[Congressional Record (Bound Edition), Volume 150 (2004), Part 15]
[House]
[Pages 20623-20628]
[From the U.S. Government Publishing Office, www.gpo.gov]




             THE TRUTH ABOUT THE MEDICARE MODERNIZATION ACT

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 7, 2003, the gentleman from Georgia (Mr. Gingrey) is recognized 
for 60 minutes as the designee of the majority leader.
  Mr. GINGREY. Mr. Speaker, it is a pleasure to come before my 
colleagues on the House floor this evening to spend an hour with them 
talking about the new Medicare Prescription Drug part D and Medicare 
Modernization Act, which was passed in December 2003 in a bipartisan 
fashion by this body and signed into law by President Bush. But before 
we get started, I want to spend time going through a lot of the nuances 
of this bill and make sure that all of my colleagues, and especially, 
of course, if some seniors and people that are watching this body and 
paying attention to what we say here on this floor, it will help them 
better understand, and I think we will have spent a very, very 
beneficial hour this evening.
  Before I get started, I cannot help but think about, this is October 
4, the fall of the year, the most beautiful time of the year in many 
parts of this great Nation of ours, especially in my home State of 
Georgia and my 11th Congressional District in the northern part of the 
State. In 27 days will be one of my favorite holidays, and I am sure my 
colleagues would agree with me that Halloween, Halloween is always one 
of the most fun times of the year, especially if you have children, as 
I have. Now they are adults. I also now have precious grandchildren. 
What an exciting thing to go door to door in your neighborhood, in a 
safe environment, trick or treating, maybe even scaring people a little 
bit, scaring other kids with the costumes and the spooks and the 
goblins; and every now and then, if you do not get a good treat when 
you knock on somebody's door, some mean old, grumpy adult, you will 
scare them too.
  But what we are seeing today in this body, maybe because it is a 
Presidential election year, but all of a sudden, Halloween does not 
seem so funny to me anymore, because what I am seeing from Members of 
this very body is adults scaring adults. And not just scaring adults, 
but scaring specific adults, and that is the great senior citizens of 
this country. In fact, I call these scare tactics, without putting on a 
costume, it is mainly just rhetoric, I call it Mediscare, Mediscare.
  I am sure lots of seniors, I know they have in my district, because I 
have gone across the 17 counties doing well over 60 town hall meetings 
now with senior citizens, talking to the seniors about this new 
program, this good program, this good first step. But they have already 
been scared. They have been scared by so much of this rhetoric, as an 
example, that says you are going to lose your Medicare as you know it. 
They, the Republican majority, the President of the United States, this 
administration, they are going to take away Medicare as you know it. 
That is one Mediscare tactic.
  Another: this bill is nothing but a giveaway to the pharmaceutical 
industry; that is all it is. The pharmaceutical industry contributes 
all of this money to Republican Members of the Congress to buy this 
bill. In fact, the pharmaceutical industry, they drew up the bill. It 
is nothing but a giveaway to the pharmaceutical industry.
  I am going to refute some of these Mediscare tactics, and on that one 
I would like to right at the outset say, if that were true, when 
Medicare was first signed into law by a Democratic President, Lyndon 
Johnson, in 1965, and we had part A and part B, part A, the hospital 
part; part B, the doctor part. I never heard anybody say, and I am sure 
my colleagues never heard anybody saying that part A was nothing but a 
giveaway to the hospitals, or that part B was nothing but a giveaway to 
the doctors, because they happen to be the ones who respectively 
provided that care under part A and part B.
  No, they did not call it a giveaway. In fact, the hospitals and the 
doctors,

[[Page 20624]]

