[Congressional Record (Bound Edition), Volume 148 (2002), Part 10]
[Senate]
[Pages 14163-14178]
[From the U.S. Government Publishing Office, www.gpo.gov]




        GREATER ACCESS TO AFFORDABLE PHARMACEUTICALS ACT OF 2001

  The ACTING PRESIDENT pro tempore. Under the previous order, the 
Senate will now resume consideration of S. 812, which the clerk will 
report.
  The bill clerk read as follows:

       A bill (S. 812) to amend the Federal Food, Drug, and 
     Cosmetic Act to provide greater access to affordable 
     pharmaceuticals.

  Pending:

  Reid (for Dorgan) amendment No. 4299, to permit commercial 
importation of prescription drugs from Canada.
  Hagel Amendment No. 4315 (to amendment No. 4299, as amended), to 
provide Medicare beneficiaries with a drug discount card that ensures 
access to affordable outpatient prescription drugs.


                           Amendment No. 4315

  The PRESIDING OFFICER (Ms. LANDRIEU). Under the previous order, there 
will now be 120 minutes for debate on the Hagel amendment No. 4315, 
with 60 minutes each under the control of the Senator from Nebraska, 
Mr. Hagel, or his designee, and the Senator from Massachusetts, Mr. 
Kennedy, or his designee.
  Who yields time?
  The Senator from Massachusetts.
  Mr. KENNEDY. Madam President, I will yield myself such time as I 
might use.
  Madam President, yesterday we had a very important debate, and we 
also had the Members of the Senate voting on two important measures for 
the prescription drug program. I am a strong

[[Page 14164]]

supporter of the proposal that was offered by the Senator from Florida, 
Mr. Graham, and Senator Miller from Georgia. That amendment achieved 52 
votes in the Senate. A majority of the Members voted in favor of a 
program based upon the Medicare system, a program that closes the great 
loophole that is part of our Medicare system, which so many of our 
seniors are faced with every single day.
  We had a good debate on that measure. And we had a good debate on the 
Republican alternative, which I believe, as I expressed during the 
course of the debate, falls well short of meeting the needs of our 
seniors. The alternative plan is inadequate, full of loopholes, and 
fails to address the overarching issue of prescription drugs for our 
seniors. But, nonetheless, we had a good debate.
  There are those who supported that program. Obviously, their 
interpretation differed with my interpretation of the program, and they 
believed--and continue to believe strongly--that their program was the 
best way to achieve the objective of universal coverage of seniors in 
this country. We did not have a difference in terms of the underlying 
concept, we had a difference in terms of approach. I believed--and 
still believe--we would be unable to guarantee protections for our 
elderly under the Republican proposal. But that was the matter of the 
debate. The Senate spoke. And it spoke more favorably of the proposal 
offered by Senator Graham than the Republican proposal.
  Now we have an entirely different proposal before the Senate. I, 
quite frankly, believe--even though I was highly skeptical of what they 
call the tripartisan proposal--that this does not even measure up to 
the tripartisan proposal.
  What we are attempting to do in the Senate is to pass a program that 
will reach all of our seniors, and do it in a way that is going to be 
affordable for our seniors. That is one of the great features of the 
underlying proposal, which we all support on this side of the aisle. 
And it does include measures that have been accepted both in our HELP 
Committee, as well as on the floor of the Senate that deal with the 
issue of the cost of prescription drugs.
  We want to make prescription drugs affordable, we want to make them 
accessible, and we want to build on a system in which the seniors have 
confidence. That is why, quite frankly, we find that virtually all the 
seniors groups have supported the proposal of Senator Graham and 
Senator Miller. They all support that proposal. Virtually none of them 
support the tripartisan program. And virtually none of them support 
this particular proposal.
  It seems to me, as we stated yesterday, our seniors--who have fought 
in the wars, brought us out of the Depression, and built this Nation up 
to be the great country that it is--are entitled to more than crumbs in 
terms of the prescription drug program.
  They are living longer, thankfully, and families are blessed by the 
presence of their parents and grandparents. These days, a number of 
generations--three or four generations--can be alive at the same time. 
That is all very good.
  I cannot understand, for the life of me, why the Senate would be 
willing to accept the amendment which is being offered now, which is so 
inadequate that it does not even deserve to be called prescription drug 
coverage under Medicare. It is a step backwards, not forwards, in 
mending the broken promise of Medicare and providing senior citizens 
the health security they deserve.
  It provides no real cost containment for the explosive growth of 
prescription drugs. That is a major problem. We have had good debate on 
those measures, but this proposal has no cost containment. Its funding 
is so inadequate that it would pay about a dime on the dollar toward 
prescription drug costs of the elderly--a dime on the dollar. One of 
the things we want to avoid in the Senate is telling our seniors that 
we are doing something meaningful for them in terms of prescription 
drugs and then failing to meet that test. When you are down to a dime 
on the dollar for prescription drugs, I believe this amendment fails to 
live up to a prescription drug coverage for the elderly.
  It is a catastrophic-cost-only plan. We tried that once, and the 
elderly, themselves, rejected it. I was here in the Senate when we 
tried the catastrophic program for the elderly, and they, themselves, 
rejected it. We can come back to that discussion later on if we want 
to.
  Under this amendment, a poor senior citizen with an income of less 
than $9,000 a year would have to pay $1,500--17 percent of their 
income--before they got any help.
  A low-income senior with an income of only $18,000 a year would have 
to pay $3,500--20 percent of their meager income--before they got any 
help.
  A moderate-income senior citizen with an income of $35,000 would have 
to pay $5,500--16 percent of their income--before they got any help.
  This isn't insurance, and this isn't Medicare. If it were to become 
law, senior citizens would still be choosing between whether they are 
going to put food on the table or take the medicines they need to 
survive. If it were to become law, senior citizens would still face the 
prospect of having their lifetime savings swept away by the high cost 
of prescription drugs. If it were to become law, the broken promise of 
Medicare would remain broken.
  Beyond the simple fact that this benefit is inadequate, it violates a 
basic principle of Medicare, by effectively imposing a means test. 
Medicare is one of the most beloved and successful programs ever 
created. The reason it has such broad public support is that it is 
universal social insurance. Everyone contributes, and everyone 
benefits.
  Republicans have wanted to turn Medicare into a welfare program ever 
since it was created. This plan is, I believe, just another step in 
that direction. The American people rejected that approach in 1965, and 
I think they still reject it today.
  This bill is more inadequate than the House Republican bill. It is 
more inadequate than either of the two bills just voted on by the 
Senate. It is not supported by a single organization of the elderly or 
the disabled. And it does not deserve the support of the Senate.
  If we are going to take steps to try to respond to the needs of the 
elderly, it seems to me we ought to be able to gain the support of 
those groups. We have to ask ourselves, each time we consider 
legislation, who benefits? Obviously, we also have to ask, who pays? 
The taxpayer. Who benefits from this program, and how do they react to 
this program? The elderly, and they are not in support of the program.
  The fight for a real Medicare prescription drug benefit did not end 
yesterday. We will continue to fight until senior citizens have the 
protections they deserve.
  A vote for this bill is a vote to substitute a political fig leaf, a 
very small fig leaf, for the real protection the elderly need.
  I withhold the remainder of my time.
  The PRESIDING OFFICER. The Senator from Nebraska.
  Mr. HAGEL. Madam President, I yield 5 minutes to my colleague from 
Tennessee.
  Mr. FRIST. Madam President, I rise in support of the Hagel-Ensign 
bill because it really strikes right at the heart of what seniors 
expect from our Government as they look at their health care and as 
they look to their future.
  When I talk to seniors as I travel around the great State of 
Tennessee and the country, they tell me a very simple and 
straightforward message regarding prescription drugs: Please, when you 
go back to Washington, enact a prescription drug benefit and do it now. 
Do not do it 3 or 4 years from now--implementing the program in 7 or 8 
years. What I want is something now; do it now.
  The beautiful thing about the Hagel-Ensign bill--and I congratulate 
the authors and sponsors and cosponsors--is that it is the only bill 
that has come to the floor of the Senate that enacts a prescription 
drug benefit now. Our seniors deserve an affordable, immediate 
prescription drug coverage. That is No. 1: Do it now. This is the only 
bill we have considered that accomplishes that.

[[Page 14165]]

  No. 2: do it responsibly. That is where the debate has changed a lot 
compared to 2 years ago or 4 years ago or even prior to the last 
election a year and a half ago. Our seniors today, individuals with 
disabilities and the future generation of seniors say: Do it now, but 
do it responsibly. Responsibly means to have a bill on the table that 
can be sustained over time, which does not sunset or have a narrow 
window of applicability. Do it now; do it responsibly.
  Yesterday, we talked about bills on the floor that cost $800 billion 
or, over a full 10-year period, $1 trillion, and that did not pass. 
Additionally, we debated a bill that cost about $370 billion. That bill 
did not have sufficient votes for the point of order. Today, we are 
talking about a bill that costs less than $200 billion--well within 
what we have budgeted.
  Even more importantly than cost, is that this particular bill 
captures the power of what is called competition or the marketplace. 
What that means is what we pass today in terms of benefits, in terms of 
the prescription drug card, and in terms of the catastrophic coverage 
will be able to be sustained over time. When you capture the element of 
competition in the delivery, what you say is that there will be prudent 
tradeoffs, and decisions made regarding--whether it is inpatient 
hospital care, acute care, chronic care, preventive care, or 
prescription drugs.
  When I say ``tradeoffs,'' I don't mean lessening of the benefits. I 
mean bringing people to the table so rational decisionmaking can take 
place, given that the benefits that are promised need to be matched 
with the resources that are available.
  The Hagel-Ensign bill is immediate, affordable, and permanent. It is 
not promised just for a period of time. Finally, it is market based--
capturing the power of competition so that it can continue to deliver 
the benefits over time.
  For that reason, I am excited about this bill. I urge my colleagues 
to support this bill. We will have the opportunity to debate and 
discuss the details over the next 2 hours. In short, it is a 
prescription drug card where every senior who participates can get a 
discount instead of paying retail for drugs. Additionally, there is a 
cap as to how much they will have to pay out of pocket. This cap 
provides seniors with security and peace of mind that in the event they 
are struck by a lymphoma, heart or lung disease and have to buy 
prescription drugs that they will only have to pay a certain amount. 
For those reasons, I urge support for this immediate, affordable, 
permanent, and market-based plan.
  The PRESIDING OFFICER. The Senator has used 5 minutes. Who seeks 
recognition? Who yields time?
  Mr. HAGEL. Madam President, I yield my colleague from Nevada 5 
minutes.
  Mr. ENSIGN. Madam President, I want to talk about a couple of 
philosophies that deal with this bill. We currently have a health care 
system that has evolved over time where we have low deductible policies 
and we have usually a small copay involved. That low deductible 
coverage over time has taken the patient out of the accountability 
loop.
  Somebody goes into the office. They have an annual deductible. They 
don't pay attention. They go in and they start getting their health 
care coverage. The doctor tells them whatever they should do. The 
doctor is trying to rush people through. They don't think the patient 
is paying for the care. So they don't take the time to explain why 
certain tests cost money. They know somebody else is paying for it. 
They don't think about the patient's cost because it isn't the patient. 
It is an insurance company that is paying the cost.
  By taking that patient out of the accountability loop, costs have 
skyrocketed in the United States. That is the fundamental flaw to the 
insurance system we have in our health care delivery system today. It 
would be akin to having homeowners insurance that paid for doing the 
landscaping around your house or painting the trim. We don't expect 
that. We expect those normal maintenance costs to be paid out of 
pocket.
  But if something like a fire happens to your house or some kind of 
other horrible thing happens--for example, I recently had a hose break 
in our washing machine. We ended up with probably about $30,000 worth 
of damage. Unfortunately, we had gone on vacation when the hose in the 
washing machine broke. We came home. There was all kinds of damage. We 
had to have floors replaced, walls; it was about $30,000 worth of 
damage. Our insurance kicked in. But I didn't expect my homeowners 
insurance to pay for repainting the trim on my house or landscaping or 
things like that.
  That is normal expenses in everyday life. That is why homeowners 
insurance has remained relatively inexpensive over the years. Health 
care insurance has not, because the patient doesn't think about the 
cost.
  Our plan says: Let's keep the patient accountable. Let's keep the 
senior citizen accountable. Senior citizens don't want to put a huge 
burden onto young people. Yes, they would like prescription drug 
coverage.
  The Senator from Massachusetts mentioned that seniors don't want to 
lose what they have saved for all the years. They want to make sure 
they have some security in their assets.
  We have said: Let's keep the patient in the accountability loop. Low-
income seniors in our bill will pay the first $1,500 or about $120 a 
month out of pocket. They are going to pay that. Seniors can afford to 
pay that. They are willing to do that. After that, the Government is 
going to pay--other than a small copay--is going to pay so that the 
senior who has diabetes, a heart condition, cancer, that senior is 
going to be covered under our plan and is going to keep from losing all 
of their valuable assets.
  So because the first dollar coverage is paid by the senior instead of 
the Government, our plan is much more fiscally responsible to the next 
generation. That is why, when Senator Frist talked about it being a 
sustainable plan, our plan, in the future, will be sustainable because 
the patients--the senior citizens themselves--will shop for medicine; 
they will not just take whatever the doctor says. They will ask: what 
about generics? Is there a generic for that? They will do that because 
they are paying the first dollars out of their pockets. They will also 
ask: Do I need that medication? I am taking four medications. Do I need 
all four? Maybe the doctor would say: I forgot about the other 
medication you were taking.
  So this brings the patient back into being accountable for their own 
health care. That is critically important to our health care system and 
especially to this new prescription drug coverage that we want to add 
to Medicare.
  Madam President, I urge my colleagues to look at this very reasonable 
proposal. It is something that can be done, and can be done now, and it 
can be made permanent.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Massachusetts is recognized.
  Mr. KENNEDY. Madam President, I think we ought to have at least some 
understanding about what the challenge is. We make decisions in the 
Senate, and this is basically a question of priorities. The issue that 
is before us, in the broader context, is whether we believe it's a 
priority to do something to keep the costs down in terms of 
prescription drugs for our senior citizens, our fellow citizens.
  Now, our good friends on the other side say: Look, we want to do 
something, but we are not going to do very much. It is better than 
doing nothing at all.
  I would like to believe we are capable of doing something more for 
those Americans who have been called the greatest generation. Rather 
than giving them crumbs, it seems to me we ought to give them a decent 
benefit package that is built upon the Medicare system. That is what is 
supported by all of the elderly groups.
  The question is, do we have the will? Or are we going to just trim 
something off the edges and give them a little something? If you are 
making $8,000 or $9,000, you are going to have to spend $1,500 before 
you ever get anything at all.

