However, we 
give tax deductions for research, as well as advertising and other 
costs of doing business. When they get to the point where they actually 
have a new drug, we give them a patent of up to 20 years to protect 
their competitive edge, their brand name, so they can recover their 
research costs.
  We know it costs a lot of money to develop a lifesaving drug. We want 
to make sure it is a good investment and they can recover their costs. 
The problem is, we get done with all of this and what do we have? The 
highest prices in the world--higher than anyone else. If you are 
uninsured and using medications--which is primarily the seniors of this 
country--and you walk into your pharmacy, you get the great pleasure 
and honor of paying the absolutely highest prices in the world. That is 
outrageous. That is what we are trying to fix, both by making sure the 
health care system works with medications through Medicare, and also 
making sure that we have greater competition, that we address the 
outrageous spiraling prices and we can bring those down for everyone. 
That is the point of the debate.
  We made some progress through amendments last week on cost 
containment. Yesterday we had an important debate on Medicare coverage. 
The question now is whether or not we will be able to get this done on 
behalf of the American people. I am hopeful we will be able to do that.
  I am happy to yield to my friend.
  Mr. DORGAN. Some say, when you talk of prescription drug prices, let 
the market decide. There is, after all, an open, free market; let the 
market decide.
  Is it not the case that there is no free market for prescription 
drugs in this country? There are price controls in the United States 
but the prices are controlled by the pharmaceutical industry, and they 
like that. I understand that. Most other countries have price controls 
in which the governing authority sets the price, including profit, and 
the drug manufactures market those drugs in those countries under those 
conditions.
  In this country, there are no such limitations. So in this country, 
you can charge whatever you like. The problem is, what if you charge 
too much for tamoxifen? What if you charge 10 times more than you 
should for tamoxifen, and they can actually buy it for one-tenth the 
price in Winnipeg, Canada? What prevents the consumer from voting with 
their feet and going to Canada? What prevents it is a perversion of the 
free market, and that is a law that says the pharmacist at the Main 
Street drugstore, the distributor cannot access drugs and bring them 
back.
  There is a law that creates an artificial barrier against the free 
market working. When we try to change that, people say they are worried 
about bioterrorism, poppy seeds in Afghanistan, or they are worried the 
Moon is made of blue cheese--the most Byzantine arguments I have heard 
since I have been in the Senate.
  Is it not the case that to say let the market decide, the free market 
is not a free market with respect to drug pricing in the United States?
  Ms. STABENOW. The Senator is absolutely correct. There is not a free 
market. There are barriers placed in the way from real competition, 
real trade across the border, and there are ways now that the companies 
stop competition--buying up generic companies and blocking other 
competition.
  I say in conclusion, unfortunately, we cannot just say, let the free 
market prevail. We are not talking about optional products. We are not 
talking about a family saying, we cannot afford a new car this year, we 
will wait; we cannot afford a pair of new tennis shoes or lawn 
equipment. We are talking about lifesaving medicine. Sometimes when 
people have to wait, they do not survive. This is different. We have to 
be serious about the difference.
  I urge my colleagues to come together and get something done.
  The ACTING PRESIDENT pro tempore. The Senator from Texas.

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