[Congressional Record (Bound Edition), Volume 151 (2005), Part 11]
[Senate]
[Pages 14725-14726]
[From the U.S. Government Publishing Office, www.gpo.gov]




                   INDIAN HEALTH CARE IMPROVEMENT ACT

  Mr. GRASSLEY. Mr. President, I want to take a few minutes to explain 
my action today related to S. 1239, a bill to amend the Indian Health 
Care Improvement Act. Today, with great reluctance, I asked Leader 
Frist to inform me before entering any unanimous consent agreements 
related to consideration of this bill, which the Indian Affairs 
Committee reported by voice vote this morning.
  S. 1239 would pencil the Indian Health Service, IHS, an Indian tribe, 
a tribal organization, or urban Indian organization to pay the monthly 
part D premium of eligible Medicare beneficiaries. The bill defines 
eligible beneficiaries as individuals who are Indian and who are 
eligible for the part D prescription drug benefit, but who do not 
receive any additional financial assistance made available under the 
Medicare Modernization Act of 2003, MMA, to beneficiaries with limited 
incomes.
  I am all for providing assistance in paying premiums for 
beneficiaries in financial need. We devoted a lot of time to those 
provisions in the MMA. I am troubled, however, that as currently 
drafted, S. 1239 would permit the IHS, an Indian tribe, tribal 
organization, or urban Indian organization to pick and choose who will 
get premium assistance. Specifically, the bill would allow them to 
consider an eligible beneficiary's ``expected drug utilization'' and 
any other factors to determine the cost-effectiveness of paying the 
beneficiary's premium.
  This provision might be an attempt to reflect that the IHS, tribes, 
and tribal organizations have limited resources. The bill language, 
however, raises a number of questions. First, how would the IHS and 
tribes determine expected drug utilization or cost-effectiveness? Would 
it be based on the number of drugs a person takes or the severity of 
illness? Second, how would they account for the fact that a 
beneficiary's drug needs could change dramatically with just one 
illness? That is the point of having insurance.
  When we crafted the MMA, we were keenly aware of the potential for 
adverse selection--meaning that beneficiaries might wait until they 
need part D coverage to enroll in part D. This would have the effect of 
driving up the cost of the part D premium for all beneficiaries. The 
additional considerations currently included S. 1239 set a dangerous 
precedent by seemingly promoting adverse selection in the part D 
program. This is exactly opposite to what we sought to achieve in the 
MMA.
  Mr. President, I welcome the opportunity to work with the sponsors of 
S. 1239, Senators McCain, Dorgan, and Baucus, and with members of the 
Indian Affairs Committee on this matter. I had hoped to accomplish that 
before the bill was reported out of committee. Unfortunately, that did 
not happen. I do not take actions such as these lightly. But I am 
deeply troubled that as currently drafted, S. 1239 could end up having 
unintended consequences for the very people it is intended to assist 
and for all Medicare beneficiaries.


                        COMBAT METH ACT OF 2005

  Mr. FEINGOLD. Mr. President, I am proud to add my name today as a 
cosponsor of the Combat Meth Act of 2005, S. 103. I want to thank 
Senator Talent and Senator Feinstein for their leadership on this 
issue. I have had the opportunity to work with my colleagues on a new 
version of the bill that I understand will be offered in the Judiciary 
Committee as a substitute when the bill is marked up, and I am very 
pleased to support this new version of the Combat Meth Act.
  Meth is a highly addictive and particularly destructive drug that can 
be manufactured from widely available household items. In the last 5 
years, the use of this terrible drug has skyrocketed, both nationally 
and in my home State of Wisconsin. When I talk to prosecutors and 
police officers from Wisconsin, they consistently tell me that meth use 
is the most daunting problem they are facing. They tell me that meth is 
the single most harmful drug--to addicts, families, children, 
communities, and the environment--that they have ever dealt with. This 
bill gives law enforcement officials a chance to stem the growing tide 
of meth use by restricting access to the cold medicines that are 
commonly used to make meth and by providing funds

[[Page 14726]]

