[Congressional Record (Bound Edition), Volume 149 (2003), Part 13]
[House]
[Pages 18184-18191]
[From the U.S. Government Publishing Office, www.gpo.gov]




 BIPARTISANSHIP BRINGS POTENTIAL SOLUTIONS TO PRESCRIPTION DRUGS ISSUE

  The SPEAKER pro tempore (Mr. Gingrey). Under the Speaker's announced 
policy of January 7, 2003, the gentleman from Minnesota (Mr. Gutknecht) 
is recognized for 60 minutes as the designee of the majority leader.
  Mr. GUTKNECHT. Mr. Speaker, I come to the floor of the House tonight 
again to talk about the issue of prescription drugs and the prices that 
Americans pay compared to the prices that people pay in the rest of the 
industrialized world. I will have colleagues joining me tonight from 
time to time from both sides of the political aisle. We have 
Republicans, we have Democrats, we have people who would consider 
themselves conservative and, hopefully, some who will be coming down 
who consider themselves to be liberals or progressives.
  Because this is not an issue of right versus left. It is an issue of 
right versus wrong. Tomorrow night we hope to do another Special Order 
on a bipartisan basis to talk about this issue again, because I think 
this is the kind of issue that we need to talk about, that Members need 
to understand.
  Mr. Speaker, I, in the past, have said that the fact that Americans 
pay so much more than the people in Canada or in Germany or Switzerland 
or France, I have always said that it is not so much shame on the 
pharmaceutical industry, it is shame on us. And it is really our 
responsibility. Our own FDA works for the Congress and not the other 
way around.
  But, tonight, my tone is going to start to change because of some of 
the things that the pharmaceutical industry has been doing over the 
last several weeks.
  President Reagan said, if you tell something that is not true but you 
do not know it is not true, that is a mistake. If you say something 
that is not true and you know it is not true, that is a lie. And in the 
last several weeks we have seen things that really do border on lies, 
because the people who are telling the stories know that they are not 
true. We are going to talk about that tonight.
  I want to thank my colleague, the gentleman from Illinois (Mr. 
Emanuel), for joining me tonight in this Special Order. I know that he 
has had an incredibly long day and he can only stay for a few minutes, 
so I would like to yield to him so that he can talk about the issue and 
the problem and what we in Congress maybe can do to bring some parity 
and fairness in terms of the prices that our consumers are forced to 
pay for these life-saving drugs.
  Mr. EMANUEL. Mr. Speaker, I thank my good colleague and friend, the 
gentleman from Minnesota, for his leadership on this issue, as he has 
shown time and again. The test of leadership is the ability of an 
individual, in the face of a great deal of opposition, to consistently 
stay whole and true to his principles; and the gentleman has done that, 
even in the face of not only political opposition but leadership 
opposition within his own party on this issue.
  Others of both parties, a cross-section that cuts a big swathe within 
our Congress, members of what one would call the extreme right and 
members on the extreme left, have come together on this. I think it is 
because, one, I think this legislation speaks to our common set of 
values; and, two, it is because all of us cannot be hard to the fact 
that because we have heard stories repeatedly of busloads and carloads 
of individuals who have gone over the border to Canada to buy 
medications that are life-saving and necessary and have done that as 
the only means in which they can afford their medication and what has 
been prescribed. All of us have heard those stories and that is why all 
of us have come here.
  Now, some may have talked about price controls. Others may have 
talked about just letting the system as is continue. This legislation, 
which we put together under the gentleman's leadership, uses market 
forces to bring prices down. It says that if you can get the

[[Page 18185]]

medication at a 12 or 15 percent reduction in Canada, and that is a 
better way for you to go, you would go there. If you can find it 
cheaper in England or in Ireland or in Germany or Italy, you could go 
there. That would force at the local pharmacy the prices to begin to 
reduce here at home for the American consumer and American seniors.
  That competition will bring competitiveness to the type of medication 
you can buy and real reductions in the prices, so that no longer would 
the American consumer, through inflated prices here at home for 
prescription drugs, be supporting the price reductions and the 
affordable prices that Canadians, Brits, the French, Germans, Italians, 
and Dutch are paying there.
  So it uses market forces to reduce prices and brings that competition 
to bear. I think once that happens, our local pharmacy and drugstore, 
because they will not want to lose market share, will reduce prices at 
their local pharmacy. It is the force of the market that will bring 
prices down.
  The gentleman has shown many times I think the prices of drugs on 
this chart, and I know the gentleman will get to it soon, but that 
competition for me is not only important for our seniors, it is 
important to our private businesses. General Motors I think has a $1.2 
billion health care package for prescription drugs for their retirees. 
This type of savings, on average, 20 percent, would save close to $240 
million for GM.
  But we will see that ripple throughout the entire economy. That would 
save, for families who are paying $60, $70 for a one-time medication, 
who can then buy it for $30 or $40, and that is a tremendous reduction.

