[Congressional Record (Bound Edition), Volume 150 (2004), Part 5]
[Senate]
[Pages 6466-6469]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   MEDICARE PRESCRIPTION DRUG BENEFIT

  Mr. FRIST. Mr. President, last night, I called my mother-in-law in 
Fort Worth, TX, just to get her perspective on Medicare and health care 
security for seniors, and to ask her what she, a

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long way from Washington, DC, understood in terms of the important 
Medicare legislation we passed on this floor in a bipartisan way--a 
Medicare bill that was signed by the President of the United States on 
December 8, 4 months ago. We had a good conversation.
  I asked a little bit in a personal way about her own experience with 
buying prescription drugs. She, like most seniors who are having to buy 
prescription drugs on their own--because, remember, until December of 
this past year, 4 months ago, prescription drugs were outside of 
Medicare. So many seniors are dependent on prescription drugs for a 
whole range of illnesses, or to prevent illnesses, whether it is 
arthritis, diabetes, heart disease, or cancer. Those prescription drugs 
have been out of reach, or at least must be obtained outside of the 
Medicare system but indeed no longer.
  It was clear to me that there is a lot of confusion by what people 
see in the press, what people see on television, comments that are made 
by opponents to that legislation. So I want to take a few minutes to 
comment on the importance of this legislation, but equally important, 
on what this legislation is doing and can do and will do for 
individuals with disabilities and seniors. I am speaking about 40 
million people who will potentially be touched by this legislation we 
passed 4 months ago.
  The first point. Already, seniors are benefiting. The legislation was 
signed December 8, and already seniors are benefiting because of the 
new bill and the reforms in that bill. Health care plans are getting an 
extra boost. As a result, seniors who are enrolled in Medicare health 
plans, Medicare private health plans, are already receiving better 
benefits at lower, what we call out-of-pocket costs. Already, these 
seniors are receiving more benefits at lower out-of-pocket costs.
  In fact, the Centers for Medicare and Medicaid Services--when you 
hear CMMS, that means Centers for Medicare and Medicaid Services, which 
is the Government organization, or entity, the center in charge of 
managing and administering Medicare. They report that 3.7 million 
seniors are already receiving increased benefits, just 4 months after 
signing the bill, and 2 million have received lower cost sharing. That 
means when they actually have a benefit delivered, they pay less for 
that benefit; 1.9 million have seen their premiums go down; and it is 
less than 4 months after the President signed the bill. That is, the 
monthly premium seniors are paying has already gone down for 1.9 
million seniors.
  Let me share with you just one specific example. Aetna has eliminated 
copayments for a whole broad range of preventive services. That 
includes routine physical examinations. It is interesting; until this 
Medicare legislation, routine physical examinations were not part of 
Medicare. They eliminated copayments for routine physical exams; they 
eliminated copayments for bone mass measurements; they eliminated 
copayments for colorectal screening exams, prostate screening exams, 
mammograms, pelvic exams, and for routine hearing and vision exams for 
seniors enrolled in their Medicare Advantage plans.
  Aetna has also slashed copayments for inpatient hospitalizations--
that is when you are admitted to the hospital--by 50 percent. They 
added coverage for generic drugs in every market and for brand-name 
drugs in many of its larger markets.
  In less than a month from now, seniors are going to also be able to 
take advantage of a new Medicare-endorsed prescription drug discount 
card. In less than 2 months, all Medicare beneficiaries, whether they 
are enrolled in private plans or whether they are enrolled in the 
traditional Medicare Program, are going to be able to use these 
discount cards, endorsed by Medicare, in order to get a 10- to 25-
percent discount off the cost of their prescription drugs. These cards, 
in 2 months, are going to be available. You will be able to take them 
in, and however you are getting prescription drugs today, you will be 
able to get an additional 10- to 25-percent discount.
  There is even better news for those 8 million lower income seniors--
those who have the hardest time affording prescription drugs, or 
additional costs of health care. They will be eligible for an 
additional $600 in subsidies and assistance on top of the discount they 
are going to get, that 10- to 25-percent discount. That is, again, 8 
million lower income seniors who will have the discount card, 10- to 
25-percent discount, but in addition will get $600 in value, subsidies, 
to purchase prescription drugs. That is $600 in assistance they didn't 
have before the President signed that bill on December 8 of last year.
