Preserving Access to Safe Affordable Canadian Medicines Act of 2003

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and to include therein extraneous material on the subject of my Special Order today.

Mr. Speaker, currently both the House and the Senate are in intense deliberations to forge a compromise on a prescription drug benefit for Medicare and Medicare recipients. I am glad to see that both Republicans and Democrats after all this time are working together to try to correct this critical deficiency in the Medicare program.

When Medicare started in the early 60s, about 10 percent of the health care costs for a senior was dedicated to out-of-pocket drug costs. Today that is around 60 percent of their health care costs, or health care dollar. And so if we are going to have a health care plan for seniors and if Medicare is going to live up to its obligations that it was originally designed to do, Medicare must have a prescription drug plan.

We all know that one of the most contentious issues in the prescription drug debate is the question of how much of the cost of drugs should be paid by government and how much should be passed on to seniors. But the crux of this problem is that both the U.S. Government and American seniors are paying too much for prescription drugs. Providing a prescription drug benefit through Medicare is unfortunately only the tip of the iceberg in addressing a widespread prescription drug access issue facing our Nation.

Much more central to the inability of many seniors and other Americans to afford the prescription drugs they need is the fact that prescription drug prices are 30 to 300 percent higher than those in other industrialized nations. The truth is one of the big problems we have here in the country is that we do not have a free market as it relates to prescription drugs and drug costs. I

really believe that one of the central points of this debate is that we need a free market.

The three things I am going to discuss today are, A, the issue that American consumers, be they elderly or others, are denied access to prescription drugs from all over the world and they are a captive market, unable to buy drugs, be they in Canada, Mexico, Germany, France, where the same drugs are much cheaper than they are here in the United States. If our consumers were allowed to have access to those drugs, there would be competition and prices would drop. But because the free market is prohibited from exercising its magic, drug costs are artificially raised.

The second point I want to discuss is the American taxpayer through two different venues provides direct and indirect assistance to the drug companies to develop the drugs. Drug companies reap all the profits, and the American taxpayers do not get any of the benefits back as an investor. If we were an investor, and I come from the private sector, private sector investors when they invest in a drug, they usually look for what is called a 30 percent IR, investment return on equity. Yet the taxpayer who provides through taxes both direct assistance to the FDA as well as through the tax write-off that pharmaceutical companies get, they do not reap any of the benefits from these drugs being developed. Yet we develop these drugs, taxpayers spend billions and billions of dollars helping develop these drugs, yet the only benefit they get besides taking the drug is they pay the highest premium price out there.

I believe the right way to get the prices under control is for the investor, known as the American taxpayer, to reap the benefits of their investment dollars. And, third, deal with the area of generics and generic markets. If we allowed generics to get to market quicker, it would also create that type of competition. I think one of the problems we have here is that the American elderly, the American taxpayer and consumer have an artificial market that is in three areas, generics, taxes and access to the same drugs in other markets around the world. Because we are a captive market, we pay artificially high prices; and the American seniors specifically are the profit margin or, as I like to call them, the guinea pig profit margin for the pharmaceutical companies. I want the free market to work. The pharmaceutical companies are treating this market as a captive market. If we had a free market, we would have reduced prices.

Medicare drug benefits being considered by Congress are very expensive. Many seniors, especially those who do not have secondary insurance, will continue to have significant out-of-pocket drug costs even with the passage of a Medicare drug benefit. In addition, the high cost of drugs remains a crisis for 42 million uninsured and countless underinsured who must pay all or most of their drug costs out of pocket. Addressing the cost of prescription drugs will both make a Medicare drug benefit less expensive for the government and greatly increase the value of what is provided for our elderly. It will also make it much more likely that millions of uninsured and underinsured in this country can afford lifesaving, life-preserving prescription drugs, what their compatriots in Germany, France, England and other industrialized nations get. Prescription drug companies are a business, and they need to earn profits in order to stay in business. But as they have the right and purpose like other businesses to earn a profit, they also have a responsibility to be a good corporate citizen and abide by the same standards as other businesses.