[[Page 14166]]

  It seems to me this is a question of priorities here in the Senate 
for the greatest generation, for our senior citizens: Are we prepared 
to make a commitment that will ensure them a benefit package that is 
equal to the request by this President for tax cuts this year--$600 
billion? I don't hear any proposals from the other side saying, let's 
defer that $600 billion tax cut and put it in here for prescription 
drugs. Let us not try to shortchange our senior citizens.
  There are two issues which are underlying all of this. One is the 
issue of cost, which is clearly demonstrated by this chart. The yellow 
represents the consumer price index, the gradual increase in inflation, 
and the blue represents the drug costs that are going up every year. 
There is nothing in the Hagel proposal that does anything to get a 
handle on these costs. Those costs are going to continue to go up. 
There is no proposal in there that does anything about cost. But there 
is another very important proposal that we have before the Senate--and 
we welcome the support of our Republican colleagues--that can make a 
difference in terms of cost.
  Our Democratic program deals with the issues of cost and also with 
the issues of coverage. Cost is going up. Our seniors need help. Let's 
just look at what we are facing globally in the United States in terms 
of prescription drugs and our seniors and where they are.
  We have 13 million who have virtually no coverage at all; 10 million 
have coverage in employer-sponsored programs--we will come back to 
that--13 million have none, and 10 million are in employer sponsored 
programs; 5 million are in the Medicare HMO; 2 million are in Medigap; 
3 million are in Medicaid, and another million have other kinds of 
public coverage. The only seniors who are protected in this whole group 
are the ones with Medicaid. They are the ones who are guaranteed. The 
rest of them are not, and we will see very quickly why they are not 
protected.
  Remember now, 13 million have none and 10 million are employer 
sponsored, 5 million in HMOs, and 2 million in Medigap. Let's take the 
employer-sponsored group. Look at what happened in the employer-
sponsored programs. This chart shows what has been happening in the 
employer-sponsored programs. Firms offering retiree health coverage 
dropped 40 percent between 1994 and 2001. That line is going down 
through the cellar of the Senate. Those 10 million who were covered by 
employer-sponsored plans are going right on down. They are being 
dropped every single day. Make no mistake about it.
  Under the Republican proposal that was before the Senate yesterday, 
this decrease would have been accelerated for 3 million seniors in that 
program because the employers would not receive any of the assistance 
they need to retain them.
  So the 10 million who have the employer sponsored are going down. We 
have the 13 million who have none and 10 million who are employer 
sponsored. They are increasingly at risk every single day.
  Well, you say, we still have 4 million who have HMO coverage. Look at 
the bottom line here. Look at the Medicare HMOs, reducing the level of 
drug coverage. This is going down every single year--70 percent of the 
HMOs limit their drug coverage to $750. So even if you have some 
coverage up to $750, you are paying higher and higher costs. That 
wasn't the case 5 or 7 years ago, but it is the case now. Fifty percent 
of the Medicare HMOs with drug coverage only pay for generic drugs. So 
this is what is happening now. The HMOs the 4 million people who have 
some kind of coverage are being restricted, they are being limited, 
they are being conditioned every single day.
  Increasing numbers of our seniors are not being taken care of. This 
is what we are facing in our country. The answer we had before the 
Senate yesterday was a comprehensive program built upon Medicare, which 
is affordable, which is dependable, which is reliable, which is 
defensible, and which the overwhelming majority of the elderly support. 
We have 52 votes for it. We would like to build on that. We are 
attempting to do so. Now, with the Republican program--as I pointed 
out, I didn't agree with it, I didn't support it. But at least those 
who did support it made the case that it was going to be able to 
provide universal coverage. They said, look, we can do it through the 
private sector, and if the private sector won't provide the coverage in 
remote areas, we are going to continue to fund them until at last they 
do.
  I suppose at the end of the day you can find someone who will sell a 
prescription drug program in a remote area of Alaska if you pay them 
enough to do so. Our concern is that with the amount of money we are 
spending to pay the private sector, we ought to be using it in the 
benefit package, ought to be enhancing the benefit package, providing 
additional kinds of relief for our senior citizens.
  Now along comes a proposal that is opposed by the AARP. Here is a 
letter that was circulated yesterday. It says:
  Given these concerns, the AARP opposes your amendment.
  The reason the seniors oppose it is they don't really believe that 
this will be any substantial or significant help, or even a little 
help, to the seniors in this country. They believe what we ought to do 
is build upon the Medicare system, a system that has been tried and 
tested, and has performed over the test of time. As the leading 
organization of the elderly finds, this proposal is completely 
inadequate. At least we ought to live up to our hopes and our dreams 
for our seniors, and that is to cover all of them.
  We ought to cover all of them. What happens to those seniors who are 
making $7,000 or $8,000, $9,000? They have to pay out $1,500. Think of 
this: An elderly person who has worked all of his or her life and has 
$9,000 in income. Now they have to pay out all of this money. They have 
to pay out $1,500 before they get any assistance at all. On what are 
they going to live? Think of the difficult choices and decisions they 
have to make to come up with that $1,500. Then they will have to pay a 
copay after that.
  A low-income person with only $18,000 in income will have to pay 
$3,500, 20 percent of their meager income before they get any help. 
This is well above what any average senior citizen is paying at this 
time. The average citizen is paying somewhere around $2,000. A person 
with an income of $18,000 will have to pay $3,500. They are making 
$18,000 a year and we are calling that moderate income.
  How do people get along with $18,000 a year to pay for a mortgage, 
pay for the heating of their home, pay for their food, pay perhaps for 
a summer camp for their children or grandchildren? How do people get 
along on that $18,000? The fact is, people are hard-pressed, and I 
think for us in this body to accept the concept that we have done 
something for our seniors with this is a complete misstatement. I just 
do not see how we can support this proposal.
  Nothing in this proposal deals with the cost of prescription drugs--
this limited program is unworthy of what we in this body ought to be 
about. 52 Members of the Senate on our side, and 48 Members on the 
Republican side voted for a universal plan. Now, we are back in less 
than 24 hours talking about a catastrophic program that will only reach 
a small number of people and will put people through the wringer to do 
so. I think this institution, this body, can do better.
  I strongly believe that seniors, who are faced with this national 
challenge and who are suffering and experiencing these extraordinary 
choices every single day deserves a great deal better. That is why I 
hope eventually that this amendment will not be accepted.
  I reserve the remainder of my time.
  The PRESIDING OFFICER. Who yields time?
  Mr. ENSIGN. Madam President, I am the designee of the Senator from 
Nebraska. I yield myself 5 minutes.
  The PRESIDING OFFICER. The Senator from Nevada.
  Mr. ENSIGN. Madam President, I wish to address some of the concerns 
of the Senator from Massachusetts. First, there are many States, at the 
income levels he is talking about--$9,000,

[[Page 14167]]

$10,000, $11,000, and even in my State of Nevada up to the $22,500 a 
year level--that are already providing some help for senior citizens.
  The Republican Governor of my State was very visionary and put 
together something called the Senior Rx Program using part of the money 
from the tobacco settlement. For people with an income of $21,500 or 
less--they are non-Medicaid-eligible people--as long as they have been 
a resident of Nevada for at least 12 months, they can have a maximum 
benefit of $5,000 a year. They have no premium. They pay $10 for 
generic drugs and a $25 copay for preferred drugs.
  In the State of Nevada, that person Senator Kennedy was talking about 
who makes $9,000 a year is taken care of. In fact, that person does 
very well. That person does better than under the Democrat proposal--
much better.
  Also, if you go out and talk to seniors--I have been in a couple of 
very time-consuming and all-encompassing campaigns 2 out of the last 4 
years--I talked to seniors all over our State, and if you say to them 
they are going to be limited to about $100, $120 a month of out-of-
pocket expenses for those low-to moderate-income people, they are 
ecstatic; they will jump at that. They will say: Sign me up, as long as 
they are limited from losing everything or from being bankrupted based 
on prescription drugs or not being able to pay their rent.
  I say to the Senator from Massachusetts that maybe he ought to 
encourage the people in his State to take a look at what the people in 
the State of Nevada have done for their seniors, because the seniors in 
Nevada who truly need help, under this plan, are taken care of.
  Those who are higher income seniors--by the way, most seniors have 
their mortgages paid for. Most of them have their cars paid for, 
compared to young people. That is what a lot of this argument is about. 
Tell someone who is making $30,000 a year and has a couple of kids that 
in the future they are going to have to pay a lot higher taxes; they 
are already paying high taxes now, but in the future they are going to 
pay higher taxes because of what we are setting up today, especially if 
the plan the Senator from Massachusetts supports became law. If the 
plan the Senator from Massachusetts supports became law, taxes in the 
future are guaranteed to go up, otherwise our Medicare system will be 
bankrupt.
  Part of that is because of what I already talked about. When you take 
the patient out of any kind of accountability for what they are 
receiving, costs are going to skyrocket. We have seen that in our 
health care system today. A lot of the issues about which the Senator 
from Massachusetts was talking and the charts he was showing with drugs 
going out of sight is because people are not accountable for what they 
are getting. Insurance is taking care of it.
  Let us look at what we have before us today. Let us do something for 
those seniors, and I want to give a couple of examples. I want to show 
you real-life examples of senior citizens with real-life diseases who 
are paying real dollars out of their pockets for prescription drugs.
  The first example I want to use is a guy named James. He is about 68 
years old with an income of about $16,000 a year. He is taking these 
following medications: Glucophage, Glyburide, Neurontin, Protonix, 
Lescol, and Zoloft, for a total cost of close to $500 a month, $5,700 a 
year.
  Under the three major competing proposals, that person with $16,000 
in income, under the plan the Senator from Massachusetts supports, 
would pay $2,900 a year out of pocket. Under the tripartisan plan, 
$2,340, and under the Hagel-Ensign plan, $1,923 a year. That is what 
this person would pay. So this person who is really sick who needs the 
help the most is actually going to get the benefit they need, but yet 
will still have some accountability, and that is the balance in the 
plan that we have done.
  We feel this kind of an example is the reason that people should 
support our plan.
  I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  Mr. KENNEDY. Madam President, to correct my colleague and friend, he 
mentioned $8,000 or $9,000. That falls within 135 percent of poverty. 
So under our program, they would not be paying any out-of-pocket 
expenditures.
  Mr. ENSIGN. If the Senator will yield.
  Mr. KENNEDY. Beyond this, he mentioned his own program in his own 
State as support. We are representing all the people of all the States. 
Quite frankly, I do not intend to get into a debate about his program 
in Nevada, although there are people who have talked about that 
program. Some of our colleagues who are former insurance commissioners 
have talked about the history of that particular program.
  I do not happen to get into that program. Let me point out my program 
in the State of Massachusetts. The annual out-of-pocket spending limits 
for deductibles and copays are $2,000, or 10 percent of income, 
whichever is less, and everyone over 65 is eligible for it.
  This program is better than the Hagel-Ensign program. No one would 
benefit from that program in Massachusetts. I do not know which States 
or individuals would benefit and which would not benefit.
  We are concerned about all of our seniors. That is what we are trying 
to address. Even if one State does a little better and one State does 
worse, we are looking at the challenge which all of our seniors face. I 
must say that I think I could go to places in Nevada or places in 
Massachusetts or any State, to find hard working, decent people, who 
play by the rules and were guaranteed, through Medicare, that their 
health care would be secure. That is what we said in 1965. No ifs, 
ands, or buts; it will be guaranteed. But it is not guaranteed, and the 
principal reason it is not guaranteed is because we do not have 
prescription drug coverage. That is the reason. We want to try to deal 
with that.
  Thinking you are giving health security to people who have incomes of 
$9,000 who are going to still have to pay out the $1,500--and people 
with incomes of $18,000 who will have to pay $3,500--does not measure 
up. I know the Senator and I differ on that, but it just does not seem 
to measure up.
  We are not talking about a comparison of particular States. We should 
be trying to look at this generation and what happens to people who 
move from State to State.
  Speaking about the overutilization of health care, the people who 
overutilize it are the wealthy individuals. Most people who are working 
40 hours a week and taking care of their children do not have time to 
sit in a doctor's office or the resources to pay a copay. I can give 
study after study that reflects that.
  The greatest overutilization of health care and prescription drugs is 
by wealthy individuals who can take all the time in a day to go to the 
doctor's office and who have unlimited resources to pay for the 
prescription drugs.
  Five dollars still makes a big difference to people in my State down 
in New Bedford, Fall River, and Holyoke. They have seen their water 
bills go up because of the pollution that has been done over a period 
of years, and this administration has backed out of making the 
polluters pay and is now shifting that onto the backs of those water 
users and water rate payers.
  They are seeing their fixed incomes dwindling gradually as they pay 
out and try to deal with those issues. They see the prescription drug 
costs going up and the Senator is not doing anything. The Senator is 
not talking about it. The Senator has not even talked about the 
escalation of costs. What is he going to do about that?
  When are we going to see from the other side an amendment that is 
going to bring prices down? Where is it? We are waiting for it. We have 
been on this bill for 5 days. We have not had a single amendment from 
that side to do something about the costs of prescription drugs--not 
one. We have not had any. We have had complaints and criticisms of 
efforts that have been made on this side of the aisle to do something 
about those prescription drugs. Now we are

