[Congressional Record (Bound Edition), Volume 148 (2002), Part 9]
[Extensions of Remarks]
[Page 12227]
[From the U.S. Government Publishing Office, www.gpo.gov]




        MEDICARE MODERNIZATION AND PRESCRIPTION DRUG ACT OF 2002

                                 ______
                                 

                               speech of

                         HON. NANCY L. JOHNSON

                             of connecticut

                    in the house of representatives

                         Thursday June 27, 2002

  Mrs. JOHNSON of Connecticut. Mr. Speaker, I rise in strong support of 
H.R. 4954 because it provides prescription drugs for all seniors as an 
entitlement under Medicare. Equally important, it prepares Medicare to 
deliver state-of-the-art health care to our seniors in the decades to 
come. Without passage of this bill, Medicare will continue to deny 
seniors the care they need and will continue to force the diversion of 
critical care hours from patients to paper work. Seniors would continue 
to be held hostage to an antiquated benefit structure while the rest of 
America benefits from advances in medicine, technology, and best 
practices.
  First, in the area of prescription drugs, this bill captures deep 
discounts on drug prices, and then further reduces the cost of drugs to 
seniors through direct subsidies of 50 to 80%--up to $2000 of costs. 
Two-thirds of seniors use less than $2000 in prescription drugs a year, 
so this bill will provide them with tremendous relief. For low-income 
seniors--up to 150% of the federal poverty level (in 2005, $15,065 for 
individuals and $19,392 for couples)--drug costs will be paid 100 
percent up to $2000 a year (this includes premiums, co-pays, and the 
deductible). I want to stress that because twice as many women as men 
have low incomes in their elder years, this is a tremendous boon to 
women's health and does what Americans want: helps those most who need 
the most help!
  The bill also provides catastrophic protections to all. It assures 
that no senior need fear that cancer or another dread disease will 
consume their life savings and leave them destitute.
  You've all been hearing from pharmacists. This bill recognizes the 
expertise of pharmacists more specifically and constructively than any 
legislation ever has. It requires that drug plans establish medication 
therapy management programs for patients with chronic health 
conditions. Pharmacists must be paid adequately to provide their 
services. Pharmacists must be involved in developing formularies.
  And access to local pharmacies is encouraged, not discouraged. To 
encourage face-to-face visits, all drug plans must provide convenient 
access to a ``bricks and mortar'' pharmacy in their network, as defined 
by Medicare; all drug plans must offer a point-of-service option that 
allows beneficiaries to go to any pharmacy they desire (for an 
additional charge); and no mail-order only plans are permitted.
  Second, this bill provides better access to preventive health care by 
offering an annual physical on entry into Medicare, cholesterol 
screenings, and new choices in Medigap plans that have no co-payment 
for preventive care. In addition, the bill revitalizes Medicare+Choice 
plans that have the flexibility to cover far more preventive services 
than traditional Medicare, from simple, useful annual physicals to 
disease management programs.
  Third, by strengthening the Medicare+Choice plans so that they can 
once again grow, this bill prepares Medicare to meet the growing 
challenge of helping seniors manage chronic illness--to dramatically 
improve their health and quality of life and manage their health care 
costs. As the majority of our seniors have multiple chronic illnesses 
and the M+C plans alone have the technology to offer disease 
management, this alternative must be available to seniors nationwide. 
Acute care coverage is simply no longer enough.
  Fourth, passage of this bill will reduce medication errors that are 
causing injury and death, because it requires adoption of computerized 
prescription ordering that will flag drug interactions and provide 
health care professionals better quality data to improve clinical care.
  Fifth, it will enable Medicare to compensate provider more 
realistically and fairly. Without action, Medicare will continue to 
follow the path of Medicaid, undermining both the quality of our health 
care system and access to services by underpaying providers and driving 
them out of serving our seniors.
  Last, this bill will enable Medicare services to be delivered more 
efficiently and cost-effectively. At long last, in fact for the first 
time in Medicare's history, this bill will radically reform the 
bureaucracy that has grown substantially as our laws and payment 
structures have exploded in number and complexity. In fact, the 
Medicare bureaucracy is in crisis.
  Medicare is governed by over 125,000 pages of regulations--more than 
the IRS regulations for the entire tax system. The error rate in 
carriers answering basic questions from physicians was 85%, dwarfing 
the problems at IRS. This problem is so great that it threatens to 
force small providers out of Medicare, be they physician practices, 
small visiting nurse providers, small nursing homes, or small 
hospitals. It doesn't take a rocket scientist to understand the impact 
of such a consequence on rural America or our urban neighborhoods.
  So while the words ``regulatory reform'' don't have the power over 
seniors' attention that ``prescription drugs'' have, in the long run 
they are equally important.
  This is a good, solid, balanced bill. It modernizes Medicare to meet 
the future. It provides prescription drugs as an entitlement to all 
seniors under Medicare. It provides total benefits to those on Medicaid 
and--with states--will provide such total coverage to seniors under 
175% of the poverty level, 44% of the population over 65. And for all 
others, this bill provides deep discounts, generous subsidies, and the 
peace of mind of catastrophic protection against high-cost drugs.

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