[Congressional Record (Bound Edition), Volume 150 (2004), Part 4]
[Senate]
[Pages 4304-4306]
[From the U.S. Government Publishing Office, www.gpo.gov]




     CONFIRMATION OF DR. McCLELLAN, MEDICARE AND DRUG REIMPORTATION

  Mr. FRIST. Mr. President, early this morning, in fact, a little over 
12 hours ago in the Senate, Dr. Mark McClellan became administrator for 
the Centers for Medicare and Medicaid Services. I thank all of my 
colleagues for their cooperation over the course of that whole

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week, this past week, in order to facilitate the confirmation of Dr. 
Mark McClellan.
  I say that because the responsibilities of the CMS--again, the 
Centers for Medicare and Medicaid Services--are that of being the 
Government organization responsible for Medicare and Medicaid in this 
country. These responsibilities are crucial. The administrator oversees 
the program that provides health care coverage for over 70 million 
people, including seniors, as we know, including individuals with 
disabilities, with low-income children, with pregnant women--a huge 
responsibility.
  This becomes critically important because the challenges facing CMS 
today are greater than at any time in this agency's history. I say that 
because the head of that agency, now Dr. McClellan, will be charged 
with implementing the Medicare Modernization Act and, in a very short 
period of time, educating seniors about the benefits of the new law, 
about the advantages of the new law, and how they best can take 
advantage of these new benefits.
  It is going to take a strong and steady hand to get the job done. I 
am confident, and I think my colleagues on both sides of the aisle have 
expressed that strong confidence, in Dr. McClellan. He has the skills, 
he has the commitment, he has the temperament, he has the judgment, he 
has the leadership abilities, all of which have been demonstrated in 
Government. He has served under both President Bush and President 
Clinton in Government, and also in the private sector as a physician. 
President Bush nominated exactly the right person for this point in 
time.
  I think the Medicare bill is a tremendous bill. It has tremendous 
potential to modernize Medicare, on a voluntary basis, where if people 
want to take advantage of this newer, more modern, more up-to-date 
Medicare, they can or they can keep exactly what they have.
  The legislation was bipartisan. It was signed by the President of the 
United States last year. If you just back away from it, it does--bottom 
line--what we know we have needed to do for a long time; that is, to 
give seniors and individuals with disabilities better access to the 
most powerful tool in American medicine today: prescription drugs, at 
lower out-of-pocket costs. That is it. And it is voluntary.
  Beginning in a few months--this is, in part, a segue from Dr. 
McClellan--seniors will be eligible for the savings of 10 to 25 
percent, and low-income seniors will receive an additional $600 in 
value in additional assistance through the Medicare-endorsed 
prescription drug cards.
  I have had the opportunity to meet this week with a number of outside 
organizations, including the AARP, where we have talked about the 
importance of educating seniors appropriately so they can take 
advantage of these new expanded benefits.
  There is a whole range of other benefits in this new, modernized 
Medicare Program--and we talked a lot about it on the floor--including 
disease management; chronic disease management; improving preventive 
care, so we can make the diagnosis of things such as hypertension for 
people who come of Medicare age; improving the efficiency and safety of 
Medicare through electronic prescribing, to eliminate the potential of 
so many errors that can be made through so many steps that currently 
the prescription of medicines travel; significant regulatory relief.
  You put those two together--with Mark McClellan as the person who 
will be responsible for implementation, with what is a complex system 
but one that takes action now--and I think we will have a very 
effective laying out of the benefits so people can take advantage of 
it.
  Mark McClellan's background as a physician, as a doctor, I think will 
be enormously helpful in translating these legislative reforms into 
lasting improvements that will give our seniors better health care 
security. That, again, is sort of the bottom line. You want to be able 
to look seniors in the eye and say: You will be more secure in terms of 
your health care with this bill. We know that is the case, but now it 
has to be implemented. So I look forward to working with Dr. McClellan 
as he works to implement this new Medicare law. We build on what truly 
was historic legislation to provide affordable, high-quality care to 
our seniors.
  On the floor earlier today, and last night, and in some hearings with 
Dr. McClellan yesterday, the whole issue of prescription drug 
reimportation has arisen, has been discussed, has been talked about. It 
is a very important issue, an issue that, as majority leader, I can 
tell you we will address. It deserves to be addressed.
  We addressed it in the past by saying reimportation, under certain 
prescriptions and limitations. Reimportation is fine, but it is fine 
only if we can demonstrate and guarantee safety; that is, we can tell a 
senior, yes, you can have reimportation, say, from Canada, but you can 
say that and allow it to happen only if you can look that senior in the 
eye and say: You are going to be OK. The medicine you get will be 
exactly what is prescribed, with the same sort of safety certification, 
safety guarantees you get with medicines that are manufactured in the 
United States.
  Some of it--in fact a lot of it--is being driven by the fact we have 
these skyrocketing costs in health care, which we have to address, we 
should address, and it is our responsibility to address because they 
cannot be tolerated long term--whether it is by an individual who is 
taking care of themselves or their children or their family members or 
a business with skyrocketing health care costs which are driving the 
cost of doing business so high they no longer are competitive against 
other businesses in this country or businesses in other countries.
  In fact, it ties to other discussions we have about outsourcing and 
insourcing and jobs going overseas, because if the cost of doing 
business gets so high here, and it is not high in other countries, you 
simply are not going to be able to grow businesses here and people will 
shift businesses overseas. So we must address it. And we will address 
it.
  Many people believe part of the skyrocketing costs can be addressed 
by addressing the reimportation of drugs. Indeed, in the Medicare law I 
was just speaking to, we began to address this issue head on. We, in 
that bill--a lot of people do not realize it--asked the administration 
to prepare a comprehensive report that would come back to us in the 
Congress to identify the myriad of critical issues that are raised by 
reimportation, including, first and foremost, patient safety.
  As a physician, I am going to keep coming back to the patient's 
safety, because unless we can look people in the eye and guarantee they 
are going to be safe through obtaining drugs from overseas, we cannot--
we just should not--proceed down that path.
  Well, in response to the Medicare legislation, the administration has 
already set up a task force. That task force has begun the process. We 
look forward to receiving the findings from that task force.
  Indeed, the public hearings will begin this coming week while we are 
in recess. I believe the first meetings are with outside consumer 
groups that will come in and report to that task force. Then the task 
force will report back to us.
  I also believe the Senate can best--or should best--address this 
through the committee of jurisdiction. As majority leader, I have tried 
to focus on appropriate jurisdiction for the committees, and the 
committee for that is the committee that the Presiding Officer has 
taken such a leading role on; that is, the HELP Committee, the Health, 
Education, Labor, and Pensions Committee, that is led by Chairman Judd 
Gregg.
  Through that committee of jurisdiction, we will begin to examine what 
barriers do exist--and the safety barrier is one--to reimportation and 
determine, first, whether there are ways you can reduce those barriers, 
but how you can reduce those barriers, how we should address those in a 
legislative fashion, and then reduce those barriers legislatively, if 
we need to.
  I look forward to working with Chairman Judd Gregg, chairman of the 
HELP Committee, and to reaching out broadly to all my colleagues--
Senator Dorgan, who has taken a real lead

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on this; Senator McCain; Senator Stabenow; and Senator Thad Cochran, 
who has been the author of the amendment we have used and addressed on 
the Senate floor, has been a real leader in this field--on both sides 
of the aisle to address this very important issue.

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