over the 38 years of the program, and it is a good program, I think it 
has served us well. I do not think we could get too many of my 
physician colleagues, and oh, by the way, I think my colleagues know 
that I am one of seven physician members of this body; not many of my 
colleagues are saying today Medicare part A or medicare part B, 
certainly my rural hospitals in the 11th Congressional District of 
Georgia, they are not saying Congressman, part A medicare has been 
nothing but a money tree for us, it has been wonderful, part A has been 
great for rural hospitals. No. They are struggling. Every day they are 
struggling.
  So we hear all of these things and these scare tactics and telling 
the seniors, even now that we have this interim prescription drug 
discount program, because it takes a while to get the prescription drug 
benefit, the insurance part, and it is totally, totally optional, not 
required; but we will not have that ready until January of 2006. But 
this President and this Congress and this leadership, this Republican 
leadership, knew that our seniors needed relief right now. They really 
do. Some are trying to make these decisions about paying their utility 
bill or their mortgage payment; and all of a sudden, it is time to 
refill that prescription and they do not have the money to do it. And 
they are breaking pills and they are skipping pills. These seniors, 
those who are on fixed income, those low-income seniors who are in that 
bind really cannot wait until January 1 of 2006. They need relief right 
now.
  That is what the interim prescription drug discount program is all 
about. It is a Godsend for them. Yet, here again, Halloween is upon us, 
really a Presidential election is upon us, just 3 days after Halloween. 
That is what it is all about. But to scare seniors, especially those 
needy seniors who, by just signing up for that prescription drug 
Medicare-approved discount card get a $600 credit each of the 2 years; 
a $1,200 credit toward the purchase of those much and badly, 
desperately needed drugs. They are being scared into not signing up, 
not picking up that telephone and dialing 1-800 Medicare and spending 
15 to 20 minutes at most on the phone and getting that card in their 
hand.
  These cards have been available since June 1 of this year. I am very 
pleased that 1.8 million currently have them of the low-income, needy 
seniors, and something like 4 million overall. But we need to do 
better, and the reason we are not doing better is simply because of 
this Halloween Mediscare mentality of scaring seniors into not 
participating.

                              {time}  2115

  Well, enough of that. We will get back to that maybe a little later 
in the hour. But let us talk a little bit about the reason that we need 
to have a prescription drug benefit under Medicare.
  Well, it is a 38-year-old program. Medicare as we know it is a 38-
year-old program. It is a 20th century health care program with no 
coverage for prescription drugs, none whatsoever, except certain 
medications that are actually administered by a physician in a doctor's 
office intravenously or intramuscularly to treat maybe end stage renal 
disease and cancer, chemotherapy. Anything else, any time the general 
practitioner, the family practitioner, the general internist, writes 
those three or four prescriptions, none of that, that is all out of 
pocket. And many of our seniors do not have any coverage.
  They do not have an insurance program through the VA program or 
TRICARE or as retirees for let us say a State worker or Federal 
employee or maybe a generous benefit from a company they have worked 
for for 35, for 40 years. Many of them do not have that. They have 
absolutely nothing. So this program is way, way overdue. And so many 
other Congresses and other presidents, the Democratic majority have 
made promises to our seniors and talked about delivering, delivering on 
a promise and failed to do so. And all of the sudden this President has 
the courage and the wisdom and the insight and the compassion to get a 
tough bill through this Congress. And now, instead of getting credit 
for that, these Medicare tactics are trying to discredit him over that. 
Amazing. In fact, down right appalling.
  Another scare tactic is this, and I know we all have heard it. When 
we debated the bill there was a lot of discussion about this, and some 
of the seniors organizations were very concerned about, is it possible 
that when we start offering a prescription drug benefit under Medicare, 
are many of the conditions that currently have a health retirement 
benefit for their employees, for their retired employees, that does 
include prescription drugs, are they going to be encouraged because now 
this Medicare Prescription Drug Part B is an optional benefit to 
seniors to just drop these programs?
  So that is another one of the scare tactics. Yeah, do not vote for 
this bill because, if you do, the first thing that is going to happen 
is your company, that you worked for 30, 35 years, they are going to 
drop you like a hot potato, as the expression goes.
  Let me point out to my colleagues, and I want to call their attention 
to this first slide. What this slide shows is that, over the last 12 
years, the number of large employers who have been offering health care 
for their retirees, the number that has actually begun to drop this 
coverage, even before we passed this bill, has been decreasing over 
these last 12 years. This first part of the slide shows people who are 
under 65 and are retired. In 1991, 88 percent of them were covered by 
health care that included a prescription drug benefit. In 2003, this 
coverage has dropped to 72 percent.
  Now, this is for the people who are under 65. What happens now when 
they become Medicare eligible at age 65? In 1991, the percentage that 
were covered by their former employer was 80 percent, less than those 
under 65 who are not eligible for Medicare yet. And the drop off again 
is substantial, from 1991 to 2003, down to 61 percent.
  The point of this first slide is basically to show that this is 
already happening, this is already happening. And it is not because of 
the fact that we now are offering a prescription drug benefit to these 
seniors who now, if they are dropped by these plans by their former 
employer, they have nothing. They have no coverage at all. And as part 
of this new Medicare modernization and prescription drug act, and I do 
not know exactly what the dollar amount of the estimated cost is, the 
Congressional Budget Office very clearly said to the Congress, it is 
going to cost $420 billion over 10 years. We have got another number 
later on that, was over $500 billion, but a significant amount of that 
money, something like $75 billion dollars is going to these companies, 
these large companies, large and small companies, to help them wrap 
around the Medicare prescription drug benefit so they will continue, 
they will continue to offer health insurance that includes prescription 
drugs and actually bend this curve, not make it worse, but maybe stop 
this normal attrition that is already occurring without the 
prescription drug benefit and the modernization to Medicare. This is 
already happening. So we are going to turn that curve around. And I 
sincerely believe that that will happen.
  Remember at the outset when I said about some of the Medicare 
rhetoric, and the first one I think we mentioned was they, the 
Republican majority, the President, indeed, they are about to take away 
Medicare as you know it. And the chairman of the Committee on Ways and 
Means, the gentleman from California (Mr. Thomas), was quoted as 
saying, ``Well, we certainly hope so,'' and roundly criticized by our 
colleagues on the other side of the aisle.
  What the chairman meant by that was quite simply, Medicare as we know 
it has been sorely lacking for all these years, no prescription drug 
benefit, part A and Part B, yes. But all of the sudden we are going to 
offer something that hopefully keeps seniors out of the hospital, they 
now have coverage for that, do they not, under Medicare part A, and out 
of the nursing home also under Medicare part A, but that coverage is 
not to infinity.
  What happens is, when our seniors go into the hospital, there is a 
significant

