[Congressional Record (Bound Edition), Volume 148 (2002), Part 9]
[Senate]
[Pages 11630-11632]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        PRESCRIPTION DRUG PRICES

  Ms. STABENOW. Mr. President, I rise this morning to speak about an 
incredibly important subject that affects every senior, every family, 
every worker, every business owner in our country. This is something we 
have been talking about for a long time but we are now poised to act. I 
want to commend our Senate majority leader, Senator Daschle, for 
understanding the critical nature of prescription drug prices for our 
seniors, for our families, for our businesses in the country, and for 
scheduling this debate in July, an important time in the midst of so 
many issues that we know are pressing. He understands--and I appreciate 
that our leadership understands--the critical nature of our seniors 
having to struggle to get their prescription drugs every day and the 
gigantic rising costs for our business community. The fact is that 
workers have to negotiate pay freezes in order to have the health care 
they need.
  This is an issue that affects everybody. We have the opportunity to 
act in the Senate. There are those who will be acting in the House of 
Representatives on a plan that, with all due respect, I believe and 
many colleague believe, just isn't good enough. We have the opportunity 
to do the right thing to make a real difference to provide for a 
Medicare prescription drug plan that will pay for the majority of the 
bill for the average senior, and also lower prices for everyone.
  I want to share with colleagues today results from a study that was 
done by Families U.S.A. and released on Monday that tracks the rising 
prices of prescription drugs. It continues to be astounding. They have 
indicated that over the 5-year period--from January 1997 to January of 
this year--the prices of the prescription drugs most frequently used by 
older Americans rose, on average, 27.6 percent--way above the rate of 
inflation.
  No wonder our seniors are having to choose between food and paying 
the electric bill and getting their medicine. No wonder our small 
business community is seeing premiums rise by 30 or 40 percent. The Big 
Three automakers in my State are struggling with the huge price 
increases for health insurance.
  We are seeing an explosion of prices for prescription drugs which is 
absolutely not sustainable, and it is absolutely not justified.
  Let me read from two of the many examples that were given by Families 
U.S.A. Premarin, an estrogen replacement drug, rose 17.5 percent--
nearly seven times the rate of inflation. Lipitor, which we hear so 
much about, a cholesterol-lowering drug, rose 13.5 percent--more than 
five times the rate of inflation.
  That is astounding when we look at the fact that the taxpayers of 
America underwrite basic research; we provide tax incentives, tax 
credits, and tax deductions so the drug companies can write off the 
cost of research. We give them patents so they do not have competition 
for up to 20 years in order to recover their costs. Then we see the 
highest prices in the world being paid by our seniors--being paid by 
everyone in the United States. This explosion in prices makes no sense.
  I am so pleased, as we come to this debate in the Senate, that out of 
the debate we will include not only a Medicare prescription drug 
benefit, which is authored by the Presiding Officer, as well as Senator 
Graham of Florida, Senator Kennedy, and many of us who join together to 
provide real coverage

[[Page 11631]]

and real help for seniors, but we also intend to tackle the pricing 
issue.
  One of the things I found astounding in this study is the fact that 
up to 10 top generic drugs--in other words, unadvertised brands that 
are equivalent to the advertised brands, but they just don't cost as 
much--of the 10 generic drugs, 9 did not increase in price at all last 
year. Nine out of ten of the generic drugs looked at did not increase 
at all. On the other hand, by contrast, only 3 of the 40 brand-named 
drugs did not increase last year.
  I have talked about the fact that in our plan we provide incentives 
and encourage the use of unadvertised brands. We will be offering 
important amendments to close loopholes which allow brand-name 
companies to stop the generic companies from going on the market to 
compete with lower prices.
  These are very important issues.
  We have two goals in the Senate: To provide a real Medicare 
prescription drug benefit, and at the same time to lower prices for 
everyone.
  We want to open the border to Canada so we can get prescription drugs 
at lower prices. We want to provide other opportunities, such as 
tackling exorbitant costs of advertising that cause these prescription 
drugs to rise so quickly.
  What does this mean for real people? We know there is a real 
difference between the House and the Senate. The House plan will cover 
about 15 to 20 percent of the average bill for an average senior. We 
are looking at covering 70 to 80 percent--a huge difference.
  What does that mean to the average senior?
  I have set up a Prescription Drug People's Lobby in Michigan where we 
ask people to come to my Web site. They can log onto my Web site by 
logging onto Senator Debbie Stabenow, and they can find out what we are 
doing to lower prices and to provide Medicare prescription drug 
coverage. I have asked people to share their stories and their 
struggles. I want to share two of those today.
  Shawn Somerville from Ypsilanti, MI, is a granddaughter who is 
expressing great concern for her grandmother. She said:

       Just this last Christmas, my grandmother was hospitalized 
     because she stopped taking her prescription so she could 
     afford Christmas presents for all of us grandkids. She later 
     died from an undiagnosed ulcer. It was very sad to me that 
     these drugs are so expensive.
       Do they need to be?

  Do they need to be? No, Shawn. They do not need to be.
  We don't need another grandma choosing not taking her medicine this 
Christmas so she can buy Christmas presents for her grandchildren. This 
is the United States of America. We can do better. It is shameful that 
we have not done better. We intend in the Senate to come forward with a 
plan that will do better.
  I have been getting e-mail from the Prescription Drug People's Lobby 
from around the country. I will share one more before turning to my 
colleague from Minnesota, who has been such a leader on this issue.
  This is from Lydell Howard from Inglewood, CA. She wrote:

       My grandfather, Esco Howard, a 75-year-old retired LTV 
     Steel worker recently experienced what we thought to be 
     impossible. He and his spouse in March 2002 were sent a 
     letter to advise them that they would no longer be covered by 
     a medical plan as provided by LTV Steel, as of March 31, 
     2002. This was due to the financial constraints of the 
     company.

  This is happening all across our country.

       We (the family and grandparents included) were devastated. 
     What would they do? How could they then survive?

  What would they do?

       Since March 31, my grandparents have been faced with 
     exorbitant medical prescription costs. Their finances 
     absorbed by the cost of medical and prescription costs, now 
     average nearly $900 per month for prescription costs alone, 
     with an income of about $1,300 per month.