[[Page 14168]]

being asked to sign onto a program that will be presented to the people 
in my State, or the people that could not afford it, to show that we 
have done something for them. But this program is not as good as the 
one in my own State. We ought to be dealing with this program for all 
Americans. That is what a majority of the Senate voted on yesterday, 
and almost a majority voted for the Republican program. Not trying to 
take the small numbers of individuals who are paying every single year 
was universal across the board.
  I would ask the Senator, this is not a lifetime expenditure, is it? 
They are going to have to pay $1,500 this year, $1,500 next year, 
$1,500 the year after--$1,500, $1,500, $1,500 every single year, or 
$3,500, $3,500, $3,500. Does anybody believe people on fixed incomes at 
those levels can afford that kind of expenditure? They cannot.
  So I hope we keep our sights higher in terms of trying to meet the 
challenges and needs of our people.
  I reserve the remainder of my time.
  The PRESIDING OFFICER. Who yields time?
  Mr. HAGEL. Madam President, I ask that I be notified when I have 
spoken for 5 minutes.
  The PRESIDING OFFICER. The Senator will be so notified.
  Mr. HAGEL. Madam President, I want to cover some areas of concern and 
questions that have been addressed, appropriately so, regarding the 
amendment, but let me generally make a comment in response to my friend 
from Massachusetts.
  One of the results the distinguished senior Senator from 
Massachusetts is not factoring in in our amendment is the discount that 
all Medicare beneficiaries would derive. The estimates of those 
discounts, which are real, which, in fact, are in existence now, those 
discount card programs, are anywhere from 25 to 40 percent. That is one 
piece of this that has not been addressed, and it is important to 
factor that back in. That is but one part of our complete prescription 
drug program. Obviously, another part is the catastrophic cap.
  I have been asked about pharmacies and how this legislation might 
affect pharmacies, because, as the Senator knows, we do not invent a 
new bureaucracy. I am sorry to have to say that again to some people 
who like big government, who think big is better, and the more money we 
throw at anything always makes everything better. That is aside from 
the debate about deficits in this country, which I hear an awful lot 
about in this body, about irresponsible spending.
  We do have to ask a question about the affordability. That may be 
painful for some of my colleagues but, in fact, that is reality. This 
program is not just about addressing what we must address--and the 
senior Senator from Massachusetts is exactly right; we need to address 
this. For too long we have deferred it. It is not just about addressing 
the problem.
  The other end of that is, who pays for the program? Who eventually is 
going to wind up paying the bill for the program? We have tried to 
develop a program that focuses on those who need it most.
  I know most people would like to have a program where they pay 
nothing; let somebody pay for it all. Well, that is not a bad life, I 
suppose, but the reality is someone is going to pay for this. When we 
look at the huge numbers that we are dealing with in this country today 
on entitlement programs, everybody better stop for a moment and think 
through the consequences of what we are doing. There is a consequence 
to whatever action we take, and the consequence is going to be on the 
next generation and the next generation, as we add a new entitlement 
program to Medicare.
  We need to do this, but it must be done in some way that is 
responsible and accountable for those who now have no say in it but we 
are saddling them with this burden. We cannot just merrily skip along 
and say, well, we have given you everything free, aren't we great, 
let's send out a press release out and hold a press conference: oh, 
Senator Hagel, you are so good to us.
  I have a 9-year-old and an 11-year-old. Many of my colleagues have 
children and grandchildren. They are the ones who will pay. When we 
look at the numbers--Senator Gramm was on the floor yesterday, talking 
about those numbers--they are significant. With a $2 trillion Federal 
budget today in this country, about two-thirds is consumed by 
entitlement programs. We cannot do anything about that. The growth path 
we are on, even if we do not add any new programs, is immense. I don't 
know how we are going to ask this next generation and the generation 
after that to carry that burden. Something will happen. The choices are 
either that you cut benefits at some point or you continue to raise 
taxes on the workers, the young people, to pay for my drugs.
  We have tried to accomplish some center of gravity, some responsible 
balance in addressing the problem. It is real. We need to address it 
but at the same time address the consequences. Who pays? That is the 
painful part of this process. Who pays? We don't like to talk about 
that.
  When I talk about using a market system in place, not developing or 
building a new Government program, what do I mean? I mean using the 
market system in place. It is imperfect. Absolutely. But it is the 
market system in place today that has given America this remarkable 
lifestyle, quality of life, longevity. Imperfect and flawed? 
Absolutely. Are there people who do not benefit from some of this 
because they are at the bottom? Absolutely; that is what we are trying 
to deal with. But do not destroy the system that has produced this 
remarkable quality of life. Why would we throw out a market system that 
works pretty well?
  We use the existing structure in place: Pharmacies, pharmacy benefit 
managers, insurance policies, systems, programs, administrators to 
administer the program at the direction of the Secretary of Health and 
Human Services. Pharmacies are a big part of this. They must be a big 
part of it. In this system, we have worked with the pharmacist. We 
preserve that beneficiary/pharmacy relationship. Seniors and other 
Medicare beneficiaries will continue to get most of their drugs at the 
pharmacy.
  Any proposal that seriously disrupts that relationship would not work 
for Medicare beneficiaries. I point this out because beneficiaries' 
relationships with pharmacies will be strengthened. A system such as 
this could not work without bringing in the pharmacies. There will be a 
greater emphasis on discounts provided by pharmaceuticals and 
manufacturers than the pharmacy discounts. It is the pharmaceutical 
companies that provide the discounts. Those are negotiated by the 
private plans at the direction of the Secretary.
  Pharmacies would be free to choose whether or not to participate. It 
would be voluntary. Right now, pharmacies are involved in many of these 
discount drug plans. They do well. It brings in traffic. They have 
consulting fees. They are a big part of the process. Our bill would 
make them more a part of a process.
  Our legislation prohibits mail-order-only programs; therefore, it 
does not eliminate pharmacists. That is an option. Pharmacies could 
directly compete as administering entities. Pharmacies, as some 
pharmacies do today, could administer these programs. I make this point 
because there have been questions raised about the role of pharmacies. 
I understand that. We have spent a lot of time listening to pharmacists 
from all over the country. I understand their concern. The way we have 
crafted this, it would enhance the pharmacists.
  I yield the floor to my colleague from Nevada for 3 minutes.
  Mr. ENSIGN. Madam President, I will address a couple of matters the 
Senator from Massachusetts talked about. First of all, the Senator said 
the plan in Massachusetts was more generous than this plan. It is a 
different plan in that it is a first-dollar coverage plan. I don't know 
if the numbers have been updated, but according to the report from the 
GAO, in Massachusetts, if you are 150 percent of poverty or below, you 
are covered up to a maximum out of pocket of $1,250. That is according 
to this report.

[[Page 14169]]