[[Page 20625]]

co-pay, and they use up their days, and then everything is out-of-
pocket. They have to go into a skilled nursing home for a very limited 
number of days per illness, and then, everything after that is out of 
their pocket. And in many instances, they literally go broke in a 
nursing home and have to go on Medicaid and lose a lot of pride and a 
lot of dignity in the process. But even more importantly, as the 
gentleman from California (Mr. Thomas), so concisely and clearly 
indicated, Medicare as we know it needs improvement. And Medicare as we 
know it, if we do not do something to improve it and we continue to let 
people get terribly sick with end-stage renal disease or significant 
coronary blockage, and they end up in the hospital needing bypass 
surgery or maybe an amputation, and then possibly spend the rest of 
their lives in a nursing home because their high blood pressure was not 
treated in a timely fashion and they suffered what we refer to 
medically as a cerebral vascular accident but what you know as a 
stroke, yes, they get treated all right in the hospital and in the 
nursing home until their money runs out. But is that the compassionate 
thing to do?
  That is Medicare as we know it. That is exactly what the gentleman 
from California (Mr. Thomas) was talking about when he said, Medicare 
as we know it needs to go. We need to improve upon it. And that is what 
we are going to do, and that is what we are doing with this interim 
drug discount program. And starting in January 1 of 2006, the 
opportunity for our seniors, the option or choice, it is not required, 
of course, but hopefully, just as many who signed up back in 1965. It 
was President Truman himself, former President Truman who voluntarily 
signed up for Medicare Part B in 1965; and some 95 percent, maybe more 
than that, of our seniors who are on Medicare, are voluntarily on Part 
B because it is a good program.
  The taxpayers are paying 75 percent of that premium, even though it 
has gone up over the years, because the cost of health care has gone 
up. But that is formula driven. But we need to change Medicare as we 
know it. And that is what we are doing with this bill, this new law. 
And I thank God for that. And I think our seniors thank God for that, 
and they thank this Congress, the Members that voted for this bill, and 
they thank President Bush for having the courage to see this through 
and deliver on a promise.
  When I came to the Congress in 2003, almost 2 years ago, as only one 
of seven physician Members on the House side, we have Dr. Frist, the 
majority leader on the Senate side, a lot of people told me back home, 
they said, especially my physician constituency, my friends that I had 
practiced medicine with for almost 30 years, You are going to go up to 
Washington and you are going to solve all of our problems, and you are 
going to explain to the 434 other Members, the non-physician Members 
how to get it done, what our needs are, what the problems are, what the 
problems with health care in general but for Medicare and our seniors 
specifically. We are counting on you. We are counting on you to make 
sure that everybody else understands this, and we solve the problems.
  And I would say to them today, I am working on it. I am trying hard. 
But what I found when I arrived here is lots of folks, some physicians, 
many not, who have been working on health care and working to deliver a 
more modern 21st century health care system for our seniors; the same 
thing that we Members of Congress enjoy, all of our Federal employees 
under the Federal health employees benefit program, State employees, 
people indeed under the TRICARE system, enjoy, 21st century medicine. 
And there have been many Members in this body who have been working 
tirelessly for quite a few years before this Member, this physician 
Member arrived.
  One of those is here with me tonight, and I am so proud to call her 
my friend and colleague. She is not a physician, but her husband is a 
physician. In fact, he is a retired OB-GYN just like myself. And as the 
chairman of the Subcommittee on Health of the Committee on Ways and 
Means, I am going to state that she has been invaluable to me and to 
all of her colleagues in sharing her knowledge, in making the most 
complex, arcane part of Medicare law understandable, understandable to 
me and to all the Members.
  So it is with a great deal of pleasure that I recognize her here this 
evening and let her take as much time as she wants to talk a little bit 
more about the specifics of this bill. The gentlewoman from Connecticut 
(Mrs. Johnson).

