[Congressional Record (Bound Edition), Volume 149 (2003), Part 2]
[Senate]
[Pages 1803-1804]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              HEALTH CARE

  Ms. STABENOW. Mr. President, I first thank my friend from California 
for her usual eloquence. I agree totally with her sense of what our 
people are feeling in terms of the anxiousness about possible war, the 
anxiousness about education for our children, about health care, about 
jobs, about homeland security. I thank Senator Boxer for her comments 
this morning.
  I will follow up talking about an area that is so important to each 
of our families and is a growing concern to businesses in the country 
and to workers in the country; that is the whole question of health 
care.
  We know there is a growing sense of anxiousness. When I sit down with 
small businesses across Michigan, they tell me their fastest growing 
cost is their health care premiums. In some cases they are doubling. 
When I talk to the big three automakers and the other manufacturers in 
Michigan, I hear the same thing. When I hear from Chrysler that they 
are spending more on health care than on the raw materials for the 
vehicles--I am concerned. This shows me we have a serious, serious 
crisis, a health care crisis.
  At the same time, we all have spoken about the seniors of our country 
who are choosing between their food and their medicine. This is real. 
People are asking us to act. Words are not enough. Rhetoric is not 
enough. We have to act in a way that provides opportunity for quality, 
affordable, accessible health care.
  On the eve of the State of the Union Address, I rise to ask the 
President of the United States what he intends to do. Will he, in fact, 
change his record and work with us on issues of health care in a 
bipartisan way, to actually get something done? I worry, myself, 
because of the record I have seen in the last 2 years. We have a record 
of this administration on health care that, unfortunately, is bad 
medicine for the American people. We have attempted on several 
occasions to move forward policies and proposals that are in the best 
interests of the American people. This administration continues to 
oppose those.
  I am talking about a Medicare benefit for all seniors for 
prescription drugs under Medicare that is affordable, that is 
dependable, that is available to all of our seniors--this President has 
consistently opposed that approach. Whether it is also making 
prescription drugs affordable for all Americans and lowering the prices 
for our businesses--the President has opposed efforts to open the doors 
to Canada to drop prices immediately, and he has opposed efforts to 
make sure we have more competition in the system by closing the generic 
drug law loopholes. Generic drugs are made by those companies that do 
not do research but take the formulas after the patents expire and are 
able to develop and put on the market lower cost prescription drugs, 
oftentimes exactly like the brand-name drugs. We know they can drop the 
prices up to 70 percent by just having the generic drug laws work.
  We have business coalitions formed across the country urging us to 
pass laws to shut down the loopholes so competition can work to bring 
prices down. Unfortunately, even after we passed a bill in this body, 
in the Senate, the administration has opposed it.
  We have innovative State solutions like what has been done in Maine 
where the State wants to come in and use its bulk purchasing power and 
leverage that to negotiate lower prices on behalf of the uninsured who 
pay the top prices in the world right now for their prescriptions. Our 
State governments understand that. Our Governors want the flexibility 
to be able to bulk purchase and lower prices. This administration has 
opposed it.
  We need fair prices for Medicare providers. While we have seen some 
willingness, and I appreciate that, to focus on the cuts that have been 
put into place for our physicians--that certainly needs to be done--
what about the home health agencies that are closing? What about our 
nursing homes? What about our hospitals, our teaching facilities? We 
have a crisis in health care, and the last thing we need to do is to be 
making more cuts to Medicare or Medicaid. Yet the administration has, 
to date, opposed fixing the Medicare problem.
  The Patients' Bill of Rights, a real Patients' Bill of Rights so that 
those who are in HMOs have the opportunity to have the physician of 
their choice and to have the rights available to them they wish to have 
to protect their families, a strong Patients' Bill of Rights--this 
administration has consistently opposed that, as well.
  And what about assistance to States for Medicaid? Right now 25 
percent of Michigan's State budget is Medicaid. We have a $2 billion 
deficit in Michigan

[[Page 1804]]

