USA Patriot Act Additional Reauthorizing Amendments Act of 2006--Continued

USA PATRIOT ACT ADDITIONAL REAUTHORIZING AMENDMENTS ACT OF 2006--Continued

BREAK IN TRANSCRIPT

PRESCRIPTION DRUGS

Mr. DURBIN. Mr. President, during this President's Day recess, I journeyed to Illinois and made stops in several cities. There were many places to visit, but I chose to visit drugstores. In each one of these towns, large and small, I sought out pharmacists--whether it was Collinsville, IL, or Decatur, IL, or Chicago--to talk about the Medicare prescription Part D plan. I thought the pharmacist was the right person to speak to because these pharmacists are on the front line in health care. Across America, many Americans view the pharmacist as their friend when it comes to their medical conditions and their health. So they have a good, trusting relationship.

Also, of course, Medicare prescription Part D is the first time we are trying to provide prescription drugs to people under Medicare, something we should have done from the beginning, but we are doing now. We are not doing it very well.

What I learned during my visit to Illinois is the fact that there are thousands of people in my home State who are struggling to make the right decision when it comes to their Medicare prescription drug program. They are struggling because there are some choices, and the choices are very difficult to evaluate. In Illinois, there are about 42 different plans from which seniors can choose. If you seek the information on the plan, you are directed to a Web site. A Web site may be of value to many people who are following the Senate proceedings, but to many senior citizens it is terror incognito; it is unknown territory.

Only one in four senior citizens have ever logged onto a computer. They do not have the luxury of going to the appropriate Web site using their mouse to click through the options trying to figure out the best choice. They are lucky, in many cases, to have one of their kids who will sit with them and work through the options.

But, I tell you, some of the professional people I run into, educated people I run into, quickly tell me that this is not an easy thing to navigate. With 42 plans, you had better make the right choice.

Most seniors start with the basic drug they are currently taking and they go to the prescription drug plan to see if that drug is offered by the drug plan. Then they calculate the prices of the drugs to try to determine how much they are going to have to spend to get into the program, or once in the program how they will pay for their drugs. What they come to learn, to their chagrin, is that many of the drugs which are part of the formulary or the drugs that are being offered in a program today are changed tomorrow. The drug you needed, the drug you are looking for may be discontinued tomorrow.

In other words, instead of a discount you may have to pay the full price. It is really a classic bait-and-switch situation.

Second, the price that is quoted to you for this drug may change as well. It is like following the stock market. You have had two different plans. These seniors are trying to choose the right one. The drugs that are covered can change day to day. The prices can change day to day. And seniors have to make their choice and live with it for a year.

It is fundamentally unfair. It is unfair that the drug plans can change right as these seniors have made their choice. And the seniors can't change their drug plan for a year.

I have introduced legislation that would give senior citizens that option, an option that if the price of the drug goes up 10 percent or more, or it is dropped from the formulary, you can change your plan without a penalty. I think that is only reasonable.

I also have to tell you that many of these pharmacists are at their wit's end. They care for these people. They really do. These are customers of a lifetime, and they come to these drugstores--some of them--distraught over what they are going through with Medicare prescription Part D, and the pharmacist tries to help. He gets on the phone. He may call that drug plan and try to make sure that the seniors are being treated fairly. He may ignore the plan, which says don't give some tablets over the course of a month, and give the person what he knows they need.

These are things he does at his own peril in terms of his own financial well-being.

I talked to one pharmacist who said that the drug Ambien, which is used by some who can't sleep at night had been prescribed, and one of the seniors who signed onto one of the plans brought in his monthly prescription for Ambien and was told he could only have 18 pills.

So the plan decided that whatever the doctor had said notwithstanding, whatever the condition, the senior citizen, 12 days out of 30, was not going to have their medication.

That is the kind of thing these seniors are facing. It is no wonder, to me, that the seniors I meet and the pharmacists who are trying to help them are really upset about this plan. They understand, as I do, that this plan wasn't written for senior citizens. This plan was written for health insurance companies that make these plans available, as well as the pharmaceutical companies. They are the big winners in many respects, first, because Medicare is not offering an overall plan for every senior to choose. I think that is where we should have started.

We have a Medicare plan in America. People were brought into it in a matter of a few months, and it has worked very well for 40 years. There could have been a Medicare prescription drug plan which would have been the basic template, the standard model that is available to every senior. If someone in the private sector wants to compete and offer an alternative, they could have. I would have voted for that. But Medicare should have been able to offer the basic fundamental model plan that every senior could turn to, and it would have been successful because Medicare, with the potential of bargaining for 40 million senior citizens, could sit down with that drug company and tell them you can't raise the price of drugs 10 percent a year, we just won't let you under the plan.

You know what happened. The same thing happened in Canada. That is exactly what the Canadian Government did to these same American drug companies. They told them if they wanted to sell to the Canadian health plan, they couldn't keep raising the cost of the drugs every single year.

