[Congressional Record (Bound Edition), Volume 149 (2003), Part 14]
[House]
[Pages 19543-19559]
[From the U.S. Government Publishing Office, www.gpo.gov]




                PHARMACEUTICAL MARKET ACCESS ACT OF 2003

  Mr. TAUZIN. Mr. Speaker, pursuant to House Resolution 335, I call up 
the bill (H.R. 2427) to authorize the Secretary of Health and Human 
Services to promulgate regulations for the reimportation of 
prescription drugs, and for other purposes, and ask for its immediate 
consideration.
  The Clerk read the title of the bill.
  The text of H.R. 2427 is as follows:

                               H.R. 2427

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Pharmaceutical Market Access 
     Act of 2003''.

     SEC. 2. FINDINGS.

       The Congress finds as follows:
       (1) Americans unjustly pay up to 1000 percent more to fill 
     their prescriptions than consumers in other countries.
       (2) The United States is the world's largest market for 
     pharmaceuticals yet consumers still pay the world's highest 
     prices.
       (3) An unaffordable drug is neither safe nor effective. 
     Allowing and structuring the importation of prescription 
     drugs ensures access to affordable drugs, thus providing a 
     level of safety to American consumers they do not currently 
     enjoy.
       (4) According to the Congressional Budget Office, American 
     seniors alone will spend $1.8 trillion dollars on 
     pharmaceuticals over the next ten years.
       (5) Allowing open pharmaceutical markets could save 
     American consumers at least $635 billion of their own money 
     each year.

     SEC. 3. PURPOSES.

       The purposes of this Act are as follows:
       (1) To give all Americans immediate relief from the 
     outrageously high cost of pharmaceuticals.
       (2) To reverse the perverse economics of the American 
     pharmaceutical markets.
       (3) To allow the importation of drugs only if the drugs and 
     the facilities where they are manufactured are approved by 
     the Food and Drug Administration, and to exclude 
     pharmaceutical narcotics.
       (4) To require that imported prescription drugs be packaged 
     and shipped using counterfeit-resistant technologies approved 
     by the Bureau of Engraving and Printing (technologies similar 
     to those used to secure United States currency).

     SEC. 4. IMPORTATION OF PRESCRIPTION DRUGS.

       Section 804 of the Federal Food, Drug, and Cosmetic Act (21 
     U.S.C. 384) is amended--
       (1) in subsection (a)--
       (A) by striking ``The Secretary'' and inserting ``Not later 
     than 180 days after the date of the enactment of the 
     Pharmaceutical Market Access Act of 2003, the Secretary''; 
     and
       (B) by striking ``pharmacists and wholesalers'' and 
     inserting ``pharmacists, wholesalers, and qualifying 
     individuals'';
       (2) in subsection (b)--
       (A) by amending paragraph (1) to read as follows:
       ``(1) require that each covered product imported pursuant 
     to such subsection complies with sections 501, 502, and 505, 
     and other applicable requirements of this Act; and'';
       (B) in paragraph (2), by striking ``, including subsection 
     (d); and'' and inserting a period; and
       (C) by striking paragraph (3);
       (3) in subsection (c), by inserting ``by pharmacists and 
     wholesalers (but not qualifying individuals)'' after 
     ``importation of covered products'';
       (4) in subsection (d)--
       (A) by striking paragraphs (3) and (10);
       (B) in paragraph (5), by striking ``, including the 
     professional license number of the importer, if any'';
       (C) in paragraph (6)--
       (i) in subparagraph (C), by inserting ``(if required under 
     subsection (e))'' before the period;
       (ii) in subparagraph (D), by inserting ``(if required under 
     subsection (e))'' before the period; and
       (iii) in subparagraph (E), by striking ``labeling'';
       (D) in paragraph (7)--
       (i) in subparagraph (A), by inserting ``(if required under 
     subsection (e))'' before the period; and
       (ii) by amending subparagraph (B) to read as follows:
       ``(B) Certification from the importer or manufacturer of 
     such product that the product meets all requirements of this 
     Act.''; and
       (E) by redesignating paragraphs (4) through (9) as 
     paragraphs (3) through (8), respectively;
       (5) by amending subsection (e) to read as follows:
       ``(e) Testing.--
       ``(1) In general.--Subject to paragraph (2), regulations 
     under subsection (a) shall require that testing referred to 
     in paragraphs (5) through (7) of subsection (d) be conducted 
     by the importer of the covered product, unless the covered 
     product is a prescription drug subject to the requirements of 
     section 505B for counterfeit-resistant technologies.

[[Page 19544]]

       ``(2) Exception.--The testing requirements of paragraphs 
     (5) through (7) of subsection (d) shall not apply to an 
     importer unless the importer is a wholesaler.'';
       (6) in subsection (f), by striking ``or designated by the 
     Secretary, subject to such limitations as the Secretary 
     determines to be appropriate to protect the public health'';
       (7) in subsection (g)--
       (A) by striking ``counterfeit or''; and
       (B) by striking ``and the Secretary determines that the 
     public is adequately protected from counterfeit and violative 
     covered products being imported pursuant to subsection (a)'';
       (8) in subsection (i)(1)--
       (A) by amending subparagraph (A) to read as follows:
       ``(A) In general.--The Secretary shall conduct, or contract 
     with an entity to conduct, a study on the imports permitted 
     pursuant to subsection (a), including consideration of the 
     information received under subsection (d). In conducting such 
     study, the Secretary or entity shall evaluate the compliance 
     of importers with regulations under subsection (a), and the 
     incidence of shipments pursuant to such subsection, if any, 
     that have been determined to be misbranded or adulterated, 
     and determine how such compliance contrasts with the 
     incidence of shipments of prescription drugs transported 
     within the United States that have been determined to be 
     misbranded or adulterated.''; and
       (B) in subparagraph (B), by striking ``Not later than 2 
     years after the effective date of final regulations under 
     subsection (a),'' and inserting ``Not later than 18 months 
     after the date of the enactment of the Pharmaceutical Market 
     Access Act of 2003,'';
       (9) in subsection (k)(2)--
       (A) by redesignating subparagraphs (D) and (E) as 
     subparagraphs (E) and (F), respectively; and
       (B) by inserting after subparagraph (C) the following:
       ``(D) The term `qualifying individual' means an individual 
     who is not a pharmacist or a wholesaler. ''; and
       (10) by striking subsections (l) and (m).

     SEC. 5. USE OF COUNTERFEIT-RESISTANT TECHNOLOGIES TO PREVENT 
                   COUNTERFEITING.

       (a) Misbranding.--Section 502 of the Federal Food, Drug, 
     and Cosmetic Act (21 U.S.C. 352; deeming drugs and devices to 
     be misbranded) is amended by adding at the end the following:
       ``(w) If it is a drug subject to section 503(b), unless the 
     packaging of such drug complies with the requirements of 
     section 505B for counterfeit-resistant technologies.''.
       (b) Requirements.--Title V of the Federal Food, Drug, and 
     Cosmetic Act (21 U.S.C. 351 et seq.) is amended by inserting 
     after section 505A the following:

     ``SEC. 505B. COUNTERFEIT-RESISTANT TECHNOLOGIES.

       ``(a) Incorporation of Counterfeit-Resistant Technologies 
     Into Prescription Drug Packaging.--The Secretary shall 
     require that the packaging of any drug subject to section 
     503(b) incorporate--
       ``(1) overt optically variable counterfeit-resistant 
     technologies that are described in subsection (b) and comply 
     with the standards of subsection (c); or
       ``(2) technologies that have an equivalent function of 
     security, as determined by the Secretary.
       ``(b) Eligible Technologies.--Technologies described in 
     this subsection--
       ``(1) shall be visible to the naked eye, providing for 
     visual identification of product authenticity without the 
     need for readers, microscopes, lighting devices, or scanners;
       ``(2) shall be similar to that used by the Bureau of 
     Engraving and Printing to secure United States currency;
       ``(3) shall be manufactured and distributed in a highly 
     secure, tightly controlled environment; and
       ``(4) should incorporate additional layers of non-visible 
     covert security features up to and including forensic 
     capability.
       ``(c) Standards for Packaging.--
       ``(1) Multiple elements.--For the purpose of making it more 
     difficult to counterfeit the packaging of drugs subject to 
     section 503(b), manufacturers of the drugs shall incorporate 
     the technologies described in subsection (b) into multiple 
     elements of the physical packaging of the drugs, including 
     blister packs, shrink wrap, package labels, package seals, 
     bottles, and boxes.
       ``(2) Labeling of shipping container.--Shipments of drugs 
     described in subsection (a) shall include a label on the 
     shipping container that incorporates the technologies 
     described in subsection (b), so that officials inspecting the 
     packages will be able to determine the authenticity of the 
     shipment. Chain of custody procedures shall apply to such 
     labels and shall include procedures applicable to contractual 
     agreements for the use and distribution of the labels, 
     methods to audit the use of the labels, and database access 
     for the relevant governmental agencies for audit or 
     verification of the use and distribution of the labels.''.

                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair would remind Members who are 
speaking to remove the yellow tags from their lapel.
  Pursuant to House Resolution 335, the gentleman from Louisiana (Mr. 
Tauzin) and the gentleman from Michigan (Mr. Dingell) each will control 
30 minutes.
  The Chair recognizes the gentleman from Louisiana (Mr. Tauzin).
  Mr. TAUZIN. Mr. Speaker, I ask unanimous consent that the gentleman 
from Minnesota (Mr. Gutknecht) be permitted to control 15 minutes of 
the debate time allocated to me.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Louisiana?
  There was no objection.
  Mr. DINGELL. Mr. Speaker, I ask unanimous consent that the gentleman 
from Ohio (Mr. Brown) be permitted to control 15 minutes of the time 
allocated to me.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.


                             General Leave

  Mr. TAUZIN. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days within which to revise and extend their remarks 
on H.R. 2427.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Louisiana?
  There was no objection.
  Mr. TAUZIN. Mr. Speaker, I yield myself 2\1/2\ minutes.
  Mr. Speaker, I join my colleague, the ranking member of our 
committee, the gentleman from Michigan (Mr. Dingell), in opposing this 
bill because it is dangerous.
  This week the gentleman from Michigan (Mr. Dingell) and I and all of 
the members of the Committee on Energy and Commerce had to face a 
horrible realization: This week we faced the parents of Steve Bechler, 
the 23-year-old pitcher for the Baltimore Orioles, who died of a heart 
attack at that young age taking ephedra tablets, tablets which we in 
1994 voted to exempt from FDA safety regulations. I have got that on my 
conscience now. In 1994, you and I decided, those of you who were here 
with me, that safety did not matter when it came to ephedra.
  Mr. Speaker, as the Justice Department criminal investigations are 
under way and as our own Committee's investigation is under way, we 
learned this week that over 17,000 serious events have occurred as a 
result of the use of unregulated ephedra; young athletes, young people, 
dying, suffering strokes, heart attacks, like Steve Bechler, because we 
voted in 1994 to say that safety did not count when it came to ephedra.
  And with this bill tonight, its authors I know well-intentioned, 
angry at the price of drugs in America, angry at Canada because they 
impose price controls that take advantage of our citizens, angry at 
those trade laws that let it happen, they are asking us tonight to do 
exactly what we did in 1994, to vote for a bill that says safety does 
not matter when it comes to drugs, that safety does not really count; 
that we are going to repeal tonight, if they get their way, the 
language that is in the law that says that FDA must certify the safety 
of any drugs that are imported into this country; to take away the 
language that says FDA must do those things appropriate to ensure that 
the drug supply in this country is never compromised; that bogus, 
counterfeit, diluted, old, rotten drugs are not permitted into this 
country.
  I voted wrong in 1994. I am not going to vote wrong tonight. I will 
never vote to compromise safety again in the use of drugs or products 
for our young people and our old people and our citizens.
  Tonight we will learn about those rotten drugs that are coming into 
this country from Canada, yes, and from a lot of other countries, 
transhipped through Canada. We will have the smoking gun for tonight to 
show what is about to happen if we open the door to that awful problem.
  I urge Members, vote against this bill.
  Mr. DINGELL. Mr. Speaker, I yield myself 3\1/2\ minutes.
  Mr. Speaker, this is a bad bill. On its face it would appear to be a 
good bill. It is not. It will allow this country to be flooded with 
unsafe, counterfeit

[[Page 19545]]

drugs; drugs that will not do what they should; drugs that are unsafe; 
drugs that will kill the American people. I tell Members, it is a bad 
bill, and I ask them to remember the experiences that were reported by 
my colleague from Louisiana.
  This bill would reduce the capacity of the Food and Drug 
Administration to protect our people from unsafe prescription 
pharmaceuticals, which will begin to flood the country if and when it 
is passed.
  H.R. 2427 is a prescription for trouble. They open our borders. They 
provide millions of Americans with access to perhaps drugs which are 
cheaper, but drugs which are unsafe and which evade the responsibility 
and the ability of Food and Drug to protect the American people.
  Mr. Speaker, do not take my word for that. Listen to what the health 
care professionals and regulators say.
  The American Medical Association says, ``We believe H.R. 2427 would 
be so dangerous to patient safety that we must oppose it. This 
legislation would eliminate most of the important restrictions on 
reimportation of pharmaceuticals in current law and replace them with a 
system of unverifiable and unsafe provisions.''
  The National Medical Association has said, ``This legislation would 
result in counterfeit, adulterated, and dangerous drugs entering the 
United States. We do not believe that H.R. 2427 should be enacted at 
the risk of jeopardizing patient safety.''
  The American Osteopathic Association says, ``H.R. 2427, while 
increasing the possible number of drugs reimported into the United 
States, does nothing to ensure the safety and efficacy of these drugs. 
There is no bargain to be found for our patients who purchase drugs 
that are ineffective or contaminated.''
  The Food and Drug Administration says, ``H.R. 2427 would authorize 
the importation of prescription drugs from foreign sources without 
adequate assurances that such products are safe and effective. H.R. 
2427 creates a wide channel for large volumes of unapproved drugs and 
other products to enter the United States that are potentially 
injurious to public health and pose a threat to the security of our 
Nation's drug supply. The bill would do so by taking unprecedented 
steps that limit FDA's authority to assure the safety of prescription 
drug products to be used by American consumers.''
  Mr. Speaker, this will enable foreign manufacturers to import into 
Canada for reimportation into the United States tons of counterfeit 
foreign drugs, drugs which are ineffective, over-age, unsafe, 
unregulated and improperly manufactured in ways which will offer 
threats to the United States, to our citizens and to the people who are 
looking to you to see to it that their food, drugs and cosmetics are 
safe.
  Mr. Speaker, let us look at it. Foreigners are going to use this 
device to enter Canada to sell unsafe drugs to the American people. Do 
not deceive yourself to think that any one of those importers will be 
bound by any requirements of American law or that they will, in fact, 
sell those drugs at less price. They will simply sell them at U.S. 
market prices, and you are going to have on your hands the possibility 
that you have voted to injure, sicken, hurt or kill the American people 
by allowing the importation of unsafe drugs.

                          Recent Counterfeits


                          Counterfeit Lipitor

       Lipitor, a cholesterol-lowering medicine, is used by 11 
     million Americans each year to help prevent serious heart 
     disease. Last month, according to FDA, a large quantity of 
     fake Lipitor entered the U.S. market. The product was 
     imported to the U.S. and repackaged here, for sale to 
     distributors and pharmacies. To date, FDA and Lipitor 
     manufacturer Pfizer have recalled 200,000 bottles of this 
     dangerous phony product.


                       Fake and Mislabeled Zerit

       Counterfeit Zerit, a medication to treat HIV infection, was 
     first discovered in 1997. According to the real manufacturer, 
     Bristol-Myers Squibb, this not only was not its authentic 
     product, but the labels incorrectly told consumers they were 
     taking 30 mg, when in fact the capsules inside the bottles 
     allegedly contained 40 mg of the active ingredient. Patients 
     were exposed both to a product of unknown origin and the 
     dangerous possibility of an overdose.