                              {time}  2215

  Second, we are about to embark on the largest expansion of an 
entitlement in over 40 years. Medicare, we are thinking about adding 
$400 billion for a prescription drug benefit. Some think it may in the 
end go up to 5 or $600 billion. I think all of us owe the taxpayers a 
little bit of respect. And when I say respect, respect is understanding 
the value of their tax dollars should go the longest way possible. 
Therefore, if we can get the prices for a prescription drug or a 
specific drug, whether it is arthritic, heart, diabetic medication at 
40 percent reduction or 30 percent reduction, we owe the taxpayers 
through Medicare the right to get them the best price.
  Corporations and the pharmaceutical company will get their profits, 
but this legislation is not about their best profits. It is about the 
best price for the seniors and our taxpayers. And two myths I want to 
strike down, one myth that those on the other side say, and they 
constantly say, is that if you do this you are going to destroy our 
ability to develop new medications. I think that taxpayers have been 
tremendously generous to the pharmaceutical industry. Through the 
research and development tax credit, taxpayers have supported research 
at these corporations, and they have paid for that research through the 
tax credits' R&D.
  Second, the taxpayers are being very generous because if you look at 
cancer drugs, you look at drugs for AIDS, every one of them was 
developed through the National Institutes of Health, which is a 
taxpayer-funded research institute. So in my view, R&D will never get 
hurt as long as the taxpayers maintain their generosity to the tax 
credit, the R&D, and through NIH. So that myth does not work.
  Second, that we are somehow endangering the health and safety of the 
medications that we have at our local pharmacy and drug stores. The 
truth is every one of the medications we have talked about are FDA, 
Federal Drug Administration, approved. They are the drugs that were 
manufactured at the Food and Drug Administration FDA facility, and 
these facilities produce the drugs for the markets here in America, 
Canada, England and France, the same companies. They are name-brand 
drugs at 20, 30, 40, 50 percent reduction. So safety is not a concern. 
Development of new products is not a concern. We would do great work 
for our taxpayers and our elderly and our American consumers.
  I know the gentleman has some examples to show to the people who are 
listening and watching the debate of this important issue.
  Mr. GUTKNECHT. Mr. Speaker, we have plenty of examples. Before the 
gentleman goes, one of the issues that I briefly referenced in my 
opening remarks was that up until the last several days I have been 
very hesitant to criticize the pharmaceutical industry because in many 
respects they did not create this system; Congress did. They did not 
allow this system to perpetuate. It was the FDA and the Congress that 
did. But recently they have begun what I think is an unethical strategy 
to try and scare seniors, to scare consumers, to begin to get them to 
believe that the problems that would be created by this legislation are 
insurmountable.
  And to the gentleman's credit, the gentleman has had the courage to 
fight back. Because they have started to run ads on radio, they started 
to do mailings to our seniors, they are making phone calls to our 
seniors, they are mailing to pro-life groups; and that is where I get 
back to this point. If you tell something that is not true and you know 
it is not true, that is a lie. And I think sometimes here in this city 
we have to call an untruth a lie. And to the gentleman's credit, and I 
want the gentleman to talk a little bit about what he has done in 
Chicago to begin to call things the way they really are and to 
counterattack. And I admire the gentleman for that. Perhaps the 
gentleman can talk a little bit about what has been happening in 
Chicago, in the gentleman's district, and what he is doing about it.
  Mr. EMANUEL. Mr. Speaker, as the gentleman knows, the pharmaceutical 
companies set up a front group, because if it was paid for by the 
pharmaceutical companies, it would totally be discredited; but they set 
up a front group to advertise and start to attack or pressure 
individual Members on this legislation. And they ran radio ads saying, 
call your Member, say you do not want unsafe drugs in the district, 
using scare tactics to frighten senior citizens and to frighten 
American consumers.
  Well, in the Chicago area it has totally backfired so I want to thank 
them for spending their money to help us. But I decided to go on with 
my own radio ad to counter what the pharmaceutical industry was doing 
and to tell them the truth and the public the truth about what was 
going on, what we were trying to do, which is bring competition, bring 
the prices down, make medications more affordable, save the taxpayers 
money.
  The gentleman and I have talked about it, others have talked about 
it; I believe that what the drug pharmaceutical companies were doing 
here was a sign of desperation.
  Now, when I mentioned to the gentleman I was running radio ads, a 
colleague of ours from Indiana mentioned the direct mail he was getting 
in his district. A colleague of ours from Massachusetts was mentioning 
the phone calls where pharmaceutical companies were calling up telling 
the same message they were delivering on the radio, saying, talk to 
your Congressman, and then patching that through. Once the staff of the 
Member's office explained it, the seniors not only felt good, they were 
happy that he was on the legislation. But they are using the scare 
tactics in a sign of desperation. Their position is untenable.
  We have competition for a car. You want to buy a Toyota, you can buy 
a Toyota. You want to buy General Motors, you can buy General Motors. 
You want to buy a Renault, you can buy a Renault, a Saab. You want to 
buy strawberries all year round, you can do that. You want to buy 
software from an American company, you can do that. You want to buy 
them from a German company, SAP, you can do that. The only area where 
you cannot buy other products from other markets in the same product 
line is in the pharmaceutical area. We can do it in cars, stereos, TV, 
electronics. And in all of those places, consumer prices have dropped 
dramatically. Competition has worked.
  The pharmaceutical industry has gamed the political system. They have 
gamed the legal system, and they have

[[Page 18186]]

