[Congressional Record (Bound Edition), Volume 148 (2002), Part 8]
[House]
[Pages 11255-11256]
[From the U.S. Government Publishing Office, www.gpo.gov]




                  MEDICARE PRESCRIPTION DRUG COVERAGE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from California (Mrs. Capps) is recognized for 5 minutes.
  Mrs. CAPPS. Mr. Speaker, in 1965 we established Medicare because the 
private insurance industry demonstrated that it could not provide 
affordable access to health care for seniors, at least not at rates 
that seniors could afford. Now, 37 years later, this Congress will be 
considering important changes to improve this most successful 
government program.
  Everyone seems to recognize that we must add prescription drug 
coverage to the program.
  Older Americans fill more than one-third of all the prescriptions 
that doctors write and will spend $1.8 trillion over the next decade on 
these critical medications, much of it from their own pockets. Our 
parents, our grandparents, the seniors living in our neighborhood need 
and deserve our help. But I am afraid that some have lost track of the 
important lessons of 1965, that markets forces are inadequate to this 
task.
  Now I recognize the power of the market. Since arriving in Congress I 
have voted for tax cuts and supported free trade and generally taken a 
pro-business stance. But here, when we are trying to provide health 
care for our senior citizens and those with disabilities, we have seen 
the markets fall short.
  The most recent example is the Medicare+Choice program, created to 
harness the efficiencies of the marketplace. The hope, indeed, the 
promise from the program's supporters, was that HMOs would offer 
seniors quality or better care for less money than it took Medicare.
  At first, it seemed to work. We have paid the HMO slightly less than 
it cost to cover a senior through a fee-for-service program; and 
seniors enrolled in the program in droves because it had low co-
payments and at least a few more benefits.
  But then the HMO's said they needed more money, a lot of it. So we 
gave them more money; and then they started pulling out of a lot of 
areas, like my district. And where they did not pull out, they cut back 
on benefits a lot. They raised premiums, they raised co-pays, and they 
still asked for more money from Congress.
  In truth, this program has not been an overwhelming success, to say 
the least. I am willing to continue to try to fix it, but we should be 
aware of its problems and shortfalls, and we should not base the rest 
of Medicare on it, particularly a prescription drug benefit.
  Last week, the Committee on Energy and Commerce and the Committee on 
Ways and Means considered legislation that would do just that and 
provide a

[[Page 11256]]

prescription drug benefit through a program similar to Medicare+Choice. 
Many of my colleagues and I offered amendments to provide a 
prescription drug benefit through traditional Medicare to these 
proposals, but the majority defeated each and every attempt to improve 
this bill. Instead, they have sent legislation to the House floor that 
would privatize Medicare, impose unfair cost sharing on seniors and not 
even offer medication coverage that most seniors could count on.
  Even the insurance companies, the people who are supposed to 
administer and offer these plans, these companies are unenthusiastic 
about the leadership's proposal.
  One of HIAA's past presidents, former Representative Bill Gradison, 
is quoted as being ``very skeptical'' of this proposal working.
  Even if the insurance companies do offer the plans and do provide the 
benefits the majority describes, it still will not help the seniors who 
most need it. In fact, their proposal pays less the more seniors needs 
medication. It offers no help to seniors with drug costs between $2,000 
and $3,700 or $4,700 per year. This means that sicker seniors with most 
health problems, those who most need medications, will not be able to 
afford them again.
  Now, 37 years ago America made a promise to our seniors. We told them 
they would have health care when they needed it most. We need to follow 
through on that promise. We need to give our seniors affordable 
prescription drug coverage.
  When this legislation comes to the floor, my colleagues and I will 
try once again to give seniors a prescription drug benefit they can 
depend upon. We will offer seniors a reliable, voluntary benefit within 
the Medicare structure, comparable to the coverage a senior receives 
for other Medicare services. In fact, unlike the bill that will come 
before Congress, our plan makes sure seniors get access to the same 
level of prescription drug coverage that a Member of Congress or 
another Federal employee receives. This is only fair.
  This plan offers seniors real help. It covers 80 percent of the cost 
of their medication. It will prevent seniors from spending more than 
$2,000 a year on their medication. It will not rely on the goodwill or 
poor business sense of insurance companies; and it will guarantee 
coverage in all areas, urban, suburban and rural. A senior in 
California would be able to count on the same benefit that a senior in 
Kansas or a senior in New York City has and vice versa.
  Mr. Speaker, I urge my colleagues to oppose the majority's bill that 
will give our seniors false hopes that will be dashed on the rocks of 
reality and to support the alternative for a voluntary, affordable bill 
that will be offered by the Democratic side.

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