                          Phony Clarithromycin

       This antibiotic, called Biaxin, is used to treat infections 
     such as pneumonia, bronchitis, and ear infections--including 
     infections in children. Recently, according to the drug's 
     manufacturer, Abbott, counterfeit Biaxin, containing 
     absolutely no active ingredient, has been found in Russia 
     (where counterfeits make up 15 percent of the prescription 
     drug market). Because the legal system in Russia makes 
     pursuit and punishment of these counterfeiters difficult, 
     these dangerous products remain available in Russia as well 
     as for export to other lucrative markets like the U.S.


             Counterfeit Neurontin, Accupril, and Celebrex

       Counterfeits of these Pfizer products--Neurontin, for 
     seizures in children 3 and older and adults and for treating 
     shingles pain in adults; Accurpril, for high blood pressure; 
     and Celebrex, for treating debilitating arthritis pain--have 
     recently been found in California, at a company called NuCare 
     Pharmaceuticals. Laboratory analysis confirmed no active 
     ingredient in any of the tablets, which actually were 
     vitamins. Neither the origin of the bottles nor the 
     disposition of the original medications is known.


                              Fake Allegra

       Fexofenadine, an important active ingredient in products to 
     treat allergies, is sold under the name Allegra in the U.S. 
     Recently, security personnel of the product manufacturer, 
     Aventis, ordered Allegra from an internet site purported to 
     be based in the UK. The product shipped was one called 
     Telfast, a fexofenadine product sold in other countries, but 
     not approved by the U.S. FDA. Furthermore, a stick-on label 
     indicated an expiration date of 1/03; the product actually 
     had expired in 1/02. Finally, although the web site appeared 
     to be promising products from a ``safe'' country in the UK, 
     this product came not from the UK but from Vanuatu, an island 
     off the coast of New Zealand well known for businesses 
     trafficking in illegitimate prescription drugs destined for 
     the U.S.


                               Fake Losec

       Losec (omeprazole), a treatment for ulcers and other 
     gastric conditions, is sold in the U.S. as Prilosec. A 
     generic version of Prilosec is also on the market in the U.S. 
     Counterfeit Prilosec, according to its manufacturer 
     AstraZeneca, was manufactured in an underground facility and 
     distributed through an affiliated wholesaler. The 
     counterfeiter boasted that the copies were sufficiently 
     clever to avoid detection by the government and, in fact, 
     only AstraZeneca had the technical information necessary to 
     determine this product was a fake.


                          Counterfeit Monopril

       Fakes of this high-blood-pressure medication were 
     discovered earlier this year by the LA County Sheriff's 
     Office. The counterfeit operation was uncovered after a local 
     printing company contacted the sheriff to report a suspicious 
     order for thousands of drug product labels. The product, 
     vitamins substituted for the real pills, bottle caps, and 
     seals were all counterfeit. Arrested individuals were owners 
     of prescription drug diversion businesses in Canada, Europe, 
     and Asia. Many other drugs found in the LA raid were expired 
     or fake, then repackaged, relabeled, and sold to American 
     doctors and pharmacies.


                        Counterfeits from India

       According to FDA, an American patient ordered product from 
     an internet site promising ``Canadian drugs manufactured in 
     the U.S.'' The drug he appears to have needed was a seizure 
     medication called gabapentin. What he received was a knock-
     off from India, labeled ``Gabantin.'' What IS ``gabantin?'' 
     Only the counterfeiter in India, and the so-called 
     ``Canadian'' on-line pharmacy knows. The patient was the 
     unwitting dupe.


                          Counterfeit Procrit

       Epoetin alpha, marketed as Procrit, treats anemia in 
     patients with chronic kidney disease, HIV, and cancer. The 
     first discovery of counterfeit Procrit was made in 2002; 
     subsequent discoveries followed. The counterfeit, of unknown 
     origin, has been found at two large wholesalers and a number 
     of retail outlets. The counterfeit, some with 20 times less 
     active ingredient than the real drug and some with no active 
     ingredient but bacteria-contaminated water, appeared 
     identical with the authentic product. Sophisticated anti-
     counterfeiting technology used on this product failed to 
     challenge the ingenuity of the counterfeiters, who quickly 
     learned to mimic it.


              Fake Crixivan, Pepcidine, Zoroxin, and Zocor

       According to Merck, the manufacturer of these products, 
     substantial quantities of counterfeits were found in a police 
     raid on a home in Bogota, Columbia. In addition to these 
     products, the home possessed many other counterfeits. English 
     language labeling suggested the final destination for many; 
     unwary U.S. patients.

  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentlewoman 
from Connecticut (Ms. DeLauro), who knows that the drug industry 
imports

[[Page 19546]]

$15 billion worth of drugs into this country, but then claims that 
importation is unsafe in order to protect their profits.
  Ms. DeLAURO. Mr. Speaker, in my 13 years in Congress, no issue has 
made such a deep impression on my constituents than the rising price of 
prescription drugs. This is an issue for seniors, but high health care 
prices are eroding the living standards of middle-class families across 
this country. We all have a stake in driving drug prices down.
  Last week, the Congress of the United States abrogated its 
responsibility to address the problem of soaring drug prices. It did 
worse than nothing, barring the government from negotiating lower 
prices for seniors.
  We can strike a blow for lower prices with a simple step, giving 
ordinary Americans the choice they are taking on their own out of 
desperation. It should be legal to reimport drugs from some countries. 
This alone would save Americans $600 billion in the next decade, 
savings passed directly on to the consumer. We know that this is a safe 
option. In 2001, U.S. drug companies reimported $14.7 billion worth of 
brand name medications from their overseas plants.

                              {time}  0115

  This legislation guarantees safety. It not only requires that drugs 
reimported from other countries are FDA-approved, but that the 
facilities they are manufactured in are rigorously inspected and 
approved by the FDA as well. Add to that the requirement that all 
prescription drugs use counterfeit-resistant packaging, which means 
every drug purchased here in the United States, reimported or 
otherwise, will be safer than the drugs that are available today.
  The FDA's opposition is one more instance of a regulatory agency 
becoming captive of the industries they are supposed to regulate. There 
is no safety issue here. This bill would only allow the importation of 
FDA-approved drugs manufactured in FDA-approved facilities from 26 
designated countries, clearly, a superior system to what we have today 
in the area of food and drug safety both.
  The issue is not safety, I say to my colleagues. The issue is price. 
It is time that this Congress stop acting as a wholly owned subsidiary 
of the pharmaceutical companies and step up to its responsibility to 
help the consumers of this Nation.
  I urge my colleagues to support this bill.
  Mr. GUTKNECHT. Mr. Speaker, I just want to clarify real quickly that 
nothing in this bill deals with controlled substances like RU486 or 
morphine, and nothing in this bill would have anything to do with 
Ephedra.
  Mr. Speaker, I am happy to yield 1\1/2\ minutes to the gentlewoman 
from Missouri (Mrs. Emerson).
  Mrs. EMERSON. Mr. Speaker, I want to thank the Speaker of the House 
for his graciousness in letting us bring this bill to the floor for 
debate tonight.
  And speaking of the leadership in the House, I thought it would be 
important to all my colleagues for a little clarification. We hear talk 
about the FDA blasting the Gutknecht bill, saying that it is unsafe. I 
want my colleagues to know, and it is very important that they know, 
that in 2000 when we passed the reimportation language that is current 
statute, that language was written, that statute was written by our 
leadership, by a person who is now working at the White House, by me, 
and by the FDA.
  My colleagues might remember it passed in the Agriculture 
appropriations act. The FDA chose the 26 countries where it felt it was 
safe to import from those countries, because our current drug 
manufacturers, U.S. manufacturers, are today manufacturing drugs in 
those facilities that are approved and inspected by the FDA.
  It is very important that my colleagues know this. This is the 
underlying bill of Gutknecht. Plus, we have added extremely high-tech 
packaging, tamper-resistant, counterfeit-proof packaging. And this is 
in addition to the safety requirements, the chain of custody that the 
FDA has written in the underlying bill today.
  Mr. TAUZIN. Mr. Speaker, I would point out that the packaging is held 
by a single company and the bill they have mandates a monopoly. We 
ought never do this in this country.
  Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Florida 
(Mr. Bilirakis), the chairman of the Subcommittee on Health of the 
Committee on Energy and Commerce.
  Mr. BILIRAKIS. Mr. Speaker, this dangerous bill is a legislative 
Trojan Horse that uses a promising veneer to hide dangerous realities.
  I do not have the time to go into all of the reasons why I personally 
am opposing this legislation, but I want to remind my colleagues that a 
number of patient advocate organizations dedicated to the health and 
well-being of our constituents, including the ALS Association, the 
National Alliance for the Mentally Ill, and the Friends of Cancer 
Research, and this long list here, and so many others that will not fit 
on this chart, are joining me in my opposition tonight. They, they 
consider the issue safety. They consider the issue safety.
  Also, the bill, in addition to the devastating impact on patient 
safety, would adversely affect the ability of our research-driven 
pharmaceutical and biotechnology industries to develop breakthrough 
cures for a myriad of devastating diseases.
  Many of the solutions to high pharmaceutical prices have already been 
considered on this floor. They include a meaningful Medicare 
prescription drug benefit and Hatch-Waxman reforms to ensure quicker 
access to less costly generic drugs. We also need to find a way to 
reduce the number of Americans without health insurance. In fact, I 
recently introduced a bill that would attempt to do just that.
  Mr. Speaker, this is a bad bill. It will do more harm than good. I 
urge my colleagues to do the responsible, the responsible and not the 
political thing, and that is to defeat H.R. 2427 tonight.
  Mr. DINGELL. Mr. Speaker, I yield 1 minute to the distinguished 
gentleman from New York (Mr. Towns), my good friend.
  Mr. TOWNS. Mr. Speaker, this is a bad bill. If we vote for this 
legislation tonight, we are kissing safety regulations good-bye and 
saying to patients, fend for yourselves in determining what drugs are 
safe. The FDA will have no oversight responsibility here.
  I will admit that I am not qualified to determine what drugs are 
safe. It takes expertise to distinguish between counterfeit medicines 
and the genuine article. We rely on our government's health and safety 
officials like the Food and Drug Administration to keep unsafe drugs 
out of American medicine cabinets.
  It is a mystery to me why anyone would vote for a bill that would 
prevent our health officials from doing their job. That just blows my 
mind. And it is a giant step in the wrong direction.
  I ask all of my colleagues here tonight to vote against this bill 
because safety is a nonpartisan issue. The life you save might be your 
own.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2\1/2\ minutes to the 
gentlewoman from California (Ms. Lee), who knows the drug industry 
profits for 20 years running are the highest of any industry in 
America.
  Ms. LEE. Mr. Speaker, let me just thank the gentleman for yielding me 
this time, and I thank all of my colleagues on this side of the aisle 
and also our colleagues on the other side of the aisle, especially the 
gentlewoman from Missouri (Mrs. Emerson) and the gentleman from 
Minnesota (Mr. Gutknecht) for leading this very important fight for 
more affordable prescription drugs.
  Mr. Speaker, I want to start off tonight by sharing with my 
colleagues the news from a study which was featured today in the Wall 
Street Journal. Now, this article begins, ``Black Medicare 
beneficiaries are more than twice as likely as white beneficiaries to 
go without a prescription drug because they could not afford it.'' This 
is a study conducted by the Robert Wood Johnson Foundation. Let me 
repeat: African Americans are two times more likely to go without 
needed medicine.
  Now, this study goes on to detail the deep disparities in access to 
drugs, reporting that fully 16 percent of black

[[Page 19547]]

recipients of Medicare said they could not afford to fill at least one 
prescription in 2001 compared with 7 percent of whites.
  Mr. Speaker, make no mistake, African Americans are suffering 
disproportionately and mightily under the current laws crafted to 
protect the drug companies and their inflated prices. And make no 
mistake, that the suffering will only get worse if we do not pass this 
bill. And the suffering will last for as long as there is this huge, 
and I cannot believe this huge, resistance to efforts to reduce the 
skyrocketing and irrational cost of these lifesaving medicines.
  The reality for African Americans and millions of Americans on 
Medicare is outrageous and shameful, but we have the option tonight to 
do something about it. We should and we must seize this opportunity to 
provide lifesaving medicine to millions of Americans who are going 
without, simply because they cannot afford the bloated costs of drugs. 
And we should do so by voting to allow, as this bill does, safe, FDA-
approved prescription drugs to be reimported into the United States.
  Now, much has been said about safety and logistics of reimportation, 
and I think it is very important to point out that the FDA-approved 
drugs are already frequently and legally imported into this country, 
but only by the manufacturers. It is also important to note that more 
than 1 million Americans already purchase their medicines from outside 
the United States, and there has not been one reported death or illness 
from Americans taking such products.
  Mr. Speaker, the simple fact is that seniors' drug costs increased 44 
percent between 2000 and 2003, with the top 50 drugs prescribed to 
seniors increasing in cost by 3.5 times the rate of inflation in the 
last year.
  The simple fact is, Americans pay 30 to 300 percent more for 
medicines than do people in other industrialized countries. We should 
pass this bill tonight.
  Mr. GUTKNECHT. Mr. Speaker, I am happy to yield 1 minute to the 
gentleman from Connecticut (Mr. Shays), the author of the Shays act.
  Mr. SHAYS. Mr. Speaker, I thank the gentleman for yielding me this 
time.
  The debate tonight to allow the reimportation of FDA-approved drugs 
is obviously long overdue. The arguments that Americans will be put at 
risk and the pharmaceutical industry will be harmed is specious and 
reminds me of the debate on the use of generic drugs that we had years 
ago in States throughout America.
  Like the reimportation of drugs, the use of generic drugs was illegal 
and stayed that way for years and years because the pharmaceutical 
industry opposed it. Like the reimportation of drugs, we were told, 
generic drugs would harm the pharmaceutical industry and endanger 
individual Americans. Fortunately, we did not listen to those false 
arguments then, and we should not listen to them now, as they relate to 
the importation of FDA drugs. If Canadians, Germans, and others have 
the ability to buy FDA-approved drugs at a fraction of the cost, then 
Americans in this day and age should have the same opportunity.
  Please vote for H.R. 2427, the Pharmaceutical Market Access Act.
  I thank the proponent, the gentleman from Minnesota (Mr. Gutknecht) 
and others, for their efforts and the House leadership for bringing 
this bill before the chamber.
  Mr. TAUZIN. Mr. Speaker, I am pleased to yield 1 minute to the 
gentleman from Pennsylvania (Mr. Greenwood), the distinguished chairman 
of our Subcommittee on Oversight and Investigation.
  Mr. GREENWOOD. Mr. Speaker, I thank the gentleman for yielding me 
this time.
  We all want safe and affordable drugs, especially for our senior 
citizens. And in recent years, as the price of drugs skyrocketed and 
seniors were without a benefit through Medicare, they became desperate, 
and many considered it a calculated risk to buy drugs from other 
countries that were not certified safe by the FDA; and this 
reimportation legislation grew from that desperation. But today we are 
on the verge of providing seniors affordable and safe drugs through 
Medicare. It will happen this fall.
  The reimportation bill is now an unnecessary relic. We do not have to 
trade off safety for affordability. We can offer our seniors both 
through Medicare, and we ought to.
  The risk is real. The gentleman from Florida (Mr. Deutsch) and I have 
been to airports and watched these packages come through, opened up by 
the Customs people, and what we saw would turn your stomach. Drugs 
coming from countries all over the world where there is no regulation, 
drugs that have incalculable content, unknowable safety. We do not need 
to put our seniors at that risk.
  Mr. DINGELL. Mr. Speaker, I yield 2 minutes to the distinguished 
gentlewoman from California (Ms. Eshoo).
  Ms. ESHOO. Mr. Speaker, I thank the distinguished ranking member for 
yielding me this time.
  I rise in opposition to H.R. 2427. Mr. Speaker, I think it is very 
important for everyone in the House to really understand exactly what 
this bill will do.
  Some think that drug reimportation will dramatically reduce drug 
costs in the United States. This has never been proven. Secretaries of 
Health and Human Services for two Presidents have stated that they 
could not certify that reimportation would actually save Americans 
money.
  Now, minus this guarantee that the bill would ever achieve its 
primary purpose, I think we are taking huge risks for little or no 
gain.
  Secondly, the bill is dangerously flawed and poses considerable risks 
to the people that we represent. Current law states that the Secretary 
of HHS must certify that reimportation will not add risks to the public 
health. This bill removes that requirement, effectively eliminating our 
last line of defense against unsafe and illegal pharmaceuticals.
  The bill expands reimportation to 25 countries, many of which do not 
have the regulatory regimes that even remotely, remotely match the FDA.