                              {time}  2130

  Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank the gentleman very 
much for yielding. As a representative from Georgia, not only has he 
been very effective here in this body of the House, but as a physician 
Member, he has been extremely effective. This is the first time we 
should have had a critical mass of physicians to participate in these 
debates, which are striking at the heart of the inadequacy of the 
public program in regard to our seniors.
  Medicine found ways to stop our seniors from dying of heart attacks, 
but then it left them living with cardiac problems. Medicare as a payor 
could pay for heart transplants and all those things that can deal with 
diagnosed heart illness, but we cannot pay for all those programs that 
we now know that medicine has now developed to prevent cardiac illness 
from getting worse and leading people to needing heart transplants and 
serious heart operations.
  That just gives you some idea. When we say Medicare is no longer 
adequate to provide health care to our seniors, that is what we mean. 
The whole world has moved into the world of disease management to 
prevent diseases from getting worse, to identify them real early, 
prevent them from getting worse, and that is what this bill does.
  It will welcome seniors into Medicare in 2006 with a Welcome to 
Medicare physical. At that physical, we will identify those early signs 
of diabetes, heart disease, hypertension, and will start then to help 
seniors manage those illnesses and have the support in managing it and 
have the medications to manage it so that they do not end up in the 
emergency room, they do not end up in the hospital beds.
  That is why, in the end, we were able to pass this bill, because 
Members who were concerned about the deficit came to understand that, 
if you do not modernize Medicare, it will go bankrupt. If you do 
modernize Medicare, you can move the money from the hospital emergency 
room treatment setting to the preventative setting and provide both 
with better quality health care and a financially secure system.
  The point that the gentleman made earlier about employer-provided 
health care for retirees was absolutely right on target. We want our 
employers to stay in the business of providing retiree health care. We 
want the big union plans to stay in the business of providing retiree 
health care, but their fastest growing cost is pharmaceuticals, and it 
will drive them out of business. It will bankrupt their plans if we do 
not do something about it.
  In this bill, we do do something about it. We share that cost with 
them, and for that reason, most employers and most unions, most public 
programs, State employer and municipal employers will be able to stay 
in the business of providing comprehensive health care for their 
retirees, including prescription drugs, in a way that they could not 
have if we had not passed this bill.
  So this bill is not only terrific from the point of view of those who 
already have health care from their employers, it is terrific from the 
point of view of seniors who do not have good drug coverage. Some have 
very good, but most do not. They either have no drug coverage or 
inadequate drug coverage but under this bill, seniors will do very 
nicely.
  If the gentleman has time, I would like to talk a little bit about 
the prescription drug benefit under this bill.
  Mr. GINGREY. Mr. Speaker, I thank the gentlewoman from Connecticut 
(Mrs. Johnson) very much, and if she will, I would like for her to go 
over that a little bit because I think there is