That is why exactly the same drugs manufactured in the United States sell for a fraction of the cost in Canada because the Canadian Government stepped in.

When we tried to do that on the floor of the Senate, the pharmaceutical companies fought us and won big time. Now we have 500 plans across America trying to negotiate better prices. And you know what that means: You don't get the discount, the bulk discount, and the lower prices that can occur.

We know the VA had already tried this. They offered the veterans who come to veterans clinics and hospitals prescription drugs at reduced rates because they bargained with the same drug companies, but these drug companies didn't want to give up their power in this negotiation. So they insisted that Medicare would not write a basic plan. They insisted that there be 500 plans across America. They knew they would make more money that way.

I am sure they will--but at the expense of senior citizens and taxpayers.

There is also this strange, inexplicable, indefensible element in Medicare prescription Part D known as the donut hole. The donut hole says as follows: Once you have spent out of pocket $2,200 for prescription drugs during the course of a year, you are on your own--no protection, no payment. Everything from that point on is out of pocket. Until you have spent an additional $2,900 and reached $5,100 total spending, then the plan kicks in and is generous to you.

The donut hole means that seniors truly in need of medication can find themselves at some point during the course of a year reaching into their savings to pay for their prescription drugs. How often does that occur?

When I went to the Order of Saint Francis Health Center in Peoria, IL, I met with the pharmacy, Wayne Beckman, and his wife Bev. I asked Bev if they had run into anyone who is concerned about this donut hole where they already spent out $2,200. She said: There was a woman in here yesterday who already reached $2,200 in the month of February. She was a transplant patient. She needed expensive medication.

So, now, this woman having gone through all of these surgeries, all of this medical care, has to reach into her pocket and pay out $2,900 before the Medicare plan kicks in again.

Could we have dreamed up a more complex and convoluted approach to providing prescription drugs to seniors?

I learned during the course of my visit that many of these seniors are desperate. They know they have to decide by May 15 to sign up for a plan. Some of them are not taking drugs at this moment but are afraid if they do not sign up for some plan and start paying for it that they will be penalized, which is part of the law as well. So they are trying to decide what the best decision might be.

I really wish my colleagues in Congress would get out of these marble halls and get into some drugstores. I wish they would stop listening to lobbyists and start listening to pharmacists. If they did, they would realize what a bad law this is. This was passed 2 years ago. We were supposed to have all the time in the world to get this right, make sure that when the moment came that this plan went into place nothing like this would occur. Yet it does.

Some of the, I guess, most painful stories involve victims who are in nursing homes--people who have really spent down everything they have in life. They have nothing left. How do they live? Social Security, Medicare, and Medicaid. Medicaid, of course, is health insurance for the poorest among us.

These poor people who usually don't have many friends, other than maybe a couple of family members, are sick in the nursing homes.

Many of them are caught in the middle of this Medicare prescription Part D and what it does to them. Someone takes their prescription to a pharmacy and finds out they will not fill a month's prescription, only 10 days, and Governors across America have had to step in to protect these people, these poor people, literally poor people, who need a helping hand.

What a sad turn of events. What could have been a source of pride for America, for seniors, for all has turned out to be a national embarrassment, an embarrassment that could have been avoided.

My colleagues have to understand unless and until we work to make Medicare prescription drugs Part D a program that reaches out and helps people, a program that is simple, fair, gives true discounts on their prescriptions, then we have not done a service to our seniors. These men and women are parents and grandparents, the greatest generation who served in America's past in so many different ways. How can we put them in this predicament? They, unfortunately, had to go to the back of the line when it came to passage of this bill. The prescription drug companies, as well as the insurance companies, were the ones that wrote the bill.

I know what we have to do. We have to take from this calendar, after we finish the PATRIOT Act, we have to push aside all the special interest legislation. We spent a week and a half on a bill last week, the clash of the special interest titans over asbestos. We have to set those aside and say, for at least a week, instead of taking up special interest legislation, we are going to take up the Medicare prescription drug bill. We are going to make this work. We are going to finally put something together that is an honor to the people who are part of our Medicare system.

I don't know if we can do that. When the President signed this bill, people said: You are going to have to change some parts of it. He said: I am not going to touch it, not a word.

The President should show a little humility. All of us in public life should from time to time. As we look at this Medicare prescription drug program, we know it is not working for America, it is not working for seniors. It is causing much too much heartache, much too much concern.

This much I will say I have learned, having been in public life a few years. There is one thing about senior citizens, they know who is on their side. They have long memories. I might add, they vote. If the leaders in Congress, the Republican leaders, the President's own party, do not understand how badly this Medicare prescription Part D program is working, some of the seniors may give them their medicine in November. They have to understand we have a responsibility to these people, not to the lobbyists in the hallway who represent the drug companies. They are doing quite well, thank you.

We have a responsibility to the people whom we were sent to represent. They may not have a lobbyist, but they have a vote and a voice and we will hear from them.

I suggest the absence of a quorum.

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