Medicare Prescription Drug Price Negotiation Act Of 2007--Motion To Proceed
Floor Speech
MEDICARE PRESCRIPTION DRUG PRICE NEGOTIATION ACT OF 2007--MOTION TO PROCEED -- (Senate - April 18, 2007)
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Mr. WHITEHOUSE. Mr. President, I speak today in outrage that my colleagues on the other side of the aisle have chosen to block S. 3, the Medicare Prescription Drug Price Negotiation Act, from coming to the floor.
You meet a lot of people when you campaign for a seat in this esteemed body. You meet people of all ages, from all socioeconomic levels, from all ethnic and cultural backgrounds, liberal and conservative, rural and urban, healthy and ailing--you meet them all. These individuals bring personal voices to national issues. They educate us with their stories, and they trust us to be stewards of their experiences. I am sure my fellow freshman Senators will agree with me when I say that listening to these stories was the best part of running for U.S. Senate.
Sometimes these stories are uplifting tales about the triumphs of government: SCHIP providing health insurance to at-risk children, AmeriCorps helping young people serve communities throughout the Nation, The Family and Medical Leave Act allowing parents, spouses, and children the time to care for loved ones. But sometimes these stories are just the opposite--depressing, discouraging, disheartening tales of how the government has failed in its duty to support and safeguard our must vulnerable citizens.
I have hosted community dinners throughout my State. Some of the very saddest stories that Rhode Islanders shared with me were about their experiences with the Part D drug benefit. I would like to share with you a particularly touching story from Travis, who came to one of my community dinners in Woonsocket. Travis told me of his great-grandmother, a woman over 90 who was living independently, in a second or third story walk-up apartment building in Woonsocket. She, like other women her age, had signed up for a Part D plan, and was taking a number of prescription medications. One day, Travis's great-grandmother arrived at the pharmacy, only to be told that she was in the donut hole, that she would now be responsible for almost the entirety of her drug bill. His great-grandmother called Travis in despair. She would no longer be able to afford her apartment, or her independent lifestyle. She was forced to choose between her spirit of self-reliance and her health.
This is a tragedy. It is a human tragedy because no human being should be forced to choose between her dignity and her life, and it is a moral tragedy because this is a totally unnecessary choice. The Congressional Budget Office concludes that the privatization of the drug benefit--the choice not to simply add the drug program onto the established Medicare benefit--costs almost $5 billion a year. The Center for Economic and Policy Research reveals that the combined cost of privatization and failure to negotiate prices is more than $30 billion a year. I do not know about you, Mr. President, but I cannot look Travis in the eye and tell him that the reason his great-grandmother cannot afford her apartment is that the government needed to give it to pharmaceutical manufacturers, an industry that, in 2004, was three times more profitable than the median for all Fortune 500 companies--an industry that from 1995 to 2002 was the most profitable industry in the entire country.
I was not in the Senate when the drug benefit was created. I was not privy to the debates that went on here regarding the complexities and particulars of the bill. But I have a very hard time understanding how, with a successful Federal drug benefit model in place at the VA, this body created a new program that pays, on average, 70 percent more for drugs than the existing VA program, according to the Center for Economic and Policy Research. I understand that there are fundamental differences between the Veterans population and the senior population, between the Veterans system and the Medicare system, but 70 percent? This seems, to me, like a de-evolution of the policy making process. We are creating new programs that function less effectively and less efficiently than the ones we already had in place.
The real question is why. Have we gained something valuable for this extra cost? Can we justify the expensive and byzantine architecture of this program based on the promotion of other values? Some of my colleagues argue that the Part D drug benefit maximizes choice, and that choice is of fundamental importance in health insurance markets. Indeed, the bill succeeds here. In 2006, there were nearly 1,500 prescription drug plans offered throughout the Nation. Beneficiaries in 46 States had over 40 plans to choose from. This year, seniors everywhere in the country can choose between at least 45 plans. In my small state of Rhode Island alone, there will be 51 plans available.
But study after study, survey after survey, has shown us that, beyond a reasonable point, more plans do not add up to beneficiary or provider satisfaction. In fact, 73 percent of seniors think the Medicare prescription drug benefit is ``too complicated.'' Sixty percent agree with the statement, ``Medicare should select a handful of plans that meet certain standards, so seniors have an easier time choosing.'' Thirty-three percent think it is ``somewhat difficult'' or ``very difficult'' to enroll in a plan. In addition, 91 percent of pharmacists and 92 percent of doctors think the benefit is too complicated. It is time to admit that a plethora of plans does not add value to the program; it adds bewilderment and burden.
And do we have a system in place to deal with the confusion we have caused? No. We have 1-800-Medicare, which is adequate at its best, and inaccurate, unreliable, or altogether unreachable at its worst. But we need not rely on anecdotal evidence. GAO itself placed 500 calls to the Medicare help line in the middle of last year to make its own determination about the usefulness of the feature. Eighteen percent of calls received inaccurate responses, 8 percent of the responses were inappropriate given the question posed, 5 percent of the calls ended in disconnection, and 3 percent of responses were incomplete. In total, one-third of calls placed by GAO in this study were handled in an unacceptable fashion. Our mechanism to demystify the drug benefit for the average consumer is furthering the confusion of one-third of callers. This is a catastrophe.
A second value that some of my colleagues argue excuses the convoluted and costly nature of the drug benefit, is expanded coverage. More seniors have drug coverage now than they did before January 2006. No one disputes this. But insurance is not insurance unless it is there for you when you really need it. Our sicker seniors are reporting far more problems getting their prescription drugs than our healthy seniors are. Over 40 percent of seniors who describe themselves as in ``fair'' or ``poor'' health report problems filling a prescription under their Part D coverage, while only 12 percent of seniors in ``excellent'' or ``very good'' health report a problem. If Part D is failing to help the sick, it is failing to meet the basic definition of insurance.
Do I mean to say that providing some coverage is worse than being uninsured? No. But that was not the option on the table in 2003. We had the option to provide everyone with excellent coverage. We had the option to care equally and comprehensively for every elderly person in this country, healthy, sick, or in between. We did not. Instead, we chose to write checks to the pharmaceutical industry, we chose to write checks to private insurers, and we left our seniors to write their own.
What, then, can we do to fix this broken benefit? There is a lot we can do, and today is the first step. Today, we can allow the Secretary of Health and Human Services to negotiate directly with drug companies to lower prices for consumers. We can require the collection of data from prescription drug plans, so that our experts at CRS, at CBO, at GAO, or at MedPAC can better understand the operations of this program. We can require CBO to study whether or not market competition is truly reducing prices, as was the intent of privatization. We can increase transparency for our seniors, by making the prices of covered drugs available to the public on the CMS website. We can pass S. 3--the only thing standing in our way is Republican obstructionism.
I thank the majority leader and Senator Baucus for their commitment to our Nation's seniors, and I hope that my colleagues on the other side of the aisle will drop their obstructionist tactics and let us get to work on this bill. As important as it is, it is only a first step to fixing our Medicare Part D program. I hope we can soon take that step and then move on to the broader issues, for I believe there is much, much more to be done.
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