[[Page 20626]]

still a lot of confusion about that, and if the gentlewoman can take a 
few more minutes and explain that. I know the Members would appreciate 
hearing from her.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, a lot of seniors have, 
first of all, been misled to think that the discount card is the 
Medicare reform bill. The discount card is not the program. The 
discount card is only an intermediate step, and it is one that, in my 
district at least, seniors who were spending $1,000, $1,500 a year on 
drugs can save considerably through a discount card. They can save 
usually, at least we are finding, about a third of their costs.
  We are also finding that seniors who do not have any drug costs are 
remembering that if they have a discount card, that if they go to the 
doctor and he prescribes an antibiotic, which is often over $100, they 
will be able to save about a third of the cost of that antibiotic when 
they go to the pharmacy to buy it. So even seniors without regular drug 
expenditures are recognizing that the discount card is a good thing for 
them, but it is only an interim step.
  The real program that goes into effect a year from January is a very 
generous program to those who need it the most. For seniors who have 
incomes under 135 percent of the poverty income; and remember, 50 
percent, just think about this, 50 percent of all the retired women all 
across our Nation are in this category; 50 percent of retired women 
will have no premium, no deductible. They will get their generic drugs 
for $1 to $3 and their brand name drugs for $3 to $5. What a giant step 
forward, for half of America's retired women, to get prescription drugs 
with no premium at all, no deductible, $1 to $3 for generics and $3 to 
$5 for brand name. That will mean that none of those seniors will have 
to make the choice between food on the table or taking the drugs that 
will keep them healthy.
  Then 70 percent of all of our seniors in America, men and women, will 
have 75 percent of the cost of their drugs paid for under this program. 
Medicare is an 80/20 deal. We pay 80 percent; you pay 20 percent. 
Eventually, we will get this Medicare prescription drug benefit back up 
to that so there will be consistency, but at the beginning, it will be 
75 percent government paid, that is, the taxpayers, that is, your 
children, and 25 percent you pay. There will be a premium, of course, 
and a deductible. Just like there is a premium and deductible for 
Medicare part B, there will be a premium and deductible for the 
prescription drug bill. Although the premium will be far lower than it 
is for part B. It will not be over $35. It might be a lot less if 
things continue to go the way they are going.
  So Medicare will offer a prescription drug benefit that for 70 
percent of America's retirees will cover 75 percent of the cost of all 
their drugs. Now, if you have very high costs, you will have to spend 
$3,600 before you get the catastrophic coverage, but that $3,600 can be 
paid by you, by your children. It can be paid by charitable 
organizations. It can be paid a number of different ways, and for 
anyone whose income is 150 percent of poverty, which is about $14,000 I 
think for a single and about $19,000 for a couple, I think that is 
about right, anyone under those amounts will not have to pay this 
$3,600.
  Anyone that lives in a State like Connecticut that has a ConnPACE 
program or like Pennsylvania that has a PACE program, any State program 
that provides subsidies for seniors with prescription drugs, they will 
never be exposed to that $3,600, and over time, we will make sure that 
the $3,600 expenditure for catastrophic coverage is not required of 
anyone who cannot afford it. But if you can afford it, it is good for 
you to pay it rather than the taxpayers because it lowers the burden on 
our children of the enormous costs associated with Medicare, Social 
Security and Medicaid's payment for long-term care which, when the baby 
boomers retire, is going to be extraordinary.
  So, as a retiree, I will want to pay my share if I need to get to 
that catastrophic level and if I can afford the $3,600. So this is a 
totally generous program to those who need it the most. It is a very 
generous program to 70 percent of seniors because it covers 75 percent 
of your drugs, and for everyone else, it is very generous up to that 
$2,250. Then it requires some effort before you reach the 95 percent 
coverage, but for that effort, you can have help.
  We just want to make sure that everyone has the help they need to 
reach the catastrophic, but it is a very generous program. I am proud 
of it. I am proud of the way it modernizes the quality of care you will 
get by, helping you manage your disease so you will not end up on the 
operative table.
  I am extremely proud of the way it revitalizes rural health care 
because, without this bill, rural doctors would be out of business in 
many parts of the country. The small rural hospitals would be quietly 
going under, and we would literally lose that provider system that 
provides health care in the rural areas.
  Medicare is like the post office. We have to be able to deliver 
everywhere all across the country to every single senior, no matter how 
small a community they live in, and to do that, we have to make the 
changes we make in this bill to assure a healthy delivery system of 
doctors, of hospitals, of home health agencies and of all of those 
providers that are crucial to a high quality of health care for our 
seniors all across this America.
  So this bill is a huge reform. It revitalizes the quality of care 
Medicare can deliver. It revitalizes the system so it will truly be a 
national delivery system, and it modernizes the benefit package by 
providing prescription drugs to our seniors. They fought hard for it. 
They deserved it. Inaction would have been absolutely a travesty, and 
anyone who voted for inaction when there was an opportunity to advance 
Medicare in so many areas was really, in my personal opinion, 
misguided.
  The seniors could not wait. They should not wait, and we will have 
this nationwide new program up and running in January of 2006, and the 
seniors will benefit for generations to come.
  I thank the gentleman from Georgia (Mr. Gingrey) very much for 
letting me join him for this Special Order on what is a very, very 
important new opportunity for seniors.
  Mr. GINGREY. Mr. Speaker, I thank the gentlewoman from Connecticut, 
the honorable chairman of the Subcommittee on Health of the Committee 
on Ways and Means. I know she has got a very busy evening, as all of 
her evenings here in the Congress are just jam-packed with other 
obligations, for her to come by tonight and help us share this time and 
explain, as I said earlier, you can see what I am talking about, she 
makes it so clear and understandable. I invite her to stay as long as 
she can, and if she needs to leave, I understand that, but I am very, 
very appreciative of her work and her expertise. I thank her so much.
  What I wanted to say, just kind of in following up on some of her 
remarks, this is a bipartisan bill. This new Medicare Modernization and 
Prescription Drug Act that preserves, protects, strengthens and 
simplifies Medicare as we know it, that is what we are talking about, 
and I am proud that it was a bipartisan vote.
  There were some Members on both sides of the aisle who were concerned 
about the bill, for different reasons, and voted against it. I think 28 
of my Republican colleagues actually voted against passage of this 
bill, and remember what they said when they came down and spoke against 
the bill and in a vote of conscience voted against it? They thought 
that the bill was costing too much; we could not afford it. We could 
not afford to deliver on this promise.
  Their concerns with the deficit, of course, are understandable. Their 
concerns with the need to continue to successfully wage this war 
against terrorism and to win is very understandable. So these 28 
Members, my colleagues on my side of the aisle, voted no. They wanted 
to do it. They knew it was a good program that they felt its time had 
come, but yet did not think we could afford to do it. They voted no.
  I think it is an accurate statement to my friends on the other side 
of the aisle, the Democrats who voted against the bill, most of them 
felt that we were