kept competition out. We pay the highest prices in the world for 
pharmaceutical drugs. The gentleman's chart shows the 10 most-used 
drugs for seniors. There is a $700 spread where American seniors are 
paying $700 more than their counterparts in Germany, 20 percent more in 
Canada. Why? Because the political system has been gamed by the 
pharmaceutical industry to keep competition out of the market.
  Now, I have seen the marketplace work. It does it in every product. 
It brings efficiency to the marketplace. The reason we have this 
tremendous inefficiency in the pharmaceutical area is because we have a 
closed market. You open up the marketplace to competition, prices will 
drop.
  One of the things I learned a long time ago, maybe this is because I 
am a middle child. I used to say about middle children, we wrote a 
book, ``War or Peace.'' We could do either one. If someone was going to 
go out and say something like that to scare and intimidate people, they 
needed to be pushed back and given some of their own medicine.
  What they did in Chicago, what they are doing around the country, the 
gentleman can correct me if I am wrong, but I think it is about $20 
million big pharmaceutical companies are spending to scare people. It 
is a sign of desperation. They are using desperate tactics. And I hope 
it is backfiring on our colleagues and realizing that type of pressure 
politics will not work, scaring people. The public is on to what they 
were doing.
  That is what I decided to do. We have run it in the Chicago area. We 
have got a tremendous amount of attention and support by the public for 
speaking out and speaking up against the pharmaceutical industry scare 
tactics. If they wanted to have an honest debate, this is worth having 
a debate. I look forward to it. But what they are doing is exactly what 
the gentleman said, they are lying. They are scaring people when they 
need not scare them.
  Mr. GUTKNECHT. Mr. Speaker, I want to thank the gentleman. We have 
sort of suffered the slings and arrows of outrageous fortune over this 
issue, but it is worth it because this is a big issue. The gentleman 
mentioned they are desperate. They understand what we understand, that 
over the next 10 years this is a $630 billion issue. And that $630 
billion is going to be paid by seniors, it is going to be paid by 
families, it is going to be paid by big businesses, it is going to be 
paid by small businesses; but that is $630 billion that Americans 
should not have to pay.
  As we talked about with many of these drugs like Tamoxifen, the 
Americans already paid for the drug. We paid to develop the drug. And 
yet they sell it, here, this box of drugs I bought in Munich, Germany, 
for $59.05. We rounded it off to $60. This drug sells here in 
Washington, D.C. for $360. That is outrageous. It is indefensible. And 
the reason that they have to resort to distortions, deceptions, and 
downright lies is because they cannot defend this chart. They cannot 
defend the fact that Cipro sells in Germany for $35, and $55 in the 
United States, that Coumadin sells for $21 in Germany and $89.95 in the 
United States. Glucophage, $21.95 in the United States, only $5 in 
Germany. Pravachol sells for $62.96 in Germany but $149.95 here, and 
the list goes on.
  The gentleman said the total price for the 10 most commonly 
prescribed drugs, $373.30 in Munich, Germany. That same group of drugs, 
same quantities, made in the same FDA-approved facilities sells for 
$1,039.65 here in the United States. That is indefensible. They do not 
want to argue this chart. They do not want to argue these numbers, so 
they resorted to the only thing that is left, and that is to try to 
scare seniors, try to deceive Members of Congress and somehow distort 
this whole issue so that it is about safety, it is about abortion, it 
is about all other kinds of issues; but that is not what it is about.
  It is about money. It is about real money. Because they believe that 
$630 billion belongs to them. We believe that $630 billion belongs to 
Americans.
  Mr. Speaker, I yield to the gentleman from Michigan (Mr. Hoekstra).
  Mr. HOEKSTRA. Mr. Speaker, I thank my colleague from Minnesota for 
having the Special Order and my colleague from Illinois, who I am 
working with on a number of different issues.
  The gentleman talks about what is going on, that they are trying to 
scare seniors, they are trying to scare Members of Congress. In an 
unprecedented way, they have taken this argument to our constituents; 
and actually I am glad that they did. Back in my district a few weeks 
ago as I am talking to my newspapers, I started getting some unusual 
inquiries. They were asking me some strange questions. They said, What 
are you working on, this reimportation? And I kind of explain it to 
them. And I kind of asked them the question and said, Why are you 
asking? I have worked on this bill for the last 3 or 4 years, and this 
is the first time you have ever asked me about it. They said, We had 
someone from the pharmaceutical companies visit us and talk to us about 
this issue. I said, That is interesting. We have some pharmaceutical 
companies in west Michigan. I have a rural district along the Lake 
Michigan shoreline and a number of dailies, a number of weekly 
newspapers. I said, Oh, one of the folks from one of the local drug 
companies. They said, No, we think this is a lobbyist from Washington. 
And almost universally they have all said, We are not quite sure what 
to make of this because this has never happened to us before that a 
lobbyist would come from Washington and meet with us and to try to tell 
us why you are, the quote was, Why you are backing the wrong horse, was 
one of the terms that they were using.
  I will get back to that, but this person was from the Pharmaceutical 
Research and Manufacturers of America and visited all of my daily 
newspapers and I think some of the weeklies and actually visited some 
that were not in my district that he thought were still in my district.
  But now they introduce the flier that says, they are spending more on 
my campaign than I spend on my own campaigns, ``Will Congressman 
Hoekstra miss an opportunity to protect the sanctity of human life?''
  Absolutely not. In 10\1/2\ years of being in Washington, I have not 
missed a vote to protect the unborn. This will not be one of the times 
that even will impact the unborn. We have a letter from a former 
colleague to the gentleman from Minnesota (Mr. Gutknecht) that talks 
about what a phony argument they are raising in this instance, in 
scaring the pro-life folks.

                              {time}  2230

  Then they have the second flier that these folks are mailing out into 
my district, a public health alert: Investigative reports expose danger 
of imported medicines for seniors. But they are mailing that out in my 
district.
  Then an urgent drug safety warning for America's family, a half-page 
ad in my local newspapers. I guess my colleague from Illinois must have 
experienced some of the radio ads that they are running, urgent. And 
the two of my colleagues are absolutely right. Because what has run in 
one of my local newspapers now is the dirty little secret that these 
folks are running away from, which is save up to 86 percent on your 
prescription drugs, 86 percent. This is an offer to constituents in my 
district to buy the same drugs, and you have got the prices up there, 
something that in the U.S. costs $80 dollars, get it for 17 bucks from 
Canada. This is after they ship it to you at 17.
  Mr. EMANUEL. Mr. Speaker, may I ask my colleague, what you have as an 
ad in your area paper, where people can buy the same medications that 
they could get at their local pharmacies, if they went to Canada, the 
reductions, if you could read a few of those comparatives.
  Mr. HOEKSTRA. Mr. Speaker, Lipitor, save 43 percent. The average U.S. 
cost is $288. Our price is $165.
  Neurotonin, you have got all these down, but average U.S. cost $130. 
Our price $78.
  Mr. EMANUEL. Our price being the one in Canada.
  Mr. HOEKSTRA. That is right. Our price being the one in Canada.
  Premarin, the U.S. price, $80. Our price, if you buy it through mail 
order from Canada, $17.