  At the end of April, in about 3, 3\1/2\ weeks, all Medicare 
beneficiaries will be receiving a letter from the Secretary of Health 
and Human Services, Tommy Thompson. In that letter, there will be a 
four-page guide with information on this discount card.
  When I talked to my mother-in-law last night, she said she faintly 
heard about this card but didn't have too much information on that. I 
told her in a few weeks this information will come to you in a letter. 
Read that four-page guide. More detailed information will be available 
from the Department of Health and Human Services. It will placed on the 
Department of Health and Human Services Web site and, as most people 
are beginning to hear, you can call 1-800-medicare and obtain even 
further information. If you call that number, they will also send you a 
32-page booklet called Guide to Choosing a Medicare-Approved Drug 
Discount Card.
  I mention all this now because people say they don't know very much 
about the card, but I point out that information will be made available 
on a timely basis so you will be able to understand what these cards 
provide, what they don't provide, and also what is the best card for 
you to choose given what drugs you may be on.
  In fact, the Health and Human Services Web site will contain a 
fantastic new analysis, or Web page, that is easy to use called Price 
Compare. It is a price-compare tool that will allow seniors to choose 
the drug card that is best for them and their individual needs by 
offering a comparison of the cards available in that area for them. It 
will be specific, where you can put on that Web page what drugs you are 
on, and there will be a comparative analysis that is placed on the Web 
site where you can say this card looks like it would benefit me better 
than the other card, as well as a listing of all the cards available in 
your area. This site will be live and up and running at the end of this 
month, on April 29. It will have information as to how individuals with 
their individual needs will be able to benefit. Actually, an individual 
or specific pharmacies in one's community will be listed as well. So I 
am looking forward to that site. It will be a fantastic new Web site.
  Right now, seniors and their families can go to a Web site, if you 
want to, www.medicare.gov. On the Web site you would look for a site 
called ``Prescription Drugs and Other Assistance Programs.'' There is a 
section on that Web site. There you can enter your ZIP Code, where you 
live, and you can enter your income and your current medications to 
find out which cards will be available in your area.
  This is a wonderful and easy way to get prepared once the final Web 
site comes out, and those benefits are made available. Again, we will 
keep you posted on when the benefits specifically become available. It 
is clear that seniors and individuals with disabilities need and 
deserve relief from these high costs of prescription drugs.
  Seniors need and deserve a Medicare Program that provides them with 
what they want, and that is health care security. In the event one 
needs medicine to prevent a disease or illness, or when one is a senior 
or an individual with a disability and an illness strikes, they will 
have access to appropriate treatment. When I say health care security, 
that is what I mean.
  Now that prescription drugs are brought into Medicare, we can say 
seniors will have affordable access with this legislation, much better 
than in the past.
  I do want to tell the seniors of America that the President of the 
United States has heard them in that it is difficult to receive and 
purchase these skyrocketing prescription drugs because of the cost. The 
leadership in

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Congress has responded with this bipartisan plan and, indeed, help is 
on the way, and more help will be on the way in the coming weeks. That 
is the positive side.
  I also want to take this opportunity to comment on the fact that 
despite this landmark and new commitment--and, yes, it does mean more 
Government resources are directed at seniors who need those resources 
in terms of help obtaining prescription drugs--hardly a day goes by 
that opponents to this legislation do not level a new attack or a new 
accusation or seek a new investigation trying to tear apart this 
tremendous accomplishment for our seniors and for our individuals with 
disabilities.
  I want to thank and commend Secretary Tommy Thompson for initiating 
an investigation that is being conducted by the inspector general of 
the Department of Health and Human Services in response to some of 
these accusations. I look forward to the inspector general's findings. 
If a law has in any way been broken, or if information was 
inappropriately withheld from Congress, clearly appropriate actions 
ought to and will be taken. However, the number of the attacks and the 
vehemence of the attacks coming from the other side, from those people 
who opposed this landmark legislation for seniors, suggests there is a 
lot more at work and a lot more is going on than just wanting strong 
congressional oversight or good government. Unfortunately, what we are 
seeing is an orchestrated scheme to discredit the progress that has 
been made to date to get prescription drugs to seniors in an affordable 
way; to dismantle the prescription drug coverage that for the first 
time in history we have put into the Medicare system. The opponents to 
the original legislation seem to want to dismantle that. It is 
political gamesmanship.
