[Congressional Record (Bound Edition), Volume 150 (2004), Part 8]
[House]
[Pages 11096-11102]
[From the U.S. Government Publishing Office, www.gpo.gov]




 THE FIRST STEP TO A BETTER MEDICARE: DISCOUNT PRESCRIPTION DRUG CARDS 
                            FOR OUR SENIORS

  The SPEAKER pro tempore (Mr. Feeney). Under the Speaker's announced 
policy of January 7, 2003, the gentlewoman from Connecticut (Mrs. 
Johnson) is recognized for 60 minutes as the designee of the majority 
leader.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I rise with pride and 
pleasure to recognize this June 1 as the first time in history that the 
seniors of America have had the opportunity to purchase a Medicare drug 
discount card as the first step, but only the first step, in reducing 
the cost of their prescription drugs.
  My colleagues have heard a lot here tonight. We have heard some very 
sharp things from the speaker who just preceded me. But listen to this: 
this is a widow in my hometown of New Britain who takes Zithromax; and 
because of this discount card at a local pharmacy in New Britain, 
instead of paying $46.50 for her Zithromax, she will now pay $39.44. 
She takes Nystatin. Instead of paying $35 for Nystatin, she will now 
pay $15 for Nystatin. And so it goes. One of the other drugs she takes 
costs $40 and now will cost $11.50.
  Mr. Speaker, this widow for whom every dollar is precious will save 
$730 on her prescription drugs every year, including this year. Now, 
that may not be a lot to my colleagues, but for someone spending $2,000 
on drugs a year, a little over $2,000 on drugs a year, that is a lot. 
That is 29 percent, almost 30 percent, of her drug costs.
  So this is a good day for seniors, and I and my colleagues are going 
to talk about a lot of the things we have been told tonight about this 
prescription drug program. But we are here to say, you be the judge. We 
are here to say, do not let nay-sayers, do not let others rob you of 
the hundreds of dollars of savings on the prescription drugs on which 
your health and well-being depend. You be the judge. You find out the 
facts. You be the judge. It is real simple.
  But to start off tonight, let me turn to the gentleman from 
Pennsylvania (Mr. English), a very good friend of mine on the Committee 
on Ways and Means.
  Mr. ENGLISH. Mr. Speaker, I want to thank the gentlewoman. I want to 
rise today not only to mark this historic day for Medicare 
beneficiaries because today, for the first time since the program's 
inception, Medicare, through a discount card, will be providing real 
relief to seniors who struggle to pay for their prescription medicines.
  I want to acknowledge that, but I also want to especially acknowledge 
the efforts of the gentlewoman as chairman of the Subcommittee on 
Health for making this legislation possible. I am very proud to have 
been part of the team that helped put this legislation together and see 
it through to the end; and I am also glad to be on the floor tonight, 
having heard some of the extraordinary claims from a number of Members 
who consistently voted against prescription drug benefits for seniors. 
They are now trying to run down the program that we put together, we 
fit into a budget, and we got passed in the House. The record shows 
that they did not offer a credible alternative, they did not offer a 
budget that they could fit it into, and they were talking a lot about 
seniors, but not delivering.
  The discount card program that was created under the Medicare reform 
bill that we passed will also ultimately create a prescription drug 
program that will be available by 2006 for every Medicare beneficiary. 
But what we have done, which is so important, is offer an interim 
program to provide immediate relief for seniors. Because I know, as the 
gentlewoman found in her district in Connecticut, in my district in 
Pennsylvania, what seniors wanted was some help that would be available 
quickly. And when I brought the head of CMS into my district for a town 
meeting and he said it would take a couple of years to ramp up a 
prescription drug program, they made it very clear, that group of 
seniors in Mercer County, Pennsylvania, they wanted to see something 
quicker, and that is what we have been able to do.
  These discount cards are meant to provide a transitional program, 
especially for the approximately 10 million Medicare beneficiaries who 
have no drug coverage. Seniors have been enrolling in the numerous 
discount cards in their area since May 3; and today, many seniors will 
begin to enjoy savings on their medicines. CMS, the Center For Medicare 
and Medicaid Services which administers the Medicare program, estimates 
that seniors will save between $3.8 billion and $5.1 billion over the 
2-year duration of the program. This is a substantial amount of money.
  For an annual enrollment fee of no more than $30, seniors will enjoy 
savings on drugs of up to 30 to 60 percent on generic drugs, 16 to 30 
percent or more on usual retail prices, and 11.5 to 17 percent off 
average retail prices with significantly larger discounts available on 
mail order drugs. This is in real contrast with the message we have 
heard from some of the critics. These are real savings.
  Even better, beneficiaries can choose the card that gets them the 
lowest prices; and if they wish, they can also get help finding low or 
no-fee cards, cards that include specific neighborhood pharmacies and/
or cards from specific sponsors. But the important thing is, this drug 
card, I think appropriately, provides additional assistance to low-
income seniors through a direct subsidy. This is a big benefit to 
seniors in my district.
  Today, seniors with limited means are eligible for a $600 annual 
credit that goes a long way toward paying for their medication. In my 
home State of Pennsylvania, we have had a great program for low-income 
seniors called the PACE program, which provides a prescription drug 
benefit for low-income seniors who do not otherwise have such a 
benefit. This has been, I think, the hallmark of Pennsylvania State 
government for many years and an extraordinary success for those who 
are eligible.
  With this new Medicare legislation, the $600 credit will go directly 
to PACE and allow them to automatically enroll about 150,000 low-income 
seniors, lower PACE's costs, and allow PACE to waive some $6 co-pays 
which low-income seniors would otherwise have had to pay to get their 
medicines.
  PACE beneficiaries will continue to use the card PACE issues them to 
receive the benefits of the new program, and seniors enrolled in a 
Medicare Advantage plan like Security Blue in my district will receive 
a drug discount card from that plan.
  Other eligible Pennsylvania seniors can choose between 43 drug cards 
to find the benefit that is best for them. And as I think the 
gentlewoman is about to point out, they have one number that they can 
call to get the information that they need.
  Mr. Speaker, signing up for the drug discount card and getting 
information on the plans offered in their area could not be easier. 
Seniors who want help in selecting a card should call 1-800-MEDICARE or 
visit the Medicare Web site at www.medicare.gov; and there it is, right 
there. There are 3,000 customer service representatives available 24 
hours a day, 7 days a week to answer these questions. To enroll in a 
particular card, beneficiaries should contact that card and receive an 
application. There is a standard enrollment form that will be accepted 
by all cards.
  Mr. Speaker, what is interesting to me is some politicians and 
special interest groups with their own narrow agendas have run down the 
prescription drug benefit as ineffective. But I would ask them how 
guaranteeing savings ranging from 11 to 60 percent is ineffective, 
especially considering the enormous credit for low-income seniors.