[[Page 18187]]

  One of my pharmacists called me today because he says I cannot sell 
this for $80. He says, when I buy this from my supplier in the U.S., it 
is costing me $74. The dirty little secret is that these folks are 
willing to sell.
  The savings are save 43 percent, save 40 percent, save 79 percent, 
save 26 percent. Save 86 percent on Nolvadex. $349 is the average U.S. 
cost. Buy the same drug, manufactured in the same plant in the U.S. and 
buy it, I am 180 miles from Detroit. Go 180 miles to Windsor and buy 
the same thing for $50.
  It is not like the Canadians have this phenomenal pharmaceutical 
system that they can build this stuff so much cheaper, manufacture this 
stuff so much cheaper. It is the same stuff built in the same plants in 
the U.S., but it is sold for 86 percent cheaper if you want to buy it 
from Canada, 45 percent, 54 percent, 23, 49, 52 percent.
  Zocor, I know that you have talked about that, $377 is the average 
cost in the U.S.
  Mr. GUTKNECHT. That must be for 100 tablets. Does it say?
  Mr. HOEKSTRA. It is 100 count tablet, 20 milligrams.
  Mr. GUTKNECHT. That is what we are talking about.
  Mr. HOEKSTRA. Buy it from Canada for $180.
  Mr. EMANUEL. That is a 50 percent reduction, little more.
  Mr. HOEKSTRA. Fifty-two percent. One of my pharmacists called me this 
morning, and he is outraged because he opens his morning newspaper, and 
he is seeing this ad and says, how do I compete? And I said, I want you 
to do a press conference with me next week. On Monday morning we are 
going to do this, and we are going to talk about that and expose the 
dirty little secret.
  This is not about drug safety. This is not about abortion. This is 
about the American taxpayers being gouged by greedy drug companies 
which I think was the headline in Illinois.
  Mr. EMANUEL. Mr. Speaker, if my colleague would yield, as a friend of 
ours once said, if they say it ain't about money, it is about money, 
and that is what this is about. It is not about abortion. It is not 
about safety. It is not about anything else but about money.
  I respect the need for them to make a profit. They will make a 
profit, but it is clear what is going on here is that the American 
consumers, the American elderly and American taxpayers are subsidizing 
the rest of the world, and it is high time we stand up for those folks 
who are trying to make ends meet, whether they be taxpayers, sick 
patients, whether they be the elderly, get the prescriptions. It is 
clear because all those drugs are name brand drugs, same name brand 
drugs made in the same facility, they are just sold at a 50 or more 
percent reduction in Canada. In that type of competition your local 
pharmacist can compete if they had that same type of price, and that is 
what we are talking about.
  Mr. HOEKSTRA. Mr. Speaker, what my local pharmacist said today was we 
would have not that great of a drug crisis in the United States if we 
had Canadian pricing or German pricing or other EU pricing.
  The three reasons that Mr. Trewhitt gave my local newspapers as to 
why this reimportation is a failed strategy, there is no guarantee any 
savings would be passed on to consumers.
  The Lipitor, save 43 percent. My belief is that if you have 
reimportation, my pharmacist in Holland, Michigan, or my pharmacist in 
Ludington, Michigan, if he can access these drugs through a purchasing 
agreement with a reputable pharmaceutical house in Canada, do I think 
he is going to buy or stay in business if he is paying $288 for it and 
the pharmacy down the street can get it for $165? I am sorry, he is 
going to be buying it, and the consumers will see the savings. The 
consumers in Canada obviously are seeing the savings. The savings have 
moved down.
  It is uncertain whether the safety of reimported drugs can be 
assured. Give me a break. You told me how many pounds or tons of 
bananas we import and these types of things. The technology exists 
where we can put the controls in place that we can maintain the 
integrity.
  But the bottom line is reimportation will not happen. What will 
happen is that we will see an equalization of the prices between the 
Canadian and the U.S. markets and the European markets and the U.S. and 
the U.S. seniors and the U.S. government. But, also, U.S. manufacturers 
will no longer be subsidizing the health care costs of the rest of the 
world.
  The third argument that Mr. Trewhitt raises, the third major reason 
he argues against reimportation is that, in essence, he said the U.S. 
also would be importing someone else's failed price controls. It does 
not look like failed price controls to me. It looks to me like price 
controls or whatever mechanism Canada is using appear to be working 
pretty well, because the folks who are manufacturing these products are 
perfectly willing to sell these products in Canada at these prices, and 
they are not willing to sell these same drugs to American consumers at 
the same price. It appears to be working for Canada.
  If this were a failed price control, these drugs would not be 
available in Canada. If these companies could not make money at these 
prices, what they would say is we are not going to distribute these 
products in Canada because we cannot make a profit at it so we are not 
going to distribute them there until we get a fair and reasonable price 
for these products. They are not going to available in Canada, and 
Canadians would be having to come to the United States to buy these 
quality drugs, but it is exactly the opposite.
  Mr. GUTKNECHT. Mr. Speaker, I want to give our friend from Illinois a 
few minutes because I know he has to leave.
  Mr. EMANUEL. I think that our other colleague from Michigan laid it 
out. What would happen is you would see a dramatic reduction in prices 
here in the United States. There would be some levelling off. Prices in 
other places would rise. We can call it reimportation. I like to refer 
to it as market access. We would go from a closed market to an open 
market. You have real competition. Once that occurred, what would 
happen at that point, prices would be reduced here at home.
  More importantly, I will use the General Motors example. There are 
businesses all across the country, look at the steel industry, what was 
really depressing the steel industry was not the competition in prices. 
It was that our steel industry had all these legacy costs for retirees, 
health care costs. You get the reductions like this, and the costs for 
our steel industry would be dramatically reduced, but that is across 
big businesses and small businesses.
  Small businesses, only one-third of them provide health care. Two-
thirds do not. Why? Because it is too costly. One of the greatest 
causes of health care inflation is, which is now running at 20-25 
percent a year, two factors, the uninsured and prescription medicines. 
Those are the factors behind health care inflation.
  We have got to bring this under control. The way to do it is not 
mandate it. Let us use market forces to do it.
  Again, I want to go back to what our opponents have done. I again 
believe that their desperation and desperate tactics, whether that is 
through the direct mail as you have shown, the radio commercials that 
are running in my district, the telephone campaign that is running in 
other folks' districts, what is interesting is, as I have said before 
and I will say again, they could have said anything. They can talk 
about their life-saving medications. They could have talked about their 
innovation, how many people they employ. They did not talk about 
something positive. They tried to scare people about what we are trying 
to do.
  To me, their first argument, their first salvo, the first arrow they 
shot is indicative of the emptiness of their position. They did not say 
something positive about what they are trying to do. They are trying to 
run us down, helping seniors and consumers.
  Again, I want to thank both of you. I do have to go. I thank both of 
you for your leadership. One of the things I am most impressed with is 
the huge bipartisanship that has been shown on this,