  Nine hundred dollars a month. That is hard to fathom--somebody 
retired coming up with $900 a month.
  This way of living is terrorizing seniors, disabled persons, and 
their families. This movement to expand Medicare to include a 
description plan is the answer. But it also must be affordable to all 
people of concern.
  Lydell Howard, I couldn't agree more. That is what this is all 
about--providing real medical help, and real Medicare help for 
prescriptions for your grandparents, and making sure prescriptions are 
affordable to everyone.
  I will say, as I have said so many times before, that we know this is 
an uphill battle. There are six drug company lobbyists for every Member 
of the Senate. People have to be involved and have their voices heard 
in order for us to be successful.
  I will conclude by once again encouraging people to join us by going 
to fairdrugprices.org, and sign a petition calling on Congress to act--
get involved and share your stories with us.
  I now yield to my colleague from Minnesota, who has been such a 
champion and a voice for people on this issue and so many others. I 
know he is standing up every day on behalf of our seniors and our 
families to lower prescription drug prices.
  The PRESIDING OFFICER. The Senator from Minnesota.
  Mr. WELLSTONE. Mr. President, I would like to not rush through this. 
We only have 10 minutes. I will use 5 minutes and then yield 5 minutes 
to my colleague from Florida, who has been such a leader on this issue, 
along with the Presiding Officer. Listen, I could go through this for 
hours. I don't know how to do this in 5 minutes, but let me try.
  I thank the Senator from Michigan. I think people get a whole lot 
more faith in politics and then people in politics when they not only 
campaign and say they are going to do something but, once in the 
Senate, they make this their passion and their goal. I say to the 
Senator from Michigan, you have done that. Every single day you have 
been focused on prescription drug coverage for people. I thank you for 
that.
  The House has a plan, and I simply have to point out to the Senate 
that I do not see it as a great step forward. I see it as a great leap 
sideways. I think people will come to see it the same way. People in 
Minnesota will.
  There are a number of problems. Part of it is ideological. When we 
passed Medicare in 1965, it was an enormous step forward. I will tell 
you, for my mom and dad, who are no longer alive, it made all the 
difference in the world. It meant there would be coverage for them.
  This was a Government program that, really, I put in the same 
category as Social Security. It was an enormous step forward, not just 
for senior citizens but made our country better. It made us a better 
country.
  What we want to do on the Senate side is extend prescription drugs as 
a part of Medicare. On the House side, basically what they are saying 
is, there is no guarantee of any benefit. But what they do say is, 
seniors will be entitled to some sort of coverage through drug-only 
insurance plans or through Medicare HMOs. By the way, a number of these 
private health insurance plans, I say to my colleagues from Ohio and 
Michigan, are telling me they are not going to provide the coverage for 
them because it will not work for them. The only people it will work 
for are people who will not need it, and they will not have a large 
enough pool, so it will not be profitable.
  But on the House side, apparently Republicans have said they do not 
want to extend this on to Medicare, in which case, really, they are 
interested in going down the road of privatizing Medicare. We are not.
  The second point is a real important one. If you are going to have 
prescription drug coverage that works for people, you have to keep the 
copays or deductibles sufficiently low and premiums sufficiently low so 
they can afford it. And it has to provide real catastrophic coverage. 
That is what people worry about the most.
  On the House side, you have this peculiar feature of between $2,000 
and $3,700 there is no coverage. While people continue to pay premiums, 
they do not get any coverage. I think probably close to half of the 
senior citizens in this country actually are paying more than the 
$2,000 in expenses for prescription drugs; and they do not get any 
coverage whatsoever in the House plan. It does not make a whole lot of 
sense.

[[Page 11632]]