As I said, I have worked in the private sector. I know that any private company when investing in research and development and in another company usually looks for a 30 percent return on their equity. The United States Government invests in pharmaceutical research by providing significant tax benefits for research and development expenses and American citizens subsidize the research as drug companies recoup their margins in America because of price controls in other countries. The American Government and the American people are getting no return on their investment. The pharmaceutical companies are reaping the financial benefits of the U.S. investments in their R&D without any responsibility to pass these benefits on to the government and American taxpayers.

American consumers are bearing the burden of price controls in other countries. When 50 tablets of Synthroid cost $4 in Munich and $21.95 in the United States, the most vulnerable Americans suffer. Also it is one of the great reasons that we have inflation running at close to triple or quadruple here in health care in the United States as opposed to the market as a whole. We are using individuals as the profit guinea pigs for pharmaceutical companies.

The legislation introduced by my good friend and colleague, the gentleman from Minnesota (Mr. Gutknecht), last week takes important steps to address the shocking disparities in prescription drug prices between the U.S. and other industrialized nations. It puts essential safety precautions in place to ensure that by opening our markets, we do not expose Americans to the dangers of counterfeit drugs. When defending the high cost of prescription drugs in this country, people will often say that the U.S. has the best health care system in the world. People come here from overseas to get a better product. But we clearly have nothing close to the best prescription drug delivery system, as many individuals are now shopping overseas for their prescription drugs. If we are going to defend our status as the best place to get health care in the world, we need to make the pillar of many people's health care, prescription drugs, accessible and affordable.

I yield to my good friend, the gentleman from Minnesota (Mr. Gutknecht).

Let me ask the gentleman a question. Can you repeat again for those who are watching, as you note, this is a miracle drug and all the investment the U.S. taxpayers did, repeat again so everybody knows the difference between the price overseas versus the United States for those two drugs.

Mr. Speaker, I ask my good friend, I did not mean to interrupt him. Did he want to keep going?

Mr. Speaker, I thank the gentleman. What I would like to do is I am going to turn to the gentleman from Illinois (Mr. Davis), our good friend and my colleague from Illinois, in a second. I would like to repeat just one point on this. If you take this market on either cancer or AIDS drugs, just those segments or families of drugs, there is not a single cancer drug today or AIDS drug on the market that was not directly developed with assistance from the United States Government, NIH; and it was not directly developed with the tax dollars from the taxpayer; and yet the only benefit of those drugs, obviously besides using them and saving lives, the American consumer, be they the elderly or just families and children, they pay, as the gentleman noted, three times more than do people in Germany, France, and other major industrialized countries; and yet we were the ones who developed it.

We were the ones who gave the tax dollars to develop this. We also not only gave it from the NIH direct funding, using tax dollars to fund it, but on the back end these companies write off their R&D. So we have to make up that loss in the tax revenue pool so they can develop these drugs; and as I think the gentleman noted in his statistics, we then get a minuscule amount of return. Actually in the private sector money like that is called dumb money. That is how they refer to it. It is foolish money. It is called dumb money. It is people who put up dumb money, do not look for the 30 to 20 percent IR on equity, and that is what has been going on for years here in this country, and we are paying premium prices; and in these companies they figure that in Germany they are going to pay X, in Canada they are going to pay Y for the same drug, England is going to pay, and they have got to make up their margin. Whom are they making up the margin with? Our neighbors, our friends, our family members; and we funded this research, and we developed these drugs.

My view is I would love for the free market to come to the pharmaceutical industry. It just has not. It is a protected industry by the United States Government, from the Tax Code to importation to the development of generics.

Yes.

I thank the gentleman. If he could yield, I would like to now ask the gentleman from Illinois (Mr. Davis), my good friend, who has joined us here to also speak about his district in Chicago that borders mine, but also about this issue as it relates to the pharmaceutical industry and prescription drugs and what is going on.

Mr. Speaker, I thank the gentleman. He brought up the breast cancer; was that correct?

I think it illustrates again what our good friend from Minnesota said and has brought forth examples is that, in fact, there is not a drug today, and we can also expand this to medical choice, but no drug today that is not being developed and has not been developed that is around the country that any way you look around the world in the major industrialized countries where we have trading companies, and the gentleman noted wheat, meat, steel, cars, computers, all types of products where there is ``free trade,'' and yet here in this specific area, we are paying top price, high-premium dollar. I think again, whether it is diabetes, breast cancer, there are other drugs that are on the market that affect other types of illnesses, and I think the gentleman highlights a very important point, especially given his district and my district that abut each other, how this creates inflation, and besides the uninsured, the cost of pharmaceutical drugs is the single largest cause for health care inflation in the health care industry which has been running at 20 to 30 percent of inflation.