[[Page 18188]]

the cross-sections of both caucuses, the Democrats and Republicans, who 
have come together, both in the House and in the Senate where 82 
Members voted for similar legislation, although it is only specific to 
Canada.
  We are talking about the European Union here, which I think would be 
real competitive because we have a common set of principles. We have 
heard too many stories of people missing medication, people, as my 
colleague has always said, and if I could steal this from him for a 
second, we have turned our elderly into drug runners, coyotes running 
over the border trying to get medication.
  Both of you have districts obviously closer to Canada than mine, but 
in Illinois there are actually three or four storefronts opening up to 
do distributions from Canada. You see it on a real day-to-day basis 
what is going on, and you see the competitive market forces that if we 
brought them here people would not drive 120 miles, which they do 
today. They would drive 12 minutes, and they would get the medication 
at their local pharmacy.
  We need that type of competition here, and it is the right thing to 
do, and I think we are on the right course. The desperate tactics shown 
by our opponents reflect the success of our message, and I think we are 
scheduled to have a vote next week, which I think America needs to 
focus on and bring their attention to.
  Again, I want to thank you for doing this again today, and I think we 
are going to have some other time this week to talk about this again.
  Mr. GUTKNECHT. Mr. Speaker, I thank the gentleman; and hopefully 
tonight we are going to have another bipartisan opportunity to come 
together, Republicans, Democrats, Independents, conservatives, 
liberals, and talk about this.
  Let me just share, I have a lot of heroes. We all have heroes, but I 
want to talk about one in particular. Her name is Kate Stahl. Kate 
Stahl is 84 years old. She is a very active member of the Senior 
Federation back in Minnesota, and she was quoted in a recent copy of 
U.S. News and World Report, and the quote is, I would like nothing 
better than to be thrown in jail.
  She is a self-described drug runner. She helps people find affordable 
medications, in Canada principally, but she will also look other 
places. She goes on-line. She helps them buy drugs. She takes them up 
to Winnipeg to buy drugs. Kate Stahl is not a common criminal. She is 
an American hero.
  One of the statistics I have come across and one of the reasons I 
fight so aggressively on this issue, there was a study done recently by 
the Kaiser Foundation, and I checked this out because I spoke to the 
community pharmacists a few months ago. The study said that 29 percent 
of seniors say that they have had prescriptions that have gone unfilled 
because they could not afford them.
  So when I spoke to the community pharmacists a couple of months ago, 
I asked them the question, have you ever had the experience where a 
senior comes in, or it does not even have to be a senior, it can be a 
mother or father comes in with a prescription, hands it to you and you 
tell them how much the prescription is going to cost and they take a 
deep breath and they drop their head and they say, well, maybe I will 
be back tomorrow and they never come back? Shame on us. Shame on us.
  These drugs are available today in other industrialized countries for 
a fraction of what we pay, but they have something we do not have. They 
have parallel marketing or parallel trading in Europe, and they allow 
the pharmacists to literally shop where they can get the best price, 
whether it is for Coumadin or Synthroid or whatever it happens to be, 
and, as a result, they have affordable drugs.

