[Congressional Record (Bound Edition), Volume 155 (2009), Part 5]
[Senate]
[Pages 6442-6443]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. DORGAN. Mr. President, last evening President Obama had invited 
the chairs and ranking members of committees in both the House and 
Senate to the White House for dinner. I wanted to mention that the 
opportunity for Republicans and Democrats, both chairs and ranking 
members of committees, to spend some time with the President was very 
important, a very important signal by the President to the Congress 
that he wants to work with everybody. He didn't give a speech. He and 
his wife, the First Lady, welcomed the Members of Congress. I was 
pleased to be there. My point is, this President is trying to reach out 
and change the culture, which is so important.
  This afternoon, I have been invited by the President to join a number 
of my colleagues, Republicans and Democrats, to go to the White House 
for a health care summit. Once again, the President is reaching out to 
see if there are ways for Republicans and Democrats, who work for the 
same masters--that is, American interests and the American people--to 
come together and find ways to reach significant policy goals. Do we 
have a need to address our health care problems? Absolutely. We spend 
much more than any other group of people on the face of the Earth on 
health care. Our costs are much greater than anyone else's, yet the 
outcomes are not. We rank 41st in life expectancy despite the fact that 
we spend far more than anyone else in the world on health care. Health 
care costs are accelerating. They are injuring businesses paying for 
health care insurance for employees. Health care costs are strangling 
family budgets. Health care costs are hurting Government, which has to 
pay for Medicare and Medicaid.
  We have to get a handle on it.
  The President is saying: Let's try to find a sensible, thoughtful way 
to reform health care. A good start is to invite a group of Republicans 
and Democrats from the Congress, a group of people from the private 
sector, from the health care industry, from the consumer side, 
supporters and opponents of various kinds of reforms and changes, to a 
summit at the White House to say: Let's talk. Let's try to figure out 
how we address these issues.
  I commend the President because we have to change the culture. This 
cannot possibly continue to be an ``us versus them'' Congress or a 
Congress and Presidency that is deeply divided.
  This country faces very serious challenges. The fact is, we have to 
work together to solve them. The very serious financial challenge, the 
crisis we face, is going to require the best energies all of us have 
and the best ideas of all of us. Included in the financial crisis is 
what health care costs are doing to the economy. That is why the 
President has indicated that one of the first issues we have to tackle, 
even as we try to stabilize the economy, is to address the issue of the 
burgeoning cost of health care. So I commend the President, and I look 
forward to the meeting today at the White House. I think it will be a 
good start to at least begin discussing health care costs.
  I want to talk about one piece of health care costs because yesterday 
Senator Snowe from Maine, myself, Senator McCain from Arizona, my 
colleague Senator Stabenow from Michigan--we announced, on behalf of 25 
Senators, a piece of legislation we introduced yesterday dealing with 
prescription drug costs. One of the fastest rising items of health care 
costs is the cost of prescription drugs.
  Now, we have introduced this legislation before, and it has 
successfully been blocked. But things have changed in a very dramatic 
way. The makeup of the Senate has changed. One of the people who 
cosponsored our legislation in the last session of the Congress is now 
sitting in the White House--then Senator Barack Obama, now President 
Obama. He was a cosponsor. The Chief of Staff at the White House, Rahm 
Emanuel, was one of the key sponsors in the House. So the fact is, we 
think we have an opportunity to pass legislation that will put some 
downward pressure on prescription drug prices. This is bipartisan and 
nonpartisan. This stretches from John McCain to President Obama. Both 
Presidential candidates were cosponsors in the last session of Congress 
of this identical piece of legislation. Many other Republicans and 
Democrats have joined us, so that as we introduced it, there are 25 
original cosponsors.
  Now, let me describe the problem we face in this country. By consent, 
I wish to show two bottles that did contain medicine. These are bottles 
of Lipitor. Lipitor, by the way, is a drug that I think probably is the 
most prescribed drug in this country, or at least one of the top 
prescribed drugs in this country. It is a cholesterol-lowering drug. 
Lipitor is made in Ireland and then shipped around the world.
  Here is the way Lipitor is shipped in these bottles: same size, same 
cap; the only difference is, one is blue, one is red; the same pill put 
in the same bottle, made by the same company, FDA inspected. This red 
one goes to the United States. This blue one goes to Canada. The 
difference? This red one costs twice as much.