[[Page 11097]]

  After many years, and after the House of Representatives, having 
acted in two prior sessions, Congress has finally acted to give our 
seniors an affordable, flexible, and dependable Medicare program. 
Today, we ring in a new era of better prescription drug coverage. 
Tomorrow, we will broaden that benefit and work to make sure seniors 
continue to get the benefits they have earned.
  As one of the earlier speakers noted, perhaps indeed people will 
remember this on Election Day. But I think as they look at this 
program, they are going to decide that this is a very substantial 
benefit. This is a remarkable accomplishment. This is a massive moving 
of the Medicare program in the right direction, and I think it is going 
to provide substantial benefits for a lot of seniors that need it.
  Again, I want to thank the gentlewoman for her extraordinary efforts.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank the gentleman from 
Pennsylvania for his comments. It is absolutely true that this was the 
first bill ever passed by the House that provided a discount card. 
Every other bill passed or proposed, whether by the Republicans or a 
bipartisan group or the Democrats, waited 2 years to provide any senior 
with any benefit. That was just too long. And while my colleague from 
the other side who spoke just before we took our time said some seniors 
will not benefit at all, he pointed to those seniors who have very good 
employer-provided coverage. That is about 30 percent of seniors. What 
he did not say was that no low-income senior, now that we are at June 
1, will ever again pay more than $5 for a drug, a prescription drug. 
All low-income seniors in America, no more than $5 for a generic; and 
much less than that that many will pay, $1 per prescription.
  Now, that matters to our seniors, I say to my colleagues. That is 
important in their lives, and I am proud that we have brought that to 
them.
  I am very proud to have another colleague of mine from the Committee 
on Ways and Means, the gentleman from Arizona (Mr. Hayworth), join us 
as we talk about this prescription drug discount card now available to 
our seniors across America on this day, June 1.
  Mr. HAYWORTH. Mr. Speaker, I thank the gentlewoman from Connecticut 
for reserving this hour for some straight talk with the American 
people, and I appreciate her efforts and the efforts of a majority of 
Members of this House, working with a majority of members of the other 
body, to have our President sign into law prescription drug benefits as 
a part of Medicare, now the law and now the reality.

