Congressional Budget for the United States Government for Fiscal Year 2005

CONGRESSIONAL BUDGET FOR THE UNITED STATES GOVERNMENT FOR FISCAL YEAR 2005

Mr. WYDEN. Mr. President, the distinguished Senator from Colorado was in the Budget Committee and saw our focus on health care issues. He said in particular he was hoping we would have an effort to bring forth ideas that would generate bipartisan support. That is exactly what I hope to do this afternoon. I want to discuss the question of laying the foundation in this budget resolution for containing prescription drug costs.

If you think about what happened in the Budget Committee, there was no topic that generated as much interest and as much concern as the question of health care and particularly Medicare and prescription drugs.

In fact, at one point the distinguished chairman of the Finance Committee, Senator Grassley, said: Well, are we going to relitigate the entire prescription drug bill on the budget? Obviously, the budget resolution does not allow for something like that.

I think Chairman Grassley's comments were indicative of the frustration and concern across this country with respect to the inability to hold down the skyrocketing costs of prescription drugs.

I want to discuss an idea about which I and others on the Budget Committee have been talking. It is also in the legislation I have been able to work on with Senator Snowe.

What particularly pleased me in the Budget Committee is Senator Gregg, the chairman of the HELP Committee, said he thought this idea had considerable merit. I am hopeful by the time this comes out on the floor, we can do what Senator Allard has been talking about, and that is to have ideas that are bipartisan that deal with these important issues, particularly concerns such as health care where we have this demographic tsunami ahead, that really do address what the American people, and especially seniors, are talking about.

What will be offered before too long is an effort to lay the groundwork in the budget resolution for making sure the Secretary of Health and Human Services has the authority to negotiate for our seniors and hold down the costs of prescription drugs.

For the first time, the Congressional Budget Office in a letter to me on March 3 said:

Giving the Secretary an additional tool-the authority to negotiate prices with manufacturers of such drugs-can put greater pressure on manufacturers and could produce some additional savings.

What I say to the Senate and colleagues is for the first time now, we have the Congressional Budget Office on record stating that giving the Secretary of Health and Human Services the authority to negotiate prices could produce additional savings for some pharmaceuticals that are purchased by our seniors.

I would hope every Member of the Senate would be sympathetic of this desire to contain costs in prescription drugs at this time. There are a couple of reasons for this. The first, in my view, is the fact we have just seen in recent weeks the prescription drug legislation that passed is going to cost $134 billion more than was estimated.

In light of this dramatic increase, which has come up in a matter of weeks, in light of the fact we have this demographic revolution ahead, it seems to me it is critical the Senate act responsibly and search for every way possible to assure access to affordable medicines for seniors and to protect the interests of the taxpayers.

I voted for the Medicare legislation. I still have the welts on my back to prove it. I also believe strongly in making sure the private sector has every opportunity to help in lowering costs and delivering needed pharmaceuticals to seniors.

I have always felt there is considerable merit in the approach used by the Federal Employees Health Benefits Program that uses the private sector to make sure you get a fair shake for Federal employees. But I also think it is important there be backup kinds of tools, that there be additional tools to the private sector approach, and that is why it is so important the Senate, before it completes its business, uses the opportunity to lay the groundwork in this budget resolution to make sure the Secretary of Health and Human Services is in a position to try to wring out the best possible bargain for seniors and for taxpayers on these medicine costs.

Given the fact the Congressional Budget Office has now told us additional savings are possible when we provide the Secretary of Health and Human Services with the authority to negotiate, it seems to me to be derelict to not have the Senate on a bipartisan basis lay the groundwork for giving the Secretary that authority to negotiate.

I was very much encouraged when the distinguished chairman of the HELP Committee, Senator Gregg, said there was considerable merit to this idea.

I see the Senator from Colorado on the floor. He has talked repeatedly about his desire to have bipartisan efforts in the health care area.

In the past, every time in the budget resolution when Senator Snowe was on the committee, Senator Smith, and others, we have been able to do it. This year it was not possible, and that is tragic, particularly in light of the increase in the cost of pharmaceuticals and the increase in the prescription drug costs over a matter of a few weeks.

