[Congressional Record (Bound Edition), Volume 149 (2003), Part 11]
[Senate]
[Pages 14160-14161]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           PRESCRIPTION DRUGS

  Ms. MIKULSKI. I thank the Chair, and, Mr. President, I thank my 
colleagues for their courtesy, particularly Senator Dorgan. I am very 
appreciative.
  Mr. President, seniors are facing a crisis, and it is caused by the 
high cost of prescription drugs. For so many years, Congress has talked 
about prescription drugs in Medicare.
  Let me tell you what my seniors say: Talk, talk, talk. They are fed 
up with our talk, and they want us to take action. They tell me: You 
can't talk yourself out of high cholesterol; you need Lipitor. You 
can't talk your way out of diabetes; you need insulin.
  The problem with the Senate, they say, is when all gets said and 
done, more gets said than gets done. The time for talking is over, and 
we need to listen to the seniors, to business, and we need to act.
  I have been in communities all over Maryland, from diners to 
boardrooms, listening to seniors who are desperate, listening to their 
families who want to help their parents and listening to employers in 
boardrooms who really want to help their retirees but are wondering if 
they can afford to do so.
  Here is what they tell me: Congress must do something about the 
prescription drug benefit, and they want us to do it now to help our 
seniors, our families, business, and our economy.
  There are several different plans floating around, and a lot of them 
have wonderful new language: Medicare Choice, Medicare Advantage, et 
cetera. I am not sure what will happen, but what I know is, we must 
have a meaningful prescription drug benefit, not just slogans and sound 
bites, not just something out of the Heritage Foundation, not something 
out of a think tank, but something that enables seniors to afford the 
prescription drugs, which they paid for the research to develop.
  I have five principles for a prescription drug benefit. These 
principles are the yardstick by which I am going to measure any 
proposal.
  First, the cornerstone of any prescription drug benefit must be 
Medicare. It must be in Medicare. It must stay in Medicare. Medicare 
must be the cornerstone. I am absolutely opposed to the privatization 
of Medicare either overtly or covertly. Let me repeat, I am absolutely 
opposed to the privatization of Medicare.
  Any prescription drug benefit that has a private insurance component 
to it must be in addition to a Medicare benefit, not in lieu of a 
Medicare benefit. It must keep a traditional Medicare component to it. 
Any private insurance program must be an option, and it must not be 
mandatory.
  That goes to my second principle: voluntary. No one should be coerced 
or forced into a private program or forced to give up coverage if they 
already have it.
  It must be affordable. Benefits must be affordable to business and 
affordable to seniors. That means a definite premium and a reasonable 
copayment.
  It must be accessible, available to all seniors regardless of where 
they live, and it must be portable so they can take it with them if 
they visit their grandchildren in another State.
  It must be meaningful and genuine. It must cover the drugs that 
doctors say they need, not what insurance executive gatekeepers say 
they are willing to give them.
  Let's talk about the meaningful benefit. Congress cannot leave this 
up to the insurance companies.
  We have been down that road in Maryland, and it was a rocky road, not 
only filled with potholes but with landmines. We had something called 
Medicare+Choice that turned out to be nothing more than a racket for 
seniors to be gouged and abandoned in my own State. I am not going to 
support any more rackets or gimmicks under the illusion of being able 
to help our seniors. Insurance companies came in. Seniors were going to 
have choice. They ended up with no choice and no coverage. The 
companies came in. They took the money from our seniors. Then they 
said, oh, it is too expensive to do this, and they left town. They left 
over 100,000 Maryland seniors without coverage. We are not going to go 
that way.
  So I do not trust the insurance companies to be there for the 
seniors. Getting rid of Medicare by forcing them into this is not going 
to be the way we go. Medicare is the answer. Medicare is not the 
problem.
  I believe honor thy mother and father is not just a good commandment 
to live by, it is good public policy to govern by. That is why I feel 
so strongly about Medicare. Congress created Medicare to provide a 
safety net for seniors. In 1965, seniors' biggest fear was the cost of 
hospital care. One heart attack could put a family into bankruptcy. 
That is what Medicare Part A is all about. Then Congress added Medicare 
Part B to help seniors pay for doctor visits, an important step to keep 
seniors healthy and financially secure.
  New advances in medicine mean seniors are living longer. New 
treatments and therapies such as prescription drugs prolong life and 
maintain quality of life. These costs were not envisioned in 1965.
  So as we look at this problem, we need to know that Medicare has 
served the Nation well. Now we know it is time to expand it to a 
prescription drug benefit. We have covered hospitalization. We have 
covered doctor visits. Yet because of the advances in medical science 
in this country, prescription drugs and medical devices save lives and 
help manage chronic conditions such as high blood pressure and 
diabetes. This is what we need to be focusing on. Let's focus on the 
American people for a change and not on the so-called hollow 
opportunities of structural reform. It is a problem for middle class 
families. Families worry about their jobs and the weak economy. They do 
not know how they are going to take care of their children and their 
elderly parents.
  American businesses are wondering about things such as legacy costs, 
and small business is wondering how they can afford health insurance as 
well. A lot of companies want to do the right thing for their employees 
and retirees. They want to offer comprehensive health care benefits, 
but they are struggling under the cost. That is why I fought for tax 
incentives for small businesses to provide health coverage for their 
employees. But those who supported the tax bill care more about special 
breaks for Joe Billionaire than about basic health care for families.
  Our businesses do not get any help, but their competitors sure do. 
The playing field is not level. When competitors in other countries do 
not have to pay for prescription drug coverage because they have a 
national health care system, in my own State of Maryland this means 
people are losing jobs in the automobile industry and the steel 
industry. That is why I fought for tax incentives for small businesses 
to provide health coverage for their employees, but those who supported 
the tax bill care more about special breaks for Joe Billionaire than 
about basic health care for families.
  We have to get real, and the first place we have to get real is to 
have a real prescription drug benefit. The Nation cannot afford to do 
nothing. Prescription drugs are lifelines to millions of Americans. 
They enable seniors to prevent and manage disease. Without access to 
medication, seniors are going to end up with trips to the hospital, 
longer hospital stays, more visits to emergency rooms.
  All the great research done at NIH is meaningless if people cannot 
afford the cures. It is time to make prescription drug coverage a 
national priority so we can help our seniors, families, American 
business, and our economy.
  When we stand up for America, we stand up for what America stands 
for, which is a safety net for our seniors and really helping our 
families be able to help themselves.

[[Page 14161]]

  By passing a real prescription drug benefit, Congress will deliver 
real security to America's seniors. Retirement security means more 
pension security. Seniors need healthcare security to be at ease in 
their retirements. In today's world, we cannot have healthcare security 
without prescription drug coverage. Congress must keep this promise to 
America's seniors.
  I now yield the floor, but if they come in with some more gimmicks, I 
will not yield the floor in this debate.

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