So he brings up, I think, a very good point, and I think it is relevant to the discussion we are having today. What I am most impressed with is the bipartisanship we have here in discussing this. And I think the truth is, and I would love to hear both their thoughts on this, that while we are doing a drug prescription benefit and we are talking about it in the Senate and we are going to be taking it up here in the House, without some type of ability to have competition in that process, we are really going to be offering a benefit at top dollar, and I think, as American taxpayers are going to be paying for the prescription drug benefit that we are going to add to Medicare, we should give them a sense of competition in the market so that we can find that drug cheaper in Canada, we can find that drug cheaper in Mexico or Germany, France, or England. We want to bring that so we can squeeze the most coverage out of our prescription drug plan for Medicare.

Right. I thank the gentleman. I yield to the gentleman from Illinois (Mr. Kirk).

I appreciate that. I yield again to the gentleman from Minnesota if he had some additional comments because I have some other things, but I would like him to go ahead.

So that is about one third.

That is a very important point.

The only reason I had a smile cross my face is when you said the word ``embedding,'' I said who knew the Pentagon was going to be so far ahead of the pharmaceutical industry, and now they are going to copy from them.

But the truth is, we all were exposed in the '80s and '90s to the notion of the $500 hammer, where the Pentagon was off buying $500 hammers, when if you just went down to the hardware store you could go down there.

The fact is, your chart up there shows exactly the similarity that is happening now to the American taxpayer and consumers, where you could buy these same drugs overseas in different markets for far cheaper than we are buying them here, and it is the equivalent.

And why is that? Just like the $500 hammer, the fix is in. So if you go down the specific area, and I do not blame the pharmaceutical industry, they are playing the game just like they are supposed to play it, and they are rigging the game and system just like they are supposed to, for maximum profit.

But take it, whether it is in the generic drug laws or in our patent laws, they are keeping generic drugs off the market, therefore driving up the cost of name brand drugs, making it more expensive for all of us. If generic drugs were on the market and the system was not being fixed, you would have real competition.

What has happened is, the Wall Street Journal did a story the other day, as generics have started to come to market quicker and there has been a quicker process set in place by the FDA to approve generics, we have allowed that patent not to be gamed for an additional 30 months, we have, in fact, seen prices drop.

They have, in relation to the importation issue, pharmaceutical industries in that area have gamed the system very well, prohibiting us from buying the same type of drugs in either Germany, Canada, France, England, Italy, Israel, wherever, they have gamed the system. We are not prohibited from buying computers, cars, food items, other types of items. We are prohibited in this space.

What is the impact? Those same drugs, cheaper over there; more expensive here at home. Yet they are the same drugs we paid for the development.

Then through the Tax Code, the IRS, where we do an R&D tax write-off, where they are allowed and subsidized by the taxpayers for the research and development, yet they get a direct subsidy from the NIH.

I highlighted the area through the NIH of cancer drugs and AIDS drugs. Not a single drug in either one of those families has been developed without direct assistance by the government, yet, again, in that area we are paying prime dollar versus our brethren in the other industrialized nations.

So I actually take my hat off to the pharmaceutical industry, because they have worked the system to their benefit. Now, my hope is, if you go back in history and look at this in fact, when Medicare and Medicaid was first developed and voted on, it received overwhelming bipartisan support. Now, these are early preliminary stories in fact.

We are seeing right now that in the Senate, as they debate the prescription drug benefit for Medicare, we are seeing the early stages of bipartisanship, and we can discuss, argue, amend about the right approach. My hope is that when we have a chance here in the House, that that same bipartisanship would be approached with regard to the prescription drug bill, but that bill would include something on generics.

Over there they have a bill. Here, the gentleman from Ohio (Mr. Brown) has a bipartisan bill dealing with generic reform, dealing with the update of the patent laws as it relates to what the gentleman from California (Mr. Waxman) developed and passed in 1984 and Senator Hatch. I would hope that we would update our laws in the generic area. I would hope we could update our laws as they relate to importation.