                              {time}  2030

  And I share, I do not know the best way to describe it, Mr. Speaker, 
my colleagues, I guess bemusement in one sense, serious concern in 
another very real sense, to hear the double-talk, the deception, the 
incredible mischaracter-
ization of something good for the American people and for our seniors, 
updating Medicare, bringing it into the 21st century, offering real 
results and real savings, with drug discount cards now available to 
seniors on Medicare.
  Mr. Speaker, my colleagues, it has been amazing to look at the 
coverage in the last month. My friend from Connecticut pointed out the 
real results for a widow in her hometown of New Britain. We had our 
colleague from Pennsylvania, another member of the Committee on Ways 
and Means, talk about his constituents in one of the counties he 
represents welcoming real savings.
  I can tell you, this is what really is amazing, Mr. Speaker, my 
colleagues, those who come to this Chamber time and again and purport 
to have the interest of the poorest seniors in mind and in their heart, 
these same people say to our seniors do not bother to sign up.
  Mr. Speaker, my colleagues, we need to reiterate this for the 
American people to hear and understand in Arizona, 106,000 seniors, 
single seniors with incomes under $12,500, married seniors, with 
incomes of under $16,800, those seniors are eligible right now for $600 
to pay for their drugs, to take a serious bite out of the situation 
where seniors have to choose between medicine and food on the table. 
Here is money to help them now; and yet there are Members of this House 
who say, well, it is just too confusing. They should not sign up for 
it. Nothing could be further from the truth.
  We held meetings in the district. We spoke with over 1,000 seniors. 
My colleague has brought to the floor the telephone number, 1-800-
MEDICARE. She will provide the steps necessary. Very simple: 
Medications you take, your zip code, the other information you can 
actually find out how to do this.
  And something else that is very troubling, and again, ironically, we 
heard it from the other side, one speaker from the other side would 
come and talk about America's greatest generation, the generation that 
won World War II, the generation that put a man on the moon, the 
generation that helped to end racial discrimination and fight for civil 
rights, and now we are told that members of this generation are 
incapable of making decisions, are incapable of shopping, when we know, 
we serve these people.
  They compare candidates, they go to the store, Mr. Speaker, my 
colleagues. When people turn 65, and my own parents will turn 72 this 
year, but when they turned 65 nobody showed up at their front door 
saying, hi, I am your federally appointed shopper, and I am going to 
take you to the one Federal store down the street and you are going to 
pick up Federal flakes for breakfast. We did not do that in any other 
part of our economy.
  Yet the same folks who purport to be friends of the most economically 
challenged in our society want us to believe that our greatest 
generation is incapable of making decisions.
  Mr. Speaker, I know it may come as a shock to the other side, but I 
love my parents. They will turn 72 this year. They make decisions all 
the time. Other seniors have the gift of health and health care and the 
ability to evaluate make decisions all the time. We are simply saying 
let us offer choices to seniors. That is what this drug discount card 
does. That is the opportunity we have.
  My colleagues have pointed out 3,000, upwards now of 4,000, call 
center experts, 24 hours a day, 7 days a week, 400 new workers hired in 
the Phoenix area alone to deal with these calls at a call center. The 
seniors we met with understood the card program. They want to take 
advantage of the program because they understand we are talking real 
money.
  And, again, I would point out it is interesting how this town can 
take a term like compassion and fold it and spindle it and mutilate it 
when, in fact, we have something that delivers for seniors.
  The good news is we celebrate one month of a milestone today for 
signing up and putting this in action. The other news we point out is 
that the program does not go away. It continues. We encourage our 
seniors, Mr. Speaker, my colleagues, to take advantage of the program, 
to call 1-800-MEDICARE or check the Web site www.Medicare.gov, take 
advantage of what is available, because you can utilize savings and 
realize savings in some cases on generic drugs up to 60 percent 
discounts. That is real money.
  And it may not be much to the command and control guys who believe 
one size fits all or have this grand vision of socializing medicine and 
having government as they measure compassion delineated by a 
dictatorial one-size-fits-all program from Washington that takes away 
choice, that takes away personal incentive, that robs people of the 
very intellect that helped take our society to such great 
accomplishments as mentioned earlier. Hate to think it comes down to 
politics, Mr. Speaker, my colleagues, but what else can you be left 
with? What other conclusion can we draw?
  To hear speaker after speaker from the other side saying it is bad, 
it is complicated, it is confusing, friends, about the only thing they 
are confused about is the notion that people can save real money and 
this can have a positive impact on the lives of those who, in many 
cases, in the cases of 106,000 Arizonans, have a tough situation at 
home choosing between their

[[Page 11098]]

prescription drugs they need, putting food on the table. This Congress, 
working with this administration, has offered real results.
  Let the others carp and complain, Mr. Speaker, my colleagues. I would 
put them on notice that when you deal in deception and double-talk and 
disinformation, Mr. Speaker, do not be surprised if those who do so are 
headed for defeat in November trying to pull these political stunts, 
trying to offer spin to counter the facts and, ultimately, literally 
costing the seniors who are looking for solutions, costing them 
prescription drug coverage all because we deign to let those seniors 
have the same freedom of choice they exercise in every other sector of 
the economy.
  Mr. Speaker, I thank my colleague from Connecticut for the time. I 
salute her efforts.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank the gentleman from 
Arizona (Mr. Hayworth). I must say that some of the statements made by 
my colleagues from the other side in preceding times do need to be 
answered.
  Mr. Speaker, let me say that it is disconcerting and unfortunate, 
frankly, that Members will get up and say things that are so distantly 
related to the bill. For instance, someone said, why do not we have a 
prescription drug benefit that is part of traditional Medicare? That is 
what we should have passed.
  Folks, that is what we did pass. The bill we passed made prescription 
drugs a benefit under Medicare. Just like part B is a benefit under 
Medicare through which you get access to doctors' care in their office, 
to the costs of tests and things like that, MRIs, all those things, 
part D will give you access to prescription drugs. It is a part of 
Medicare. The discount card is a part of the prescription drug benefit. 
It is a part of Medicare.
  I appreciate that the gentleman who used that phrase did not vote for 
the bill, but that does not excuse misleading the public about it. If 
Jeanne had not been a self-starter, my widow friend in New Britain, if 
she had not been so thoughtful, she would not now be able to pay $11.50 
for a drug she used to pay $40 for.
  Let me just show you here a minute how easy this is. Because this 
word ``confusion,'' ``confusion,'' ``this is so hard, our seniors will 
not be able to follow, they will not be able to understand,'' you see 
how easy it is.
  First of all, write down your zip code. Very important. Write down 
your zip code. Because Medicare is going to tell you the price of your 
drugs at various pharmacies in your area, and they can decide that 
through using your zip code. If you want to know about two zip code 
areas because you live near a border, fine, use two zip code areas. But 
have your zip code written down so you will be ready to say it 
accurately when the question is asked.
  Then write down your medications. Write down the name of each drug 
you are taking. Write down the dose. Because you do not want to find 
out the price for the right drug but the wrong dose. You want to find 
out the discount price for the right drug, the right dose, taken so 
many times a day.
  So get all your facts laid out: The names of all the drugs you take 
and the dosage of those drugs, and the cost that you pay, just so you 
know. When you have that information, your drugs, the dose, the cost, 
and your zip code, then, easy as pie, call 1-800-MEDICARE. We are going 
to put that back up in a minute. Call 1-800-MEDICARE; and one of the 
now 4,000 operators who are available 24 hours a day, 7 days a week, 
and, of course, remember to call in the evening, call in the early 
morning so you will not have to wait, call on the weekend you will not 
have to wait. Call Monday or Tuesday, the wait will be longer. You know 
that from many sales activities you have done throughout your life. 
Call 1-800-MEDICARE.
  Or go have your daughter your son or your grandchild, if you do not 
feel comfortable doing it. Go to the computer and go into 
www.Medicare.gov. So it is easy to get to a person or to a program in 
the computer that will then ask you for the information I have told you 
about, your zip code, the names of every one of your drugs, the dosage, 
and then for your information also what you pay per drug. And then you 
should have your income. That is the next bit of information you need 
to have. Because by telling the operator your income that operator will 
know whether or not you are one of the people that qualify for this 
$600 credit.
  Low-income seniors that do not have any readily available cash have a 
hard time just buying those antibiotics they may desperately need to 
get over an illness. We understand that. So this discount card is not 
just a discount card. It is a $600 cash benefit for those who need it, 
those below 100 percent of poverty income; and then using that cash 
credit and the discount, you see, they will pay a lower price and 
stretch out that $600 available to them.