[[Page 6443]]

  The U.S. consumer is told: You pay more than twice as much for the 
same prescription drug. Why? By what justification should not just 
Lipitor but other medicines be priced in a manner that says to the 
American consumer: You pay much more than we are asking others around 
the world to pay for the identical prescription drug? There is no 
justification.
  Zocor, here is an example of a cholesterol-lowering drug. The United 
States and Canada--$5.16 for a 20-milligram pill in the United States; 
$2.45 in Canada.
  Let me describe where these drugs are coming from. We are told by the 
opponents of this: Well, if drugs were to come into this country from 
outside the country, there might be a counterfeiting problem. Well, do 
you know what. Most of these drugs are made outside of our country. 
Lipitor is made in Ireland. Nexium is made in France. Tricor is made in 
France. Vytorin is made in Singapore and Italy and the UK.
  Now, my point is simple: We have a law in this country that says the 
drug companies can import drugs into our country, made in other regions 
of the world, but consumers cannot, registered or licensed pharmacists 
cannot, and wholesalers cannot. Our piece of legislation is very 
simple. It says, let's provide some competition here. If the 
prescription drug industry is selling their drugs in virtually every 
other country in the world for a fraction of the price they sell those 
drugs here, let's let licensed pharmacists in our country purchase them 
from Canada or another country and pass the savings along to the 
consumer. Let's let wholesalers who are licensed in this country access 
those lower cost prescription drugs. Let's allow American consumers to 
access those drugs from Canada.
  Now, I sat on a hay bale out on a farm 1 day at a little town meeting 
where there were 40 or 50 farmers, and we sat and talked about life and 
about the farm program and about what was going on in their region of 
North Dakota.
  There was one old codger there who was kind of lamenting what it was 
costing him to live. He said: We don't make much money. We don't have 
much spendable income. And he said: I'm over 80 years old, and my wife 
has been fighting breast cancer for the last 3, 3\1/2\ years. He said: 
She has to take a drug called Tamoxifen. He said: So we have been going 
to Canada to try to buy Tamoxifen because it costs 80 percent less in 
Canada. It is the same drug--exactly the same drug--prescribed for an 
elderly woman who is fighting cancer, but you can pay much, much, much 
more here in the United States or much, much, much less in other 
countries. He said: For us, we have to drive to Canada to try to access 
this drug.
  Americans should not have to do that. This ought to be a fair pricing 
strategy for American consumers, and today it is not. So we have 
introduced legislation that has substantial safety requirements 
attached to it. We provide substantial additional funding for the Food 
and Drug Administration. We provide pedigree requirements for drug lots 
produced anywhere in the world. We provide much more inspection of 
plants that produce drugs the FDA is approving. By the way, we know 
that substantial amounts of ingredients come from China and elsewhere. 
We also know that despite the fact there are supposed to be inspections 
of many of these plants, the inspections are few and far between.
  The legislation we have introduced will dramatically increase the 
margin of safety--not decrease it--increase the margin of safety. What 
it will do is allow the American public to have access to lower cost 
prescription drugs. If one part of driving up the costs of health care 
in this country, as rapidly as it has gone--if one part of that is the 
rapidly increasing price of prescription drugs, then we can remedy 
that. We can simply say to the pharmaceutical industry: Give us the 
opportunity to have the same kind of pricing the rest of the world has. 
We can make that happen, not by asking them to give it to us, but by 
requiring a circumstance where our pharmacists and our wholesalers can 
access those same lower cost drugs.
  Now, what does it mean? Well, we could save with this legislation 
about $50 billion in the next 10 years for American consumers; and 
about $10 billion of that would be saved by the Federal Government for 
its programs, Medicare and Medicaid.
  Here is a New York Times piece. It says: ``More Americans Are 
Skipping Necessary Prescriptions, the Survey Finds.'' That was from 
January of this year. It says: One in seven Americans under 65 went 
without prescribed medicines, as drug costs spiraled upward in the 
United States, a nonprofit research group said.
  Well, we can fix this. We can pass this legislation. As I indicated 
earlier, finally I think we have a bit of a tailwind here. We have a 
President who wants this. He put it in his budget. So now we have put 
in the architecture of a complete piece of legislation. We have worked 
on it for many years. My colleague, Senator Snowe, and I, and many 
others--from Senator Kennedy, Senator McCain, Senator Grassley, Senator 
Stabenow--all of us have worked to make this happen: increase the 
margin of safety, reduce prescription drug prices, and give the 
American people the opportunity to have some sort of competitive 
prescription drug prices that others all around the world have as a 
result of the current scheme that--let me not use the term ``scheme''--
as a result of the current pricing policies of the prescription drug 
industry.
  Let me complete my statement by saying, we introduced this 
legislation yesterday. We will continue to try to access more and more 
cosponsors. Whether this is a part of a health care reform bill or 
passed on its own, I think it is going to be good news for American 
consumers.
  Let me say one more time that the President's call today for a health 
care reform summit at the White House is one more example of bringing 
Republicans and Democrats together. This President is determined to do 
that. That is good news because there are a lot of good ideas that can 
come from every corner of this Chamber and every corner of the 
political system.
  We ought to work together to give the American people the best of 
what both political parties have to offer rather than the worst of 
each, and nowhere is that more important than to do it in health care 
reform.
  I thank the President for creating this summit this afternoon. One of 
the issues I will raise there will be the prescription drug importation 
bill, which I think could put some downward pressure on prescription 
drug prices, and that would be good for the people who live in this 
country and be good for this country's budgets and business budgets and 
so on.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Maryland.

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