[Congressional Record (Bound Edition), Volume 152 (2006), Part 3]
[House]
[Page 4151]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            MEDICARE PART D

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Oregon (Mr. DeFazio) is recognized for 5 minutes.
  Mr. DeFAZIO. Madam Speaker, well, Congress is temporarily in 
Washington between breaks, and I don't know how some Members on the 
other side of the aisle spent theirs, but along with Representative 
Hooley and Representative Blumenauer, all of us from Oregon, we spent 
the day yet going up the length of the Willamette Valley holding 
meetings in senior centers and other public venues to hear from 
seniors, senior advocates, people who work with seniors and care about 
seniors about the experience with the so-called Medicare part D 
prescription drug benefit.
  Now, I heard from the other side of the aisle what a stunning success 
it is. We are protecting the profits of the pharmaceutical industry. 
They will get an extra $139 billion in profits. We are subsidizing the 
insurance industry to offer these plans, plans which can be changed on 
a weekly basis even though seniors can only sign up for one plan a 
year.
  Yet as great as they say these things are, about half the seniors in 
my State and across America who were not mandatorily enrolled are not 
yet participating in the plans, in part, because in my little State, 
there are some 46 plans in my district, I guess in Portland a few more, 
so there are actually a total of 96 variants available to seniors.
  They describe to us what happens when you go on these sites, these 
are the advocates, not the seniors. You will get, and there will be a 
little tiny asterisk by certain drugs, and they have given you some 
plans that might be good for you because you need a plan that will pay 
for the drugs your doctor has prescribed.
  If you hit the little tiny asterisk, then a drop-down window comes 
out. Most seniors don't know about drop-down windows. The drop-down 
window says limits may apply. It turns out the limits might be you take 
60 of those twice, two a day. The limit might be one a day, but it is 
not very explicit about that. When you call the 1-800 number, you can't 
get a human being to get information. So seniors are, for the most 
part, totally confused. They are having trouble, even when they try to 
focus in on a plan that might give them help, getting to a point where 
they can make a choice.
  Of course, even if they do choose a plan that pays for that plan, 
that plan can change the drug benefit on a weekly basis, not something 
that a senior can do.
  Now, we also heard from a small pharmacist, because of the confusion 
in the transition for the dual eligibles, her pharmacy, her little 
pharmacy, had to front $45,000 in prescriptions to seniors and has yet 
to be reimbursed. The reimbursements are starting to trickle in. She 
had spent 8 hours the day before trying to reconcile some of those to 
the actual outlays in the drugs that she had fronted for her seniors.
  We heard time and time again about problems. My doctor has hired an 
additional person to try and deal with all the prior approvals required 
for seniors who have been taking a drug for years, many of these new 
plans will require all sorts of documentation on why they should get 
that drug. Many seniors don't know, who have already subscribed, that 
they are temporarily getting their old drugs until the 1st of April. On 
the 1st of April, they will fall under their new plan's mandates, and 
they may not be able to continue taking the drug their doctor has 
prescribed.
  Minimally, Congress should revisit this punitive time limit. The time 
limit, you have to sign up by May 15, or we will penalize you. They say 
1 percent per month; but guess what, you can't sign up again until next 
fall.
  Any senior who doesn't sign up by May 15 will be penalized 6 percent 
tax, 6 percent extra for life as a bonus to the already subsidized 
insurance companies on top of their premium. That is not fair. Congress 
should undo that arbitrary mandate. That was to try and stampede 
seniors into plans that they don't understand that they might not want, 
and that should go.
  But then perhaps we should do what the head of Walgreens has 
suggested. He said there are so many plans out there, so many benefits, 
so many formularies, his pharmacist can't figure it out.
  Like Congress did 25 years ago, he says Congress should standardize 
these plans and say, there will be five or 10 plans out there with 
standard benefits, so everybody can understand what the 10 options are. 
They can just learn 10 options and then let the private companies 
compete over price, perhaps without a subsidy from the taxpayers.
  Or, God forbid, we could actually take on the pharmaceutical industry 
since the drug prices under these plans are actually on average higher 
than the prices offered by Costco. What a great deal. The President 
likes to talk about how these insurance companies, or PBMs, how they 
have just bargained so hard and driven down the prices. They are only 
50 percent higher than the prices that the VA gets through negotiations 
for our veterans. But the Republicans outlawed, they outlawed, Medicare 
bargaining lower drug prices on behalf of Medicare beneficiaries.
  Now, who does that help? They said that was un-American to negotiate 
lower drug prices. It is not un-American to give huge windfall benefits 
to the pharmaceutical industry.

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