                              {time}  2045

  So as one of the columnists that I read said, a low-income senior who 
has an income less than $12,500 a year for a single person or for less 
than 16,000, almost 17,000 for a married couple, they should not walk 
to the discount card. They should run to get this discount card, 
because they will pay no more than $1 for generics or up to $5 for 
prescription drugs, an extraordinary benefit for them.
  Finally, look for this label on the discount card: Medicare approved. 
That is why it is part of Medicare, because it has gone through the 
process of being approved by the government and being, consequently, if 
it does not perform fairly, if it says it is going to charge you one 
thing and it charges you a lot more, the government is there enforcing 
the rules, penalizing them and forcing them to comply what it promised 
to you.
  There is a lot more to this program, but I did want to run through 
how easy it is to sign up, how easy it is to figure out which card is 
for you, but I will not go into any further details because I want to 
hear from my colleague, the gentleman from Georgia (Mr. Gingrey), who 
is also a physician, who therefore has a very tangible and real 
understanding of the terrible hardships that patients, who cannot 
afford the drugs they need, face in our communities and what an 
important first step, only a first step, this discount card will be.
  Mr. GINGREY. Mr. Speaker, I would like to thank the gentlewoman from 
Connecticut (Mrs. Johnson) for putting this time together for us 
tonight to make sure the Members of this body understand how important 
this new benefit is. And the gentlewoman's mention, of course, that I 
am a physician by profession, and I did that job for 30 years and 
certainly had lots of seniors, lots of Medicare patients and understand 
some of the hardships that they are going through, as she points out. 
She knows as well as I do, because her husband was also an OB-GYN 
physician for many years.
  Mr. Speaker, I wanted to mention something. I could not help as I 
came to this Chamber hearing one of my colleagues from the other side 
of the aisle, the gentleman from Ohio, talking about how bad this 
program is and how the bill was passed in the dark of night after hours 
of debate. Mr. Speaker, as the gentlewoman said, I am an OB-GYN 
physician. I can tell you right now that my patients, they might have 
come in in the dark of night and delivered in the bright of day or they 
came in the bright of day and delivered in the dark of night. It does 
not matter. Just like an obstetrician, the Members of this body work 24 
hours a day; and when we finally delivered a product, it was a 
beautiful baby. Just because it came at 5 o'clock in the morning, for 
the gentleman to suggest that we were trying to put something over on 
somebody.
  And he also said, that gentleman from Ohio, talked about the pressure 
that the leadership on our side of the aisle put on three freshmen 
Members, freshmen Republicans, Mr. Speaker. I want to remind the 
gentleman from Ohio that there were about five freshmen on his sides of 
the aisle sitting in that front row just waiting until that vote 
changed so they could switch their no votes to a yes.