And we have a bipartisan bill, the gentleman and I have. We have a generic bipartisan bill here. So we would keep that spirit and that tradition as it relates to Medicare, as it relates to prescription drugs, that, through and through, that bill would be bipartisan. I would hope, obviously, it can relate to some of the funding issues and recoup some of the investment our taxpayers have made through the direct funding through the NIH or IRS piece of the Code where we pay and subsidize pharmaceutical companies to do what is in their business plan, develop drugs.

I yield additional time to my good colleague from Minnesota.

First of all, I thank the gentleman for organizing this and thank you for introducing your legislation. I think this is the right approach.

I think, again, whether it is the area of generics coming to market and updating our patent laws, whether it is the tariffs or limitations we put on importation or access to these drugs, the same drugs we see on the shelves in our pharmacies, that the American consumer has access to them, each of these, at least on the generic and reimportation, are bipartisan issues.

I think that this is the right approach, not only because it is bipartisan and it reflects our values and reflects a common set of values that we can come around, but, most important, is that in dealing with the issue of a prescription drug, the truth is, all these drug plans have some limitations. People will not be covered. So the question is, how do you squeeze the most out of that dollar? It may be $400 billion over 10 years. The final product may be $450 billion.

The question, though, we have to ask ourselves is, can we get more out of that? Can we get more people covered? Can more people get a plan, so their deductible is not as high as it is? And the only way to do that is to make sure that a prescription drug plan as it relates to Medicare, as it relates to the cost of prescription drugs in the dime stores and drugstores and pharmacies across the country, can we reduce the prices? We can do that if we would bring the free market approach to the pharmaceutical industry.

So I applaud this. I am very pleased to be a bipartisan supporter and original cosponsor of the gentleman's legislation. I am on the generic drug legislation.

I think that approach comes together, not just because we are Democrats and Republicans, we come together on a common set of values. We approach this from the basis we may need more money for a prescription drug benefit plan, but we are going to make sure this $450 billion over 10 years, we get the biggest bang for the buck, and that this game that has been going on, and they have been gaming the system, is going to come to an end.

We are not going to allow this to happen. We are not going to allow you to have frivolous lawsuits that keep patents on another 30 months. I want frivolous lawsuits to end. We are going to have them end. It is specifically how pharmaceuticals have been treating generic drugs and preventing them from coming to market.

We are not going to allow the pharmaceutical companies to keep up the game and not allow us to import the same drugs that overseas are at close to 30 percent to 300 percent cheaper than we pay here. And if you did that, you would be on your first step of controlling health care inflation that has been running at close to 20 to 25 percent, which is just suffocating our small and large businesses, who are seeing their insurance policies just go right through the roof.

The second item, obviously, and we may have a different approach to this, but the second item would be to insure the uninsured in this country. If you did that, and I also note when it relates to the working uninsured in this country, the only issue in which the Chamber of Commerce and the AFL-CIO agree on on health care, and they are both running campaigns, is we have got to insure the working uninsured.

They are showing up in emergency rooms, they are driving up the cost of insurance policies, and the hospitals pass that on to insurance policies, insurance policies pass it on to businesses, and businesses now pass it on to employees. And those two factors, controlling the cost of drugs and insuring the uninsured, would literally be taking the steam out of the pipe as it relates to health care inflation. If we do that, we will see immediately the health care tax alleviation for our middle-class and working-class families all across the country.

I applaud the bipartisanship and look forward to working with the gentleman on this. Hopefully, we will get an opportunity to offer an amendment to the prescription drug bill when it is down here on the floor, because it is going to be essential in making sure that whatever dollars we spend of the taxpayers, that we stretch those dollars to the greatest possibility. I think the American people, if they knew that we had the opportunity to offer an amendment bringing free market principles, competition to this debate, to make sure that they got a return on their dollar of investment, to make sure that the pharmaceutical companies could not prevent other choices from coming to market, be they from overseas or in the generic area, they would applaud our work, Democrats and Republicans and Independents alike; people north, south, east and west would applaud us, because we would be coming around a common set of values that we all can agree on. So there will be places that we disagree, but on these there is bipartisanship. So that would be my hope. I think we will be successful if we can come together in this area, work together, make sure the principles of the free market and our values are reflected in what we pass.