  The bottom line is the difference is Massachusetts covers the first 
dollars, but it caps the amount that Massachusetts will pay. Our plan 
caps the amount the seniors will pay. That is the difference. If they 
want to do first-dollar coverage in Massachusetts--and that is what we 
do in the State of Nevada--that is up to the State. What we want to do 
is say to the seniors, you will have the amount capped that you can 
actually pay out of your pocket so you don't end up going into poverty.
  Why didn't the State of Massachusetts make a more generous benefit? 
They only did it up to 150 percent of poverty. Why? Are people making 
more than $12,000 a year rich? Can they afford some of the outrageous 
drug costs? Of course they cannot. The reason they did that is because 
that is all the State of Massachusetts believed they could afford at 
the time.
  Do what you can with the money you have. The Federal Government is 
not unlimited in its resources. We have to be fiscally responsible to 
the next generation.
  Yesterday the amendment that the Senator from Massachusetts supported 
was outlandish. It would bankrupt this country and bankrupt Medicare. I 
believe it was irresponsible in the long run to the next generation. 
This bill we present today is responsible, but it provides the coverage 
seniors really need. When you combine it with the help the States are 
giving, those low-income seniors, those sad stories we have heard, 
those people are truly going to be helped.
  I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  Mr. KENNEDY. How much time do I have?
  The PRESIDING OFFICER. Thirty-two minutes.
  Mr. KENNEDY. Madam President, first of all, I ask my good friend from 
Nevada to get current with regard to the Massachusetts plan. I will try 
and get current with regard to his if he gets current with regard to 
ours.
  Massachusetts residences not on Medicaid, 65 or older, are eligible. 
Every one is eligible. The annual out-of-pocket spending for deductible 
and copay is limited to $2,000 or 10 percent, whichever is less for 
individuals.
  It is a good deal different from what the Senator described.
  I am not here to offer this as an amendment. Some States do a little 
better than other States. Massachusetts is clearly a good deal better 
than what we are being offered with the amendment of Senator Hagel and 
Senator Ensign. Senator Hagel has pointed out the real problem is the 
issue of cost. Now we have cut to the bone. There are a lot of costly 
programs. Medicare is costly. Yet this country made the decision that 
for our elderly, who was going to try to offset the cost for frail 
elderly men and women who worked hard all during their lives? Would it 
be the individuals who will have an average income of $13,000, and two-
thirds below $25,000, or are we going to recognize that as a nation we 
are going to provide help and assistance?
  We made the judgment and decision that we would do that as a country. 
We did the same on Social Security. Many believe we ought to do it on 
prescription drugs. My good friends do not believe so.
  What are we asking? There was a comment that some of the elderly are 
asking for something for nothing. Who are these people? They are 
parents, people who took care of everyone in this room. Asking for 
nothing? These are the people who fought in the wars. They are the 
frail elderly, asking for nothing, who have sacrificed for this 
country, sacrificed for their children, sacrifice, sacrifice, 
sacrifice. And they are accused in the Senate of trying to get away 
with something for nothing.
  Are you asking them to give up going to the movies once in a while? 
Or taking their grandchildren out to dinner once in a while? How much 
can you squeeze from someone with a $9,000 income? How much can you 
squeeze them?
  Defend the market system. Defend the market system. Defend the market 
system. Prescription drug companies are violating the market system by 
jiggling the patent system so that there cannot be competition.
  Why aren't we hearing something about the market system over there on 
the underlying amendment? No, we don't hear anything about that. We 
just hear something about the frail elderly trying to get something for 
nothing.
  What about States being able to use the power of all their people to 
try to get a better drug price? That is the market system. We don't 
hear anything about that. No, no, we don't hear about that. We just 
hear about these frail elderly, all these greedy elderly senior 
citizens who are trying to rip off the system. Come on. That is the 
heart of the Republican program. You just heard it out here.
  That is what this decision is about. It is priorities, whether you 
want to have a massive tax cut that is going to go to the wealthy, or 
do we as a country and society put the value of our senior citizens 
ahead of that. It is a value issue. And I believe it is a moral issue 
as well, as long as we can do something about it and help these senior 
citizens. That is what the issue is about. We just heard it. We just 
heard it.
  Somehow, we are against the market system when we are trying to stop 
the kind of violations of patents to let competition get in? We are in 
violation of the market system when we are trying to let States get 
better deals for their fellow citizens? We are against the market 
system?
  Senator, that is just wrong. I do not know how much more we can do in 
terms of our senior citizens; how much more we can squeeze them; how 
much more, when they are paying out that 15 percent, 18 percent, 20 
percent of their income every single year, watching their total life 
savings go right on down. How much more can we squeeze them so we can 
give tax breaks for the wealthiest individuals, who have had the 
greatest profitability over the period of recent years? How much more 
can we squeeze these men and women who have built the country, 
suffered, and done such an extraordinary job?
  This country has been built by our parents and our grandparents. If 
it is a great country, and it is, it is because of them. They are the 
ones who are frail. They are the ones who need the help and assistance. 
And I reject the fact that we are trying to speak of them as 
individuals who are trying to rip off the system and get something for 
nothing. That is not what this debate is about, and it should not be.
  I yield 10 minutes to the Senator from New York.
  Mr. SCHUMER. I came after the Senator from North Dakota so, if it is 
OK, I will take my 10 minutes after him.
  The PRESIDING OFFICER (Mr. Johnson). The Senator from North Dakota.
  Mr. DORGAN. Mr. President, I joined my colleague earlier on the third 
floor of the Capitol at a press conference to talk about the generic 
bill. That bill is very important and one about which I have held a 
hearing.
  In terms of prescription drugs, we need to do two things that are 
important. We need to have a prescription drug benefit, and we need to 
do something that puts some downward pressure on prescription drug 
prices. We must find a way to put a prescription drug plan in the 
Medicare Program, one that works, works for all beneficiaries, and 
provides them with the ability to access the medicine they need when 
they need it.
  I said earlier that there is nothing lifesaving about drugs if you 
cannot afford them. There are no miracles in miracle drugs if you can't 
afford them.
  I just heard my colleague talk about those people who helped build 
this country. Tom Brokaw's book described some of them who went to war 
in the Second World War as ``the greatest generation.''
  I had a fellow come to a meeting a while back, who is a member of the 
greatest generation. He served in the Air Corps in the Second World 
War. He was in his late seventies and he needed new teeth and didn't 
have any money for them.
  I arranged for a dentist and I also helped him get some teeth. Here 
is a fellow who fought in the Second World

[[Page 14170]]

War, who ends up with nothing, who needs a new set of teeth and has to 
come nearly begging people to help him get his new teeth.
  Senator Kennedy is right. We have a lot of people in this country who 
have needs. They reach their declining income years, their retirement 
years, and they discover the things they need such as new teeth or 
prescription drugs, cost a fortune.
  Senior citizens are 12 percent of America's population and they 
consume one-third of all prescription drugs. Is it because they want to 
be sick? Is it because they like to take prescription drugs? I think 
not.
  You meet them at town meetings and various locations around the 
State, and they come up to you and say: You know, Mr. Senator, I am 80 
years old and I have diabetes. I have heart trouble. I have to take 
seven different prescription medicines. Mr. Senator, I can't afford it. 
I don't have the money. I wish I didn't have to take the drugs, but I 
need them and can't afford them.
  A doctor in Dickensin, ND, told me one day about a cancer patient who 
had breast cancer, a senior citizen. After the surgical removal of her 
breast he told her about the drugs she was going to have to take to try 
to minimize the chance of recurrence of her cancer.
  He said she looked at me and said: Doctor, what will these 
prescription drugs cost? And when he told her what they would cost, she 
said: Doctor, I couldn't possibly afford those prescription drugs. I 
don't have the money. I'll just have to take my chances. I'll just have 
to take my chances.
  We can do better than that. We need to put a prescription drug plan 
in the Medicare Program, one that works--one that really works. At the 
same time as we do that, it has to be complemented by a couple of other 
provisions we--the generic bill offered by my colleague, Senator 
Schumer and the Canadian reimportation bill, both of which will put 
downward pressure on prices. If we do not do that, we just break the 
bank. I am not interested in breaking the bank, hooking a hose up to 
the tank and just sucking all the money out. We can't do that. I am 
interested in making sure we have a prescription drug benefit plan that 
works. No, not some sliver of a plan, that says to a poor person: By 
the way, spend a lot of your money first, and then we'll give you a 
little help.
  No. 1, let's have a plan that works; No. 2, a plan that includes in 
it downward pressure on prices, not just for senior citizens but for 
all Americans. That is why this is so important.
  I imagine some members of this body could come up with a dozen 
reasons not to do this. In fact, the negative side of the debate is 
always the easiest. I think it was Mark Twain who was asked if he would 
engage in a debate of some sort. He said: Of course, as long as I can 
take the negative side.
  When it was pointed out to him that he hadn't been told the subject 
of the debate, he said: It doesn't matter. The negative side takes no 
preparation.
  It is easy to take the negative side. It is much more difficult to 
come up with a positive approach. That is what we are trying to do 
here. Yesterday, 52 Senators in a very important vote, for the first 
time in over 40 years, said we would like to put a prescription drug 
benefit in the Medicare Program. Fifty-two Senators said that. It takes 
60 votes.
  The question now is, Will the minority of the Senate block it in the 
next couple of days? The answer is, I hope not. I hope all Members of 
the Senate understand this is not just some run-of-the-mill issue. This 
is not just some issue of convenience. This is life or death issue for 
those who have reached their declining income years. Those who in many 
cases are living in or near poverty and who are told by their doctor 
they must take five or seven different kinds of prescription drugs. And 
they do not have the ability to pay for those drugs. That is why this 
issue is important.
  Let's do this and let's do it right. Let's not take slivers of policy 
here or there and pretend that we have constructed something 
meaningful. Let's put a real plan together, one that adds up, one that 
makes sense, and one that provides real benefits.
  Mr. SCHUMER. Will my colleague yield for a question?
  Mr. DORGAN. I am happy to yield.
  Mr. SCHUMER. I thank my colleague. He spoke so poignantly of the 
doctor in Dickinsin and the senior citizen who had breast cancer and 
could not afford the drugs.
  Again, I appreciate the approach that my colleagues from Nebraska and 
Nevada have taken. It is an honest approach, but it is a minimalist 
approach. It is based on the theory that we do not have enough money to 
do more, even though 52 people in the Senate voted to do significantly 
more.
  I would just ask my colleague this: Isn't this part of the same 
budget where they take $600 billion over 10 years to reduce the estate 
tax? Isn't it true that estate tax reduction does not go to people 
whose income is $17,000 or $35,000 or $350,000, but to people whose 
estates will eventually rise, I believe it is, to $2 million or $4 
million? That is a minimum amount. This is not an abstract discussion.
  I ask my colleague if I am right. Do you want to give somebody who is 
a millionaire, who has an estate worth over $2 million, a total 
exemption from any tax and deprive patients in North Dakota their 
desperately needed medicine? It isn't either/or. In my judgment, it is 
not that we can't afford it. If tomorrow the President and his budget 
friends on the other side in their budget say we are not going to make 
the estate tax reduction permanent, there would be more than enough 
money to afford the plan that we voted for on the floor yesterday.
  Am I wrong? Is this a question of choices? This is not simply an 
abstract discussion about how much we should spend. My colleagues on 
the other side of the aisle have said they would like to do more, but 
we can't afford it. But, all of a sudden, when it comes to estates of 
$10 million, $20 million, $100 million, or $1 billion, that should come 
ahead of the senior citizen about whom the doctor in Dickensin talked. 
And we have thousands--tens of thousands--of the same people in New 
York--poor senior citizens who are struggling and don't have the money 
for their desperately needed medicine.
  Mr. DORGAN. Mr. President, the Senator from New York is certainly 
correct.
  One-hundred years from now we will all be gone. Everyone in this room 
will be dead. And historians will look at the choices we made in terms 
of our values and systems and evaluate what we thought was important.
  My colleague Senator Feingold offered an amendment on the estate tax 
which said, let us have an estate tax and we will exempt everybody 
under $100 million. The only estates that will bear a tax will be those 
above $100 million.
  That lost, because some here believe that the estate tax must be 
abolished for everybody--even those at the top who are billionaires. 
Good for them and their success. But I happen to think that when they 
die part of their wealth should be used to help deal with some of our 
other needs.
  The point is, as the Senator from New York pointed out, we are forced 
to make choices. What is important? What are the right choices for our 
country? People are living longer and living better. It is not unusual 
to find 80-year-olds. My uncle is 81 years old. He runs 400s and 800s 
in the Senior Olympics. He has 43 gold medals. It is not unusual to see 
people living longer in our country but not all of them are as healthy 
as my uncle. Most of the elderly need prescription drugs to deal with 
medical conditions. And many of them don't have enough income or assets 
to pay for them. They simply don't have the means to purchase them.
  If we were writing a Medicare bill today, there is no question that 
we would have a prescription drug benefit in that bill. It would be a 
benefit that works--one that is thoughtful, reasonable, and helps all 
senior citizens. That is what we ought to pass. It is not acceptable, 
in my judgment, just to grab slivers here and slivers there, and say, 
oh, by the way, we can't afford much because we decided we wanted to 
have

[[Page 14171]]