[[Page 11099]]

  It is also important, Mr. Speaker, for the Members of this body and 
anybody who happens to have the opportunity to be paying attention, I 
hope the whole Nation is, that this bill, although in the House when it 
passed, December of last year, it was a close vote, absolutely a very 
close vote, but it was not a partisan vote. They are suggesting that 
this is a Republican bill. Well, certainly the Republican leadership 
had the guts to bring it forward, as did this President, the courage to 
deliver on a promise, but this was a bipartisan bill. In fact, on our 
side of the aisle there was some 25 Republicans who voted no.
  So certainly for them to suggest and to try to play this class 
warfare game, it goes back in fact to the elections of 2000, the old 
sorry loser man crowd, weeping and gnashing their teeth over the fact 
that they could not get the job done.
  Mr. Speaker, people talk about how much you can get done, what a 
group of people or an organization can get done if nobody cares who 
gets the credit. It would seems to me that this harping and carping 
that we hear constantly from the other side of the aisle would suggest 
that they do care about who gets the credit or discredit. They are 
trying to discredit this program.
  Mr. Speaker, I cannot think of any reason, none whatsoever, why a 
senior would not sign up for this prescription drug discounts card 
program that is going to be available to them over the next 18 months.
  In fact, when I do my town hall meetings, and I just came from 
Columbus, Georgia, in my district, the 11th of Georgia, this morning we 
had a great town hall meeting at the senior center there. I talked to 
my seniors and said, look, if you can think of any reason, I want you 
to let me know. Because I want to bring that information back to the 
Committee on Ways and Means, back to the gentleman from California (Mr. 
Thomas) back to the Subcommittee on Health, the gentlewoman from 
Connecticut (Mrs. Johnson), and I want to tell them about it. I want to 
make sure we have not missed anything. But I can tell my colleagues 
with a straight face, Mr. Speaker, that I can think of no reason.
  Now when we get to the part D, the new Medicare prescription drug 
insurance program, optional program under traditional, as you know it, 
Medicare, or the Medicare advantage, seniors have a choice of that. And 
there will be maybe 40, 50 percent of them who will find that they 
already have something that is better, whether that is Medigap 
insurance coverage or they have health insurance coverage with a 
prescription drug benefit from a previous employer that they worked for 
for 30 or 40 years or whether they have TRICARE for life. There will be 
a number of seniors who decide that they already have something that is 
serving them perfectly well, and they decline this optional Medicare 
prescription drug benefit.
  But to decline this card today, as the gentlewoman from Connecticut 
(Mrs. Johnson) points out, if you are low income, and we estimate that 
a third of the 41 million seniors who are on Medicare will be eligible 
for this credit, this $600 credit plus the discount that will be 
affected on their medications up to 15 to 20 percent, why in the world 
would the other side of the aisle, the minority leader, tell her 
Members, go out and tell your constituents, tell your seniors not to 
sign up for the prescription drug card?
  Well, I am going to tell you what. If they do that, let them do that. 
That is fine. When their constituents find out that their friends and 
neighbors and other seniors across this country are getting this 
discount, and many of them are getting the $600 credit, not just for 1 
year but for 2 years, then I am telling you they are going to charge 
their Members with malfeasance of office is what they are going to do.
  I think it is so unfair to suggest to just block something because 
they are so concerned about who gets the credit. I do not care who gets 
the credit. As I say, this was a Republican and a Democratic bill, a 
bipartisan bill, both in this Chamber and in the other Chamber. So let 
us get over that. Let us get over this sore loser man stuff and let us 
try to bring the benefits to the seniors. Because they have been 
waiting a long time. In fact, they have waiting 39 years. That is how 
long it has been since the original Medicare, when the first person to 
sign up for part B was former President Truman.
  There is so much and the gentlewoman from Connecticut is so kind to 
give me some time, and I do not want to abuse that opportunity. I 
appreciate her letting me speak on this tonight. It is very, very 
important for people to understand that this discount card can only 
help you.
  As the gentlewoman pointed out, you go to 1-800-Medicare, and the 
Secretary, Mr. Thompson, has hired 1,200 new people to man those phone 
lines, or go on line at www.Medicare.gov. It is simple as she said. You 
put in the zip code. And the most important thing is when you go on 
line or on the telephone is to know what medications you are on, know 
that price, know how often you take it, what the strength is. And then 
you see what cards are available to you and what cards give you the 
best discount. It is that simple.
  I really appreciate the gentlewoman giving me the opportunity, Mr. 
Speaker, tonight to talk about this. It is so important. There are a 
few of us physician Members in this body. We do not have all the 
answers. In fact, I think the gentlewoman from Connecticut has a whole 
lot more answers than we do, as all the members of the Committee on 
Ways and Means and the Committee on Energy of Commerce, I commend them 
for the work they have put in to giving us this interim program as we 
wait for the full Medicare prescription drug benefit in 2006.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank the gentleman. When 
you call up that 1-800-Medicare number and you tell them your zip code, 
your income and the drugs you take, they send you a printout. It has 
the pharmacy's name on it and the address and another pharmacy and that 
address right near you and another pharmacy and that address and the 
price that each of those pharmacies charges for each of the drugs that 
you take.
  Now, then you can go on and you can get more. But you can tell them 
my favorite pharmacy is this. I want to know which card gives me the 
lowest price at my favorite pharmacy, and they will tell you that. Or 
you can say, I want to know where the lowest price is in all the 
surrounding towns; and they will tell you that.
  So never have we brought the service of technology to our seniors as 
we have in this program, not just in advertising it but in having 
people there to assist seniors in deciding what card is best for them. 
And, of course, it is true, if you are in a program where your employer 
pays all of your drug costs, you will not need a discount card, but 
that is a very small percentage of our retired seniors. And if you are 
very, very poor, on Medicaid and the taxpayers are paying all of your 
drug costs, that is true, you will not benefit from a prescription drug 
discount card, although your State will. Your State will save some 
money, and that will help them carry the burden of other programs.
  So, ironically, if you are on Medicaid, you will not feel the 
benefit. But in my State that has had to kill some Medicaid benefits, 
they are going to use the money we save them on Medicaid to strengthen 
another part of the Medicaid benefit for other Medicaid groups. So it 
is a good thing for everybody.
  Now, just before we go on to some of my colleagues, I do want to say 
one other thing. First of all, year after year, we have failed in the 
House and Senate to be able to pass a bill. Year after year, seniors 
have waited. Year after year, seniors have begun to doubt whether we 
were as good as our word, whether we did care. This was the third time 
the House passed the bill. The first year the Senate passed the bill; 
the first session the Senate passed the bill. But together now we have 
a bill.
  In the Senate, it was an extremely bipartisan vote. In the House, it 
was less bipartisan because of the nature of the House. But, in the 
end, it delivers to seniors a generous drug benefit that will result in 
half of America's retired seniors having no more than $1 for generic 
costs and $5 for brand name costs