I am very hopeful now we will have a chance to move ahead on this issue. The approach that will be offered is one I think is consistent with the votes of those who supported the legislation and many who were against it. Many who were against the legislation said they had reservations because it did not do enough to contain costs. Now we have the opportunity, because of what the Congressional Budget Office has told us, to actually rein in the costs of this program. We have seen we can do it in some areas that are very significant. Take single-source medicine. The American Academy of Actuaries has found in many instances these drugs comprise a significant portion of the entire expenditure of the program. I think we can do this in a fashion that ensures access for those who need this medicine.

I have worked so closely with those programs-the National Alliance for Mentally Ill and others-that are concerned about those drugs. We can get these cost savings, ensure access for those individuals, and save taxpayers money. It seems to me if the Congress simply lets pass this opportunity to rein in the costs-and we see the costs of the program have skyrocketed more than $100 billion in a matter of months-one has to ask oneself, What is ahead? How much more of this program, a program so desperately needed by the elderly, is going to be eaten up as a result of the Senate not taking the steps to rein in the costs?

The Congressional Budget Office has told us now what is possible, so it really becomes a question of political will. I am very hopeful as the Senate goes about its work over the next few days, we understand here is a chance to build on the legislation that passed. It is not putting in place price controls and some kind of arbitrary "set the prices from Washington, DC" kind of regime. I believe private marketplace forces can work. I have seen that in my hometown where we have many older people in managed care programs. But I also want us to make sure the Secretary of Health and Human Services has every appropriate additional tool to try to wring out price savings for both seniors and taxpayers. With the nonpartisan Congressional Budget Office now telling us for the first time, reversing the position they outlined back in January of this year, I think we ought to make sure we pass legislation that lays the groundwork for the Secretary of Health and Human Services to have the tool, the authority to negotiate prices, that can produce the additional savings for some pharmaceuticals the Congressional Budget Office has outlined.

I want to emphasize to my colleagues this is not price controls. This would not set aside the private sector and the authority of the private sector to negotiate. I happen to think that is constructive. I think we will get some savings. Certainly, the fact some seniors will get their health care medicines and pharmaceuticals through managed care plans and have the kind of buying power that produces will be very useful, and I support that. But I also think on top of that private sector leverage, we ought to give the Secretary the authority to negotiate.

It is, in effect, a fallback tool that can ensure you wring out savings for taxpayers and for older people. I offer in the spirit the Senator from Colorado talked about in the committee-he wanted to see people come forward with ideas, and I say to the Senator from Colorado, I have come forth with an idea.

I have come forth with an idea that the distinguished chairman of the HELP Committee, Senator Gregg, says has considerable merit. When there is that kind of opportunity and one faces these escalating costs we have seen just in a matter of weeks, $134 billion more than was originally envisioned, the Congress ought to act.

A number of colleagues have worked very hard on this issue over the years-Senator Kennedy, Senator Feingold, Senator Stabenow on this side. I have been so pleased to be able to work with Senator Snowe and Senator Smith on many of these issues over the years.

I ask my colleagues to reflect on what the Congressional Budget Office has said on this topic. When there are these kinds of increases in prescription drug costs both for older people who walk into a pharmacy and for the entire Medicare Program, $134 billion increase in a matter of months, let's heed the objective analysis of the Congressional Budget Office and make sure we wring out every possible savings for the taxpayers and seniors of this country.

There was a reason why in the Budget Committee no subject was discussed at such length as health care costs. The reason is medical costs are gobbling up everything in sight. There are no costs going up like medical bills. We see that for every possible group.

I am one who believes the private sector can help contain costs. That is why I have been a supporter of the Federal Employee Health Benefit Plan. I also believe when the Congressional Budget Office tells us there are ways to make additional savings by giving Health and Human Services the authority to negotiate a good deal for senior citizens under the Medicare Program, it would be derelict for the Senate not to make sure that opportunity was not picked up on.

We will have a good debate on this issue. I am very hopeful that the words we heard from the distinguished chairman of the HELP Committee, the idea of giving the Secretary the authority to negotiate prices for seniors has considerable merit and that we can have bipartisan support for the efforts in this budget resolution to lay the groundwork for an approach on prescription drug cost containment.

This is about cost containment. It is not about throwing the whole law in the trash can. It is not about starting over. It is about containing costs. It is about the principal concern older people and taxpayers have all across this country. The Congressional Budget Office has told us we have a chance to contain costs. We ought to lay the groundwork to do that.

I yield the floor.