                              {time}  0130

  This is very different from ``Canada only.'' We have the safest drug 
supply in the world today, and Americans rely on this safety every day. 
Do we really want to dilute this?
  The sponsors of 2427 have said the bill contains numerous provisions 
that will ensure that drugs reimported into our country are safe. I 
disagree. The bill purports to only allow reimportation of drugs made 
in FDA-approved factories, but the bill also eliminates the 
requirements that reimporters demonstrate who has had custody of a drug 
since its creation. Now, how can we verify that a drug is made in an 
FDA-approved facility if we do not even know who had custody of it 
last?
  The bill requires reimporters to test the drugs they are bringing 
back into the United States to ensure they are legitimate. The results 
of those tests are to be verified by the FDA. Is there an appropriation 
to this bill to fund the added mandate to the FDA? There is not.
  The bill requires counterfeit-proof packaging for many of the drugs 
that will be reimported to the United States. And yet there is not any 
guarantee that the counterfeit technology itself will not be 
counterfeit or tampered with. This is happening in the United States 
today as we debate this bill. This is an example of a hologram that has 
been tampered with. You and I would not know the difference. The FDA 
would. My mother would not.
  We have to remember that nearly 20 years ago the gentleman from 
Michigan (Mr. Dingell) introduced and passed the prescription drug 
marketing law. He did so on the heals of a multiyear investigation by 
oversight and investigations of the Committee on Commerce. We should 
not give up this safety. What my fear is is that we have so taken for 
granted the efficacy of pharmaceuticals that we are willing to let it 
go tonight. Vote against this bill.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman 
from Arkansas (Mr. Berry), who knows that a Federal Government that 
says it can store nuclear waste for 10,000 years can surely ensure the 
safety of imported prescription drugs.

[[Page 19548]]


  Mr. BERRY. Mr. Speaker, I am the only registered pharmacist in this 
Congress. And I know what I am talking about.
  Now, do not confuse safety with the fact that FDA many times just 
simply does not do its job. Let me tell you what the real danger is. 
The danger is not getting or not being able to afford the medicine you 
have to have to stay alive, stay healthy, and have a decent life-style. 
That is danger.
  Now, this safety deal is bogus. I am not even going to tell you how 
bogus it is. On the front page of Roll Call this morning it says, ``The 
Food and Drug Administration has formed an unofficial alliance with the 
pharmaceutical industry to urge House Members to vote today against a 
bill that could flood the Nation with cheap prescription drugs from 
Canada and overseas.''
  Now, would that not be a tragedy, that our people could afford the 
medicine that they need? This is a classic, cynical example of crony 
capitalism. An alliance between the Food and Drug Administration has 
existed for many years, and the pharmaceutical industry makes them 
nothing better than common thieves. And if you vote against this bill 
tonight, just think about what you are going to tell your constituents 
when you go back and say, I voted to keep your medicine five times more 
expensive than any place else in the world. I voted to let the 
pharmaceutical industry continue to rob the old people in this country. 
You go back and tell them that.
  What I have seen here this evening makes me think of that old 
Southern philosopher, Brother Dave Gardner, who said when you get 
people down, kick them. It gives them an incentive to rise above 
themselves.
  We were charged by our Founding Fathers with this responsibility, and 
we will be judged by God Almighty as to how we do it.
  Mr. TAUZIN. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I would point out that both the American Pharmacists 
Association and the Arkansas Pharmacists Association have sent letters 
in strong opposition to this bill.
  Mr. Speaker, I yield 1 minute to the gentleman from Indiana (Mr. 
Buyer).
  Mr. BUYER. Mr. Speaker, I am quite bothered that someone would 
actually come to the floor and denigrate the great minds of the world 
that come to the only free market, America. And these individuals 
improve the quality of our life, not only just us, but around the 
world. This debate needs to be elevated, elevated, because other 
countries out there who call themselves friends of America are taking 
advantage of those manufacturers. This is a serious trade issue, and we 
think we can only address it by addressing price? I do not know where 
you all went to school. You cannot address it just on price.
  This is safety. We have a closed system. When you take that pill, you 
have trust and confidence that it will do exactly what the label will 
say.
  Somebody brought up the issue of chain of custody. When those drugs 
end up, and we create a very wide berth and a very wide channel for 
drugs, we lose that chain of custody. We do not know what it is going 
to do. You can go to Canada, but it will not have the labeling. This is 
very serious.
  Mr. DINGELL. Mr. Speaker, I yield 2\1/2\ minutes to the distinguished 
gentleman from New York (Mr. Meeks).
  Mr. MEEKS of New York. Mr. Speaker, as we enter this late night, I am 
reminded of a show: Things that make you say hmmm. When I think of just 
the title of this bill and what is referred reimportation of drugs, I 
say hmmm.
  Reimportation tries to give the implication that the drugs were 
manufactured here, gone over, and they are coming back here so, 
therefore, they are safe. If the issue of safety were not there, what 
would we be talking about? We are really talking about the 
reimportation of drugs from many a different country. The FDA, if you 
just look up at the Web site of the FDA, over the last 5 years they 
have only inspected labs, labs over the last 5 years. Yet, we say 
safety is not an issue.
  My esteemed colleague from Illinois talked earlier. He said he spoke 
with the former Secretary of the FDA, Donna Shalala; and she said if 
the FDA had additional money, maybe they could do this. Well, as 
indicated, there is no additional appropriations here because the 
implication is if the FDA does not have the money, they cannot ensure 
safety of the medicine.
  What money will go to the FDA? There is no appropriations to this 
bill.
  Just recently there was a situation that occurred in Florida where 19 
individuals were indicted for distributing millions of dollars of 
counterfeit cancer, AIDS and other drugs. It occurs all over this 
country. If H.R. 2427 were to pass tonight, this is exactly what the 
Congress would be encouraging. Yes, we would be encouraging counterfeit 
drugs, improperly stored drugs, expired drugs, diluted products to 
enter our borders and to be distributed by qualified individuals, who, 
when I read the bill, qualified individuals, who they are? They have 
added, qualified individuals can bring this in, but there is no clear 
definition of who those qualified individuals are.
  Supporting this bill suggests that health and safety warnings, I 
present, are simply myths. I beg to differ.
  I have two pills in my hands. Distinguish between an authentic pill 
and a counterfeit pill. I ask anybody to just tell me how you, not 
experts, can determine which is the real one and which one is the 
counterfeit.
  Mr. DINGELL. Mr. Speaker, how much time remains?
  The SPEAKER pro tempore (Mr. LaHood). The gentleman from Louisiana 
(Mr. Tauzin) has 9 minutes. The gentleman from Minnesota (Mr. 
Gutknecht) has 12\1/2\ minutes. The gentleman from Michigan (Mr. 
Dingell) has 5 minutes. The gentleman from Ohio (Mr. Brown) has 8\1/2\ 
minutes.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 1 minute to the gentleman 
from Vermont (Mr. Sanders), who recognizes that 270 Members voted for 
free trade for Singapore yesterday while many oppose free trade for 
prescription drugs for American today.
  Mr. SANDERS. Mr. Speaker, I became involved in this issue several 
years ago when I took women who were struggling with breast cancer 
across the border from Vermont and they were able to purchase the 
breast cancer drug Tamoxifen for one-tenth of the price that they paid 
in the United States. Mr. Speaker, tonight we must end the national 
disgrace of Americans being forced to pay by far the highest prices in 
the world for prescription drugs.
  Tonight, in terms of safety, we must understand that one million 
Americans have gone to Canada to buy their medicine without one death, 
without one problem. To the gentleman from Louisiana (Mr. Tauzin), yes, 
the death of one baseball player is a tragedy; but it is a far greater 
tragedy that millions of elderly people in this country are suffering, 
and in some cases dying, because they cannot afford prescription drugs. 
And the issue tonight is do we stand up to the money interests and 
protect the American people or are they going to buy the House of the 
people? Let us stand tall.
  Mr. GUTKNECHT. Mr. Speaker, I yield myself 15 seconds to respond.
  First of all, I hope Members would at least read the bill. We have 
heard a lot about safety tonight. This bill specifically includes 
section sections 501, 502, 505, which are the safety codes. As the 
gentlewoman from Missouri (Mrs. Emerson) said earlier, essentially the 
FDA wrote all the law that is here. Secondly, the FDA has inspected, 
this is the report, 949 facilities, all the way to China in the last 5 
years.
  Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. 
Hensarling).
  Mr. HENSARLING. Mr. Speaker, I rise tonight to appeal to my fellow 
conservatives to open markets and help seniors by supporting this act.
  Some critics say this act will merely import price controls. But 
every day in America we import a myriad of products from food to 
machinery that have some form of government price controls embedded 
within them, be they subsidy, tax preference or direct price controls. 
Yet we do not block their import even though their prices are not 
derived in a truly free market.

[[Page 19549]]

  The relevant question for us ought to be: are we working for more 
competition or less competition and whether or not we respect the 
economic liberties of our citizens.
  Now, other critics say this bill will cause less research and 
development. I am uncertain if this is true, but I do know that closing 
our borders to trade and denying Americans their economic liberties is 
not the answer. Typically, we let private individuals within a 
competitive marketplace make these R&D decisions. If we choose to 
second guess them and believe that they have underinvested, then 
Congress can easily remedy the situation by a variety of means, like 
tax credits and subsidies. This body does it every day, wind energy, 
aerospace technology, semiconductors, the list goes on.
  Finally, critics contend that seniors will be hurt by a rash of 
counterfeit imported drugs. Are thousands dying in Europe and Canada 
from fake drugs? Can counterfeit drugs not be produced domestically as 
well as overseas?
  Every year we import tons of food and occasionally this food may be 
tainted, yet we do not prohibit agricultural imports. Should 
pharmaceuticals be different?
  Perhaps the safety argument may have some merit, but I also know it 
is usually the first argument of the protectionist. Mr. Speaker, it is 
time for my fellow conservatives to choose. We can choose free trade 
over protectionism. We can choose to side with seniors' interests over 
pharmaceutical companies' interests. We can choose less government and 
more freedom. The choice is ours. And if there should be any doubts 
whatsoever, we should err on the side of freedom.
  Mr. TAUZIN. Mr. Speaker, I yield 1 minute to the distinguished 
gentleman from New Jersey (Mr. Ferguson), who knows the difference 
between a cancer drug and a strawberry.
  Mr. FERGUSON. Mr. Speaker, after the attacks on our Nation on 
September 11 when thousands of Americans died, many from my 
congressional district, what was our collective response in this House? 
What did we do? Did we decide to eliminate the safety and security laws 
of our Nation to make ourselves more vulnerable to those who would seek 
to do us harm? Of course not. We did the opposite. We strengthened our 
laws.

                              {time}  0145

  We strengthened our laws. We took steps to protect our citizens and 
we made America a safer place.
  Then why, I ask, at a time when we are at an increased danger of 
counterfeit and altered drugs, when we are having a tough time keeping 
up with attempts by criminals who want to smuggle dangerous, 
counterfeit drugs into this country, why would we then pass a law which 
would gut the current law of this Nation? Why would we pass a law that 
would eliminate 16 different health and safety regulations which are 
specifically designed to protect our citizens against these dangers?
  Unfortunately, that is exactly what this bill would do.
  Mr. DINGELL. Mr. Speaker, I am low on time and I would reserve.
  Mr. BROWN of Ohio. Mr. Speaker, could the Chair let us know how much 
time each of us has.
  The SPEAKER pro tempore (Mr. LaHood). The gentleman from Louisiana 
(Mr. Tauzin) has 8 minutes remaining. The gentleman from Minnesota (Mr. 
Gutknecht) has 10\1/4\ minutes remaining. The gentleman from Michigan 
(Mr. Dingell) has 5 minutes remaining. The gentleman from Ohio (Mr. 
Brown) has 7\1/2\ minutes remaining.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 30 seconds to the gentleman 
from Hawaii (Mr. Abercrombie) who knows the drug industry has 1.5 
lobbyists for every Member of this body.
  Mr. ABERCROMBIE. Mr. Speaker, this is about money, money, piles of 
money, oodles of money, tons of money. This is what this is about.
  You do not have to worry about safety because if you cannot afford 
the drug in the first place, you are not even going to get it to take 
it, and if you are a Democrat, a minority Democrat, and you do not vote 
for this bill, there is not any Democrat in the country that is not 
going to say you sold out and you rolled over belly up again and you 
are not standing up for the people of this country.
  We deserve to be in the minority if we cannot pass this bill. We are 
defying everything that makes us Democrats, and if you are a 
Republican, then they are going to say you are in the pockets of the 
big pharmaceuticals again and you are just acting like a Republican.
  If you are a Republican or Democrat, vote this bill through and save 
the integrity of this House.
  Mr. GUTKNECHT. Mr. Speaker, I yield 1 minute to the gentleman from 
Michigan (Mr. Hoekstra), who has the unenviable task of following that.
  Mr. HOEKSTRA. Mr. Speaker, amen, Brother. I notice that none of the 
folks that are opposed to the bill are willing to answer the single 
most important question tonight which is, why do drugs cost 40 percent 
more in the United States than they do in Canada and in Europe? That 
question is not being answered.
  It is about safety, but they are missing the big elephant in the 
room. They do not want to talk about pricing. We have to realize that 
when working Americans pay 40 percent more for prescription drugs than 
the rest of the world, our workers are subsidizing the health care 
costs of the rest of the world.
  If we reject this bill, once again this Congress will undercut 
America's workers, will force American workers to continue to subsidize 
foreign workers' prescription drugs; and then we will go out and ask 
them to compete in global markets. No wonder America is facing a crisis 
in manufacturing. This is blatantly unfair. How long do we believe 
American workers can survive under this burden?
  Tonight, we have a wonderful opportunity to support working 
Americans, let them have access to fairly priced products and improve 
their global competitiveness.
  Mr. TAUZIN. Mr. Speaker, I am pleased to yield 1 minute to the 
distinguished gentleman from Illinois (Mr. Crane).
  Mr. CRANE. Mr. Speaker, I thank the chairman for yielding me the 
time, and Mr. Speaker, I rise today in opposition to H.R. 2427.
  It is clear to me that the best way to help seniors is both to ensure 
that they have access to safe, affordable prescription drugs and to 
foster an environment where innovation can flourish, where new and 
better drug treatments will be developed for future generations.
  The U.S. continues to be the world leader in the development of new 
drugs and treatments that improve the quality of every American. I want 
to lower drug costs for the seniors in my district, but not at the risk 
of stifling the very innovation that creates the drugs in the first 
place.
  Some have called this a free trade issue. Yet it runs contrary to the 
fundamental tenets of free trade. Free trade creates efficiencies by 
opening borders, lowering tariffs, and giving consumers access to 
products and services from other countries. Reimportation stands this 
fundamental tenet on its head by giving Americans access to American 
pharmaceuticals that have been sold to the Canadian Government, a 
single payer that can, in effect, name its price at a lower cost than 
the laws of supply and demand allow.
  Congress can take a number of different steps to lower the cost of 
drugs for all consumers. We have already taken the most important one 
by passing a $400 billion drug benefit for Medicare beneficiaries.
  Mr. GUTKNECHT. Mr. Speaker, I am happy to yield 1 minute to the 
gentleman from Nebraska (Mr. Osborne).
  Mr. OSBORNE. Mr. Speaker, I thank the gentleman for yielding me the 
time.
  I think ultimately each of us has to be responsible to our 
constituents, and what I hear from Nebraska seniors contacting me is 
much more concern about high prescription drug prices than safety 
issues. Many of those Nebraskans are already getting their prescription 
drugs from Canada, and if drug prices continue to escalate as they have 
been and as they will continue to do, the $400 billion prescription 
drug benefit passed by the House

