[Congressional Record (Bound Edition), Volume 149 (2003), Part 4]
[Senate]
[Page 4993]
[From the U.S. Government Publishing Office, www.gpo.gov]




                A PRESCRIPTION DRUG BENEFIT FOR SENIORS

  Mr. DORGAN. Mr. President, having said that, I want to mention two 
additional quick items.
  We have had a discussion, and will have a discussion, about the 
subject of Medicare. It will be a significant issue in this Congress, 
and should be. We have been talking, for a long while, about the health 
needs of senior citizens who do not have access to prescription drugs 
because they are too expensive. Too many senior citizens are told: You 
must take prescription drugs for these ailments you have; and they 
discover: Well, I can't take prescription drugs. I don't have the 
money.
  Republicans and Democrats have been debating how to add a 
prescription drug benefit to the Medicare plan. Today I see the 
President is going to send us a proposal that says we would like to 
give everybody a discount card who would qualify under Medicare, and 
then say to others, if they want to get some real help for real 
prescription drug coverage, they have to join an HMO or a managed care 
organization. That doesn't make any sense to me as a matter of public 
policy. We need to put downward pressure on prescription drug prices 
first and foremost.
  Second, I believe we ought to provide a prescription drug benefit in 
the Medicare Program. If we were writing that program today, we would 
do that. I don't think we ought to hinge that on the requirement that 
someone join an HMO.
  I have been in the Chamber telling stories for 3, 4 years about what 
is happening to HMOs. Some of them are wonderful. But the construct of 
an HMO says to a senior citizen: By the way, here is your doctor. We 
will choose your doctor. You don't get to go to the doctor of your 
choice. Here is the doctor available for you. By the way, in too many 
circumstances, we have seen that in many of those organizations, major 
health care is a function of profit and loss.
  I told the story, when we debated a Patients' Bill of Rights, about 
an HMO. A woman fell off a cliff in the Shenandoah Mountains. She was 
injured badly, had a long fall, broke many bones, had internal 
injuries. She was taken to a hospital in a coma. As she was wheeled 
into the hospital room on a gurney, there was a question whether she 
would survive. She did survive. It took a long while. Month after 
month, she finally convalesced and survived.
  Her HMO told her: We will not pay for your emergency room treatment 
because you didn't have prior approval for emergency room use.
  This is a woman hauled into the emergency room in a coma and was 
told: You don't get paid for the emergency room because you didn't get 
prior approval. Is that nuts? Of course it is. That is exactly what 
happened to this woman because somebody was looking at her in terms of 
profit and loss. That is not the way someone's person or body should be 
presented in the medical system. This is not profit and loss. It is 
about saving lives.
  To say to senior citizens we will help them with the cost of 
prescription drugs but only if they go into an HMO or a managed care 
organization does not make much sense to me. This Congress can do 
better than that. We must do better.

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