[[Page 11100]]

all across America. That is when the full program is implemented, the 
discount and the subsidy. So this is a giant step forward.
  One of the gentlemen earlier talked about price, how the cards do 
change its price. Now, yes, it can; and we wanted them to. It is too 
bad really that we do not have more Members stop and remember their 
basic economics. There is not a senior out there that does not watch 
the sales. There is not a senior out there that does not go out and buy 
things regularly when they are on sale at whatever grocery store they 
are cheapest. And we know that, so we put all the discount cards out, 
and look what happened.
  The first week they could advertise themselves. See these two cards 
had very high prices. For the bundle of 10 drugs that one of my 
colleagues from the other side defined, they were going to charge a 
total of $1,300 for just those 10 drugs. Well, they began to see, you 
see, what the other cards were going to charge; and they figured out, 
they figured out that even though it cost them a million dollars 
probably to put that card out there, they were not going to get any 
customers and they would lose all the money then put into developing 
their cards. They knew that a customer would be more likely to choose a 
card that was going to cost them only $930 for the same group of drugs 
that this card was going to charge $1,300.
  There is not a senior I know that does not get it. $930 is a lot less 
than $1,300. You are going to sign up for this card. You are not going 
to sign up for these.
  So what happened? Well, let us see. It only took one week, one week. 
Look what happened. Those cards brought their prices down to just about 
the same as the others. And each week there was change.
  In other words, if you put a new product on the market, it costs you 
money. You invest in that product. And if you do not get customers to 
buy your product, I do not care whether it is drug card or an 
automobile or new shoes, you lose because nobody is buying your 
product. So if you want people to buy your discount cards, you better 
be sure you drive those discount prices low, and that is what we have 
been seeing happening. And I am proud of it, and we are going to see it 
happening more and more because this is the first time in history that 
prices have been out there on the Internet for everybody to see. Before 
that, you had to go store by store and then only you knew. Now 
everybody knows.
  Let us turn now to my colleague, the gentleman from Texas (Mr. 
Burgess), another physician in the House.