other things such as an estate tax repeal for the largest estates in 
the country.
  These are choices that we have to make. I believe we must make the 
right choices today and tomorrow as we go about our business on behalf 
of senior citizens and all Americans.
  The PRESIDING OFFICER. Who yields time?
  The Senator from Nebraska.
  Mr. HAGEL. Mr. President, I yield to my friend and colleague from New 
Mexico 10 minutes.
  The PRESIDING OFFICER. The Senator from New Mexico.
  Mr. DOMENICI. Mr. President, fellow Senators, first, I thank the 
Senator from Nebraska for yielding time. Second, I compliment him and 
the senior Senator from Nevada for offering this proposal which gives 
us a chance to do something very significant for our senior citizens.
  Let me go back and trace a little bit of modern history so everybody 
will know what caused the predicament we are in and why we can't do 
much more than this for our seniors at this point in time.
  First, the last budget resolution that passed was a budget resolution 
when we were in control by one or two votes. That budget resolution 
provided for a reform of Medicare and a prescription drug benefit that 
did not cost more than $300 billion over 10 years. We didn't use that 
because the history has it that the last President got in a very big 
argument with a bipartisan committee and told them to vote with him and 
out the window went a bipartisan reform bill. It went, because the last 
President--President Clinton--wanted Medicare reform, but only his, 
even though he had appointed a commission.
  There is one. Chalk that one up. Who is responsible for that one? 
President Clinton, without a doubt.
  Now comes the time when we are supposed to pass a budget resolution. 
The last time I heard it was the responsibility of the majority party 
to report one out and to take one up on the floor. They didn't have to 
report it out but to take it up and do the business of the Senate by 
passing a budget resolution.
  What happened in the middle of all this was that a Senator left our 
side of the aisle and joined their side of the aisle for votes and they 
became responsible for passing a budget resolution.
  For the first time, since we had a Budget Act 27 years, we are 
operating without a budget. We are operating without a new budget that 
suggests how much money the Senate wants to spend in the next 10 years 
on prescription drugs. There is no current budget that says that. If 
they would have put one in place, guess what. It would only require 51 
votes. That is not our fault. That is their fault. They did not do it. 
Consequently, 60 votes are required to get the seniors of America a 
Medicare bill.
  I am not sure that some people think that is good and others think 
that is bad. I am just stating the facts. That is the reason 60 votes 
are required. The seniors ought to know that.
  That is not the Republicans. That is not our President. That is the 
Democratic leadership here which said, That budget is getting too 
tough, let us just not do one.
  I did 27 in my life; 12 of them as the chairman when we had to 
produce them. We always produced them. Believe you me, they were tough. 
Some took 2 weeks. Some took 80 votes. One time we did 37 votes in a 
row with Howard Baker sitting right at that table, all of which we had 
to win and all of which we had to fight for, because under the old 
rules you could offer almost anything.
  Here we come at the end of the year and the leadership on that side 
of the aisle promises a Medicare bill for the seniors of America, but 
they cannot pass one because they did not do a budget. Therefore, 60 
votes are required--not 51.
  I repeat: That is not the Republicans' fault. It is not the 
President's fault.
  I can vividly recall some leading Democrats when they were asked, Why 
aren't we doing a budget resolution? Oh, well, one of them said, It is 
too hard this year. Maybe we don't need one. Now here is where we are 
as a result of that.
  I compliment the two Senators. They have a third Senator. I am very 
lucky. I joined them yesterday. I am a cosponsor of theirs.
  Frankly, I went with the tripartisan bill yesterday. If that had 
passed, we would be finished. But it didn't pass because it only got 48 
votes, or 47. It needs 60. That is a pretty good chunk of votes, 
however, to get you started.
  What do I say? I look at all of this and I ask, Is there anybody who 
has an amendment that does not require 60 votes and still will do 
something good for the seniors? This amendment will not exceed $300 
billion. I do not know the number exactly, but I am going to guess with 
you that it is between $285 billion, $290 billion, or $295 billion. So 
this amendment clearly only needs 51 votes. If you want to give the 
seniors something, 51 votes is all that is necessary.
  From what I can tell, it is a very good approach to get the seniors 
something this year. It will take care of the seniors who are in the 
biggest trouble with expensive drug bills. For those who have expensive 
drug bills now, it will take care of them and all of the people who are 
poor under anyone's definition of poverty. It will take care of them.
  What is wrong with that? About $295 billion, or $280 billion--just 
what the budget resolution said you ought to spend on the whole program 
just 18 months ago.
  I thank the Senators for what I think is a rather ingenious bill. I 
don't think it carries with it any acrimony. If the Democrats don't 
want any bill at all, they can look right there to the seniors and say 
this is what they are going to get.
  The Hagel amendment does not have a 60-vote requirement in terms of 
cost because it comes in under the cost. However, it was not produced 
by the Finance Committee because they were not permitted to produce any 
bill. So it probably needs 60 votes.
  Clearly, if we have the sufficient votes to adopt this, there would 
be some way of getting it back to committee, and getting it out of 
there.
  I urge a vote for it because there is a real chance we will send the 
right signal, and set before us a way to get a bill this year.
  I thank the Senator, again, for yielding. And I thank the Senate for 
listening. I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  Mr. SCHUMER. Mr. President, I yield myself 10 minutes.
  The PRESIDING OFFICER. The Senator from New York.
  Mr. SCHUMER. Mr. President, I want to address further this proposal 
before us. I was glad my colleague from New Mexico finally mentioned 
that it would take 60 votes. So we are dealing with 60 votes, and 60 
votes, and 60 votes, because of the variety of the very technical, 
detailed, and sometimes tortuous reasons for the Senate rules, which 
have a wisdom to them way beyond my ken. But I would like to make a 
couple points.
  First, I would add to the Record, if it has not been added already, 
the CBO estimate of the Hagel-Ensign amendment. I think last night we 
were talking about $160 billion. Now CBO--and the Senator from New 
Mexico has stated it correctly--estimates this bill costs $294.7 
billion. However, if the Schumer-McCain bill were added to it, it would 
reduce the cost by $13 billion to $284 billion. That is within the 
budget resolution. My friend from New Mexico is exactly correct.
  It is also $130 billion more than we were talking about last night. 
With that money, the close to $300 billion, I just want to remind my 
colleagues of who it covers and who it does not cover.
  Again, a senior citizen, poor, with an income of $9,000, would have 
to first pay $1,500 before they would get a nickel from this bill. I 
will tell you, $9,000 does not buy much. It buys even less in New York 
than it would buy in Nebraska or in Nevada, but it does not buy much 
anywhere--and to ask that person to have to pay $1,500 first?
  This amendment does nothing to take away the conundrum that poor 
senior citizens have: prescription medicines, wonderful drugs that they 
desperately need, or an adequate meal on

[[Page 14172]]

the table, a plane ticket to see the grandchildren maybe at 
Christmastime, whom they have not seen in 3 or 4 years. This amendment 
does nothing to relieve that burden.
  A senior citizen making $18,000 now--that is not a poor senior 
citizen, but it sure as heck isn't a rich one--would have to pay $3,500 
before they got a nickel from this action. That is enormous. That is a 
huge burden to them. Yet we are spending $300 billion for that.
  I remember when we dealt with prescription drugs a couple years ago, 
and there was a general conclusion that if you are going to do this, do 
it right, really help people, do not bite around the edges. And this 
proposal does just that.
  And then let's go to a senior citizen who is doing OK. They have a 
$35,000 income. They are almost never going to get benefits. They have 
an income of $35,000, and they would have to first spend $5,500 on 
their prescription drugs before they would get a nickel from the 
amendment.
  I think I know what is going on here. There is a demand that we do 
something. Everyone wants to say: I am for a bill. I would bet my 
bottom dollar, if you could get 280 million Americans in an auditorium, 
if you could get the--how many senior citizens do we have in America? 
About 40 million, 45 million. If you could get every senior citizen in 
an auditorium and ask, for $300 billion, should we adopt an amendment 
that helps so few, they would say: No. Go back. Do it better.
  And then again my colleagues will say--I will make the point again 
because it just gnaws at me--we don't have the money to do more.
  The Senator from New Mexico, my good friend, knows the budget, 
studies it. He is almost a priest of the budget, God bless him. He 
says: We don't have a budget.
  I will tell you why we don't have a budget. It is because of the 
insistence of the other side and the White House that we continue the 
tax cuts for the very wealthy, that we can't afford in the President's 
budget proposal--I repeat, $670 billion to eliminate the estate tax. 
Many of my same colleagues who are supporting this proposal were on the 
floor talking about how that is important.
  Go ask those 40 million senior citizens. Go ask the 280 million 
Americans do they want a better benefit than the very measly benefits 
in this amendment or do they want the estate tax repealed. When? Right 
now, if your estate is in the millions of dollars, it is taxed, but if 
it is below that, you are not taxed.
  Ask them if they want us to say, let's say anyone with $20 million 
should pay an estate tax, and we would get a lot more benefits in the 
bill.
  So who are we kidding? We know there is enough money to do this, if 
we want to. But if we are going to play trickle down, if we are going 
to say, first, let's reduce the estate tax, and then work in the 
confines of that, and provide some dribbles to the senior citizens, to 
the lady in Dickinson who has breast cancer and cannot afford the 
drugs. Who are we kidding?
  Where would 90 percent of the American people be? If the cupboard 
were bare, if we had no dollars for anything else, if we needed it all 
for our war effort or for Social Security, maybe we would have to come 
up with this amendment.
  But when we hear the priorities of the other side are tax cuts, 
particularly the estate tax cut, first, and then whatever is left over 
we will sort of craft into a plan that makes someone whose income is 
$9,000 pay $1,500 first before they get a nickel from the benefit, who 
are we fooling?
  So the whole argument that I have heard from my good friends from 
Nebraska, Nevada, and others is: We don't have enough money to do more. 
This is fiscally responsible. Is it fiscally responsible, then, to call 
for $600 billion in cutting the estate tax? And that, of course, is 
eliminated--I need to get the right number. I know we go up to $2 
million or $4 million per estate, but I think right now it is somewhere 
between $1 million and $2 million where estates are eliminated.
  Whom are we kidding? We all have priorities. We have a Senate because 
not everyone has the same priorities. We have a House of 
Representatives for the same reason. And our priorities are different. 
But admit the truth. It is not that we do not have the money to do 
better, it is that people have other priorities.
  I will tell you where the priorities of the senior Senator from New 
York are. They are for a plan that got 52 votes on the floor of the 
Senate yesterday above cutting the estate tax for the very wealthy. How 
many of you will join us in saying that? I doubt very many. And if not, 
then the underpinning of the argument that we can't do better is false.
  We can do better. We can pass a better bill, by rearranging our 
priorities, and telling that senior citizen who makes $9,000, you don't 
have to wait until you spend $1,500 before you get a benefit; telling 
the senior citizen who makes $18,000, you don't have to wait until you 
spend $3,500 before you get a benefit.
  If this were an honest debate about priorities, then there would not 
be a need for the minimalist plan that my colleagues have offered.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. Who yields time?
  Mr. HAGEL. Mr. President, I yield my colleague from Nevada 1 minute.
  Mr. ENSIGN. Mr. President, I want to clear up a couple points the 
Senator from New York talked about. He said no benefit for somebody 
until they pay out-of-pocket expenses. He forgets the drug discount 
card which will save seniors somewhere from 20 up to 40 percent because 
of volume buying. So they immediately benefit, anybody who signs up for 
the plan.
  Our plan fits really well--I talked about this before--with those 
State plans that are already out there. The State of Nevada has a great 
plan using tobacco money. Other plans in States work very well with our 
plan. Those seniors who need help the most will get the help under this 
plan.
  Let's be honest about this plan. It is fiscally responsible to the 
next generation but also truly does get the help to the seniors who 
need it today.
  Mr. HAGEL. Mr. President, I yield 6 minutes to the senior Senator 
from Idaho.
  The PRESIDING OFFICER. The Senator from Idaho.
  Mr. CRAIG. Mr. President, I thank my colleagues from Nebraska and 
Nevada for bringing to the floor what is a valuable piece of 
legislation to address the issue of prescription drugs.
  As chairman of the Republican Policy Committee, I had not engaged in 
this debate on the floor from the time it began several days ago 
largely because, while it is a phenomenally important debate, it was a 
play, a drama to be acted out and ultimately to close with no result. 
That does not mean that those who come to the floor, such as my 
colleagues from Nebraska and Nevada, to put forth a substantive piece 
of legislation aren't well meaning. It does not mean that at all. It 
means that the majority leader of the Senate set up this play with the 
purpose of never accomplishing anything in the end but to allow those 
who wish to make a political statement and to shape themselves for the 
November election to have that opportunity.
  That in itself is a tragedy in the formation of public policy. It 
allows those to come to the floor and talk about all kinds of other 
things except that which is very meaningful; that is, a good 
prescription drug program for the seniors of America.
  If this bill had been formed by the Finance Committee in a bipartisan 
manner, it would be on the floor. It would receive a majority vote, it 
would be in conference with the House to work out our differences, and 
the seniors of America would have a drug prescription policy. That is 
not a statement of myth; that is a statement of fact. It would not be a 
drama; it would not be a play with all the characters hustling down to 
the curtain call; it would in fact be an action of positive legislative 
effort to produce a bill.
  The Senator from New York has talked about tax cuts. My goodness, 
what he has suggested is die and take everybody's money and put it into 
a social welfare program. No, sir, not on