This is truly one of those examples where the Devil is in the details.
  I guarantee you, when senior citizens--and it is not just about 
senior citizens; it is their children and their families; we are all in 
this together--see there isn't any coverage, people are going to say: 
What is this about? This does not meet our needs.
  The third issue which is important to me is that the House plan says 
we want to make sure that low-income seniors--the profile is not very 
high; it is not true the majority of senior citizens are ``greedy 
geezers'' playing all the swank golf courses around the country--
probably a full 75 percent have incomes below $30,000 or $35,000 a 
year.
  For low-income seniors, the House says, of course we would not have 
people paying, that it would be coverage they could afford, it would be 
free coverage, except then they have an assets test so that if you have 
a savings account of more than $2,000, or you have a car that is worth 
$4,500, or you have a burial plot worth more than $1,500, you would not 
necessarily be eligible for any help whatsoever. That strikes me as 
being stingy. To tell you the truth, it defies common sense. We ought 
not to be having this kind of stringent assets test when it comes to 
whether people can afford prescription drugs.
  My final point--and I could spend a lot of time on this--I am a 
cosponsor of the Senate bill. I think it is extremely important. I 
thank both my colleagues. I would love to see us have some cost 
containment. I think we should do it. I could talk about three options, 
but with only 30 seconds, I am only going to talk about one, because I 
have been working on it for several years. And so have Senator 
Stabenow, Senator Dorgan, and Senator Jeffords.
  I do believe at the very minimum we ought to allow our citizens to 
reimport these prescription drugs from Canada, according to all of the 
FDA safety guidelines. There is no reason in the world why our 
pharmacists, our wholesalers, and our families cannot reimport drugs, 
where they can get a
30-, 40-, or 50-percent discount. There is no reason whatsoever. I 
grant you, the pharmaceutical industry will not like this.
  But what we also have to do is make sure there is a way we can reduce 
the costs. I think that would be a helpful addition to what I think is 
a very important piece of legislation.
  I say to my colleagues, I think the House bill is a nonstarter. I 
think it is a great leap backwards. I think we have a much stronger 
bill. I look forward to the debate.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Florida.
  Mr. GRAHAM. Mr. President, first, I commend my two colleagues for 
their eloquent statements. I commend the Presiding Officer for his 
great leadership on this effort to pass a prescription drug benefit 
this year.
  The most fundamental reform for our Nation's Medicare Program is its 
transformation from a program that has focused, since 1965, on dealing 
with people's needs after they were sick enough to go to the doctor or 
the hospital and to create a modern commitment to good health.
  Access to medications is an absolutely central part of that 
commitment to good health. Access to medications not only helps people 
live longer, happier, healthier lives, but it also will help Medicare 
save money.
  These truths are particularly important to the most vulnerable of our 
elderly, those who are too well off to qualify for Medicaid, the 
program for poor Americans, but are too poor to afford their medically 
necessary prescription drugs.
  There are approximately 10 million older Americans living on an 
annual income of $13,000 or less per year. Of that 10 million, 5.5 
million have no prescription drug coverage because they do not qualify 
for Medicaid.
  These Americans face the tough choices of deciding whether they can 
afford their prescription drugs. One example of this is Mrs. Olga 
Butler of a beautiful community in central Florida, Avon Park.
  Mrs. Butler receives a monthly Social Security check of $672, which 
makes her barely over the income limit for Medicaid coverage. This 
means that the 67-year-old Olga has to pay for her own medications, 
sometimes having to make the choice among food, rent, and her 
prescriptions.
  Olga is on Lipitor and clonidine for her hypertension and high 
cholesterol. She pays $95 per month for Lipitor and $22 per month for 
clonidine. These prescription drugs not only improve the quality of 
Olga's life, but they are helpful in warding off a possible stroke or 
heart attack, for which she is at great risk.
  In addition to the personal devastation of having a stroke or a heart 
attack, these would cause significant additional costs to the Medicare 
Program.
  An average hospitalization for a typical stroke patient costs 
Medicare $7,127.59. Physicians' time, tests, and consultations will 
add, on average, another $1,600 cost to Medicare. This is an avoidable 
event.
  If Olga can continue to take her medications, chances are she will 
not have a stroke, she will not have a heart attack, and, if she is 
fortunate, she will not need further hospitalizations, nursing facility 
care, and rehabilitation services. This, of course, is expensive, but 
it is also avoidable.
  You might ask, why are you discussing this issue of the poor, but 
above Medicaid eligibility, elderly? Don't both competing prescription 
drug plans that have been offered for Medicare offer similar benefits 
to Olga Butler? The answer is, not quite.
  Under the House Republican plan, which I understand may be debated 
today and where I know there are considerable misgivings among Members 
on both sides of the aisle, maybe one of the reasons for those 
misgivings is the fact that, before Olga can receive any help with her 
drug costs, she must pass an assets test. An assets test?
  For the first time in the history of Medicare--for the first time 
since 1965--we are about to impose an assets test in order for a low-
income Medicare beneficiary to be eligible for prescription drug 
assistance.
  What does this mean to Olga Butler? It means she must deplete her 
life's savings to less than $4,000, sell off her furniture and personal 
property that is worth more than $2,000, get rid of her burial fund if 
it exceeds $1,500, and sell her car, if it has a value of more than 
$4,500--all of these in order to qualify for low income assistance 
under the inadequate Republican proposal.
  I ask unanimous consent for an additional 5 minutes to complete my 
remarks.
  Mr. REID. Objection.
  The PRESIDING OFFICER. Objection is heard.
  Mr. GRAHAM. Mr. President, I look forward to an opportunity to 
continue to outline the circumstances under which Olga would be 
disadvantaged if the plan being considered in the House today were to 
improvidently be adopted.

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