                              {time}  2100

  Mr. BURGESS. Mr. Speaker, I thank the gentlewoman for bringing this 
hour to the House of Representatives this evening, and I am so glad 
that she brought that chart because that chart really is so powerful in 
describing just what we are trying to do, what is available to seniors 
with this card, and that is by the free and full dissemination of 
information.
  We live in the information age, and that information now being 
readily available on the telephone or the Internet, with the free 
availability of information, we have driven the cost of commonly 
prescribed drugs down a significant amount in the first 2 or 3 weeks 
that this discount program has been around.
  I need to say again that the Medicare prescription drug benefit that 
we passed in this House last November 21 and was signed into law by the 
President in December will occur in two phases. The first phase begins 
today, begins June 1, and is a prescription discount drug card that is 
going to be available to every senior, but low-income seniors will 
receive an additional $600 benefit.
  What is important about that $600 benefit, you might say. Well, gosh, 
we are halfway through the year, so what is going to happen if I have 
not used all of my $600? It rolls over until the next year. So my good 
friend, the gentleman from Georgia (Mr. Gingrey), who pointed out there 
is not one good reason not to buy or not to avail yourself of one of 
the Medicare prescription drug discount cards, there is even more 
reason to look at that card because essentially a low-income senior 
gets a $1,200 benefit over the next 18 months' time until the full 
prescription drug benefit rolls out January 1, 2006.
  The card will be voluntary. The prescription drug benefit program in 
2006 will be voluntary, and no one locks themselves into purchasing 
that part B Medicare in 2006 if they take the discount card that is 
available to them today; and, again, what is so powerful about taking 
that prescription drug discount card today is we are likely to see 
prices change even more over the next month, over the next year, 
indeed, over the next 18 months until the full prescription drug 
benefit kicks in.
  Now, in the interest of full disclosure, I did go on the Medicare Web 
site, and I did log in myself and put in my own ZIP code. I am 
fortunate enough not to be on any medications on a regular basis, but I 
made some up and put them in. Indeed, you can get information about 
your pharmacy or your mail order pharmacy if you use one. Some of the 
prescription drug cards do cost money, and perhaps that would be a 
reason where one of the gentleman from Georgia's (Mr. Gingrey) 
constituents would not buy into the program because the card costs $30; 
but I submit to you the savings are going to be a great deal more than 
$30 over the course of the next 18 months' time; and even more 
importantly, some of those cards do not cost anything at all. They are 
available simply from filling out the form, and no expenditure is 
necessary up front at all.
  So if you are not hooked onto the Internet, your child or grandchild 
undoubtedly is; and, again, one of the other powerful things about this 
program is that we may even see physicians use this program and compare 
prices for their patients. If their patient comes in and says I would 
love to be on that Fosamax so my bones do not get so brittle, but 
doggone, it costs so much money, I do not know that I can afford it, 
perhaps their physician will even take the time and trouble to go on to 
that Medicare Internet drug site and find the best bargain for that 
senior so that they can take their medicine so they are not forced to 
choose between a life-saving medication and food on the table.
  But for the first time, seniors are going to have highly competitive 
pricing available and readily available at their fingertips. They can 
shop for what is best for them; and most importantly, they can make an 
informed choice, but the choice will be up to them. It will not be up 
to someone sitting on the other side of this House who wants to do 
everything for them.
  If you like this system, you can stay with this system after 2006, 
but the program will be voluntary. The prescription drug benefit 
program will be voluntary, and no one locks themselves into a future 
benefit by taking advantage of the prescription drug benefit card this 
month.
  I submit again that the prescription drug discount card benefit that 
is available in 2006 will be even better because of the work that the 
gentlewoman from Connecticut (Mrs. Johnson) has been doing on bringing 
the prices down by making the information free and available and 
readily available to anyone who cares to look it up.
  I thank the gentlewoman.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank my colleague, who 
is also a physician, for joining us this evening; and I am pleased to 
yield to the gentleman from South Carolina (Mr. Wilson), my colleague, 
this evening as we move toward the end of our Special Order.
  Mr. WILSON of South Carolina. Mr. Speaker, I appreciate the 
gentlewoman's leadership on this issue. She has truly in the House of 
Representatives, working with our President, been the leader to 
establish the prescription drug benefit for the people of the United 
States; and I have seen firsthand how this is going to be helpful to 
the people in the district that I represent.
  I have had the opportunity to travel the district, and I have heard 
criticisms tonight that are confusing.
  We, as Congressmen, have a duty when a new law is passed to go and 
explain to our constituents the law and

[[Page 11101]]