[[Page 20627]]

not doing enough. Another one of those Medicare tactics I was talking 
about in this Halloween season is, the hole in the donut is too big; 
the hole in the donut is big enough to drive a truck through.
  So they wanted to do more. In fact, the proposal that I heard from a 
number of Members on the other side of the aisle who voted ``no'' was, 
well, let us close that hole in the donut so we give better coverage to 
everybody, especially good coverage to those needy seniors that the 
gentlewoman from Connecticut was talking about.

                              {time}  2145

  But that bill would have cost us something like $2 trillion over a 
10-year period of time. And we certainly could not afford that. Yet, 
for whatever reason, those who felt like we were not doing enough and 
we needed to do more, and those who felt like even though we were not 
doing enough we could not even afford that much, that was a vote of 
conscience on their part. And that is understandable.
  But the bill did pass in a bipartisan fashion, a much wider margin, I 
might add, than the other body, than the Senate. But my Republican 
colleagues who voted ``no,'' a vote of conscience, you do not hear one 
single voice from my side of the aisle going around and scaring seniors 
and telling them do not accept a Medicare prescription drug discount 
card, this interim program, which is available right now. And many of 
those beneficiaries are eligible for that $600 credit. All they have to 
do is pick up the telephone, 15-minute conversation, and they have got 
that prescription drug discount card, which probably lowers the cost of 
their prescriptions maybe 20 percent, if it is a brand-name drug, 
possibly up to 40 percent if it is generic, in addition to the $600 per 
year or $1,200 over the course of the interim program.
  You do not hear my friends who voted ``no,'' a fiscally conservative 
vote, you do not hear them telling the seniors not to sign up for those 
cards. But you do hear that from my colleagues on the other side of the 
aisle who voted ``no.'' Again, a vote of due conscience because they 
thought we were not doing quite enough, that we needed to do more. Wish 
we could. Hopefully, as the gentlewoman from Connecticut (Mrs. Johnson) 
said, as we go further along into this program, we will be able to do 
more; and we will work with our colleagues on the other side of the 
aisle to try to make it a program, which is already a great first 
start, even better as we go forward, as we can better afford to do 
more.
  Oh no, that is not enough for them. They have to scare seniors, and 
they have been doing it ever since December of 2003. Not just this 
Halloween season, but of course the rhetoric is getting a little more 
heated now because not only are we getting close to Halloween but we 
also are getting closer to November 2, and we all know what November 2 
is. So it is all about who gets the credit or, from their perspective, 
who gets the discredit. They want to scare the seniors enough and tell 
them do not even accept the prescription drug discount card, when they 
can get $600 a year credit in their medications and, in many instances 
if they are a low-income senior, will cost them nothing. Unbelievable. 
Unbelievable.
  The gentlewoman from Connecticut was talking a little bit about the 
basic program, the part B, the insurance program, that will be 
available as a voluntary option in January 2006. For the average senior 
whose income is, let us say, more than $18,000 to $20,000 a year, this 
is what the program will cost. And I want to call my colleagues' 
attention to this slide.
  Basically, $35 a month premium, a $250 deductible per year, and then 
25 percent copay. That means the good news is Medicare and the general 
taxpayer, those individuals who are still out there in the workforce 
paying that payroll tax, cover 75 percent, up to $2,250.
  Now, yes, there is a gap in coverage. This is what we refer to as the 
hole in the donut. And beyond that point, until the senior has spent 
$3,600 out of pocket, there is no coverage and the senior has to pay 
100 percent. That is the part we are going to improve as time goes on. 