[[Page 19550]]

will be insufficient. I think we all know that intuitively, and I think 
OMB knows that empirically.
  So I see that the only solution, that I can think of at least, is 
holding drug prices down through competition in the free market, which 
I think most of us believe in. We import meat, fruit, wine, cheeses for 
direct consumption without undue alarm about safety. Americans take 
millions of dollars of imported prescription drugs each year, and yet 
no deaths or significant problems have occurred.
  I have a lot of confidence in this country. I believe we can have 
cheaper drugs and also have the intelligence and technology to have 
safe drugs.
  Mr. DINGELL. Mr. Speaker, I yield 1 minute to the distinguished 
gentlewoman from the Virgin Islands (Mrs. Christensen), my good friend.
  Mrs. CHRISTENSEN. Mr. Speaker, I rise in opposition to H.R. 2427, not 
because I do not believe, like my fellow Democrats, that we must do 
something about the high cost of medicines, I am committed to that end, 
but this is not the way to do it.
  I will always be against bypassing established authorities and 
applying quick fixes to complex challenges. The first because it is 
always a mistake, proven sooner or later, and sometimes with grave 
consequences, and the latter because such remedies usually end up no 
fixes at all. This bill fails on both tests.
  I know through my years of medical practice the difficulty of lower-
income people and seniors and even middle-income people having to pay 
for life-improving and -saving medication, but there are also cases 
where medicines have been brought back in from other countries and 
caused harm.
  This is not an easy issue because health and lives are at the center 
of it, and the high prices present a major barrier to the important 
goal of eliminating disparities and improving the well-being of many, 
especially our racial and ethnic minorities.
  We must continue to seek ways to lower drug prices safely, and we 
must eliminate this and every other barrier that exists in this country 
to good health, but H.R. 2427 is not the way.
  I urge my colleagues to vote no.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 1 minute to the gentleman 
from New Jersey (Mr. Pallone) who knows opponents of this bill offer no 
alternative strategy for bringing down drug prices.
  Mr. PALLONE. Mr. Speaker, I urge my colleagues, do not believe the 
FDA or the drug companies on this bill. They do not have any 
credibility.
  If you think about it, the bill says that these products can be 
imported for FDA-approved drugs from FDA-approved facilities. We are 
already importing drug products from these types of facilities in these 
various countries that are mentioned in the bill. If the FDA had a 
problem with it, why are they not shutting down the facilities? They 
are not credible when they tell you there is a problem because they 
have the authority to shut them down if they are not safe or they think 
the product is causing a problem here in this country.
  The drug companies, forget that. They have no credibility at all. 
They have told you to oppose reimportation. They told you to oppose any 
kind of Medicare benefit that has a negotiated price reduction. They 
told you to oppose Hatch-Waxman and any kind of generic drugs being 
used in some type of competition. They have no credibility. They are 
only concerned about price. They only want to make sure that their 
profits are secure.
  That is all there is here, and I do not believe that we are going to 
get Hatch-Waxman reform. I do not believe that we are going to get even 
a Medicare benefit. This is the only alternative for the seniors to 
lower prices.
  This is it. Vote for it. Do not vote against it. Do not leave those 
seniors hung out to dry.
  Mr. TAUZIN. Mr. Speaker, I am pleased to yield 1 minute to the 
distinguished gentleman from Indiana (Mr. Pence).
  Mr. PENCE. Mr. Speaker, I rise in opposition to the reimportation 
bill, but I do so with the deepest respect and affection for the author 
of this bill whose character and tenacity I admire greatly.
  America, without a doubt, has the greatest health care system in the 
history of the world. Some have spoken of riding buses to Canada to 
purchase prescription drugs. Well, they have, and I am sure they could 
wave at the many tens of thousands of Canadians that come on buses 
across our border to receive the elective treatment that takes 9 to 18 
months in some cases in their system.
  It has been asked today by my colleague from Michigan, why do drugs 
cost 40 percent more in Canada. Well, the answer is very simple. 
Because Canada, like Germany, like France, are socialist countries. I 
am sure pharmaceutical drugs would have been cheaper in the Soviet 
Union.
  The truth is, reimportation of drugs is simply reimportation of price 
controls and socialism. Let us not import Canadian price controls and 
socialism. Let us export the free market health care principles that 
make our system the envy of the world.
  Mr. GUTKNECHT. Mr. Speaker, I am happy to yield 1 minute to the 
gentleman from Arizona (Mr. Shadegg).
  Mr. SHADEGG. Mr. Speaker, I rise in strong support of the 
Pharmaceutical Access Act against protectionism and in favor of a free 
market.
  I want our pharmaceutical companies to be profitable. I particularly 
want them to have the funds they need to do the research and 
development they must do. I just do not want them to take that money 
from Americans and only Americans and to impose the burden of that R&D 
on our seniors only. It simply is not fair to impose the entire cost of 
the phenomenally expensive research and development on just America's 
seniors and to allow the rest of the world to profit from that.
  Over and over again, we hear the issue is safety, safety, safety, and 
yet there are thousands of counterfeit drugs in the market today 
precisely because we do not have a free market, precisely because we do 
not allow reimportation. The minute you allow reimportation, a system 
similar to the Good Housekeeping Seal of Approval or the Underwriters 
Laboratory will arise and that system will advertise, If you buy our 
drug, we have inspected the plants where they came from; we have 
certified the shipping of that drug; and we certify it safe. Americans 
will buy those drugs and those drugs only.
  Trust the market. End protectionism. Americans cannot afford to pay 
protectionist prices for our drugs any longer. Fix this market. Allow a 
free market to work.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 30 seconds to the gentlewoman 
from Ohio (Ms. Kaptur) who knows that the breast cancer drug Tamoxifen 
is more expensive in our country than in Canada.
  Ms. KAPTUR. Mr. Speaker, I thank the gentleman for his leadership on 
this important issue and rise in support of H.R. 2427.
  I wish to say, last year, average drug prices in our country were 67 
percent higher than in Canada and double that of Europe. The real issue 
is that pharmaceutical companies have been gouging the American public 
for far too long, and the leadership in this Congress has allowed them 
to do that.
  This bill requires the FDA to do what it must to assure safety, but 
more than that, it finally blows the whistle on an industry that has 
been taking America's seniors to the cleaners. It is time their gig is 
up. Support H.R. 2427.

                              {time}  0200

  Mr. TAUZIN. Will the Speaker announce how much time remains.
  The SPEAKER pro tempore (Mr. LaHood). The gentleman from Louisiana 
(Mr. Tauzin) has 6 minutes remaining, the gentleman from Minnesota (Mr. 
Gutknecht) has 7\1/4\ minutes remaining, the gentleman from Michigan 
(Mr. Dingell) has 4 minutes remaining, and the gentleman from Ohio (Mr. 
Brown) has 5\1/2\ minutes remaining.
  Mr. TAUZIN. Mr. Speaker, I am pleased to yield 1 minute to the 
gentleman from Texas (Mr. Burgess).
  Mr. BURGESS. Mr. Speaker, drug prices can be higher in some cases for

[[Page 19551]]

consumers than in other industrialized countries because the 
governments of Canada, Mexico, and Europe hold down the costs through 
market intervention. In other industries we do not permit the 
imposition of foreign price controls on American businesses, and we 
should not in this case either. These price controls would stifle the 
development of new drugs, drugs like Avastin, a powerful and promising 
new anti-cancer drug that inhibits blood vessel growth in tumors, an 
entirely new approach to treating cancer. This drug took 20 years and 
millions of dollars to develop.
  In my own medical practice, I have witnessed what might be politely 
called therapeutic misadventures resulting from drugs illegally 
imported from Mexico. Vote ``no'' on H.R. 2427 and let us work together 
on feasible solutions that will bring down the cost of prescription 
drugs in a constructive manner, not proposals like this that will put 
our constituents at risk.
  Mr. GUTKNECHT. Mr. Speaker, I am happy to yield 1 minute to the 
gentlewoman from Louisville, Kentucky (Mrs. Northup).
  Mrs. NORTHUP. Mr. Speaker, I thank the gentleman for yielding me this 
time.
  Mr. Speaker, despite the histrionics we have seen tonight, there is 
not one Member of Congress that would vote for a bill that would 
endanger the people in this country, not the seniors, not our children, 
and no one in between.
  The false arguments, the scare tactics, the unrelated examples should 
not surprise anybody because we hear them every day, and these tactics 
have worked in the past. But Americans know the truth. Over 1 million 
have imported drugs every single year into this country safely. They 
buy drugs that are manufactured and regulated on how they are 
distributed the same way we regulate them in the United States. In 
fact, they are the same plants, and they are the same distribution 
systems.
  Our unions and our businesses are telling us that drugs are costing 
them a fortune, and without relief our taxpayers are going to foot the 
bill for our seniors who are going to have to pay extraordinary prices 
for their drugs. Tonight is historic. We are going to, without the 
money, without the staff, and without the army of lobbyists take back 
the House and pass this bill to reduce the cost of drugs for our 
seniors.
  Mr. DINGELL. Mr. Speaker, I reserve the balance of my time.
  Mr. TAUZIN. Mr. Speaker, I yield 1 minute to the gentleman from Texas 
(Mr. Sessions).
  Mr. SESSIONS. Mr. Speaker, I thank the gentleman from Louisiana for 
yielding me this time. Tonight is a very important debate for this 
country. It is important for us to understand that the drugs that get 
reimported in this country may not be known and understood exactly for 
what they are by the consumers of this country.
  As a person who travels overseas, when I want to buy a shirt that 
might be on the street in Bangkok or in Shanghai, I know that that is 
probably a counterfeit. I buy that and purchase that shirt knowing 
that. But as a consumer in this country, going on the Internet, 
thinking I am buying something from Canada, it can be from somewhere 
else. It happens every day.
  Let us not let this happen to consumers. Let us let them know what 
they are buying, where they are getting it from; and let us make sure 
we reduce the cost of prescription drugs in this country. We have a 
plan to do that. That plan is called a prescription drug plan that the 
Republican Party has had on this floor. Let us reduce the cost of 
prescription drugs but let us keep our seniors safe.
  Mr. GUTKNECHT. Mr. Speaker, I am happy to yield 1 minute to the 
gentleman from Georgia (Mr. Kingston).
  Mr. KINGSTON. Mr. Speaker, I thank the gentleman for yielding me this 
time. I want to say as a supporter of the Gutknecht bill that this bill 
is about safety because it is unsafe not to take your medicine.
  If you need Glucophage, if you need Lipitor, if you need Tamoxifen, 
you have to get it as inexpensively as you can or you are going to be 
skipping your groceries to do it.
  What you can do is join millions of Americans and go to our biggest 
trade partner, Canada, and get it at 40 percent less than what we are 
paying now. And incidentally, in the next 10 years senior citizens 
alone will spend $1.8 trillion on prescription drugs.
  What should we do about the people who are buying these drugs from 
Canada? Should we arrest them now? Or since it is so unsafe, why do we 
not just wait for them at the hospital and then arrest them?
  The reality is that this right now is the domain of the border State 
constituents and the savvy Internet buyer. I want to support this bill 
so that the working people can have access at their local pharmacists 
to these low-cost prescription drugs. That is what this is about. 
Support the Gutknecht bill.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 30 seconds to the gentleman 
from Texas (Mr. Green), who knows that a drug you cannot afford is 
simply not a safe drug.
  Mr. GREEN of Texas. Mr. Speaker, I rise in support of the 
Pharmaceutical Market Access Act, and I would not be here this morning 
supporting this reimportation bill if we had passed a real 
pharmaceutical prescription drug plan under Medicare that did not have 
a hole you could drive an M-1A tank through.
  I have constituents who now go to Mexico and order pharmaceuticals 
through Canada on the Internet. I have bought pharmaceuticals in Mexico 
myself to use. They are safe. We need to make sure they are available 
for our constituents legally.
  If we are not going to pass a real pharmaceutical prescription drug 
plan under Medicare, we need to at least pass this bill.
  Mr. Speaker, I rise today in support of the Pharmaceuticals Market 
Access Act, and urge my colleagues to join me in voting for this 
important legislation.
  For far too long, Americans have been paying a premium for 
prescription drugs. Our constituents are paying top dollar for their 
drugs, while citizens from other industrialized countries like Canada, 
France, Italy, Germany, and Great Britain are getting deeply discounted 
prescription drugs.
  American consumers are charged, on average, 38 percent more than 
consumers in Canada, 31 percent more than citizens of Great Britain, 45 
percent more than French consumers, and 48 percent more than Italian 
citizens. This is simply unacceptable.
  Now I know that opponents of this bill will try to muddy the waters 
by raising the specter that reimportation is unsafe and unfair, but 
this is simply not true.
  Manufacturers have been safely importing drugs into this country for 
years. In 2001 alone, they spent $14.7 billion bringing prescription 
drugs into the United States.
  Additionally, H.R. 2427 specifically prohibits counterfeit drugs, 
drugs that have been tampered with, and expired drugs from entering the 
United States.
  Under this bill, only FDA approved drugs would be allowed into the 
country. The only difference from U.S. manufactured drugs will be the 
more affordable price.
  And don't be alarmed by cries that this will decrease research and 
development into new medicines. Pharmaceutical companies' after-tax 
profits--and after expenditures for R&D--averaged 17 percent from 1994 
to 1998. This leaves plenty of money for R&D.
  The bottom line is that opponents of this bill want to protect 
pharmaceutical industry profits.
  I urge my colleagues to stand up against these special interests, and 
for your constituents.
  Mr. GUTKNECHT. Mr. Speaker, I am happy to yield 1 minute to the 
gentleman from Arizona (Mr. Flake).
  Mr. FLAKE. Mr. Speaker, I thank the gentleman for yielding me this 
time.
  It has been a great debate tonight. I am not supporting this bill 
because I believe that it will lower drug prices substantially in the 
long term. I do not believe that it will. But what it will do is, as 
has been pointed out earlier tonight, it will force some of the other 
countries who have been freeloading off of us for far too long to pay 
some of the costs of R&D to develop these medicines for the future. 
That is important.
  I want to also read this. From ``The Wealth of Nations,'' Adam Smith 
addressed this issue. He said: ``To narrow competition can only serve 
to enable the dealers, by raising their profits