                              {time}  2245

  It really is time for us to open up markets, because markets work. 
Again quoting Ronald Reagan, ``Markets are more powerful than armies.'' 
We have to open up markets. We have to have some competition. And if we 
do that, we will have more affordable prescription drugs, not just for 
seniors but for moms and dads, families, and for small businesses.
  Mr. Speaker, I yield back to my friend from Michigan because he has 
been a champion of small businesses, and particularly a champion for 
small businesses. He has seen what is happening to manufacturing and 
one of the reasons for the cost of health care. Perhaps he wants to 
talk a little about why this does matter whether you are a senior 
citizen or a manager of a small manufacturing plant.
  Mr. HOEKSTRA. Mr. Speaker, I thank my colleague for yielding. So much 
of the debate has been about ensuring that seniors have access to 
health care, and that is important, that they have access to affordable 
health care. But what has been lost in the debate, and my colleague 
from Illinois brought this up briefly before he left, was that small 
businesses and others are struggling with the cost of health care.
  When a small business is expected to pay these kinds of prices that 
are double or triple what would be paid in Canada, what happens is, and 
it is not too difficult to figure out, the health care cost for a small 
business in Canada that is paying $33 for a prescription and a company 
in Michigan that is paying $100 for that exact same prescription, and 
prescriptions are becoming a much greater percentage of the total cost 
of health care, well, naturally, the insurance costs are going to be 
higher for that company in the U.S. than what they are in Canada.
  In the manufacturing sector today, companies are competing on the 
basis of pennies. If I can make this widget for a few cents less in 
Canada or in Europe versus the U.S., guess what, I am moving. That is 
how competitive the market is. Markets work. Sources of supply shift. 
And so, in effect, not only are we subsidizing the health care costs in 
Canada and in Europe for the seniors, our businesses and our workers 
carry this additional burden of increased health care costs. Our 
companies and our workers in America are subsidizing the very workers 
that they have to compete with in Canada and in Europe based on health 
care.
  Our workers not only have to be productive enough to cover the cost 
of their own health care, but they also are picking up a part of the 
health care cost of the very people that are trying to put them out of 
work each and every day in Canada, in Europe, and, as my colleague 
likes to refer to them, the starving Swiss. Those are the folks our 
people are competing against each and every day, and they are now being 
asked to pick up part of the burden for their health care costs. It is 
absolutely outrageous.
  Manufacturing is under assault in the U.S. Talk to a small 
businessperson today and the first thing they will bring up is the 
competitive nature of the market that they are in. There is no safe 
market any more. It is not like we found our niche; we are going to 
have a good year. Competition is tough each and every day, and they 
have to go out and fight to get a customer and to keep a customer.
  The second thing they will say is that the fastest rising cost in our 
business is health care. And a big component of it is that they are 
paying more so that Canadian companies and Canadian workers can get 
their health care cheaper. There is no reason why mom and dad, who go 
to work during the day and want to raise their family, that while they 
are working they are subsidizing the health care costs of competitors 
across and outside of our borders.
  This is one of the things that we need to deal with as we try to 
resurrect and strengthen manufacturing in the U.S. This is one small 
step, but it has to take place. We have to equalize those health care 
costs.
  Mr. GUTKNECHT. Reclaiming my time, Mr. Speaker, the gentleman is 
absolutely correct. I have been astonished at the response by some of 
the people here in Washington. We all claim to be very concerned with 
the fact that we have lost over 2 million manufacturing jobs in the 
last 4 years; and some people are saying, well, the answer is more 
government programs; and some people say, well, the answer is tax cuts. 
But here is an idea that if

[[Page 18189]]