But the good news in that, the glass being half full and not half 
empty, is that when they reach that point, then the coverage is 95 
percent insurance and 5 percent copay.
  Mr. Speaker, I want my colleagues to pay attention to this next 
slide, just to give them an example of some of the savings that will be 
affected by this interim prescription drug discount program. If a 
senior is paying today $100 per month for prescription drugs, and 
believe me those who have had those town hall meetings and talked to 
their seniors, many of them are paying $100 a month, some are paying 
$500 a month and more. But let us just take $100 a month. They will 
have an annual savings of $773, basically reducing their annual 
prescription cost for drugs, for prescription drugs, by 64 percent.
  Let us take another example. Let us say it is $500 a month. Let us 
say it is a senior, someone like myself, who has had a little heart 
surgery and is on four medications a month, each one of them costing 
$100-plus. Pretty quickly they are up to $500 a month. Well, this 
prescription drug plan, over a period of a year, is going to save them 
$2,700, reducing their annual cost by 45 percent.
  Let us continue. How about $800 a month? How many have relatives, 
parents, or grandparents who may be on six or eight prescription drugs 
a month and they are paying over $800 a month? The annual savings, 
$5,871, some 61 percent reduction of their annual cost for prescription 
drugs. Simply amazing.
  Mr. Speaker, I think it was the Honorable Speaker Tip O'Neill who 
said a few years ago ``all politics is local,'' so let me spend a few 
minutes talking about my district, the 11th in Georgia. I want to call 
my colleagues' attention to this slide.
  In Georgia's Eleventh Congressional District alone, the average 
senior will save $1,488 off their prescription drug costs over 18 
months. Over an 18-month period of time $1,488 savings. That is not 
pocket change. That is certainly not pocket change for seniors, many of 
whom are on a fixed income. These savings represent 42 percent off of 
the typical senior's drug cost.
  In fact, it is estimated that prescription drug savings for the State 
of Georgia, all the seniors in the State of Georgia will reach $186 
million; $186 million. That will certainly help the bottom line in 
Georgia, and the bottom line especially for our needy seniors.
  I also want to call attention to this next slide. This is just a 
typical example of what a Medicare prescription drug discount card 
looks like. And I guess the most important thing here, and I know we 
have 1.8 million seniors who have these, but we want more to take 
advantage, because the time is slipping away and the opportunity to get 
that credit that so many of them are eligible for. We do not want them 
to lose that opportunity. But the most important thing about this card 
is that it has the Medicare seal of approval. That way you know that 
that is the real deal. That is the card.
  There will be plenty to choose from. They are available now. In fact, 
they have been available since June 1 of this year. It is time for our 
seniors to reject the Mediscare rhetoric and get these cards. Sign up 
for them. All you have to do is pick up that telephone and dial 1-800-
Medicare, and they will walk you through the steps in 15 or 20 minutes.
  Mr. Speaker, this is another slide that I am calling my colleagues' 
attention to; and basically what it reflects in the respective States 
is how many Medicare beneficiaries are there who will actually pay no 
more than $5 per prescription under this new Medicare Modernization Act 
and Prescription Drug Bill. The State that, of course, jumps off the 
page at me is my State. I am sure my colleagues feel the same as they 
look at this slide and pick out their State, whether you are from the 
West, the North, the East, the South, or wherever, or in the 
heartlands.
  When I look at Georgia, the great State of Georgia, and realize that 
233,000, 233,000 Georgians under this new plan, because of their 
income, because they are on a fixed income, maybe they are below 150 
percent of the Federal poverty level, the most that they will pay on 
this program is $5