for programs that have been shown to combat the meth problem. The bill 
targets those who purchase over-the-counter drugs for the purpose of 
manufacturing meth, while still allowing law-abiding Americans to have 
adequate access to the cold medicines they need.
  Methamphetamine is derived from pseudoephedrine, a chemical that is 
found in most common cold medicines. Meth ``chefs'' can manufacture the 
drug by buying large quantities of cold medicine, mixing it with other 
common chemicals, and heating it. This process can occur nearly 
anywhere and requires only limited knowledge and experience. Even 
beginners can easily manufacture this drug.
  Given how easy it is it make, it is not surprising that meth use has 
been increasing rapidly. A recent report from the National Institute on 
Drug Abuse finds that meth use has swept across the country, starting 
in Southern California and moving steadily eastward. The situation has 
become particularly dire in the Midwest, where meth use accounts for 
more than 90 percent of all drug prosecutions. Literally millions and 
millions of individuals have reported using meth--and this trend shows 
no signs of slowing. Meth cases in my home State of Wisconsin have gone 
up 500 percent in just the last 4 years, from 101 prosecutions in 2000 
to 545 in 2004. And Wisconsin is doing much better than many other 
Midwestern States thanks to proactive efforts by state officials in the 
late 1990s, before meth had taken hold, to educate communities about 
the dangers of meth and the need for prevention. These education and 
prevention efforts paid off, keeping the number of meth labs relatively 
low in Wisconsin compared to neighboring States, but the problem 
remains a very serious one.
  Both the manufacture and the use of meth have devastating 
consequences for users and those around them. In the short-term, even 
occasional meth use leads to a whole host of physical and psychological 
problems. It causes inflammation of the heart lining, increasing the 
risk of heart attacks and strokes. It causes damage to the nervous 
system and creates abscesses on the skin. It also attacks the brain, 
leading to bouts of paranoia, anxiety, and insomnia.
  Meth's long-term effects are even more destructive. It has highly 
addictive properties, quickly turning occasional users into desperate 
addicts. Meth addicts often go for days without eating or sleeping. 
They suffer from a variety of heart ailments and can sustain permanent 
and often irreversible brain damage. The drug's effect on the brain 
also leaves addicts vulnerable to the entire spectrum of mental health 
problems, from paranoia and depression to aggression and psychosis. And 
the drug's chemical effects are particularly insidious, meaning that 
addicts often require extended detoxification periods before they can 
begin treatment.
  Sadly, meth's harmful effects are not confined to its users. The 
process of manufacturing meth creates unique environmental hazards that 
can poison surrounding communities. Cooking the chemicals that create 
meth can lead to explosions, fires, and the release of noxious gases. 
Remnants from the procedure are often washed down the drain or dumped 
in the ground, where they can contaminate local water sources.
  Another related danger of significant meth use in a community is an 
increased crime rate. Meth addicts often resort to violence to gain 
access to the materials they need or to the money they must have to 
sustain their addiction. Additionally, people who are high on meth are 
disposed to aggressive and violent behavior. The results are apparent. 
For example, local news reports indicate that Eau Claire County in 
Wisconsin, which has been hard hit by the meth problem, has seen a 
significant increase in meth-related crimes as meth use has become more 
prevalent. This drug does not just poison users; it can affect entire 
communities.
  And in the unkindest cut of all, children who are exposed to meth 
manufacturing or use can be scarred for life. Children of meth addicts 
are exposed to toxic fumes and volatile chemicals, resulting in 
potentially serious health problems, and they are often abused or 
neglected by those in the throes of addiction.
  This problem calls for immediate Federal action. When Oklahoma was 
the first State earlier this year to pass a law that successfully 
restricted access to pseudoephedrine, the sale of products containing 
pseudoephedrine grew noticeably in neighboring States. The Oklahoma 
experience shows that States acting alone cannot address what has 
become a national meth problem. We need a law that creates national 
standards for the sale of products containing pseudoephedrine and puts 
the resources of the Federal Government behind the effort to stop meth 
use.
  The new version of the Combat Meth Act provides the national response 
that we need. It attacks the meth problem at all stages of the process: 
It gives State and local officials the tools they need to prevent the 
sale of products used to make meth, to investigate and prosecute meth 
manufacturers, and to treat meth addicts and protect the children they 
harm.
  This bill helps prevent meth use by restricting the sale of 
ingredients needed to manufacture meth. Under the new bill, cold 
medicines that contain pseudoephedrine will be placed behind pharmacy 
counters and purchasers will only be able to buy 7.5 grams of the 
product per month--more than enough for people who really need the 
medicine but not enough for those who are buying the medicine to make 
meth. It requires people purchasing pseudoephedrine products to sign a 
written log, but I am pleased that the new version of the bill ensures 
the privacy of this potentially sensitive medical information by 
allowing the information to be used only to find individuals who might 
be purchasing these products to make meth. The bill also provides 
funding to States to monitor the sale of products containing 
pseudoephedrine.
  The Combat Meth Act gives States the resources they need to bring 
meth manufacturers to justice. It provides money for training programs 
for State and local law enforcement and expands the scope of currently 
effective meth investigation and clean-up programs. Once meth producers 
and traffickers are found, this bill helps put them behind bars by 
hiring additional Federal prosecutors, training local prosecutors in 
Federal and State meth laws, and cross-designating local prosecutors as 
Special Assistant U.S. Attorneys, allowing them to bring legal action 
in Federal courts.
  While this bill strengthens enforcement and prosecution measures, it 
also recognizes that most meth addicts require treatment rather than 
harsh criminal sanction. To that end, the bill authorizes the creation 
of a meth treatment assistance center, which will help states learn how 
to effectively treat those who suffer from this awful addiction. And 
for this drug's most innocent victims--the children who are exposed to 
meth by the users around them--the bill provides a $5 million grant to 
allow Federal, State, and local entities to work together to help 
assist and educate children who have been harmed by a family member's 
meth addiction.
  The widespread use of meth, particularly in the Midwest, has become 
an unsupportable burden for many families and communities. The new 
version of the Combat Meth Act is a common-sense response to a growing 
problem one that requires immediate Federal attention. While the bill 
does not address the increasing problem of meth imports from overseas, 
it will help cut back on domestic meth manufacturing and the many harms 
that accompany it. I am proud to support this new version of the bill 
and I urge my colleagues to support it.

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