we are right, and I think we are, and I think the evidence supports 
this, that we can save at least $630 billion.
  Now, if you want to allow Americans to keep and spend $630 billion of 
their money, here is a good place to start; and it does not cost the 
Federal Treasury a dime. It just begins to equalize, so no longer will 
American consumers and American taxpayers be subsidizing the health 
care cost of the rest of the world.
  And I just want to come back to one point, because people do not 
realize, and the gentleman from Illinois (Mr. Emanuel) started talking 
about this, we subsidize the pharmaceutical industry in three separate 
ways. First of all, we subsidize them in the tax codes because they get 
very generous tax benefits for what they do on research and so forth. 
They get to write off at least 50 percent. In many cases, they get a 
dollar-per-dollar tax reduction in the form of tax credits.
  Secondly, we subsidize them in the amount we spend on research. This 
year, and I am proud of this fact, we will spend about $27 billion in 
taxpayers' dollars through the NIH, the National Science Foundation, 
actually through the Defense Department. We spend an awful lot of money 
on research which ultimately benefits the pharmaceutical industry. With 
the drug tax laws, for example, we spent almost $.5 billion taxpayer 
dollars developing Paxil. Then we licensed that drug to a 
pharmaceutical company and they went out and sold $9 billion worth of 
Paxil to the market. Even though we took it all the way through phase 2 
trials at taxpayer expense, they have sold $9 billion and they paid us 
a royalty of $35 million.
  Finally, we subsidize the pharmaceutical companies in the prices we 
pay. As the gentleman said, I think we ought to subsidize the people in 
sub-Saharan Africa, but I think the time has come to say we will no 
longer continue to subsidize the starving Swiss.
  Mr. HOEKSTRA. If my colleague will yield, Mr. Speaker, I think this 
is a very, very critical point. We are fighting in a world economy for 
every job. Every American worker faces not only competition, but in 
Michigan we face competition from Wisconsin, Illinois, Minnesota, and 
Ohio, each and every day. And each and every day they fight competition 
from Canada, from Europe, and the Far East.
  Now, not that long ago we had a plant close in my hometown and move 
to Canada. One of the reasons they moved was due to the ridiculous 
sugar subsidy we have here that inflated the price of sugar in the U.S. 
The other reason was that the cost of labor, which includes the cost of 
health care and other benefits, was higher in the United States. And so 
not only is it that health care costs more here, it is because the 
workers here were covering their own health care and paying a portion 
of the health care costs for the very people that ended up putting them 
out of a job.
  We are subsidizing other companies to compete against U.S. 
manufacturers and U.S. workers. We cannot lose that point through this 
debate. It is absolutely critical that the American people need to 
recognize that when we are paying triple or four times the prescription 
drug prices in the U.S. versus what they are paying in other countries, 
it is the U.S. worker who is subsidizing foreign workers who are trying 
to take their job each and every day. That is why this is absolutely so 
critical.
  The gentleman and I have been here for a period of time, and we are 
always talking about free trade. Let us have free trade. Because we 
say, hey, competition works. But when it comes to this area where it is 
so clear that competition would work, because we have this discrepancy 
between Detroit and Windsor, where all we have is a river with a bridge 
over it and a tunnel underneath it, and you have to go a couple of 
miles and you can save 70, 60, 50 percent, yet we will not let them do 
it, that tells us that there is something wrong.
  Mr. GUTKNECHT. And we should do something about it.
  Mr. Speaker, we have been joined by our friend, the gentleman from 
Vermont, someone who has been in these trenches fighting this battle I 
think for even longer than I have.
  Mr. HOEKSTRA. And if the gentleman will yield briefly, I just have to 
say that I do believe this will be the first time that I have ever been 
joined on a Special Order by my colleague from Vermont. So welcome.
  Mr. GUTKNECHT. Mr. Speaker, I yield to the gentleman from Vermont.
  Mr. SANDERS. Mr. Speaker, I thank the gentleman for his leadership on 
this issue. I think what is very interesting on this issue is that we 
are finding people from different philosophical perspectives, 
Republicans, Democrats, Independents, Conservatives, Progressives, 
Liberals, Moderates, coming together and making one very strong point. 
And while our analysis may be different, the bottom line that we all 
agree on is that it is simply unacceptable that the people of the 
United States year after year are forced to pay by far the highest 
prices in the world for prescription drugs, many of which are 
manufactured right here in this country.
  As the gentleman from Minnesota knows, several years ago I took some 
of my constituents, and I was the first Member of Congress to do that, 
and being in Vermont we are right near the Canadian border, so we went 
from Franklin County, northern Vermont, over the border, and we had 
with us a number of women who were struggling with breast cancer, a 
terrible illness. They were able to purchase, and the gentleman has it 
right in his hands, a widely prescribed breast cancer drug called 
Tamoxifen.
  These women could not believe their eyes when they ended up paying 
one-tenth the price, 10 percent of the price, in Montreal than they 
were paying in the State of Vermont.
  Now, my view is that the time is long overdue for the Members of the 
United States Congress, Republicans, Democrats, Independents, to stand 
up to what I believe is the most powerful lobby in the history of our 
country. The pharmaceutical industry has spent hundreds of millions of 
dollars fighting every effort here in Congress. No matter what the idea 
is, they have fought it.
  My understanding now, and my colleague can correct me if I am wrong, 
is that they are running ads all over the country against the concept 
of reimportation. They are lying about people's political beliefs. They 
are putting up and funding phony front organizations to represent their 
interests. And the point to be made, in my view, is that it is absurd 
that year after year, when the pharmaceutical industry leads all other 
industries in the profits that they make, when they have enough money 
to pay their CEOs exorbitant compensation packages, when they have 
enough money to have over 600 paid lobbyists, and, my friends, there 
are only 435 Members of the House, yet they have 600 lobbyists, former 
leaders of the Republican Party, former leaders of the Democratic 
Party, they are besieging the institution, that we cannot walk the 
hallways without bumping into a representative of the pharmaceutical 
industry telling Members of Congress, please, do everything you can to 
make sure that Americans continue to pay the highest prices in the 
world.
  The last point I would make, and my friend from Michigan touched on 
this issue, I happen not to be an advocate of free trade. I think free 
trade in the last number of years has been a disaster for American 
workers, et cetera. But for all of those people in Congress, a majority 
of people, who think that it is okay to bring in products from China, 
to bring in vegetables from Mexico and Latin America, to bring in beef 
and pork bellies from Canada, if all of that is okay, how come we 
cannot bring FDA safety-regulated prescription drugs from Canada, which 
has a regulatory system quite as strong as the FDA? I would love our 
colleagues to tell me that answer.
  Mr. GUTKNECHT. Well, if the gentleman will yield back, that is the 
question I asked my colleagues and that is how I got involved in this 
debate. I always tell people I feel like the little boy who came in and 
asked his mother a question, and his mother was

[[Page 18190]]

busy. She said go ask your dad. And he said, well, I did not want to 
know that much about it.
  The more I have learned about this, the more pernicious this thing 
is. But what really got me involved was several years ago on behalf of 
my pork producers, when the price of hogs dropped from about 37 cents a 
pound down to about 9 cents a pound, 8 cents a pound, my hog producers 
started calling me saying, Congressman, can you not do something about 
this? I said, I do not know what I can do. They said, at least can you 
stop the Canadian hogs from coming into the American market making our 
situation even worse, making the supply and demand thing even worse? 
Can you do something about the Canadian hogs, at least stop them?
  So I called the Secretary of Agriculture and I called the Secretary 
of Commerce and I got essentially the same answer. They said, well, 
that is called NAFTA. It is called free trade. All of a sudden a light 
bulb went on above my head. I said, wait a minute, we have free trade 
when it comes to pork bellies and blueberries, but we do not have free 
trade when it comes to Tamoxifen? The one area where Americans could 
save billions.
  Mr. SANDERS. That is amazing.
  Mr. GUTKNECHT. Billions. And that is when I began to move. As Winston 
Churchill once said, ``The difference between a fan and a fanatic is, a 
fanatic is one who cannot change their mind and will not change the 
subject.'' I have become a fanatic on this, and we will not step down.