[[Page 20628]]

per prescription. That is it, $5 per prescription. That is 233,000 in 
the great State of Georgia.
  We have some tremendous strains, of course, in the Medicare program. 
I mentioned at the outset how tough it is for the physicians to stay in 
the program, that it is not a giveaway. Part B is not a giveaway to the 
doctors. Fortunately, many, through compassion, are staying in the 
program. But it is certainly no giveaway. And for sure no giveaway to 
our hospitals is part A. And, parenthetically, part D, the prescription 
drug part, is no giveaway to the pharmaceutical industry.
  But just look at this slide, my fellow colleagues. Look at this and 
pick out your State and see the benefit to your hospitals, especially 
your rural hospitals, that are struggling so badly to keep those doors 
open. Outside of the school system, they are probably the largest 
employer in your county, in your congressional district. Just look at 
the benefit that your State gets through the hospitals under this 
program.
  Here again, I go right to Georgia, and that is where it is most 
important to me. Over $550 million worth of benefit to the hospitals, 
especially the rural hospitals in the State of Georgia. That is $550 
million, almost half a billion dollars. This is a Godsend to these 
hospitals. And that is what we are doing with this Medicare and 
Modernization Prescription Drug Act.
  Mr. Speaker, I realize we are coming to the close of our hour, which 
has been, I think, a good time to spend talking with my colleagues and 
making sure that everybody understands. We have done something very 
historic in this 108th Congress. We have finally delivered on a promise 
that was made a long time ago. Thirty-eight years is a long, long time 
for our seniors to wait for a prescription drug benefit to modernize 
this Medicare program, which is still in the 20th century.
  The rest of us, those of us who are not yet quite 65, although some 
Members of this body are, we have a benefit plan that has an emphasis 
on wellness, on prevention, and making sure that catastrophic illnesses 
do not occur to us.

                              {time}  2200

  This is such an important point to remember that including a 
prescription drug benefit may very well, in the long term, over a 10-
year period of time, result in some savings to the Medicare program. 
Yes, we are estimating it might cost $500 billion over 10 years, but I 
want my colleagues to understand that it will only cost $500 billion 
over 10 years if it does not work. Because I would suggest that if it 
does work, and I sincerely believe as the President believes in this 
compassionate effort to finally deliver that we are going to reduce the 
cost of Medicare that we spend on part A, the hospital part, we are 
going to keep people out of the hospital. We are going to reduce the 
cost of part B, the part of Medicare that we spend on physician 
reimbursement because we are not going to be doing as much open heart 
surgery. We are not going to be doing as much renal dialysis and kidney 
transplants. We are not going to have as many people in the nursing 
homes for the rest of their lives who are trying to recover from a CVA, 
or, as you know it, a stroke, because these seniors will be able to 
control that high blood pressure that heretofore they could not. They 
knew they had it but they could not take their medication, and the only 
benefit they get is when a catastrophe has occurred.
  I thank my colleagues for giving me an opportunity to talk to them 
tonight about this great program that is going to only get better. I 
think it is time to stop scaring our seniors. We have got 27 days 
before Halloween. We have got about 30 days before our elections. Let 
us take the politics out of this. Let us not try to ride our reelection 
train on the back of our seniors by scaring them over this program. It 
is unconscionable to do that. They deserve so much better. And you are 
better. I know that.
  We get awfully partisan up here sometimes, but when we talk out in 
the halls or we realize that we are all basically the same, we have got 
families, we have got children, we have got grandchildren, we have got 
seniors in our district, let us all work toward the betterment of them 
through this program and quit scaring our seniors. Beyond this 
Halloween and this election and going forward in the 109th Congress, we 
will make this program even better than it is now.

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