[[Page 14173]]

my watch. You bet the Senator from New York and the Senator from Idaho 
are different people, coming from different States. I don't believe in 
that.
  Mr. SCHUMER. Will my colleague yield?
  Mr. CRAIG. I will not yield at this time. I do believe that people 
who work hard all their life and build an estate ought to have a right 
to take a little of it, because it is after tax money that builds an 
estate, and they want to pass it on to their children. That is right. 
That is reasonable. We call it the American dream. I don't think we 
ought to step back in and swoop it up for the Government to spend, all 
in the name of a social welfare state. That is wrong. It is 
fundamentally un-American.
  Debate it, if you wish. The reality is, use that as an excuse. That 
is law today. It is only an excuse not to have to face the reality of 
why we are here and not getting anything done.
  The reality of why we are not getting anything done is that the 
majority leader would not allow the chairman of the Finance Committee 
to do what he should have done at a very important time in American 
history, at a time when pharmaceutical drugs have become a part of the 
American health care culture. The seniors of America who are living 
longer and healthier today are finding that a very important part of 
their lifestyle. Medicare doesn't address that issue.
  The Senator from New York and the Senator from North Dakota said it 
right: If we were writing a Medicare Program today, prescription drugs 
would be in it. It would be in it, and I would vote for it, and they 
would.
  At the same time, we are not going to cram in a proposal that costs 
hundreds of billions of dollars, to the tune of $700 or $800 billion, 
doesn't take effect until 2004, terminates in 2008 or 2009, and call 
that something we want to take home and say: Look what we have done for 
you.
  Why not something that our country can afford, that our seniors will 
find a reliable approach toward acquiring the necessary pharmaceutical 
drugs to deal with their health care in a way that will not break them? 
That is not going to be allowed to happen in the Senate in the 107th 
Congress.
  There are 40 million-plus seniors. Put them all in one room and ask 
them this question: Do you want a pharmaceutical drug program now? The 
answer is: Yes, we do. We want it now, not 2004. No, we don't want it 
to terminate in 2008. Most importantly, we don't want it to bankrupt 
our country. Yes, we would pay a small deductible and, yes, we would 
even pay a small premium because a small deductible of maybe $100 a 
month to pay for a $400 drug bill is a right and reasonable thing to 
ask.
  The Senator from Nevada put it well when he said there are State 
programs--that wasn't counted--that can offset the truly needy. And 
there are many. Those who have little to no money--and there are many 
seniors in this position--could have full access. It wouldn't have to 
come through the Medicare Program or, I should say, the Medicaid 
Program that oftentimes is administered by the State.
  The PRESIDING OFFICER. The Senator has used his time.
  Mr. CRAIG. I ask for 1 more minute.
  Mr. HAGEL. I yield 1 minute to the Senator from Idaho.
  Mr. CRAIG. I thank the Senators from Nebraska and Nevada for bringing 
a realistic amendment to the floor, one that could take effect now, one 
with which we could go home to New York or Idaho and say to our 
seniors: We have cut your drug bills well over a half or two-thirds. 
You have it now, not wishes 4 years from now, not wishes 3 years from 
now, a program that won't bankrupt the country and won't demand that 
those who have saved and earned all their life have to give up their 
estates so that you can live well.
  That is not what this country ought to be about. More importantly, 
that is not what this debate ought to be about. It ought to be about a 
substantive, affordable program that truly allows America to say to its 
seniors: We have changed the dynamics of health care from a 30-year-old 
model to a modern model that allows pharmaceutical drugs to be 
affordable, to be fitted into the program.
  I strongly support the effort of my colleagues from Nebraska and 
Nevada.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from New York.
  Mr. SCHUMER. Mr. President, I will speak for a minute. I want to make 
some comments to my friend from Idaho. He keeps talking about, we are 
going to take everybody's money. No, we are not going to take 
everybody's money in the estate tax. We are not even taking most 
people's money. We are not even taking 5 percent, the wealthiest 5 
percent of people's money. We are taking only from people who have 
estates certainly over $1 million and probably somewhat more than that.
  That is how this debate often gets off track. We are not saying to 
the plumber who built up a little business: We are taking your money. 
We are not saying to the steelworker who has a pension: We are taking 
your money.
  Yes, we are saying to the very wealthiest: God bless America, you 
have made a great living, you have lived well. Are you willing, in this 
social compact we call America, to tell the senior citizen who can't 
afford to pay for these drugs, and it is life or death, that you have 
to keep it all--and not even keep it all, pass it all on to your heirs?
  That is the issue. It is not everybody. It is not half of the people. 
It is not a quarter of the people. It is not 5 percent of the people. 
What is driving the estate tax is the very wealthiest people in America 
who somehow have won over the other side. But they never talk about 
them. They say ``everybody's'' money. Not so. Then the other side of 
what my good friend said--he said take everybody's money and put it in 
a social welfare program. The definition of what my friend said, the 
Hagel-Ensign amendment, is a social welfare program. Social Security is 
a social welfare program. Medicare is a social welfare program.
  Yes, in America, we believe in those things. Back in the 1870s, we 
did not. The life expectancy was 40 years; one out of every four 
children died in childbirth; people lived in slums, tenements; farmers 
went bankrupt every year. Yes, America has changed, and it is not a 
country that should be run exclusively for the wealthiest people and 
you give the crumbs to the others. We learned that in the 1890s, in 
1912, and in the 1930s. We learned it in the 1960s, and we have learned 
it since then.
  So I reiterate my point. It is a choice of priorities. In this 
context, yes, you are right, as long as there is a budget deadlock--
primarily because we would not go along with reducing taxes even 
further on the very wealthiest Americans while doing nothing for the 
middle class--we don't have enough to do a prescription drug bill in 
the right way. We are left debating whether we should do one that the 
vast majority of Americans would agree doesn't solve their problems.
  So, yes, I regret that the debate has come to this. I don't think it 
is where the American people are. I think they are much more on the 
side of the bill that got 52 votes yesterday. But because of the rules 
of the Senate and, more importantly, because we don't have enough 
Senators who have the priorities I am enunciating, we will not get 
that.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Nebraska is recognized.
  Mr. HAGEL. Mr. President, I yield to the Senator from Pennsylvania 1 
minute.
  Mr. SANTORUM. Mr. President, I thank Senators Hagel, Ensign, and 
Gramm. They have put forth a plan that focuses in on exactly the 
problem most Americans understand, which is that we have people who 
have a high cost of drugs but simply don't have the ability to afford 
them. They have to make difficult decisions about how to provide for 
themselves as well as provide the medicine they need.
  Secondly, they provide a focused attempt to help the lower income 
people, who may not have that high of a drug cost, but even with a 
small amount of the prescription drugs they need, they don't have the 
resources to pay for them. This is a commonsense approach.

[[Page 14174]]

This is a focused approach. This is a good first step. It gets us very 
far down the playing field.
  To me, it is a little bit frustrating to see a proposal that makes so 
much common sense, is within the budget framework that has been worked 
out, and we find opposition to going way down the field in a proper 
direction. Some will say no because it doesn't give us everything we 
want, it doesn't get us the whole loaf, and somehow that is not good 
enough.
  This is a very solid proposal. I think it is something that should 
have very strong bipartisan support.
  The PRESIDING OFFICER. The Senator from Nebraska is recognized.
  Mr. HAGEL. Mr. President, I yield 3 minutes to the senior Senator 
from Texas.
  The PRESIDING OFFICER. The Senator from Texas is recognized.
  Mr. GRAMM. Mr. President, I thank our dear colleague from Nebraska 
for his leadership on this issue. I think the best proposal that has 
been presented to the Senate is the Hagel-Ensign proposal. It is the 
only proposal that is rational. It is the only proposal that is 
organized in such a way as to give most of the help to the people who 
need it the most. It is the only proposal that is affordable.
  My strong suggestion and my recommendation to my colleagues is that 
we adopt this proposal. This proposal basically says if you have a 
moderate income and you have high drug bills, you are going to receive 
assistance from Medicare. A simple guideline is that if you have a 
family income, in retirement, of less than $23,000 a year, if this bill 
goes into effect, you will spend only slightly more than $100 a month 
on pharmaceuticals before you receive assistance. The amount that 
people would have to spend before they hit the critical level where 
they would receive assistance rises with people's incomes, so that at 
$46,000, you would have to spend $3,500, or about $300 a month; at 
$69,000 of income, that amount would be $5,500.
  So what does this do? It does two things. Immediately, it provides 
assistance by setting up a program whereby we can use the ability to 
negotiate prices. Medicare does not buy competitively. It is estimated 
that by allowing people to choose among selections that will be 
available through Medicare and by utilizing a purchasing cooperative, 
whereby they will enter into an agreement with private companies to 
purchase their pharmaceuticals and find the cheapest price for them, 
every senior will save between 25 percent and 40 percent on their drug 
bills. That benefit will start immediately--not in 2004 as the Democrat 
alternative does, not in 2005 as the tripartisan alternative does, but 
upon adoption. The other parts of this bill will go into effect as of 
January 1, 2004.
  So this bill helps everybody now, brings efficiency in purchasing 
health care for every senior, and provides assistance to people who 
need it the most. I urge my colleagues to vote for this amendment.
  The PRESIDING OFFICER. The Senator from New York is recognized.
  Mr. SCHUMER. Mr. President, I yield myself 2 minutes.
  Mr. President, I have heard about the generosity of this plan. Well, 
I think we all can admit it is the least generous plan on the floor. 
Any plan that tells someone making $9,000 that they have to spend 
$1,500 first, I don't think most people would call generous. I would 
say any plan that says to someone making $18,000 that you have to spend 
$3,500 before you get a nickel is not a generous plan. Again, if that 
were the best we could do, fine. But it is not. We here on this floor 
are not in sync with the American people's priorities.
  Go back to the issue I have been bringing up this last hour, the 
estate tax--$670 billion to repeal the estate tax only for estates of 
over $1 million or even more. Most of that money comes from estates of 
$50 million. Are you going to tell that person, you get your tax cut, 
or are you going to tell our senior citizens, you don't have to spend 
$1,500 of your $9,000 income before you get a bit of benefit?
  My colleagues, again, this is a question of choices. We can say that 
we will keep the status quo, that we will continue the tax cuts on the 
wealthiest of Americans. All things being equal, I would like to get 
rid of the estate tax. But if telling the senior citizens of New York 
State that they don't get a benefit before we take the taxes of people 
making $50 million down a few more notches, you know what side I am on. 
I ask my colleagues which side they are on.
  The PRESIDING OFFICER. Who yields time?
  Mr. HAGEL. Mr. President, I yield 6 minutes to the Senator from 
Nevada.
  Mr. ENSIGN. Mr. President, we are coming to the close of this debate. 
A couple of things need to be cleared up. There has been talk about the 
estate tax versus prescription drugs. Medicare is a program that is 
paid for out of the payroll tax. It has always been that way. 
Hopefully, it will always be that way. Payroll taxes pay for Medicare.
  Our amendment, we believe, is responsible. The difference between our 
bill is that the seniors pay their first dollar out of pocket for 
coverage. The other bills, the seniors pay a portion of the first 
dollar out of pocket. The reason for that is we thought it was 
important to keep the senior in the accountability loop. I mentioned 
that earlier in the debate, but it needs to be reemphasized.
  When seniors or any other patients in health care do not have to 
think about the financial aspects of their care, whether it is in 
purchasing drugs or in getting their health care, if they are only 
paying a small portion, they do not even think about that. But if they 
are paying the first dollars--and in our plan, if they have up to 
$17,700 in income, they will pay out of pocket $1,500--they are going 
to think about prescription drugs. This is about $120 a month.
  Seniors with whom I have talked literally would jump at knowing they 
would be limited to about $120 a month for prescription drugs. They 
just do not want to be bankrupt. They do not want to think they are 
going to lose their house. Many are concerned about long-term care, and 
that is their biggest fear--that they have to lose everything to get 
long-term care.
  It is the same with prescription drugs. They do not want to lose 
everything before they are so poor that they have to go on Medicaid to 
get prescription drugs from the Government. Our amendment is basically 
limiting out-of-pocket expenses.
  The other misconception of our amendment is that you do not get any 
help if you have, say, $9,000 in income. You absolutely do. That is 
what our prescription drug discount card is all about. Every senior on 
a voluntary basis--if they want to sign up--because of group buying, 
this cooperative-type buying, similar to what HMOs do today, can save 
about 40 percent. Most HMOs say you save 40 percent versus retail on 
their prescription drugs. Every senior who signs up for our plan would 
be able to save up to 40 percent on their prescription drugs, 
regardless of income. Regardless of where in any of these ranges they 
fit, they save up to 40 percent.
  When we combine that prescription drug discount card with limiting 
out-of-pocket expenses, along with what many States have done--if 
States want to be more generous, they can be. My State of Nevada is 
more generous. The State of Massachusetts, as we have learned today, is 
more generous. The State of West Virginia has a drug discount card that 
is working very well. Other States have put these programs into effect. 
Our plan fits with most of the plans that are already working across 
the country. So for those seniors who truly need the help, they will 
get it.
  I wish to close my time today with a couple real-life examples. Doris 
is a patient. She is 75 years old. We changed her name, obviously, for 
privacy reasons. She has an income of about $17,000 a year. This is a 
real-life case. She is being treated for diabetes, hypertension, and 
high cholesterol. She is on Lipitor, Gloucophage, insulin, Coumadin, 
and Monopril. These are common medications. These are $300 in monthly 
expenses, about $3,600 per year.