[[Page 19552]]

above what they naturally would be, to levy, for their own benefit, an 
absurd tax on the rest of their fellow citizens.''
  The absurd tax has been paid by Americans for far too long. It ought 
to be shared by the rest of the world to pay for the cost of research 
and development.
  Mr. TAUZIN. Mr. Speaker, I am pleased to yield 1 minute to the 
gentleman from California (Mr. Gary G. Miller).
  Mr. GARY G. MILLER of California. Mr. Speaker, I rise in opposition 
to this bill. The argument is we are dealing with reimportation, not 
drugs manufactured in Canada.
  Ask yourself the question, why are there no major manufacturing 
facilities in Canada? The reason is they invest billions of dollars in 
these drugs to save our lives. Of every thousand they work on, seven 
hit the market place and one makes a profit. Now, ask yourself the 
question, Canada represents 1 percent of the marketplace. That is all 
they represent. Do you believe that U.S. manufacturers are going to 
ship enough drugs to Canada to sell them back at less prices in the 
United States to fill the volume that is needed in the largest market 
in the world?
  When people get sick in Canada and they are seriously ill, they come 
to the United States. Why? Because we have the best health care and the 
best treatment forms in the world.
  It is already legal to reimport if you can prove safety, but they 
cannot prove safety; and you know it. And they will have that same 
difficulty in the future. So do not believe there is some manufacturer 
in Canada who is just arbitrarily going to ship drugs here. Our 
companies do not meet the demand.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 30 seconds to the gentleman 
from Rhode Island (Mr. Langevin) who knows that a Federal Government 
who says it can build a national missile defense can surely ensure the 
safety of imported drugs.
  Mr. LANGEVIN. Mr. Speaker, I rise in strong support of H.R. 2427, the 
Pharmaceutical Market Access Act. We know that Americans pay 30 to 300 
percent more for their medications than those in other industrialized 
nations. The United States has failed time and time again to assert our 
force in the pharmaceutical marketplace, and we should continue to 
pursue all available avenues to lower drug costs for our citizens.
  Today, we have the opportunity to take action by passing H.R. 2427. 
This bill makes possible the reimportation of FDA-approved drugs from 
FDA-approved facilities. It includes new standards for safety messages 
in the packaging of drugs. It is the right thing to do for our seniors 
and we must act now.
  Mr. Speaker, I rise in support of H.R. 2427, the Pharmaceutical 
Market Access Act. I am grateful that the House of Representatives has 
the opportunity to substitute existing reimportation language in the 
House-passed Medicare bill with a meaningful provision, one that could 
result in billions of dollars in savings to American seniors and bring 
balance back to the global marketplace for prescription drugs.
  American taxpayers heavily subsidize the research that leads to life-
saving medications, used worldwide. Despite that, citizens of this 
country pay 30 to 300 percent more than those in other industrialized 
countries. The reason for this disparity is that the government of 
every other industrialized nation works on behalf of it's citizens to 
control the cost of medication--through the use of bulk purchasing 
power, and other methods the United States has failed to adopt. The 
recently-passed Medicare bill failed to incorporate any meaningful cost 
control measures for the 54 million Medicare beneficiaries--in fact the 
legislation strictly forbade the U.S. government from negotiating for 
these seniors and discouraged reimportation. There are other steps the 
United States should be taking to lower costs, and we should continue 
to pursue the use of bulk purchasing power and speeding the approval 
process for generic drug entry to the market--but tonight, we have the 
opportunity to vote on market access.
  Americans are suffering because of their government's failure to 
assert their force in the pharmaceutical market. Last month, I joined 
the Rhode Island Academy of Family Physicians in releasing a survey 
showing that a third of seniors in Rhode Island are relying on 
physician samples for their necessary medications and 20 percent are 
failing to take them as prescribed because of cost--skipping 
prescriptions to make them last longer and failing to refill them. 
There is absolutely no reason for this. Today, we have the opportunity 
to take action by passing H.R. 2427, which would level the playing 
field by allowing American pharmacists, wholesalers and individuals to 
legally and safely import the same drugs they are paying inflated 
prices for at home from other countries. The tangible result of this 
policy will be significant savings--savings that will be passed from 
pharmacists and wholesalers to American consumers.
  It is ironic that the drug companies are telling us that importation 
cannot be done safely. For years now, drug manufacturers have safely 
and legally reimported drugs--$14.7 billion worth in 2001--and in 
certain circumstances, individuals have been able to purchase their own 
medications abroad. In the years of this legal reimportation--there 
have been zero reported deaths from Americans taking imported 
pharmaceuticals. However, thousands of Americans become ill or die from 
food-borne illnesses each year, yet no one suggests the banning of the 
importation of food. Instead, we work hard to regulate the importation 
of food, and we incorporate current technology to ensure the safety of 
the process. H.R. 2427 includes new standards for safety measures in 
the packaging of drugs and limits importation to FDA-approved drugs 
from FDA-approved facilities. This can be done, and it can be done 
safely.
  Earlier today we heard a number of Members on the floor talking about 
the benefits of free trade, as we debated the United States-Chile Free 
Trade Agreement. I am certain that these Members recognize drug 
companies can set drug prices at extraordinarily high prices in the 
United States, because current law protects them from competition. I 
hope that, in the spirit of consistency, these Members will support 
H.R. 2427, and allow the market forces to work in favor of American 
consumers when it comes to the purchase of life-saving medications.
  We must not let the opportunity to lower the cost of prescription 
drugs for Americans pass us by. I urge all of my colleagues to vote in 
favor of H.R. 2427.
  Mr. TAUZIN. Mr. Speaker, may I inquire once again as to the time 
allocations.
  The SPEAKER pro tempore. The gentleman from Louisiana (Mr. Tauzin) 
has 3 minutes remaining, the gentleman from Minnesota (Mr. Gutknecht) 
has 4\1/4\ minutes remaining, the gentleman from Michigan (Mr. Dingell) 
has 4 minutes remaining, and the gentleman from Ohio (Mr. Brown) has 4 
minutes remaining.
  The order of closing will be the gentleman from Ohio (Mr. Brown) will 
go first, the gentleman from Minnesota (Mr. Gutknecht) will go second, 
the gentleman from Michigan (Mr. Dingell) will go third, and the 
gentleman from Louisiana (Mr. Tauzin) goes last.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 30 seconds to the gentleman 
from Ohio (Mr. Strickland) who knows this debate is not about safety, 
but about drug industry profits.
  Mr. STRICKLAND. Mr. Speaker, this is an interesting debate because it 
is not primarily between Democrats and Republicans; it is between the 
people and the pharmaceutical companies.
  The gentleman from Louisiana (Mr. Tauzin), the distinguished chair of 
my committee, says he is concerned about safety, that if we pass this 
bill people may die. I contend that people are dying every day in this 
country. People are dying because they are not getting the medicines 
they need because they cannot afford the medicines they need.
  Does the gentleman believe if we pass this bill others may die? I 
believe if we do not pass this bill there will be many Americans who 
will die as a result of our inaction.
  Mr. TAUZIN. Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 30 seconds to the gentleman 
from Ohio (Mr. Kucinich).
  Mr. KUCINICH. Mr. Speaker, night after night my Democratic colleagues 
come to this floor to characterize the Republican Party as being the 
party controlled by monied special interests. Well, this evening, my 
fellow Democrats, is a moment of truth for the Democratic Party and 
what we stand for and who we stand for and who we stand with: the 
people or the big drug corporations.
  Seniors in my district are splitting their pills to make their 
prescriptions

[[Page 19553]]

last. And if a big PhRMA splits our party over the issue of lowering 
drug prices, it is a prescription for disaster for the Democratic 
Party. It is time we stood up and showed America who we really are, 
with the people or with the corporations.
  Mr. GUTKNECHT. Mr. Speaker, I yield 1 minute to the gentleman from 
Arizona (Mr. Hayworth).

                              {time}  0215

  Mr. HAYWORTH. Mr. Speaker, I thank my friend from Minnesota for 
yielding me this time, and I thank my friends across this Chamber for 
the warm reception.
  Mr. Speaker, when a prescription is written by a physician, there is 
not an inquiry as to partisan affiliation or political persuasion. A 
decision is made that a medicine is needed. The question tonight in 
this House is how best can that delivery be achieved. Economic 
conditions are the overwhelming criteria upon which this must be 
decided.
  My friend from Arizona spoke earlier, and he was quite right. An 
unfair tax has been levied on Americans. We have borne the costs that 
should be shared with others. Oh, yes, and we already subsidize many of 
those costs and we also have a research and development tax credit that 
exists currently in the Tax Code.
  Vote ``yes'' on the Gutknecht legislation. Let us seek a rational 
solution.
  Mr. DINGELL. Mr. Speaker, I yield 1 minute to the distinguished 
gentleman from North Carolina (Mr. Price).
  Mr. PRICE of North Carolina. Mr. Speaker, H.R. 2427 is both a 
diversion and a danger. It is a diversion from the prescription drug 
coverage we should be providing.
  What have we done instead? We have instead passed a Republican 
Medicare bill which actually denies the Secretary of HHS the ability to 
negotiate volume discounts. So much for my colleague's elephant in the 
room.
  And it is a danger. This bill is a danger. It would allow 
distributors to import drugs that have been sold, stored and 
transported outside the FDA's closed regulatory system. Massive and 
haphazard reimportation is the wrong prescription for a very real 
problem, the lack of drug coverage under Medicare available to all 
beneficiaries.
  I urge colleagues not to be diverted, to vote against the inferior 
and dangerous solution which H.R. 2427 represents.
  Mr. TAUZIN. Mr. Speaker, I am honored to yield 1 minute to the 
distinguished gentleman from California (Mr. Dreier), chairman of the 
Committee on Rules.
  Mr. DREIER. Mr. Speaker, yesterday afternoon, earlier this 
legislative day, we made history by passing two very important measures 
which are designed to eliminate tariff barriers in our relationship 
with both Singapore and Chile. And now we have people who have injected 
the issue of free trade in this debate.
  Mr. Speaker, the fact of the matter is, as we look at this challenge, 
what it is that we are dealing with is government subsidization, 
government cost controls and mandatory licensing, which is antithetical 
to the entire concept of the free flow of goods and services and ideas. 
Vote against this measure.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 30 seconds to the gentleman 
from New York (Mr. Nadler) who knows that if you want to talk safety, 
we should talk about Americans having to split their pills to afford to 
pay for their expensive medicines.
  Mr. NADLER. Mr. Speaker, for 30 years the pharmaceutical companies 
have opposed proposals for the government to help senior citizens buy 
their products. Why? Because they are afraid that the government, as a 
bulk purchaser, would exercise market power to do what a bulk purchaser 
in a free market society should do, use bulk market power to get lower 
prices. And they tell us that lower prices will mean they could not do 
research and development when they spend 33 percent of their revenues 
on marketing and 14 percent on research and developing.
  That is why the Republican bill we debated a few weeks ago prohibits 
the government from negotiating prices. This bill is a substitute for 
that, not a good substitute, but the best we are likely to get. It will 
help the seniors buy their drugs and we ought to pass it.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 30 seconds to the gentlewoman 
from Texas (Ms. Jackson-Lee) who knows the drug industry's pricing 
policies put the health of American patients at risk every day.
  Ms. JACKSON-LEE of Texas. I thank the distinguished gentleman for 
yielding me this time.
  Mr. Speaker, tonight's vote is a vote of the heart and a vote of 
one's conscience. This weekend, many of us spent time with our senior 
citizens, and I am glad that we are talking now not about Democratic 
and Republican politics but about saving lives.
  I grappled with this whole question of pharmaceuticals and senior 
citizens, but when I got this letter from Ms. Davis and said, ``My 
pressure pill is too high, the rest of my medicine is too high, I 
cannot afford no medicine; my doctor gives me samples, I cannot afford 
the regular medicine,'' I had to stand with these senior citizens who 
need our help.
  We have got to vote for this bill so we can save lives in America.
  Mr. Speaker, I must say that this is one of the toughest votes I have 
made in my tenure in Congress. We have an epidemic upon us in America 
today. It is not an epidemic caused by a virus or a bacterium. Instead, 
it is the epidemic of Americans who have no access to affordable 
healthcare.
  One of the fastest growing segments of our nation's healthcare budget 
is the cost of prescription drugs. I had a town hall meeting last week, 
so that I could hear the seniors in my district talk about their 
prescription drug costs, and what they want me to do about it. The 
conversation turned to the question of why Americans pay 2 to 10 times 
more than Canadians, for the exact same prescription drugs. It was then 
that I realized the truth: that those seniors, 70, 80, one over 90 
years old--many living on about $12,000 per year that they receive from 
Social Security--are buying drugs for rich Canadians. Every Canadian or 
German or Brit, no matter of their income gets a giant discount on 
their drugs, because the elderly in our Districts here in the U.S. are 
paying on average about 60 percent too much for their drugs. They are 
having to choose between eating and taking their medications on a 
regular basis, and they are subsidizing the costs of people around the 
world with much more.
  That is outrageous.
  I and my fellow Democrats have been fighting to ensure that more 
Americans have access to affordable medications, and I believe that the 
drug industry wants more people to be able to buy their medications. 
Surely we should be perfect collaborators. Furthermore, the drug 
industry has made tremendous advances in their labs, that have 
lengthened and improved the lives of millions of people around the 
world. That is why I have been trying to work with our nation's drug 
companies to find common ground, to seek compromise that helps people 
get the drugs they need, and enables our companies to get the profits 
and recognition they deserve. On several occasions they have stepped up 
to the plate--with patient assistance programs giving free drugs to the 
working poor, and discount cards, like Together Rx, that give discounts 
to low-income seniors. They have also donated drugs to those suffering 
in Africa and other developing nations. I commend the drug industry for 
their good works.
  I was hoping to build on those modest steps, and continue to make 
progress toward increasing access to state-of-the-art prescription 
drugs, by partnering with the good people in the industry--and I do 
believe there are good people in PhRMA. But the Republican leadership 
put an end to that, and turned this into a political war. I and my 
fellow Democrats fought to give the Secretary of HHS the ability to 
negotiated with the drug industry on behalf of our 40 million seniors 
on Medicare, to lower their drug costs. Such negotiations would have 
brought about prices lower than we pay now, but probably not quite as 
dramatic a decrease in PhRMA profits as H.R. 2427 will bring about. The 
Republican leadership denied us that common sense provision, so a door 
was closed.
  As H.R. 2427 was coming to the floor, there were some of us who felt 
that there could be compromise legislation, that would increase safety, 
and would perhaps lessen the impact on our drug industry, and their 
workers, and their investors. But we knew, as usual, that there would 
be no chance for such smart improvements, and as we see today the Rules

[[Page 19554]]