                              {time}  2300

  Mr. HOEKSTRA. Mr. Speaker, the interesting thing that the gentleman 
from Minnesota (Mr. Gutknecht) is talking about, if you are buying pork 
or hog bellies from Canada, they were raised and grown in Canada and 
exported to the U.S.
  These drugs that we are talking about shipping into the U.S. were 
probably made in the U.S. under the FDA, they were shipped to Canada, 
and this is kind of a reverse NAFTA. We are shipping this stuff out, 
and they are selling it at these phenomenal discounts in Canada. Then 
the American consumer would like to buy American product back, and they 
are saying that it is too dangerous, illegal, and plus you will promote 
abortion.
  Mr. SANDERS. Mr. Speaker, common sense would dictate, is it not far 
more difficult to regulate the vegetables or the beef or pork that are 
raised on farms and ranches, what pesticides are they using, who knows, 
it is very difficult to regulate, but it is okay to import that product 
into the United States. But when you have prescription drugs 
manufactured in the United States and approved by the FDA, sent to 
Canada, approved by their regulatory system, all of a sudden we cannot 
regulate it. On the surface it is absurd and laughable, and anyone who 
makes that case should be laughed out of this institution.
  Mr. HOEKSTRA. Not only on the surface is it ridiculous, but as we 
peel the onion, it gets even more absurd. They say that these are 
Canadian drugs, who knows where they manufactured. No, they were not 
manufactured in Toronto. These things were manufactured, produced in 
our own factories.
  Mr. SANDERS. The gentleman from Indiana (Mr. Burton) and I did a 
study. We requested of the CRS to take a look at the Canadian 
prescription drug regulatory system. We are not dealing with some Third 
World in Canada. What the CRS told us is that the Canadian prescription 
drug regulatory system almost always is equivalent to the FDA in the 
United States, which makes the argument that the drugs coming in would 
be unsafe totally ridiculous.
  Mr. GUTKNECHT. Mr. Speaker, coming back to the abortion piece, if 
anybody knows what the rules are on the drug RU-486, it is the drug 
companies that make it. We talk about Canada and Mexico, we do not even 
mention Mexico in our legislation because we only talk about 
industrialized countries. We mention only the G-8 countries, countries 
that we know have very sophisticated methods of regulating the drugs. 
But let us come back to RU-486. That is what they are going after with 
some of the pro-lifers with that mailer. Here is what they know.
  Mr. HOEKSTRA. It is the pharmaceutical companies.
  Mr. GUTKNECHT. Exactly. It is all funded by the pharmaceutical 
companies. We know that, and we will be able to prove that within the 
next 72 hours.
  But let me come back to this point. They know the rules. You cannot 
get the abortion drug RU-486 with a prescription in the United States. 
You can only get it administered by a doctor in a hospital or in the 
doctor's office. In other words, he or she cannot write you a 
prescription and you get it filled at the pharmacy.
  The pharmaceutical industry knows that, and that is why this is such 
a bald-faced lie. In fact, they do not even go so far as to say you 
cannot even get it legally in Canada or Mexico. It is outlawed 
completely in those countries. Only the FDA has allowed the abortion 
drug.
  I do not think they should, but whichever side of the story you are 
on, stick to the facts. And if anybody knows the facts, it is the 
companies that produce it. It is not laughable. It is sad. I used to 
think of them as an ethical industry. No more. It is unethical. What 
they are doing is dishonest, and they deserve all of the spite that the 
consumers are beginning to heap upon their shoulders.
  Mr. SANDERS. Mr. Speaker, I am pro-choice. I am proud of it. I have 
always been, and I will always be. But for the pharmaceutical industry 
to lie about the pro-life people just shows the desperateness as to 
where they are. What they are nervous about and what this Special Order 
is about is people from different political parties coming together on 
behalf of the American people and saying, enough is enough, 
pharmaceutical industry, you cannot rip the American people off. I 
think we have them on the run, and if we keep our fiber and keep 
working together, we will win this effort.
  I want to thank the gentleman from Minnesota (Mr. Gutknecht) for his 
leadership efforts on this issue.
  Mr. HOEKSTRA. Mr. Speaker, I think what my colleagues have both 
alluded to is the dishonesty or questioning the motives of the 
pharmaceutical companies.
  My mom and my in-laws are mid-80s, and they take prescription drugs. 
They are paying four times what somebody in Canada or Europe will pay. 
How in the world can a drug company justify those numbers and say just 
the very simple fact of a border means if you need a life-saving 
prescription in Canada, it is going to cost you $17 and in the United 
States it will cost you $80?
  It is absolutely outrageous that that is what these folks are doing 
each and every day. For whatever reason, they are pricing people and 
seniors out of the market here in America. They go to bed at night 
feeling perfectly comfortable doing that and then throwing this garbage 
out there to justify it.
  We may differ on life, but you are absolutely right, the folks that 
developed RU-486 are the ones that are paying for the ads that say, how 
terrible, they are going to promote abortion. It is like, excuse me, 
you are the ones that came up with this drug.
  Mr. Speaker, I congratulate my colleague for leading the fight and 
being a staunch supporter on this and the gentleman from Vermont (Mr. 
Sanders) coming to join us tonight. I cannot wait until we have a vote 
on this. I think we are going to win in overwhelming fashion, and we 
are going to demonstrate that different parts of this Congress can come 
together and stand up for the consumers.
  Mr. GUTKNECHT. Mr. Speaker, I yield to the gentleman from Vermont 
(Mr. Sanders).
  Mr. SANDERS. Mr. Speaker, I want to thank the gentleman from 
Minnesota (Mr. Gutknecht) and the gentleman from Michigan (Mr. 
Hoekstra).
  There is no question that there are people in this country who are 
literally dying or suffering because they cannot afford the high prices 
that they are forced to pay in this country. It is not acceptable that 
an industry which is so wealthy and so profitable can continue to force 
Americans to suffer in that way.
  It excites me that we are coming together regardless of philosophy or

[[Page 18191]]

party to say enough is enough. I look forward to that vote. I think we 
have them on the run, and I think the literature that the gentleman 
showed is just an indication of how desperate and panicky they must be. 
I would say to the American people it is a sad state of affairs when an 
industry has to stoop to that level. I think Congress has caught up to 
them, and I think we are finally going to represent effectively the 
American people on this issue.
  Mr. GUTKNECHT. Mr. Speaker, we have had a very lively discussion. 
This is an important debate. Ultimately, it is about hundreds of 
billions of dollars that Americans pay and will be forced to pay if we 
do not do something about it. There is nothing in it for any of us 
except the satisfaction of doing what we believe is honestly right.
  I will close with the words of the American philosopher and country 
western singer Tom Petty, ``We won't back down.''

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