[[Page 14175]]

  To compare the various plans on a real-life case, under the Graham-
Miller-Kennedy plan, the leading Democrat proposal, she would have out-
of-pocket expenses of $2,200. Under the tripartisan plan, it is about 
$2,100. Under our plan, it is $1,700. Ours is more generous to the 
person who is really sick, who has a low to moderate income.
  Example No. 2: Betty is 68 years old with $15,500 per year in income. 
She has breast cancer, not uncommon for a lot of senior women. She 
takes morphine, Paxil, dexamethazone, Acifex, trimethobenzamide, and 
Nolvadex. These cost almost $670--almost $8,000 per year.
  Let's compare what happens under the various plans. Under the leading 
Democrat proposal, she would pay $3,180 out of pocket. Under the 
tripartisan plan, she would pay about $2,600, and under the Hagel-
Ensign plan, she would pay $2,150.
  Once again, in a real-life example, the person who is sick who needs 
the most would do better under our plan, and that is why we are asking 
people to support this plan.
  Mr. GRASSLEY. Mr. President, last night and earlier today the Senate 
debated the Hagel-Ensign prescription drug amendment. During the course 
of that debate, some Members on the other side made a comparison of the 
cost of the Graham-Kennedy prescription drug amendment and the revenue 
loss of a proposal to repeal the ``sunset'' of death tax relief 
provisions in last year's bipartisan tax relief bill.
  The essence of the argument was that the budget effects of these 
proposals are roughly equal. As we heard many times, the Senate was 
supposedly making a choice between these two proposals. Senator Schumer 
claimed, during the argument, two different figures for repeal of the 
sunset. At one point, the Senator from New York claimed the revenue 
loss was $670 billion. At another point, a few moments later, the 
Senator from New York claimed the revenue loss was $600 billion.
  The Congressional Budget Office scored the Graham amendment as a 
spending increase of $594 billion. This figure covers the 8-year 
proposal's 10-year budget effect. Now, if you accepted Senator 
Schumer's figures as is, then there might be some basis for his 
argument. That is, if, in fact, the Joint Committee on Taxation scored 
the proposed permanent death tax relief proposal at $600 billion or 
$670 billion, then Senator Schumer's argument might be worth debate.
  The facts are different. I don't know where Senator Schumer got his 
figure. Maybe it was a liberal think tank, such as the Center on Budget 
Policy and Priorities. Maybe it was a partisan liberal communications 
shop, like the Senate Democratic Policy Committee. I don't know where 
he got the number.
  I do know this: The number doesn't apply. For purposes of the 
Congressional Budget Act, tax provisions are to be scored by the 
nonpartisan Joint Committee on Taxation.
  According to Joint tax, the permanent death tax relief proposal 
scores at $43.6 billion if you use the fiscal year 2002 budget 
resolution. That is the one the Senate is currently operating under. If 
you use the fiscal year 2003 budget resolution, the one under which the 
House is operating, permanent death tax relief scores at $99.4 billion.
  So the real number is, at most, $99.4 billion, for permanent death 
tax relief. That is one-sixth the cost of the Graham amendment.
  It is interesting to note that during last month's debate on the 
death tax that the Senator from New York supported Senator Dorgan's 
amendment. That amendment was scored by Joint Tax as losing $111 
billion over 10 years. Basically, Senator Schumer voted for death tax 
relief of $11 billion more than the proposal he criticized last night 
and today.
  So if we are talking about choices between resources for prescription 
drugs and death tax relief, let's review the record. Let the record 
reflect that Senator Schumer and 39 other members of the Democratic 
Caucus voted for $11 billion more in death tax relief than their 
colleagues. For reference, that's rollcall vote No. 149. It is set out 
in page 10078 of the Congressional Record of June 12, 2002.
  The Senator from New York's use of erroneous data on the bipartisan 
tax relief package is unfortunately part of a coordinated strategy on 
the part of the Democratic leadership. It is also data unchallenged by 
many in the media. In fact, many in the media parrot another of the 
Democratic Leadership's equally erroneous statistics. We keep hearing 
and reading that the bipartisan tax relief package yielded 40 percent 
of its benefits to the top 1 percent of taxpayers. This statistic, like 
Senator Schumer's other tax relief statistics, is dramatically at odds 
with Joint Tax, the official scorekeeper for Congressional tax relief.
  According to Joint Tax, the bipartisan tax relief package makes the 
Tax Code more progressive.
  I make this statement for one basic reason. The issues of 
prescription drugs and death tax relief are important matters. 
Certainly every one of us hears about both of these issues when we are 
back home. They are issues that our constituents expect us to resolve. 
Folks back home expect us to be intellectually honest in debating these 
important matters. When we debate these issues, we ought to use 
intellectually honest figures.
  I ask unanimous consent to print the Joint Committee on Taxation's 
revenue estimate of the proposed estate tax relief and the distribution 
analysis in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                                               ESTIMATED REVENUE EFFECTS OF H.R. 2143, ``PERMANENT DEATH TAX REPEAL ACT OF 2001'', FISCAL YEARS 2002-2012
                                                                                                          [Billions of Dollars]
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                   Provision                                    Effective                     2002       2003       2004       2005       2006       2007       2008       2009       2010       2011       2012     2002-07    2002-12
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Make Permanent the Repeal of the Estate Tax     dda & gma 12/31/10.......................  .........       -1.2       -1.5       -1.8       -2.3       -2.5       -2.7       -2.8       -4.0      -24.9      -55.8       -9.2      -99.4
 and the Generation-Skipping Transfer Tax.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Note: Details may not add to totals due to rounding.      Legend for ``Effective'' column: dda=decedents dying after; gma=gifts made after.

    Distributional Effects of the Conference Agreement for H.R. 1836

  (Prepared by the staff of the Joint Committee on Taxation, May 26, 
                                 2001)

                                           DISTRIBUTIONAL EFFECTS OF THE CONFERENCE AGREEMENT FOR H.R. 1836\1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                      Change in Federal      Federal taxes\3\ under    Federal taxes\3\ under     Effective tax rate\4\
                                                          taxes\3\                 present law                proposal         -------------------------
               Income category\2\                ------------------------------------------------------------------------------ Present law    Proposal
                                                    Millions     Percent      Billions     Percent      Billions     Percent     (percent)    (percent)
--------------------------------------------------------------------------------------------------------------------------------------------------------
 
-------------------------------------------------------------------CALENDAR YEAR 2001-------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
Less than $10,000...............................         -$75         -1.0           $7          0.4           $7          0.4          8.7          8.6
10,000 to 20,000................................       -2,989        -11.5           26          1.5           23          1.4          7.5          6.7
20,000 to 30,000................................       -5,790         -9.4           62          3.5           56          3.3         13.4         12.2
30,000 to 40,000................................       -5,674         -6.4           89          5.1           83          4.9         16.1         15.1

[[Page 14176]]

 
40,000 to 50,000................................       -5,490         -5.4          102          5.9           97          5.7         17.4         16.4
50,000 to 75,000................................      -11,546         -4.5          256         14.6          244         14.4         19.1         18.3
75,000 to 100,000...............................       -8,488         -3.5          244         13.9          235         13.9         21.7         21.0
100,000 to 200,000..............................      -10,488         -2.6          408         23.3          397         23.5         24.2         23.6
200,000 and over................................       -6,997         -1.3          555         31.7          548         32.4         27.8         27.4
                                                 -------------------------------------------------------------------------------------------------------
      Total, All Taxpayers......................      -57,536         -3.3        1,748        100.0        1,690        100.0         21.4         20.7
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   CALENDAR YEAR 2002
--------------------------------------------------------------------------------------------------------------------------------------------------------
Less than $10,000...............................          -75         -1.0            7          0.4            7          0.4          9.2          9.1
10,000 to 20,000................................       -3,596        -13.3           27          1.5           23          1.3          7.6          6.6
20,000 to 30,000................................       -7,124        -11.3           63          3.4           56          3.2         13.5         12.0
30,000 to 40,000................................       -6,849         -7.6           91          4.9           84          4.8         16.1         14.8
40,000 to 50,000................................       -6,198         -5.8          106          5.8          100          5.7         17.5         16.5
50,000 to 75,000................................      -13,251         -5.0          267         14.5          254         14.4         19.0         18.0
75,000 to 100,000...............................      -10,227         -4.0          255         13.9          245         13.9         21.7         20.8
100,000 to 200,000..............................      -14,416         -3.3          442         24.1          427         24.3         24.2         23.4
200,000 and over................................      -16,557         -2.9          578         31.5          562         32.0         27.9         27.1
                                                 -------------------------------------------------------------------------------------------------------
      Total, All Taxpayers......................      -78,294         -4.3        1,836        100.0        1,758        100.0         21.5         20.6
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   CALENDAR YEAR 2003
--------------------------------------------------------------------------------------------------------------------------------------------------------
Less than $10,000...............................          -83         -1.1            8          0.4            8          0.4          9.7          9.6
10,000 to 20,000................................       -3,516        -12.9           27          1.4           24          1.3          7.6          6.6
20,000 to 30,000................................       -7,135        -11.0           65          3.3           58          3.1         13.6         12.1
30,000 to 40,000................................       -6,946         -7.5           93          4.8           86          4.6         16.0         14.8
40,000 to 50,000................................       -6,155         -5.7          108          5.6          101          5.5         17.4         16.4
50,000 to 75,000................................      -13,554         -4.9          279         14.4          266         14.3         18.9         18.0
75,000 to 100,000...............................      -10,553         -4.0          265         13.7          255         13.8         21.7         20.8
100,000 to 200,000..............................      -15,487         -3.2          479         24.8          464         25.1         24.2         23.4
200,000 and over................................      -17,453         -2.9          609         31.5          591         31.9         28.1         27.3
                                                 -------------------------------------------------------------------------------------------------------
      Total, All Taxpayers......................      -80,882         -4.2        1,933        100.0        1,852        100.0         21.5         20.6
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   CALENDAR YEAR 2004
--------------------------------------------------------------------------------------------------------------------------------------------------------
Less than $10,000...............................          -69         -0.9            8          0.4            8          0.4         10.0          9.9
10,000 to 20,000................................       -3,429        -12.6           27          1.3           24          1.2          7.6          6.6
20,000 to 30,000................................       -7,121        -10.8           66          3.3           59          3.1         13.6         12.2
30,000 to 40,000................................       -6,964         -7.3           96          4.7           89          4.6         16.0         14.8
40,000 to 50,000................................       -6,320         -5.8          110          5.4          103          5.3         17.4         16.4
50,000 to 75,000................................      -15,049         -5.2          288         14.2          273         14.2         18.7         17.8
75,000 to 100,000...............................      -12,913         -4.6          279         13.8          266         13.8         21.5         20.5
100,000 to 200,000..............................      -22,095         -4.3          512         25.2          490         25.3         24.1         23.0
200,000 and over................................      -21.671         -3.4          642         31.6          620         32.1         28.2         27.3
                                                 -------------------------------------------------------------------------------------------------------
      Total, All Taxpayers......................      -95,630         -4.7        2,028        100.0        1,932        100.0         21.6         20.6
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   CALENDAR YEAR 2005
--------------------------------------------------------------------------------------------------------------------------------------------------------
Less than $10,000...............................          -76         -1.0            8          0.4            8          0.4         10.1         10.0
10,000 to 20,000................................       -3,867        -14.0           28          1.3           24          1.2          7.6          6.5
20,000 to 30,000................................       -7,937        -11.6           68          3.2           60          3.0         13.7         12.1
30,000 to 40,000................................       -7,720         -7.9           98          4.6           90          4.4         16.0         14.7
40,000 to 50,000................................       -6,945         -6.2          112          5.3          105          5.2         17.2         16.2
50,000 to 75,000................................      -16,630         -5.5          303         14.2          286         14.1         18.7         17.6
75,000 to 100,000...............................      -14,709         -5.1          287         13.5          273         13.5         21.4         20.3
100,000 to 200,000..............................      -24,654         -4.5          547         25.7          522         25.8         24.0         22.9
200,000 and over................................      -21,182         -3.1          678         31.9          657         32.4         28.3         27.4
                                                 -------------------------------------------------------------------------------------------------------
      Total, All Taxpayers......................     -103,720         -4.9        2,129        100.0        2,025        100.0         21.6         20.6
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                   CALENDAR YEAR 2006
--------------------------------------------------------------------------------------------------------------------------------------------------------
Less than $10,000...............................          -76         -0.9            8          0.4            8          0.4         10.4         10.3
10,000 to 20,000................................       -3,789        -13.6           28          1.2           24          1.1          7.6          6.6
20,000 to 30,000................................       -7,853        -11.4           69          3.1           61          2.9         13.7         12.2
30,000 to 40,000................................       -7,839         -7.9           99          4.4           91          4.4         16.0         14.7
40,000 to 50,000................................       -7,570         -6.5          116          5.2          108          5.2         17.2         16.0
50,000 to 75,000................................      -18,755         -6.0          313         14.0          294         14.0         18.6         17.5
75,000 to 100,000...............................      -17,212         -5.8          297         13.3          280         13.3         21.3         20.0
100,000 to 200,000..............................      -30,208         -5.1          588         26.3          558         26.6         23.9         22.7
200,000 and over................................      -44,177         -6.1          719         32.1          675         32.1         28.3         26.6
                                                 -------------------------------------------------------------------------------------------------------
      Total, All Taxpayers......................     -137,476         -6.1        2,238        100.0        2,100        100.0         21.7         20.3
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\Includes provisions affecting the child credit, individual marginal rates, a 10% bracket, limitation of itemized deductions, the personal exemption
  phaseout, the standard deduction, 15% bracket and EIC for married couples, deductible IRAs, and the AMT.
\2\The income concept used to place tax returns into income categories is adjusted gross income (AGI) plus: [1] tax-exempt interest, [2] employer
  contributions for health plans and life insurance, [3] employer share of FICA tax, [4] worker's compensation, [5] nontaxable Social Security benefits,
  [6] insurance value of Medicare benefits, [7] alternative minimum tax preference items, and [8] excluded income of U.S. citizens living abroad.
  Categories are measured at 2001 levels.
\3\Federal taxes are equal to individual income tax (including the outlay portion of the EIC), employment tax (attributed to employees), and excise
  taxes (attributed to consumers). Corporate income tax and estate and gift taxes are not included due to uncertainty concerning the incidence of these
  taxes. Individuals who are dependents of other taxpayers and taxpayers with negative income are excluded from the analysis. Does not include indirect
  effects.
\4\the effective tax rate is equal to Federal taxes described in footnote (3) divided by: income described in footnote (2) plus additional income
  attributable to the proposal.
 