Committee has sent this bill to the Floor with yet another Closed Rule. 
Again a door was closed.
  In 2006, a Medicare Prescription Drug benefit will probably kick in. 
If it looks like anything that came out of the House or Senate last 
week, that benefit will leave many of our seniors far worse off than 
they are today. According to Republican estimates, a senior paying 
$5000 per year will only get 20% of their costs covered by their 
insurance plan. But by 2006, drug costs will have risen more than 20%, 
and also the discount card programs that the industry has put forth, 
will end as seniors get a drug benefit.
  So, I don't see many options here. I do not like the idea that under 
this legislation, we will be shipping American drugs overseas, paying 
foreign middlemen to handle them, then ship them back to us, all in an 
effort to get a better price out of companies in our own backyards. 
There should have been a better way; but I do not see it today.
  Today the problem of access is out of hand; it is about life and 
death. Every one of us has an elderly friend or relative, who has 
suffered a catastrophic blow to their health and watched the emotional, 
physical, and financial struggle that that can cause. We have people in 
the richest nation in the world choosing amongst eating, or paying 
rent, or buying their medications. Losing any one of the three can be 
deadly. I cannot help perpetuate this nightmare. I will support this 
bill.
  The one issue that might have caused me to rethink my vote is that of 
safety. If I really believed the hype--that this bill would lead to a 
deluge of dirty drugs from Canada, or Switzerland, or Japan, or 
wherever--I would have voted against it. But I do not. We have the 
technology and the creativity to make this venture safe. And the bill 
before us does not strip the FDA of its powers to search for potential 
sources of counterfeits, or damaged, or outdated products, and stop 
their influx into this country. Those abilities are specifically 
protected in the bill.
  This is a bill whose time has come, and I believe that it will save 
lives. My one regret is that it may cause some temporary hardship to 
some excellent companies. But I am confident that they will survive. 
They are creative and industrious, and I hope that they will work 
harder to increase their profits overseas.
  I also want to work with the industry to create provisions that will 
improve the Medicare Prescription Drug Bill in a way that will increase 
access to fairly priced drugs to ensure fair profits for producers, and 
protect the health of consumers. It is possible, but the leadership 
will need to put lives before politics.
  Again, it is an idea whose time has come.
  Mr. BROWN of Ohio. Mr. Speaker, I yield the balance of my time to the 
gentleman from Illinois (Mr. Emanuel) who knows the same Federal 
Government that put a man on the Moon certainly can ensure the safety 
of prescription drugs.
  The SPEAKER pro tempore (Mr. LaHood). The gentleman from Illinois is 
recognized for 2 minutes.
  Mr. EMANUEL. Mr. Speaker, people from around the world come to 
America for their medical care. Yet Americans travel around the world 
for affordable medications. Between 2000 and 2003, seniors' 
expenditures on prescription drugs increased 44 percent.
  The legislation we are debating today is about inserting competition 
and the free market into the pricing of medication to ensure that 
Americans no longer have to pay a 25 to 40 percent premium over the 
prices paid in other countries.
  For too long, our constituents have subsidized the starving French, 
Germans, Italians and Canadians. Americans have also subsidized the 
research and development for pharmaceutical companies through the NIH 
funding and through the R&D tax credit. We are about to embark on the 
largest expansion of entitlement in over 40 years and spend $400 
billion of the taxpayers' money. We owe it to the American taxpayer to 
ensure that they are getting the best price for their money, not the 
most expensive price.
  I want to address and speak to the myth of safety concerns. Last 
year, Americans imported $14.8 billion worth of medications from around 
the world. Lipitor is a cholesterol drug that is on every 
pharmaceutical counter. It is made in Ireland, but we import it. If it 
is unsafe, get it off the counter and get those ads off the television, 
because we import Lipitor from Ireland.
  Folks, when somebody tells you it ain't about money, it is about 
money, and that is what this debate is about. I know how this system 
works like everybody else here. There is a pharmaceutical lobbyist and 
a half for every Member of Congress. They have spent over $100 million 
in contributions, entertainment, lobbying expenses, all focused on us. 
But meanwhile our seniors are being overcharged approximately $100 
billion.
  The question before us tonight is, are we going to put more priority 
on the $100 million focused on us or the $100 billion that our 
constituents are overcharged?
  I know why we all came here. We ran for a set of ideas, a set of 
values and a set of principles. They may be different, but we share a 
common set of values. Whether you believe in competition in the free 
market, protecting our taxpayers or ensuring affordable prices, tonight 
the vote is about the special interests versus the American people. I 
ask you to support our constituents.
  Mr. GUTKNECHT. Mr. Speaker, I yield myself the balance of my time.
  The SPEAKER pro tempore. The gentleman from Minnesota is recognized 
for 3\1/4\ minutes.
  Mr. GUTKNECHT. Mr. Speaker, first of all, let me say thank you to the 
gentlewoman from Missouri (Mrs. Emerson), because we would not be 
having this historic debate tonight without her courage, and I want to 
thank her.
  Mr. Speaker, I have been down on this floor many, many times with my 
charts, talking about this issue. I have had charts and plenty of 
statistics, but the saddest statistic of all that I have come across is 
this from the Kaiser Foundation. Twenty-nine percent of seniors say 
that they have had prescriptions that went unfilled because they could 
not afford them. Shame on us.
  I was at a community pharmacists meeting a few months ago. There were 
300 community pharmacists there. I asked them this question: Has this 
ever happened to you where someone comes into your store with a 
prescription, they hand you the prescription, you tell them how much it 
is going to be and their head drops, their voice drops, and they say, 
Well, maybe I'll be back tomorrow. And they never come back. Shame on 
us.
  We have heard about safety. We have heard about intellectual property 
rights. No one wants unsafe drugs or to steal patents. We have heard 
about price controls and aren't we simply importing them. But the plain 
truth is today, Americans are subsidizing them.
  This bill is not perfect, but it is not complicated, either. We 
simply take away the FDA's power to defy the will of this the people's 
House and in its place we put counterfeit-proof, tamper-proof 
packaging.
  I will not question any Member's motives, but others will. If you are 
going to vote against this bill tonight, you had better go back to your 
office and write a letter to your constituents explaining exactly why, 
because you will be asked. Maybe it will be at a town hall or a 
candidates forum, or maybe in your opponent's ads next year, but you 
will be asked. Someone is going to hold up a package of pills and they 
are going to ask this: Why is it that Americans have to spend $360 for 
this drug, this lifesaving drug, when Germans can buy it for $60? And 
then they are going to ask the even tougher question: Congressman, what 
did you do about it?
  Tonight we can send a very simple but clear message. The status quo 
is unacceptable, and we will not stand idly by and allow Americans to 
be forced to pay the world's highest prices for prescription drugs.
  Members, all I ask is vote your conscience. Millions of proud 
Americans are counting on us.
  Mr. DINGELL. Mr. Speaker, I yield the balance of my time to the 
distinguished gentlewoman from Colorado (Ms. DeGette).
  The SPEAKER pro tempore. The gentlewoman from Colorado is recognized 
for 3 minutes.
  Ms. DeGETTE. Mr. Speaker, this legislation will harm patients. It 
will harm the children, and it will harm the elderly. It lacks the 
necessary guarantees of safety and we should not subject the American 
people to it.
  Permitting reimportation would significantly increase the risk that 
counterfeit, misbranded and adulterated

[[Page 19555]]

drugs would show up in U.S. pharmacies and American homes. Every one of 
us here tonight is concerned about the high cost of prescription drugs, 
but we should not and must not substitute the hope of lower 
prescription drug prices for the fundamental safety of the drugs that 
we are providing to our citizens. We have a duty to protect the people 
of this Nation.
  Every expert agrees, this bill will not help Americans. The Food and 
Drug Administration, along with the U.S. Customs Service, currently 
cannot enforce the existing laws. Counterfeit drugs are pouring across 
our borders. I used to think I supported this legislation, and then the 
Subcommittee on Oversight and Investigations had hearings. This chart 
is just one example of counterfeit Viagra that was received in the 
Miami office. There are tons of counterfeit drugs coming into this 
country right now.
  Proponents of the bill say that the quality of the drugs will be 
protected. I have not heard one Member on either side of the aisle say 
how that will happen, when you have drugs that are coming in from all 
parts of the world. This is counterfeit Voltaren. It is a pill that is 
used to relieve pain, tenderness, inflammation and stiffness caused by 
arthritis.

                              {time}  0230

  Every one of these pills is marked with the manufacturer. It looks 
real. There is no active ingredient in these pills. I challenge anybody 
who just thinks that we will be safe to come get on a plane to Miami 
and see the counterfeit drugs that are coming into this country.
  The gentleman from Arkansas (Mr. Berry) said the country will be 
flooded with cheap prescription drugs. That may happen under this bill, 
but we cannot guarantee that any of those cheaper prescription drugs 
will have any active ingredients in them. The gentleman from 
Pennsylvania (Mr. Hoekstra) asked why the Canadian drugs are 40 percent 
cheaper. I have a different answer than the gentleman from Indiana (Mr. 
Pence) had. I think they are cheaper because Canadian law allows the 
government to negotiate with pharmacies for lower prices. And that is 
what we should do too in this country. We should not go in a roundabout 
way letting these counterfeit drugs come in, putting our citizens at 
risk simply because we want lower prices.
  Here is the bottom line. We were elected to preserve the health and 
safety of the people we represent, over 600,000 each. Let us not 
sacrifice that fundamental right for a convoluted bill that is not even 
guaranteed to do what it is supposed to do. Vote ``no'' on this ill-
conceived legislation.
  Mr. TAUZIN. Mr. Speaker, I yield myself such time as I may consume.
  Current law allows importation. Current law contains 10 provisions to 
protect the safety of drug supplies in this country, 10 provisions 
protecting the safety of those drugs that are imported into this 
country. This bill that the Members are asked to vote on tonight 
strikes all 10 of those safety provisions, all 10.
  I am going to show the Members tonight what we get if we pass this 
bill. What we are looking at now is a Web site of a Canadian 
prescription center where one can order prescriptions from Canada right 
now which would be legalized under this bill, illegal under current law 
because the FDA cannot verify the safety of drugs obtained on this Web 
site.
  The FDA obtained some drugs on this Web site to just see what they 
could get. I want to show the Members what they got. What they got was 
this drug. This is a drug called Gabapentin. It is used as an 
antiseizure measure. It is to prevent seizures for people who have all 
kinds of seizures with all kinds of diseases. Do the Members know where 
it was made? It was made in India, not in Canada; and it came to an 
American over that Canadian Web site. And do the Members know what is 
in it? Nothing. It is water inside this package. And the folks who buy 
it in America at these cheap prices we are told they are going to get 
it for nothing except fake drugs.
  Here is another set of drugs to look at. This is one is called 
Serostim. It is used by HIV/AIDS patients to prevent wasting. This is 
the authentic one; this is the fake one. The fake one contains nothing 
but pond water. Imagine giving that to an HIV/AIDS patient. Is the 
price, half price, quarter price worth it to take a drug like that?
  I want to ask the Members something before we end this debate, and I 
have the greatest respect for those who bring this issue to the floor 
because I hate the fact that Canada and other countries take advantage 
of our patients in America, and we have to end those trade imbalances. 
We have to fight them. We do. We do. But I want to ask one question. If 
the Members vote to say that safety does not count and Americans 
increasingly buy these drugs full of nothing but pond water and diluted 
and old and rotten drugs, are they going to have to face the mother and 
father the way we faced them this week who said, Why is my son dead, 
because you did not put FDA regulations into place?
  Vote down this bill. It is dangerous for every American. It needs to 
be defeated.
  Mr. HOLT. Mr. Speaker, I am sad to say that for the second time 
during this Congress, the House has considered legislation offering a 
false promise to help for seniors struggling to pay for prescription 
medications.
  Last month, the House passed a bill that purported to offer Medicare 
prescription drug coverage. I have long supported providing seniors 
with a reliable, comprehensive, and affordable drug benefit under 
Medicare. I could not in good conscience vote for the bill passed by 
the House, however, because it would provide only a meager benefit 
while quite possibly leading to the death of the traditional Medicare 
program that has served seniors in my district so well.
  Congress has an obligation to help Americans who cannot afford the 
prescription drugs they need. Seniors need and deserve a voluntary, 
universal, prescription drug benefit under Medicare that can help lower 
prices using the collective buying power of the Medicare population. 
But making it easier to bring counterfeit, substandard medicines into 
the United States is not the way to help seniors get the drugs they 
need. H.R. 2427 poses a very serious danger--exposing American 
consumers to unsafe counterfeit drugs.
  The evidence of this is well documented. The Food and Drug 
Administration, which has for nearly a century been responsible for 
certifying the safety and efficacy of medications sold in the United 
States, opposes reimportation. According to FDA Commissioner Mark 
McClellan, ``At a time when FDA faces more challenges than ever in 
keeping America's supply of prescription drugs safe and secure, H.R. 
2427 would create new drug safety problems. H.R. 2427 creates a wide 
channel for large volumes of unapproved drugs and other products to 
enter the United States that are potentially injurious to public health 
and pose a threat to the security of our Nation's drug supply. The bill 
would do so by taking unprecedented steps that limit FDA's authority to 
assure the safety of prescription drug products to be used by U.S. 
consumers.
  These sentiments are shared by eight former FDA Commissioners as well 
as current and former HHS Secretaries Tommy Thompson and Donna Shalala, 
who both refused to certify the safety of reimportation. The Nation's 
largest association of physicians, the AMA, also opposes this dangerous 
policy.
  The dangers of reimportation were brought to life recently, when 19 
people in Florida were arrested in charges of selling ``adultered'' 
drugs, including fake Lipitor pills imported illegally from England. We 
were lucky in this case. Sometimes the dangers of counterfeit imported 
pills don't become apparent until it's too late.
  Mr. Speaker, I cannot vote to jeopardize the safety of our supply of 
medications. The United States is the envy of the world because its 
medicines are the safest. Opening our borders to the peril of 
counterfeit drugs is simply a foolish way to increase accessibility. We 
need a Medicare prescription drug benefit--not a flood of dangerous 
counterfeits. Do we really want to open our borders to let in drugs 
from other countries when the worldwide rate of counterfeit drugs is 8 
percent.
  I urge my colleagues to protect the safety of U.S. consumers and vote 
no on H.R. 2427.
  Mr. UDALL of Colorado. Mr. Speaker, I cannot support the 
reimportation bill because it will create a flood of unsafe, 
counterfeit or ineffective drug products that will end up in the 
medicine cabinets of millions of Americans, and I do not think it will 
result in the cost savings that supporters are hoping for.
  First and foremost, this issue is about patient safety. I agree with 
the Food and Drug

[[Page 19556]]