  Part of it is driven by the success of passage of this wonderful 
legislation. Part of it is the fact that it is a political year and we 
have 7 months or so going into these elections, and people say this 
Medicare legislation, which is a success for the President of the 
United States and a success for this body, needs to be discredited in 
some way, I would argue, for political purposes.
  We know for a fact that attacking Medicare is in part an aspect of 
the opponents' game plan for the elections. Why do I say that? Because 
we can actually find it in writing in a memo written earlier this year 
to Democratic leaders. Party pollsters outlined a game plan for 
discrediting this landmark Medicare Modernization Act. The pollsters' 
advice in the memo was unequivocal that Democrats were in danger of 
surrendering the Medicare issue unless they were willing to totally 
discredit the legislation by defining it as, and I draw upon their 
words, ``unacceptable.''
  We are seeing results. This poll-driven political game is being 
followed. For some, voting against the legislation was not enough. They 
have also tried to prevent seniors from learning about the new benefits 
to which they are entitled, some of which I just outlined. They have 
leveled charges intended to frighten seniors and to undermine the 
legislation itself.
  We simply will not let it happen. We cannot let it happen. I want 
seniors to know we will not turn back the clock on the progress we have 
made, under the leadership of the President of the United States and 
this body. We will make sure seniors and individuals with disabilities 
get these new benefits they need and deserve.
  When this law is fully implemented, the bottom line is that seniors 
will have better access to more affordable medicines and prescription 
drugs they need.
  There are several examples. Sixteen million lower income seniors--
there are 40 million seniors today and 16 million lower income seniors 
are going to be paying little or no monthly premium, and no more than 
$5 for each prescription. That is a huge benefit to those people who 
are most vulnerable to not being able to obtain prescription drugs.
  If we look at the 40 million seniors today, there will be 10 million 
seniors who have no current prescription drug coverage who will get 
relief from the high cost of prescription drugs by this legislation. 
All 40 million seniors today, and the 80 million baby boomers who will 
be coming through the system over the next 30 years, will have access 
to more preventive care because of this legislation. By that I mean 
simple things such as cholesterol screenings that were not a part of 
Medicare but are a part of Medicare today.
  I mentioned baseline physical examinations. For the first time in 
Medicare--and it is through those baseline physical examinations that 
the diagnosis of hypertension or possibly diabetes is made. For the 
first time, these baseline physical examinations will be a part of 
Medicare. The purpose is to diagnose the potential for having a stroke 
by figuring out whether or not one has hypertension, or one is at a 
risk for heart disease, diabetes, or cancer.
  We talk about chronic care coordination and disease management. Those 
are terms that are misunderstood, but they are very important. As a 
physician, it is important because with an aging population we see more 
chronic disease. As people live longer and we are able to treat acute 
and chronic disease such as heart disease, rheumatoid arthritis, or 
other debilitating arthritis, diabetes, or stroke, after one has had a 
stroke, it is very important. Couple that with diseases such as 
Alzheimer's or Parkinson's disease, how those chronic diseases are 
managed, especially when there is one, two, or three of the diseases 
with overlapping care, it is absolutely critical.
  Our system historically has not been set up very well. Especially in 
Medicare it has not been set up at all until recently, until this bill, 
to manage this complex overlap of diabetes with heart disease, with 
arthritis, with Parkinson's disease. For the first time in this 
Medicare bill there is an appropriate system set up for disease 
management and chronic disease coordination. Physicians will be able to 
continue treating Medicare patients because in the new law there was $7 
billion included to help safeguard medical services to seniors. Seniors 
in rural areas will benefit from the legislation's historic $25 billion 
investment in improving health care in rural America, to provide 
services that may not be there today, to set up a system that will 
attract or keep nurses and physicians in rural areas, $25 billion 
injected into the system to better accomplish taking care of and 
managing the care of seniors in rural America.
  For the whole category of retirees today who get health coverage from 
their former employer, the cost of this bill will be more secure, 
thanks to the bill's $89 billion in increased Government assistance to 
retirees.
  I mentioned last night that my conversation with my mother-in-law 
very quickly came to the cost of a particular medicine she was taking 
and how, over the last three billing periods, I think she said, each 
time the cost of that one medicine has gone up. Was it addressed in the 
Medicare bill?
  As a first step, it was addressed. We still have a lot more to do. 
This Medicare bill was never intended to solve all of the challenges we 
have in Medicare today, but we did take a first step in controlling 
those prescription drug costs.