out of a $9 billion budget. Our new Governor is doing a wonderful job 
of trying to make the numbers add up, but without Federal support and 
help they will not add up and people will be hurt and doctors and 
health facilities will be hurt. Yet, consistently, when we have tried 
to put forward plans on this floor, even plans that have passed the 
Senate have not made it all the way because this administration will 
not support efforts to help our States and to help Medicaid.
  Finally, there was a commitment made to double the National 
Institutes of Health funding by 2003. The administration supports 
funding cuts that will not meet that goal.
  Unfortunately, the Bush record on health care to date has been bad 
medicine for the American people. I ask the President today, rather 
than moving forward with the proposals we are hearing about attempting, 
essentially, to privatize Medicare, this evening I urge him to reassess 
and to join us in bipartisan efforts to make sure our citizens have the 
health care they need and our businesses can afford.
  Mr. DURBIN. Will the Senator yield for a question?
  Ms. STABENOW. I will be happy to yield.
  Mr. DURBIN. I would like to ask the Senator two brief questions, but 
first I salute her for her leadership. Since she has arrived in the 
Senate, she has been the most outspoken advocate for making health care 
affordable and accessible for Americans.
  Let me make certain I understand. As you describe it, President 
Bush's proposed Medicare reform will say to seniors: If you want 
prescription drug coverage, you have to leave the Medicare Program and 
go into an HMO.
  Because we have not passed the law giving people in an HMO the right 
to pick their own doctor, what he is saying to seniors is: If you want 
to have your choice of prescription drugs, then you have to give up 
your choice of a personal doctor.
  Is that what the choice is?
  Ms. STABENOW. That is absolutely correct. I thank my friend from 
Illinois, who is always in the Chamber fighting on behalf of the people 
of his State and the country.
  There is no doubt about it, while the President is talking about 
increased choices, what he is really saying is, if you want to get help 
with your exploding prescription drug costs, if you want to stop having 
to pick between meals and your medicine, then you are going to have to 
go into a private insurance company, an HMO, where they will decide 
about your doctor. In fact, he is not willing to support a Patients' 
Bill of Rights to make sure they get what they need while they are in 
the HMO.
  Mr. DURBIN. One last question. I know the Senator has more to add. Is 
there anything you heard about what the President is going to suggest 
that will lower the cost of health insurance for families and 
businesses across America, an exploding item in terms of their expenses 
which is pushing more and more people into the situation of being 
uninsured, underinsured, or putting more and more of their paycheck, 
every week, into the cost of their health insurance? Has the President 
suggested anything that will address that?
  Ms. STABENOW. Unfortunately, no. We have seen a consistent effort to 
put forward plans that are supported by the brand name pharmaceutical 
industry itself or by the insurance companies, but not those things 
that will lower prices and make health care more affordable and more 
available.
  Last summer, with a very rigorous debate on the Senate floor and a 
strong bipartisan vote, we passed a bill that would create more 
competition to lower prescription drug prices; it went to the House of 
Representatives where it did not see the light of day. Unfortunately, 
without the President's support and leadership, it will continue to be 
that way. We need the President to step up and say that the fact that 
prescription drug prices are going up three times the rate of inflation 
every year and that is too much.
  It is too much. Our businesses cannot sustain that. They cannot 
sustain seeing their health care premiums double. At the same time, if 
you are an uninsured senior in this country, you are paying top dollar. 
Isn't it ironic that of all of those who pay for prescription drugs 
around the world, the people who pay literally the most for their 
medicine are uninsured people, most of whom are seniors, because they 
do not have anybody negotiating on their behalf. They do not have 
Medicare right now coming in and saying: We are going to negotiate a 
group price. So they pay the highest price.
  Why wouldn't it make sense to have Medicare coverage? The brand name 
companies do not want Medicare negotiating on behalf of 40 million 
seniors and the disabled to lower prices. So what they have come up 
with is this scheme that would essentially not allow the clout of 
buying power because Medicare would not directly be providing the 
prescription drug coverage. But they want to act as if they would like 
to have prescription drug coverage for seniors, so they come up with 
this plan that would say: We will help you with your medicine if you go 
into a private-sector HMO.
  By the way, in Michigan, now we have seen, since the inception of 
what is really Medicare+Choice--which is the plan that has already been 
out there for private sector Medicare HMO coverage--more than 51,000 
seniors in Michigan have been disenrolled because plans have withdrawn 
from Michigan. In fact, we do not have any HMOs in the Upper Peninsula. 
We have very few plans in Michigan.
  In fact, my own mother, who was in an HMO and enjoying the coverage 
under Medicare+Choice, was dropped because the plan withdrew from 
Michigan. So we only have four private sector HMO plans in Medicare 
left in Michigan, and they only serve 2 percent of the eligible 
Medicare beneficiaries in the State--2 percent--and the majority are in 
nine counties in southeastern Michigan, with the rest of the State not 
being covered. By the way, none of those plans are accepting new people 
or new enrollees.
  So the President says: Let's take this plan that covers very few 
people, where it is not working, and let's say if you want Medicare 
prescription drug coverage, you have to go through this failed plan. I, 
for the life of me, cannot understand why this approach is being put 
forward except for the fact that certainly from the prescription drug 
industry's standpoint, it is better than going under Medicare.
  So, Mr. President, I would ask this evening for you to please speak 
to the anxiety, the anxiousness that we all feel, that Americans feel 
for our families, for our businesses, that workers feel when they now 
find their pay being frozen so their employers can afford the explosion 
in the health care crisis. I would like you to speak to those issues in 
very real ways. Do not offer failed plans just to be able to speak 
about this issue. Join with us in bipartisan efforts that we know will 
work, efforts that have been supported by the private sector as well as 
the public sector, efforts that are supported by workers, by seniors, 
by all of those who have a stake in making sure that health care is 
affordable and available.
  We had a plan. We had a bill, S. 812, that passed this Senate last 
summer. I commend all of my colleagues on both sides of the aisle who 
voted for that legislation. We can cut prices that lower premiums for 
our businesses. We can provide Medicare coverage. And we can do it in a 
real way.
  I urge, tonight, that the President speak to us. And I invite him to 
join with us in a plan that will work.
  The PRESIDING OFFICER. The Senator's time has expired.
  The PRESIDING OFFICER. Under the previous order, the Senator from 
Delaware is recognized.

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