Administration, the American Medical Association and many physician and 
patient organizations who say that allowing wholesalers and pharmacists 
to reimport drugs from foreign countries will pose serious public 
health concerns for our country. There are no safety provisions in this 
bill that will assure Americans that the drugs they are taking are safe 
and effective. And the bill does not provide any resources to the FDA, 
Customs, or other Federal agencies to test, inspect and certify that 
drugs coming into our country from around the world are safe.
  In addition to the safety issues involved, I do not think this bill 
will lower the cost of drugs in the U.S. Recently, the non-partisan 
Congressional Budget Office released a report saying that reimportation 
legislation ``would not produce substantial savings to the Federal 
government.'' Furthermore, some regulations in the bill will result in 
higher prices for pharmaceuticals. If our aim is to make drugs more 
affordable for seniors, Congress should pass a fair and affordable 
Medicare drug benefit bill.
  Pharmaceuticals play a critical role in our health care delivery 
system. As such, I want to support initiatives that spark research and 
innovation in the pharmaceutical industry and that increase 
accessibility to prescriptions drugs. These should not be mutually 
exclusive goals. Ultimately, I cannot support legislation that will 
endanger the health of millions of Americans who rely on medications to 
treat a condition or an illness.
  Mr. DAVIS of Illinois. Mr. Speaker, I rise today in strong support of 
H.R. 2427, the Pharmaceutical Market Access Act of 2003. Those who are 
debating this bill can be divided into just two separate groups: those 
who support making pharmaceuticals more affordable to Americans, and 
those who are swayed by the pharmaceutical industry's attempts to 
maintain astronomical profit margins. I proudly stand with the first 
group.
  You cannot deny the skyrocketing prescription drug costs in this 
country. The price of the top 50 drugs used by American seniors rose at 
three and a half times the rate of inflation in 2002. At community 
clinics, physicians prescribing common antibiotics find that their 
patients cannot afford them. Americans with diabetes, high blood 
pressure, and other manageable diseases go without life-preserving 
medications. Meanwhile, those in other countries pay as little as one 
tenth what Americans pay for the exact same pharmaceuticals. In Canada, 
the country's national health care system allows them to negotiate 
prices with drug companies, substantially reducing costs for Canadians. 
In their quest for profit, those drug companies raise prices in the 
U.S. to compensate for lost profits in Canada.
  Contrary to our opponents' claims, H.R. 2427 has built-in provisions 
to ensure the safety of reimported drugs. The new technologies 
developed to ensure the safety of reimported drugs will also safeguard 
domestic pharmaceuticals against counterfeiting. Our opponents claim 
that the FDA fails to adequately monitor the safety of drugs already 
being imported into the U.S. The answer is not to deny Americans the 
right to reimported pharmaceuticals, but to hold the FDA accountable 
for its failures and demand improvement.
  Our opponents claim that H.R. 2427 would hurt low-income Americans, 
in attempts to win more support for their position. In fact, this bill 
would only provide poor Americans with more access to the medicines 
they need through cost reductions.
  Mr. Speaker, as health care costs rise out of control, we must take 
every step possible to improve health care for the 41 million uninsured 
and countless underinsured Americans. I urge you to join me in support 
of H.R. 2427. Do now allow our opponents, influenced by the 
pharmaceutical industry, to deny safe, affordable prescription drugs to 
Americans.
  Mr. KIND. Mr. Speaker, I rise today in support of the Pharmaceutical 
Market Access Act (H.R. 2427). Every day, seniors in western Wisconsin 
face the escalating cost of prescription drugs. A recent Families USA 
study found that the prices of the 50 drugs most commonly used by 
seniors increased by an average of three and a half times the rate of 
inflation over the past year. And between 2000 and 2003, seniors' 
expenditures on prescription drugs increased by 44 percent.
  One solution for many Wisconsin residents is to drive to Canada where 
they can purchase prescription medication at a substantial savings 
compared to a drug store in the United States. On average, American 
consumes in 2002 were charged 38 percent more than consumers in Canada. 
A 38 percent savings is sizable amount of money to an individual on a 
fix income. H.R. 2427 would help all seniors realize this savings.
  The legislation we are debating today is about inserting competition 
into drug pricing, to ensure that Americans no longer have to pay a 25- 
to 40-percent premium over the prices paid in other countries. As we 
embark on the largest entitlement expansion in recent history, $400 
billion, we must ensure that we get the best price for prescription 
medicines. We owe it to our taxpayers to ensure that they are getting 
the best bang for their buck.
  The legislation before us would lower prescription drug costs for all 
American consumers by allowing the importation of drugs with 
appropriate safeguards. This legislation mandates that the Food and 
Drug Administration approve drugs and manufacturing facilities before 
reimportation. In addition, imported drugs must be packaged and shipped 
using approved counterfeit-resistant technologies. The truth is, more 
people in Wisconsin have become sick from imported strawberries than 
from imported prescription drugs. Today, the FDA only imports roughly 1 
percent of imported food. Surely we can do a better job of ensuring the 
safety of imported drugs.
  As I travel around my district in western Wisconsin I consistently 
hear about the high cost of prescription medicines, not only from my 
seniors but also from businesses and average citizens. The 
Pharmaceutical Market Access Act is a significant step in the right 
direction to bring prescription drug costs down and ensure that all 
Americans have better access to affordable medicines. I urge my 
colleagues to support H.R. 2327.
  Mr. SIMMONS. Mr. Speaker, I rise in opposition to H.R. 2427, 
Prescription Drug Reimportation legislation. My fear is that this bill 
will result in a flood of fake foreign pharmaceuticals into our 
country.
  Immediately following 9/11/01, Congress came together in a bipartisan 
fashion and moved quickly and swiftly to protect our borders, protect 
our airports, protect our drinking water, our food supply.
  Yet the reimportation bill before Congress today would allow the 
import of unregulated prescription drugs through our borders.
  That's why so many groups oppose H.R. 2427. This bill, although well-
intentioned, jeopardizes the safety of consumers who use prescription 
drugs.
  Among the opponents to the bill is the Food and Drug Administration. 
In a letter to Congress, the FDA stated that H.R. 2427 ``would erode 
the ability of the FDA to fulfill its challenging mission of ensuring 
the safety and efficacy of the U.S. drug supply.'' The FDA goes on to 
state it, ``simply cannot support legislation that exposes Americans to 
greater potential risk of harm from unsafe or ineffective drugs.''
  The American Medical Association, who also opposes the bill, stated 
in a recent letter, ``We believe that H.R. 2427 would be so dangerous 
to patient safety that we must oppose it.''
  From my home state, the Connecticut Medical Society says, ``While we 
support broader availability of prescription drugs at the lowest price 
possible, quality must be assured. For the safety of our patients in 
Connecticut, we respectfully urge you to reject H.R. 2427.''
  Our Nation's pharmacists also oppose the measure. The National 
Community Pharmacists Association says it ``is strongly opposed to any 
legislation that legalizes and/or encourages the importation of 
prescription drugs by individuals.''
  Mr. Chairman, I believe in listening to the experts. And it's clear 
that the experts all oppose this unsafe policy.
  Instead of supporting a risky reimportation bill, Congress must work 
harder to bring a cost-effective prescription drug bill to our 
citizens. American citizens deserve access to safe, effective American 
drugs.
  I urge my colleagues to join me in voting against H.R. 2427.
  Ms. KILPATRICK. Mr. Speaker, I rise in support of H.R. 2427, the 
Pharmaceutical Market Access Act of 2003, sponsored by Representatives 
Gutkneckt and Emerson. I appreciate their hard work and efforts to 
bring this bill up for debate in this chamber. They have faced 
considerable obstacles in trying to get this bill considered by this 
chamber. They are to be commended for their success in having H.R. 2427 
debated tonight.
  Opponents of this bill suggest that patients whom we intend to help 
with the passage of this bill will actually be harmed. They charge that 
they will be vulnerable to purchasing unsafe prescription drugs and 
that we are encouraging patients to purchase lower-cost drugs from 
countries that have less stringent regulatory regimes. Opponents are 
also concerned that the bill repeals language that requires the 
Secretary of Health and Human Services to certify that reimportation of 
prescription drugs is safe before any reimportation occurs. There are 
more objections to the legislation, but I have mentioned the major 
arguments advocated by the bill's opponents.
  Not too long ago a pharmacist from Michigan visited with my 
Washington staff. He told my staff how seniors would leave his pharmacy 
in tears because they did not have the

[[Page 19557]]

resources to purchase their medicine. This is an important issue to 
seniors. It is an important issue to all Americans because the high 
cost of prescription drugs is driving many families to dilute 
prescribed dosages in order to stretch out their prescription orders to 
make them last longer. If pharmacists were able to purchase drugs, 
lower costs would be passed on to our seniors and families who are 
struggling with the high cost of health care.
  This is the only opportunity that this Congress will have to vote on 
legislation dealing with the cost of prescription drugs. I am using 
this opportunity to support lower drug prices for many Americans. This 
bill puts people before profits. It puts affordable health care for 
Americans ahead of profit margins for the pharmaceutical industry. It 
is time to send the industry and the Administration a message: 
Americans want affordable drug prices. Support this bill and put people 
ahead of the profit margins of the pharmaceutical industry.
  Mr. EVANS. Mr. Speaker, everyone knows American seniors are facing 
staggering prescription drug costs. Currently, safe and cheaper drugs 
lie across our northern border in Canada. Seniors do not have to go far 
to see how much less the rest of the world pays for the same FDA-
approved drugs sold many times higher in our country.
  The issue of the safety is a non-issue. Seniors in Illinois know that 
the pharmaceutical industry is fighting one of the biggest and most 
expensive fights to keep the United States in this protectionist state, 
not because drugs from FDA-approved facilities in other industrialized 
countries are unsafe, but because this measure forces drug companies 
here to lower their hugely inflated prices.
  With the implementation of affordable, anti-counterfeit technology, 
we will know that drugs that come into this country are indeed safe, 
reliable, and tamper-free. There is a counterfeit technology currently 
being used by the drug industry in the EU. This is a similar technology 
used on billions of pieces of currency around the world which is a 
testament to its effectiveness and true affordability. There is no 
evidence to believe that the importation of prescription drugs will 
increase Americans' risk of receiving tainted drugs.
  It is ironic, Mr. Speaker, that the discussion of drug re-importation 
comes hours after debate on two free trade bills. While we have debated 
and passed today two bills that do not meet these standards, many of my 
colleagues are not willing to engage in the trade of FDA-approved drugs 
from industrialized nations that do indeed meet these standards. Many 
of these countries already have free trade agreements with the U.S. and 
the most important factor is that this reimportation will benefit 
Americans greatly through reduced pharmaceutical prices; not taking 
away a single American job.
  H.R. 2427 will make sure that Americans have access to fair prices by 
forcing the drug industry to play by the same rule as every other 
business. My colleagues continually come to this floor to speak on 
behalf of ``free markets'' and this is one opportunity to demonstrate 
whether they support an industry hiding behind protective trade 
barriers or one providing a needed good at a competitive price. I urge 
my colleagues to do the right thing for America's seniors and support 
this legislation.
  Ms. SCHAKOWSKY. Mr. Speaker, I rise tonight in support of H.R. 2427, 
the Pharmaceutical Access Act.
  Over 13 million senior citizens on Medicare and 42 million uninsured 
Americans have no access to prescription drug coverage. Millions of 
others have skimpy coverage that runs out quickly, leaving them to face 
months of bills that they must scramble to find the money to pay. The 
excessive price of prescription drugs creates financial crises for 
those who struggle to pay exorbitant bills and health crises for those 
who are forced to go without needed medications, to share drugs with 
family members, or to take half doses in an attempt to make their 
prescription last a little longer.
  I wish that we were on the floor tonight debating legislation to 
force U.S. drug manufacturers to charge reasonable prices for their 
products, products that are developed and tested with significant 
amounts of U.S. taxpayer dollars. It is shameful that we--alone among 
the industrialized world--have left the pharmaceutical industry free to 
price gouge our constituents. We should be here tonight debating 
measures to ensure that health care consumers can go to their local 
pharmacy and get the drugs that they need at a price that they can 
afford. We should be passing legislation to make sure that American 
consumers here at home are not charged many times more than their 
neighbors in Canada for the same drugs.
  Unfortunately, the drug companies have used their financial clout to 
prevent those debates. Last year, drug companies spent over $91 million 
to lobby Congress. They hired 675 lobbyists--enough to provide each 
member of Congress with their own personal lobbyist with more to spare. 
They have spent millions of dollars on front groups to get their 
message out. Tragically for the American consumer, those investments 
have paid off. Last month, this body even passed a Medicare 
prescription drug bill that prohibits Medicare from using its power to 
negotiate for discounts or from interfering in any way to lower 
unconscionably high drug prices. Ironically, a number of my colleagues 
who support H.R. 2427 because it will give American consumers access to 
affordable drug prices established through negotiations by other 
governments, voted to prevent Medicare from using the same techniques.
  Tonight, the drug industry is now working to shut down the only 
remaining avenue open to senior citizens and other health care 
consumers. Having stopped access to affordable drugs here in the United 
States, the drug companies are now trying to block access to affordable 
drugs from Canada and other countries.
  Reimportation can and must be done safely. We all want to make sure 
that consumers get safe medications. H.R. 2427 provides access only to 
FDA-approved drugs manufactured in FDA-approved facilities. There are 
requirements that drugs must be packaged to prevent tampering. There is 
not a single documented death from imported drugs, and we have the 
means to maintain that record.
  We all know that the reason the drug industry is pulling out all the 
stops to prevent passage of the Pharmaceutical Access Act is not their 
concern about safety, it is their concern about their profits. We could 
put every safety protection in a reimportation bill and the U.S. drug 
industry will still oppose it. They will oppose any bill that prevents 
U.S. consumers from being held hostage to their price-gouging 
practices.
  If this body is unwilling to take on the drug industry here at home, 
the least that we can do is to ensure that U.S. consumers will have 
access to safe and affordable drugs through reimportation. We should 
pass H.R. 2427 but, in doing so, we should not be too quick to claim 
victory. We should not be proud of telling our constituents that they 
must rely on the actions of foreign governments to provide them with 
affordable medications. The real solution--the solution of which we 
could all be proud--would be if we were willing to join those 
governments in confronting the power and greed of the pharmaceutical 
industry.
  Mr. LEVIN. Mr. Speaker, tonight I vote for H.R. 2427 with some 
reservations. I have put those reservations aside because this is not 
the final step in the process.
  I would have much preferred if the Republican leadership had not 
blocked a vote on the Emerson ``Save Our Seniors Act'' and all other 
amendments. Unfortunately, the Republican leadership decided to block a 
vote on Emerson and all amendments in the hopes of shutting this effort 
down and saving the pharmaceutical industry's policy of charging 
Americans the highest drug prices in the world.
  Our senior citizens are more likely to need prescription drugs and 
less likely to have insurance to cover them than any other group. As a 
result, many of them pay high prices or go without needed medication. 
That is wrong.
  In recent years, many seniors in my district have tried to solve this 
problem by traveling to Canada, where drugmakers charge lower prices 
for the same medications. Some of them have been able to purchase 
medications, especially for chronic illnesses, at a thirty to 50 
percent discount. I strongly support allowing them to continue doing 
this without interference from the Food and Drug Administration or the 
U.S. Customs department. I believe that Canada's system of regulating 
prescription medications sold at its pharmacies is safe and reliable 
for my constituents.
  But bus trips to Canada should not be the answer to the serious 
problem facing our seniors. The real answer is a Medicare prescription 
drug benefit so that they can get the drugs they need here at home. I 
have cosponsored H.R. 1199, which would add a comprehensive 
prescription drug benefit to the Medicare seniors know and trust. If 
H.R. 1199 becomes law, the federal government will be able to negotiate 
lower prices for medications and help seniors afford to buy them.
  Last month, the House instead passed a bill which uses an inadequate, 
unreliable drug insurance program for seniors as a decoy to distract 
people from the bill's real purpose--privatizing Medicare and turning 
it into a voucher program. I voted against that bad bill. That bill is 
now in a House-Senate conference, which is charged with combining it 
with a very different Senate bill. If H.R. 2427 passes the House 
tonight, it will become part of the discussion for that conference 
committee and increase the pressure for that committee to address the 
issue of affordable drugs, rather than focusing on privatizing 
Medicare.