how it can be beneficial; and as the gentlewoman has so correctly 
pointed out, this is a law which can be easily understood which is so 
beneficial to the people of our districts.
  Additionally, I heard criticism that it was so confusing they could 
not understand, but I agree very much with the gentleman from Arizona 
(Mr. Hayworth) that, indeed, this is the generation that survived the 
Depression; that won World War II; that protected our country's freedom 
in the Cold War. We know that the people who are affected by this law 
are very bright, very capable. I have faith that they will see through 
the confusion.
  Additionally, I heard criticism that you might have 53 options. Well, 
how wonderful. That is not negative. That is positive. The gentlewoman 
has really explained it so well today and tonight by using the 1-800 
number, by going to the Internet and how simply by providing your ZIP 
code and then you receive the information by having pharmacies in your 
immediate area specifically on the pharmaceuticals that you need, and 
so this is so easily understood, and I appreciate the gentlewoman's 
efforts to promote the bill.
  I know that personally again as a Member of Congress, with her 
leadership, helped prepare mass mailings. I have had district meetings. 
I have had Medicare forums. We will have our district open house next 
week to provide information.
  We have had meetings with the AARP, which provides an excellent 
brochure. I urge everyone to see the AARP brochure. It is very easy to 
understand, explains the full benefit; but today, June 1, 2004, is a 
crucial day because the discount drug card comes into effect.
  My experience in traveling the district, when I was in Bluffton, 
South Carolina, at Palmetto Electric Co-Op, I was pleased to be with 
the Healthcare Leadership Council, Darren Katz, who gave a very 
authoritative presentation. We had wonderful people there from Sun 
City. They really were terrific, asking wonderful questions, and it 
came out a very positive experience.
  Then in Aiken, at the Aiken County Commission on Aging with the Aiken 
County Community Hospital. We then found worksheets from the AARP which 
were so easy to understand.
  At Hilton Head Island, which is one of the leading and most beautiful 
retirement centers and communities in the whole world. I was very 
fortunate to be at Tidepoint Community with Thom Jones and with the 
Golden Rule Company for a presentation and the Cypress Retirement 
Community and I met people, and it was extraordinary to me. I was 
talking to people who would come up to me and say, I was 90 last week. 
They were so much fun, and they were just such a delight to be with and 
an inspiration to me.
  Additionally, in Orangeburg, South Carolina, I was there at 
Orangeburg County Aging Commission with the Orangeburg County Regional 
Hospital. This is a lower income area, and we had a real cross-section 
of the community, and it was wonderful to see them understand the 
availability of this card and what it would mean to them.
  In Columbia, the capital of South Carolina, I had the opportunity to 
be at the senior citizen center at Maxcy Gregg Park; and, again, we had 
a cross-section of community leaders who came to find out about the 
program, and it was very, very encouraging.
  Finally, I will be at the Gilbert Community Center in Gilbert, South 
Carolina, next week promoting the legislation, explaining the bill with 
the Lexington County Recreation and Aging Commission and also the 
Lexington Medical Center. I know that the people of Gilbert and the 
people famous for the 4th of July Peach Festival will be enthusiastic 
to get information about this and how it means so much to the senior 
citizens of our community.
  Another part about the confusion, it is really my point, and what I 
have discovered at these meetings is the AARP is so helpful. We have 
chapters all over the United States. If you have got a question, 
obviously we have got the 1-800 number, we have got the Internet 
connection which is easily available to everyone, but the AARP has the 
information. They have got wonderful and capable people who would be 
happy to meet with you. We know that these brochures are also at senior 
citizens centers throughout America. At every senior citizen center 
they are available, and people can find out and cut through the 
confusion.
  I know personally that it has been my experience that when I worked 
with insurance and I was a real estate closing attorney for 25 years, I 
did not try to understand the insurance policy. I went to an agent that 
I trusted and I go to him or her and get the policy and I have faith in 
that. As a real estate closing attorney, I did not even imagine that 
people would understand a 20-page mortgage sometimes written in old 
English using English common law. You find a good attorney that you 
trust and you go to them; and it has been my experience, and you have 
referenced this earlier, and that is, go to a pharmacist that you 
trust. These are dear people. They really do care about their patients, 
their customers.
  I know my next-door neighbor Bobby Perry and his daughter Roberta 
Vining are two of the finest pharmacists you can ever find. These 
pharmacists care about their patients. These are people who really make 
your heart warm; and so I would urge anyone, if politicians are 
confusing, do not get discouraged. Listen, first of all, to the 
gentlewoman from Connecticut (Mrs. Johnson), but after that, if you are 
confused, go to your pharmacist, talk with them, find out what they 
recommend.
  Again, I want to thank the gentlewoman for her leadership. It has 
been inspiring to me as a relatively new Member of Congress, and I am 
just so appreciative of her persistence and her understanding of the 
issue and her devotion to promoting a real prescription drug benefit to 
the people of America.
  Mrs. JOHNSON of Connecticut. Mr. Speaker, I have served in Congress a 
long time; and when there is a real problem in the lives of the people 
you represent, I believe your job is to solve it. I believe your job is 
to take action, to do something; and I know that this is the most 
important health care bill we have passed for seniors since Medicare 
was founded.
  It not only offers them prescription drugs. As I showed you earlier, 
it is absolutely voluntary. It is simple. You just use your ZIP code. 
You give us the pharmacist you like the best. You give us the names of 
your drugs, and we will tell you how much money you can save. It is not 
for everyone, if people already have very good coverage through their 
employers, but particularly important to those seniors who have no 
prescription drug coverage. It is real savings in their lives, and that 
is important to me.
  When the whole bill goes into effect, we will pay 75 percent of the 
costs of their drugs, a gigantic step forward. Just as we pay 80 
percent of the cost of their visits to the doctor, we will pay 75 
percent of the cost of their drugs. In the bill I wrote, it was 80 
percent. We will get it up to 80 percent, but you have to act. You have 
to do something, and all these nay-sayers who voted against doing 
anything one more year, this would have been the fourth year we would 
have done nothing. What a record. All those nay-sayers are now telling 
you do not bother, do not bother.
  Listen, take a minute, bother, call 1-800-MEDICARE. Do what Jean did 
and find out that you can save $30 on one drug she has to buy every 
month, $20 on another drug. It all adds up to hundreds of dollars. 
That, in my estimation, is a good thing. That helps our seniors.
  I am proud of the bill we passed because it brings prescription drugs 
to seniors; but you know what else, not a senior I know does not have 
chronic illnesses. Twenty percent of our seniors have five or more 
chronic illnesses. Medicare does not pay for chronic illness care. The 
rest of the world knows about it.
  Many, many employer-provided plans do a lot more for people with 
diabetes or heart conditions. Do you understand that in this 
prescription drug and Medicare reform bill, for the first time we are 
going to provide chronic disease management for our seniors? We are 
going to give them the kind of state-of-

[[Page 11102]]

the-art support that means that people with chronic disease do not have 
to end up in the hospital, do not have to end up on dialysis if they 
have diabetes, do not have to fear going to the emergency rooms. I 
mean, it is going to be a revolution. It is bringing preventive health 
care right to those who have chronic disease and are going to suffer 
the most serious health consequences.
  So this is about prescription drugs. This is about a discount card 
today, about a full prescription drug card subsidy in 2006 and about 
Medicare offering state-of-the-art care to people with chronic 
illnesses in a way it never has.
  I am proud to have helped write this bill. I am proud that I was the 
only woman on the conference committee, because I think that is 
important.

                              {time}  2115

  Women and men both need to be present to make our laws, and do not 
any one of the young people watching tonight forget that.
  But this is a big step forward, and do not let naysayers rob you of 
the very considerable savings this discount card could bring to you. 
And, remember, you be the judge of your interests. You alone can make 
that judgment. We here in Medicare have made it very easy, and I urge 
you to take advantage of the Medicare prescription drug discount card, 
which starts today, June 1.

                          ____________________