  Drug costs will be held more firmly in check for all Americans, not 
just seniors but for all Americans. That is because the Medicare bill 
had a whole part which speeds the cheaper generic drugs that are just 
as good, with just as much what we call efficacy--they are equal in 
efficacy, but it speeds those generic drugs to market, and by market I 
mean consumers; by consumers I mean patients; by patients I mean people 
such as my relatives, my mother-in-law, seniors who are out there 
today. Also, the Medicare bill helps close many of those loopholes in 
our Nation's patent laws that prevented prescription drug price 
competition.
  Again, it is a first step. It doesn't attempt to solve all of the 
prescription costs, the skyrocketing costs we see for prescription 
drugs, but takes a very definite first step.

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  There is a lot of confusion about what health savings accounts are, 
but when you look at the Medicare bill, for the first time we have 
offered a health savings account or medical savings account that an 
individual can own. It does not apply just to seniors; it can start 
with a 20-year-old or 25- or 30- or 35- or 40-year-old. But it is an 
account that you yourself pay into, tax free. For health benefits that 
you want to pay for, you take it out tax free. So it is a tax favored 
savings account that you own and you can take with you through life. If 
you pay into it when you are 25 years of age or 30 years of age or 35 
years of age, but say you have a high deductible insurance policy, and 
you don't have any health expenses that year, the money that you put in 
or that your employer put in or somebody from your family put in, rolls 
over to the next year and grows. If you don't need it the next year, it 
grows again. If you don't need it when you are 33, it grows again, or 
35 or 40 or 45. You take it. You draw down on it, but you take it with 
you.
  When you get to be a senior, you can use it to pay for some of those 
copayments for a prescription drug or you can use it to pay for your 
long-term care if you need long-term care.
  It is a fantastic new entity that gives the individual real 
ownership--control over health care decisionmaking, control over that 
health care dollar. It is called a health savings account. It will be 
coming on line very soon. It was part of this Medicare bill signed by 
the President 4 months ago.
  In closing, this Medicare Modernization Act is helping millions of 
seniors in countless ways. Millions are being helped right now because 
of the passage of this bill. We are getting results. It is a major 
first step. I say it is a first step, a major first step, because, 
although it is a big bill, an important bill, a significant piece of 
legislation, because clearly there are things we will have to do about 
the cost of health care, affordability to our seniors, access to health 
care, addressing the issues of the trust fund itself, addressing the 
doubling of the number of seniors who will come into the system over 
the next 30 years with a diminishing number of the workforce actually 
paying into the system. These are all issues we will have to address. 
But this bill is a major first step that is to the benefit of every 
senior listening to me today and those 78 million people who will be 
new seniors over the next 30 years.
  We worked hard on this in this body, the Senate. We worked with the 
House. We worked in a bipartisan way to provide these benefits to 
America's seniors. We have worked hard to give seniors today the 
coverage they need and to give them the Medicare coverage they deserve. 
We simply cannot, we will not let election politics get in the way of 
health care for millions of America's seniors.
  I will close and review again very quickly those benefits on the 
chart next to me that outline how important this particular bill is 
that was not law on December 1 but on December 8 was signed by the 
President of the United States. Those benefits include a drug card with 
10-25 percent immediate prescription drug discounts and additional 
relief for 8 million low-income seniors. That is now a reality. 
Comprehensive prescription drug coverage for 16 million low-income 
seniors is now a reality. Protection against high--catastrophic 
prescription drug costs, something that all seniors fear, not knowing 
what might happen to them 5 years from now or 10 years from now. There 
are new preventive benefits, including that annual physical examination 
where, for the first time, when that blood pressure cuff may be put 
around your arm and the diagnosis of high blood pressure is made, for 
the first time in the cost of the Medicare bill you can get help 
getting a drug, through Medicare, to prevent that hypertension causing 
a heart attack which otherwise would put you into the hospital--very 
expensive--or cause a stroke--very expensive. Now that can be 
preventative.
  There is $7 billion in improved physician payments which physicians 
deserve; $25 billion in rural health improvements in order that our 
rural communities will be able to access the appropriate health care 
they need today; $26 billion in State Medicaid relief and affordable 
health care through tax deductible health savings accounts. All of it 
is a first step, a start.
  I wish to comment this has been accomplished in a bipartisan way. We 
need to continue working in a bipartisan way. I look forward to doing 
that. I look forward to working with both sides of the aisle to the 
benefit of America's seniors.
  I yield the floor.

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