Source: Joint Committee on Taxation. Detail may not add to total due to rounding.

Updated Distribution of Certain Federal Tax Liabilities by Income Class 
                         for Calendar Year 2001

 (Prepared by the staff of the Joint Committee on Taxation, August 2, 
                                 2001)


                              INTRODUCTION

       This document, prepared by the staff of the Joint Committee 
     on Taxation, shows the update distribution for calendar year 
     2001 of certain Federal tax liabilities of individuals by 
     income class. This distribution has been updated to reflect 
     changes enacted in the Economic Growth and Tax Reconciliation 
     Relief Act of 2001 (Public Law 107-16).
       The first table shows the distribution of the Federal 
     individual income tax and the second table shows the 
     distribution of the Federal individual income tax, Federal 
     excise taxes, and Federal employment taxes.
       For purposes of these tables, the income concept used for 
     classifying taxpayers is adjusted gross income (``AGI'') 
     plus: (1) tax-exempt interest, (2) employer contributions for 
     health plans and life insurance, (3) employer share of FICA 
     tax, (4) worker's compensation, (5) nontaxable Social 
     Security benefits, (6) insurance value of Medicare benefits, 
     (7) alternative minimum tax preference items, and (8) 
     excluded income of U.S. citizens living abroad.
       The first table shows the distribution of the Federal 
     individual income tax, including the outlay portion of the 
     earned income

[[Page 14177]]

     credit (``EIC'') and the child credit. The table shows, by 
     income category, (1) the number of returns and the percent of 
     all returns represented by the category, (2) the aggregate 
     income and the percent of all income represented by the 
     category, (3) the aggregate individual income taxes paid and 
     the percent of all individual income taxes paid by the 
     category, and (4) the number of returns with zero or negative 
     tax liability and the percent of all returns with zero or 
     negative tax liability represented by the category.
       The second table show the distribution of the combined 
     Federal individual income tax (including the outlay portion 
     of the EIC and the child credit), Federal excise taxes, and 
     Federal employment taxes (those taxes required under the 
     Federal Insurance Contributions Act and Federal Unemployment 
     Tax Act). The table shows (1) the number of returns and the 
     percent of all returns represented by the category, (2) the 
     aggregate income and the percent of all income represented by 
     the category, and (3) the aggregate Federal taxes paid and 
     the percent of all Federal taxes paid by the category.

                                     DISTRIBUTION OF FEDERAL INDIVIDUAL INCOME TAX LIABILITY\1\--CALENDAR YEAR 2001
                                                                [Updated August 2, 2001]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                      No. of returns\3\              Income             Individual income tax   No. of returns with zero
                                                 ------------------------------------------------------------------------------   or negative liability
               Income category\2\                                                                                              -------------------------
                                                    Millions     Percent      Billions     Percent      Billions     Percent      Millions     Percent
--------------------------------------------------------------------------------------------------------------------------------------------------------
Less than $10,000...............................         19.9         14.0          $83          1.0           -6         -0.7         18.9         37.4
10,000 to 20,000................................         23.3         16.4          347          4.2          -13         -1.3         16.4         32.4
20,000 to 30,000................................         18.5         13.0          460          5.6            3          0.4          8.5         16.9
30,000 to 40,000................................         15.8         11.1          549          6.7           22          2.4          3.8          7.5
40,000 to 50,000................................         13.1          9.2          589          7.2           33          3.5          1.8          3.7
50,000 to 75,000................................         21.9         15.4        1,337         16.4          100         10.6          1.0          2.0
75,000 to 100,000...............................         12.9          9.1        1,121         13.7          110         11.6          0.1          0.2
100,000 to 200,000..............................         12.8          9.0        1,683         20.6          226         23.9        (\4\)          0.1
200,000 and over................................          3.8          2.7        1,999         24.5          471         49.7        (\4\)        (\5\)
                                                 -------------------------------------------------------------------------------------------------------
      Total, All Taxpayers......................        142.0        100.0        8,168        100.0          948        100.0         50.6        100.0
                                                 =======================================================================================================
            Highest 10%.........................         14.2         10.0        3,431         42.0          670         70.7        (\4\)          0.1
            Highest 5%..........................          7.1          5.0        2,556         31.3          559         59.0        (\4\)        (\5\)
            Highest 1%..........................          1.4          1.0        1,402         17.2          357         37.6        (\4\)        (\5\)
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\Includes the outlay portion of the EIC and child credit.
\2\The income concept used to place tax returns into income categories is adjusted gross income (AGI) plus: [1] tax-exempt interest, \2\ employer
  contributions for health plans and life insurance, [3] employer share of FICA tax, [4] worker's compensation, [5] nontaxable Social Security benefits,
  [6] insurance value of Medicare benefits, [7] alternative minimum tax preference items, and [8] excluded income of U.S. citizens living abroad.
  Categories are measured at 2001 levels. The highest 10% begins at $107,455, the highest 5% at $145,199 and the highest 1% at $340,306.
(\3\)Includes filing and nonfiling units. Individuals who are dependents of other taxpayers and taxpayers with negative income are excluded.
(\4\)Less than 50,000.
(\5\)Less than 0.005%.
 
Source: Joint Committee on Taxation.
Detail may not add to total due to rounding.


                          DISTRIBUTION OF FEDERAL TAX LIABILITY\1\--CALENDAR YEAR 2001
                                            [Updated August 2, 2001]
----------------------------------------------------------------------------------------------------------------
                                        No. of returns\3\              Income             Federal tax liability
        Income category\2\         -----------------------------------------------------------------------------
                                      Millions     Percent      Billions     Percent      Billions     Percent
----------------------------------------------------------------------------------------------------------------
Less than $10,000.................         19.9         14.0          $83          1.0           $7          0.4
10,000 to 20,000..................         23.3         16.4          347          4.2           23          1.4
20,000 to 30,000..................         18.5         13.0          460          5.6           56          3.3
30,000 to 40,000..................         15.8         11.1          549          6.7           83          4.9
40,000 to 50,000..................         13.1          9.2          589          7.2           97          5.7
50,000 to 75,000..................         21.9         15.4        1,337         16.4          244         14.4
75,000 to 100,000.................         12.9          9.1        1,121         13.7          235         13.9
100,000 to 200,000................         12.8          9.0        1,683         20.6          397         23.5
200,000 and over..................          3.8          2.7        1,999         24.5          547         32.4
                                   -----------------------------------------------------------------------------
      Total, All Taxpayers........        142.0        100.0        8,168        100.0        1,689        100.0
                                   =============================================================================
            Highest 10%...........         14.2         10.0        3,431         42.0          890         52.7
            Highest 5%............          7.1          5.0        2,556         31.3          686         40.6
            Highest 2%............          1.4          1.0        1,402         17.2          391         23.2
----------------------------------------------------------------------------------------------------------------
\1\Federal taxes are equal to individual income tax (including the outlay portion of the EIC and child credit),
  employment tax (attributed to employees), and excise taxes (attributed to consumers). Corporate income tax and
  estate and gift taxes are not included due to uncertainty concerning the incidence of these taxes.
\2\The income concept used to place tax returns into income categories is adjusted gross income (AGI) plus: [1]
  tax-exempt interest, [2] employer contributions for health plans and life insurance, [3] employer share of
  FICA tax, [4] worker's compensation, [5] nontaxable Social Security benefits, [6] insurance value of Medicare
  benefits, [7] alternative minimum tax preference items, and [8] excluded income of U.S. citizens living
  abroad. Categories are measured at 2001 levels. The highest 10% begins at $107,455, the highest 5% at $145,199
  and the highest 1% at $340,306.
\3\Includes filing and nonfiling units. Individuals who are dependents of other taxpayers with negative income
  are excluded.
 
Source: Joint Committee on Taxation. Detail may not add to total due to rounding.

  The PRESIDING OFFICER. The Senator's time has expired. The Senator 
from Nebraska.
  Mr. HAGEL. Mr. President, how much time remains on our side?
  The PRESIDING OFFICER. Five minutes forty-five seconds.
  Mr. HAGEL. I yield myself such time as I consume.
  Mr. President, this debate in which our body has engaged over the 
last 5 days I believe has been helpful for our country because it has 
focused on a critical need, a need to come forward with a Medicare 
prescription drug plan, a plan that is focused on those who need it 
most and that is responsible.
  None of the programs we have debated over the last few days have been 
perfect. The proposal that Senator Ensign and I and others have brought 
to the floor is not perfect. We were not given much of an opportunity 
to work through these issues where we normally have opportunities to 
work through issues, and that is in committee. So we debated something 
so critical to our seniors, to the future of our country on the floor 
of the Senate. When we do it that way, we have to rush. We slam things 
together. There are imperfections in that process, but nonetheless, 
again, I believe this has been an important, enlightened, educational, 
and helpful process.
  We now have one option before us. We voted down two options 
yesterday. We have the Hagel-Ensign plan that we will vote on within 
the hour. What this plan does is give our seniors a very significant 
benefit. I ask: Would we really deny our seniors not only the benefit--
the real, practical, relevant, tangible benefit--of this program, but 
also something maybe more important, and that is the peace of mind that 
they will not be ruined by catastrophic drug costs? Let's again review 
quickly what this amendment does.
  This is immediate. It can be up and running on January 1, 2004. It is 
permanent, unlike the Democratic plan that we voted down yesterday.
  It offers discount drug card programs with 20- to 40-percent 
discounts for all who enroll.
  It is affordable. Seniors pay only a $25 annual fee and then a small 
copayment after they have reached their out-of-pocket expense level.

[[Page 14178]]

  It provides catastrophic coverage. We use the market system. We do 
not invent more government, bigger government, impersonal government. 
We propose a real-world solution to a real-world problem with this 
proposal.
  This bill gives our seniors the protection they need and for those 
who need it most. I encourage my colleagues to look seriously and 
closely at what we are proposing today.
  It is accountable, it is responsible, it fits within the $300 billion 
budget resolution that we passed last year for a prescription drug plan 
over the next 10 years. We are giving the seniors an opportunity for 
peace of mind and real benefits that will enhance their quality of life 
and enhance the ability for not just this senior generation but future 
generations to pay for their health care costs, at the same time taking 
into consideration the generations ahead who will have to pay for this 
program.
  Someone will pay for this program. We need a program, but let us use 
some common sense. Let us find a center of gravity, an equilibrium, and 
do it right. We believe our amendment accomplishes that.
  I yield the floor.
  The PRESIDING OFFICER (Mrs. Carnahan). The Senator from 
Massachusetts.
  Mr. KENNEDY. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The bill clerk proceeded to call the roll.
  Mr. BYRD. Madam President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________