[[Page 19558]]

  I believe we must address the issue of real drug coverage for seniors 
and the issue of unreasonably high drug prices. The Republican 
leadership hoped to avoid that issue by only allowing a vote on the 
broadest possible approach. Tonight, I stand with my colleagues in 
refusing to play games, and I will vote for H.R. 2427 to keep this 
issue alive and force action.
  Mr. STARK. Mr. Speaker, I rise in support of H.R. 2427, the 
Pharmaceutical Market Access Act.
  This bipartisan legislation overcomes the stranglehold that the drug 
lobby has on Congress and provides a means of providing safe, 
affordable medication to all our citizens. It allows for the 
importation from Canada and Western European countries of Federal Drug 
Administration (FDA)-approved prescription drugs that sell at prices 
significantly below those charged for the same medications in the 
United States.
  Last year, average drug prices in the United States were 
approximately 67 percent higher than those in Canada and about twice 
those in Italy and France. Yes, for the same drugs! As a result of 
these high prices, many Americans are denied the medical treatment they 
require. They just cannot afford to pay for the drugs they need for 
their health. This bill takes a commonsense approach to address this 
problem; it provides Americans ready access to these same lower cost 
drugs from other countries.
  The opponents of this bill--most notably the administration, 
Republican House leaders and the powerful drug lobby--contend that the 
passage of this legislation would compromise the safety of prescription 
drugs in this country. Let's examine the validity of this contention:
  There is no validity to opponents' claims that this legislation would 
open our markets to counterfeit drugs. The legislation not only 
requires that these imported drugs meet current Federal drug 
regulations, but it strengthens these standards by requiring all 
prescription drugs sold in the country to use high security, 
counterfeit-resistant packaging. (A technology already being used 
throughout the European Union). Furthermore, the legislation only 
allows the importation of FDA-approved drugs manufactured in FDA-
approved facilities.
  Opponents falsely claim that this legislation would allow individuals 
to access drugs without prescriptions. The regulations currently in 
effect controlling the accessibility of prescription drugs are not 
changed at all by this legislation.
  Despite protests from those who oppose this bill, the fact is that 
drug manufacturers safely import an estimated $14.7 billion worth of 
FDA-approved drugs into this country today. It is also estimated that 
more than a million Americans already purchase their medications from 
outside the American market--for example, by taking trips into Canada 
or by making an Internet purchase--without any evidence of adverse 
effects.
  Thus, it appears that the safety argument is just a red herring. A 
bogus argument to defeat this legislation and continue the practice of 
providing Americans with ready access solely to drugs offered at 
inflated prices that feed the insatiable profit-hungry appetite of the 
pharmaceutical industry and corporate investors. It is time to put an 
end to this practice.
  The goal of this bill is simple. It will allow American consumers the 
right to purchase needed medication at a lower price. I urge my 
colleagues to support the passage of the Pharmaceutical Market Access 
Act.
  Mr. BLUMENAUER. Mr. Speaker, I am glad that the House has finally 
decided to confront what can only be described as a national 
embarrassment. Today we must take steps to prevent our low-income 
seniors from paying the highest prescription drug prices in the world.
  Reimportation is a valid approach. While it may slice drug profits, 
it costs taxpayers nothing.
  If we do not act to protect seniors from skyrocketing drug prices, I 
worry that it is because we are choosing to protect drug companies from 
competition on the world market. This competition with willing sellers 
of FDA approved drugs from abroad will ensure that our seniors get the 
lower prices that citizens in other countries enjoy.
  Opponents of this common sense solution warn of grave risks, which 
the evidence suggests are wildly exaggerated. There are certainly fewer 
risks than continuing the mass underground reimportation that takes 
place today.
  Tonight's vote is an important step in this struggle to stop the 
exploitation of seniors. It is, however, just a beginning. I look 
forward to building on this momentum for the hard task ahead.
  Mr. SMITH of Texas. Mr. Speaker, I rise in opposition to H.R. 2427. 
Like many of my colleagues, I am greatly alarmed by the negative 
ramifications of this legislation. This bill threatens continued 
patient access to safe and regulated prescription drug products, fails 
to address affordability issues for senior citizens, and violates U.S. 
drug patent and trade agreements.
  This bill directly undermines the current regulatory system to 
prevent unapproved or otherwise unsafe prescription drugs from entering 
the U.S. consumer market. It prevents regulating authorities from 
enforcing drug labeling standards, inspecting the quality and 
components of imported drugs, verifying that strict safety standards 
are met, and maintaining market-related drug prices.
  In addition, H.R. 2427 fails to provide lower prescription drug costs 
to patients and senior citizens. According to the congressional Budget 
Office, the importation program does not result in savings to the 
federal government or consumers as previously predicted. In fact, CBO 
reports that if ``manufacturers were unable to limit the supply of 
drugs entering the U.S. market from Canada, the likely result would be 
that brand-name prices in Canada would rise much more than the price in 
the U.S. would decline.''
  Finally, this legislation allows the wholesale and individual 
importation of drugs into the U.S. from Canada even where a U.S. patent 
exists. This will nullify a patent owner's exclusive right to prevent 
importation and thereby undermine U.S. patent rights. Further, these 
provisions breach various U.S. international treaty obligations. By 
allowing drugs with a U.S. patent to be imported, the provisions 
violate several free trade agreements to which the U.S. is a party 
because most require that the owner of a patent be able to prevent 
third parties from importing the product without their consent.
  This legislation would dangerously decrease the overall quality of 
drug products that consumers purchase, sabotage the regulatory system, 
and conflict directly with U.S. patent and trade agreements. All 
without lowering prescription drug prices.
  I urge my colleagues to vote ``no'' on H.R. 2427.
  Mr. FRANKS of Arizona. Mr. Speaker, a wise man once said, ``markets 
are more powerful than governments.'' Ronald Reagan believed in the 
power of a free market system. He believed that the market is a model 
for growth throughout the world. That is why I rise today in support of 
H.R. 2427, the Pharmaceutical Market Access Act. As a co-sponsor of 
this legislation, I believe this bill breaks open a market that 
currently does not exist. We live in a terrible anomaly where Americans 
continue to pay drug prices that are 30 to 300 percent more than in 
European and other industrialized nations. Over the next 10 years, 
seniors will spend $1.8 trillion on prescription drugs. That is a 
shocking statistic--one that will cause prescriptions to go unfilled 
because prices are too high in the United States. But, if seniors had 
access to world market drugs, they would save 35 percent, or $630 
billion. We, as American consumers, have the power to knock down this 
unfair barrier to growth and freer access to pharmaceuticals.
  The Opponents of this legislation will tell you that this legislation 
will bring dangerous drugs into this country. They will tell you that 
it allows for faulty packaging and poor shipping conditions. They will 
tell you that this legislation forces American consumers to risk their 
own health. None of these claims are true. The Pharmaceutical Market 
Access Act contains language written by people at the FDA that requires 
that each pharmaceutical shipment be tested, unless the package already 
uses counterfeit-resistant technology. This kind of technology is the 
same technology that the U.S. Department of the Treasury uses to secure 
U.S. currency. And, more importantly, market access would be limited to 
25 industrialized nations, such as Canada, Australia, Japan, Norway, 
Switzerland and New Zealand. The FDA will implement a system to allow 
Americans access to FDA-approved drugs from FDA-approved facilities.
  Today, we prohibit Americans access to other markets, but other 
products in the consumer chain--like, fruit or meat--are allowed. This 
is or opportunity to codify our fundamental right to open 
pharmaceutical markets and allow seniors to keep more of their hard-
earned dollars in their pockets. This is our opportunity to give 
pharmaceutical companies the leverage that they need to knock down 
barriers, and more importantly, to knock down price controls. In the 
long run, this will be better for pharmaceutical companies and better 
for American consumers. I commend Mr. Gutknecht  for being a champion 
of this important issue and I urge my colleague to support this effort.
  Mr. KNOLLENBERG. Mr. Speaker, I rise today to urge my colleagues to 
protect the well-being of the American people by voting against H.R. 
2427, the Pharmaceutical Market

[[Page 19559]]

Access Act, which would allow the re-importation of drugs.
  It is estimated that more than 10 percent of drugs worldwide are 
counterfeit, and in some countries, more than half the drug supply is 
fake. We have seen in this country the tragic consequences of 
counterfeit drugs.
  For example, many American AIDS and cancer patients were victims of a 
counterfeit version of the injectible medication, Procrit. Hawked as 
the life-prolonging Procrit, the counterfeit drug proved to be lethal, 
non-sterile tap water. How many more cases like this will we experience 
with re-importation?
  In fact, multiple FDA commissioners have declared, ``Consumers are 
exposed to a number of potential risks when they purchase drugs from 
foreign sources.''
  I sincerely appreciate my colleagues' efforts to make prescription 
drugs more accessible. However, this pursuit of accessibility 
compromises the health and safety of American citizens. I encourage all 
my colleagues to ensure the safety of our citizens by voting against 
H.R. 2427.
  The SPEAKER pro tempore (Mr. LaHood). All time for debate has 
expired.
  Pursuant to House Resolution 335, the bill is considered read for 
amendment, and the previous question is ordered.
  The question is on the engrossment and third reading of the bill.
  The bill was ordered to be engrossed and read a third time, and was 
read the third time.


               Motion to Recommit Offered By Mr. Dingell

  Mr. DINGELL. Mr. Speaker, I offer a motion to recommit.
  The SPEAKER pro tempore. Is the gentleman opposed to the bill?
  Mr. DINGELL. Most vigorously so, Mr. Speaker.
  The SPEAKER pro tempore. The Clerk will report the motion to 
recommit.
  The Clerk read as follows:
       Mr. Dingell of Michigan moves to recommit the bill, H.R. 
     2427, to the Committee on Energy and Commerce.

  The SPEAKER pro tempore. Without objection, the previous question is 
ordered on the motion to recommit.
  There was no objection.
  The SPEAKER pro tempore. The question is on the motion to recommit.
  The motion to recommit was rejected.
  The SPEAKER pro tempore. The question is on the passage of the bill.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.


                             Recorded Vote

  Mr. TAUZIN. Mr. Speaker, I demand a recorded vote.
  A recorded vote was ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, this 15-
minute vote on passage will be followed by a 5-minute vote on the 
motion to instruct on H.R. 1308, if ordered.
  The vote was taken by electronic device, and there were--ayes 243, 
noes 186, not voting 6, as follows:

                             [Roll No. 445]

                               AYES--243

     Abercrombie
     Ackerman
     Aderholt
     Allen
     Baca
     Baird
     Baldwin
     Ballance
     Bartlett (MD)
     Bass
     Becerra
     Bell
     Bereuter
     Berkley
     Berry
     Bishop (GA)
     Bishop (NY)
     Blumenauer
     Bono
     Boozman
     Boswell
     Boucher
     Boyd
     Brady (PA)
     Brady (TX)
     Brown (OH)
     Brown (SC)
     Brown, Corrine
     Brown-Waite, Ginny
     Burton (IN)
     Capito
     Capps
     Capuano
     Cardoza
     Carson (IN)
     Case
     Castle
     Clay
     Conyers
     Cooper
     Costello
     Cramer
     Crowley
     Culberson
     Cummings
     Davis (AL)
     Davis (CA)
     Davis (IL)
     Davis (TN)
     Davis, Jo Ann
     DeFazio
     Delahunt
     DeLauro
     DeMint
     Deutsch
     Dicks
     Doggett
     Doyle
     Duncan
     Edwards
     Ehlers
     Emanuel
     Emerson
     Engel
     Evans
     Everett
     Fattah
     Filner
     Flake
     Forbes
     Frank (MA)
     Franks (AZ)
     Frost
     Garrett (NJ)
     Gilchrest
     Gonzalez
     Goode
     Goodlatte
     Gordon
     Green (TX)
     Grijalva
     Gutknecht
     Harman
     Hastings (FL)
     Hastings (WA)
     Hayworth
     Hensarling
     Hinchey
     Hinojosa
     Hoeffel
     Hoekstra
     Holden
     Hooley (OR)
     Hoyer
     Hunter
     Hyde
     Inslee
     Israel
     Istook
     Jackson (IL)
     Jackson-Lee (TX)
     Janklow
     Jenkins
     Johnson (CT)
     Jones (NC)
     Jones (OH)
     Kanjorski
     Kaptur
     Kennedy (RI)
     Kildee
     Kilpatrick
     Kind
     King (IA)
     Kingston
     Kleczka
     Kolbe
     Kucinich
     LaHood
     Lampson
     Langevin
     Lantos
     Larsen (WA)
     Larson (CT)
     LaTourette
     Leach
     Lee
     Levin
     Lewis (GA)
     Lipinski
     Lowey
     Lucas (KY)
     Lynch
     Majette
     Maloney
     Manzullo
     Markey
     Marshall
     McCarthy (NY)
     McCollum
     McDermott
     McGovern
     McHugh
     McInnis
     McKeon
     McNulty
     Meehan
     Mica
     Michaud
     Miller (MI)
     Miller (NC)
     Miller, George
     Mollohan
     Moore
     Moran (KS)
     Moran (VA)
     Murtha
     Musgrave
     Myrick
     Nadler
     Napolitano
     Neal (MA)
     Neugebauer
     Northup
     Oberstar
     Obey
     Olver
     Ortiz
     Osborne
     Otter
     Owens
     Pallone
     Paul
     Pelosi
     Peterson (MN)
     Peterson (PA)
     Petri
     Platts
     Pomeroy
     Rahall
     Ramstad
     Rangel
     Rehberg
     Renzi
     Reyes
     Rodriguez
     Rohrabacher
     Ross
     Roybal-Allard
     Royce
     Ruppersberger
     Ryan (OH)
     Ryan (WI)
     Sabo
     Sanchez, Linda T.
     Sanders
     Sandlin
     Schakowsky
     Schiff
     Schrock
     Scott (VA)
     Sensenbrenner
     Serrano
     Shadegg
     Shaw
     Shays
     Sherwood
     Shuster
     Simpson
     Skelton
     Slaughter
     Smith (MI)
     Smith (NJ)
     Snyder
     Solis
     Spratt
     Stark
     Stenholm
     Strickland
     Stupak
     Tancredo
     Taylor (MS)
     Taylor (NC)
     Thornberry
     Tierney
     Toomey
     Turner (TX)
     Udall (NM)
     Van Hollen
     Velazquez
     Vitter
     Wamp
     Waters
     Watson
     Watt
     Weiner
     Wexler
     Wicker
     Wilson (NM)
     Wolf
     Woolsey
     Wu
     Wynn
     Young (FL)

                               NOES--186

     Akin
     Alexander
     Andrews
     Bachus
     Baker
     Ballenger
     Barrett (SC)
     Barton (TX)
     Beauprez
     Berman
     Biggert
     Bilirakis
     Bishop (UT)
     Blackburn
     Blunt
     Boehlert
     Boehner
     Bonilla
     Bonner
     Bradley (NH)
     Burgess
     Burns
     Burr
     Buyer
     Calvert
     Camp
     Cannon
     Cantor
     Cardin
     Carson (OK)
     Carter
     Chabot
     Chocola
     Clyburn
     Coble
     Cole
     Collins
     Cox
     Crane
     Crenshaw
     Cubin
     Cunningham
     Davis (FL)
     Davis, Tom
     Deal (GA)
     DeGette
     DeLay
     Diaz-Balart, L.
     Diaz-Balart, M.
     Dingell
     Dooley (CA)
     Doolittle
     Dreier
     Dunn
     English
     Eshoo
     Etheridge
     Farr
     Feeney
     Ferguson
     Fletcher
     Foley
     Fossella
     Frelinghuysen
     Gallegly
     Gerlach
     Gibbons
     Gillmor
     Gingrey
     Goss
     Granger
     Graves
     Green (WI)
     Greenwood
     Hall
     Harris
     Hart
     Hastert
     Hayes
     Hefley
     Herger
     Hill
     Hobson
     Holt
     Honda
     Hostettler
     Houghton
     Hulshof
     Isakson
     Issa
     John
     Johnson (IL)
     Johnson, E. B.
     Johnson, Sam
     Keller
     Kelly
     Kennedy (MN)
     King (NY)
     Kirk
     Kline
     Knollenberg
     Latham
     Lewis (CA)
     Lewis (KY)
     Linder
     LoBiondo
     Lofgren
     Lucas (OK)
     Matheson
     Matsui
     McCarthy (MO)
     McCotter
     McCrery
     McIntyre
     Meek (FL)
     Meeks (NY)
     Menendez
     Millender-McDonald
     Miller (FL)
     Miller, Gary
     Murphy
     Nethercutt
     Ney
     Norwood
     Nunes
     Nussle
     Ose
     Oxley
     Pascrell
     Payne
     Pearce
     Pence
     Pickering
     Pitts
     Pombo
     Porter
     Portman
     Price (NC)
     Pryce (OH)
     Putnam
     Quinn
     Radanovich
     Regula
     Reynolds
     Rogers (AL)
     Rogers (KY)
     Rogers (MI)
     Ros-Lehtinen
     Rothman
     Rush
     Ryun (KS)
     Sanchez, Loretta
     Saxton
     Scott (GA)
     Sessions
     Sherman
     Shimkus
     Simmons
     Smith (TX)
     Smith (WA)
     Souder
     Stearns
     Sullivan
     Sweeney
     Tanner
     Tauscher
     Tauzin
     Terry
     Thomas
     Thompson (CA)
     Thompson (MS)
     Tiahrt
     Tiberi
     Towns
     Turner (OH)
     Udall (CO)
     Upton
     Visclosky
     Walden (OR)
     Walsh
     Waxman
     Weldon (FL)
     Weller
     Whitfield
     Wilson (SC)
     Young (AK)

                             NOT VOTING--6

     Ford
     Gephardt
     Gutierrez
     Jefferson
     Pastor
     Weldon (PA)


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (Mr. LaHood) (during the vote). Two minutes 
are left to vote.

                              {time}  0251

  Mr. SMITH of Texas changed his vote from ``aye'' to ``no.''
  So the bill was passed.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.

                          ____________________