So again, I want to applaud the gentleman for introducing this, bringing this to my attention, although I have talked to many people about it but, most importantly, being open to working together across party lines so we can represent the people we came here to, not only vote on their behalf, but to give voice to their values.

Mr. Speaker, the gentleman from Minnesota (Mr. Gutknecht), the gentleman from Maine (Mr. Allen), the gentleman from Vermont (Mr. Sanders), and the gentlewoman from California (Ms. Watson) and myself are going to be talking this hour about the problems that we have in this country with exorbitant pharmaceutical prices.

We all believe in the free enterprise system, and we believe that private industry ought to make a profit, but we also believe the American people ought to get the best bang for their buck. Unfortunately, the pharmaceutical industry has been taking advantage of Americans for a long, long time, and it is just now becoming evident.

The gentleman from Minnesota (Mr. Gutknecht) made this chart up originally, and this chart, I know it is difficult for my colleagues to see, but it shows the disparity between pharmaceutical products purchased in the United States and those purchased in Canada. In some cases, products, pharmaceutical products manufactured here in the United States that are sold in other parts of the world, sell for one- tenth the price that they sell for here in the United States; and yet the American people, when they try to buy those products abroad through the

Internet, are being criticized for that, and the Food and Drug Administration, hiding behind the veil of protecting the public from products that might harm them, are saying that they are not going to allow these Internet sites to sell these products. The very same products sold here in the United States, they are not allowing them to be purchased from Canada or other countries so the American consumer can save as much as 50 percent of their pharmaceutical costs.

I have a constituent who was paying $1,300 a month or $1,200 a month for pharmaceutical products, and he bought the very same products on the Internet from Canada for less than half that amount, so he was saving $7,000 a year by purchasing them from Canada. And now the FDA, along with the pharmaceutical companies, are trying to stop him from doing that.

We have over a million people in this country, probably closer to 2 million, who are buying their pharmaceutical products from Canada over the Internet. But the pharmaceutical companies and the FDA are trying to stop the American people from saving money and getting the products at a fair market price.

Today, in the New York Times there is an article, and I do not quote from the New York Times very often, but there is an article talking about the exorbitant amount of money that the pharmaceutical industry is going to be spending over the next year to influence Congress, State legislators, government agencies and so forth to keep the prices of pharmaceutical products very high in the United States and prohibit the importation or reimportation of their products from other countries where they are selling them much cheaper.

In 1990, PhRMA spent $2.3 million in that cycle here in Washington and around the country. In 1992, it more than doubled to $4.9 million. In 1994, it went to $5.2 million; and in 1996 it went to $9.2 million. In the year 2000, it jumped up to almost $20 million, and it was over $20 million in the year 2002.

Let me read what was in the New York Times today. ``Lobbyists for the drug industry are stepping up spending to influence Congress, the States and even foreign governments as the debate intensifies over how to provide prescription drugs benefits to the elderly, industry executives say.''

The article goes on to say, ``The documents show that the trade association, the Pharmaceutical Research and Manufacturers of America, known as PhRMA, will spend at least $150 million this year. That represents an increase of their total budget of 23 percent over last year which was $121.7 million. Directors of the trade association approved the new budget, together with an increase in membership dues, to pay for an expanded lobbying campaign at a meeting last week. They have over 600 lobbyists in Washington, D.C.''

Here is what they say: ``Unless we achieve enactment this year of market-based Medicare drug coverage for seniors, the industry's vulnerability will increase in the remainder of 2003 and in the 2004 election year,'' and it will demonize the industry if they do not get this done.

Now, we are for market-based pricing. The gentleman from Minnesota (Mr. Gutknecht) has said that many, many times. But that should be across the spectrum, not just here in the United States of America. I mean, in Canada if you can buy a product for $70, why should it cost $122 here in the United States right across the border, just a mile apart? And the reason is they are charging an exorbitant amount of money to the Americans, and they are loading the research and development and everything else on the back of American consumers instead of spreading it across the world.

If they are talking about market-based drug coverage for seniors, then the burden should be spread equally across the spectrum, not just here in the United States but across Canada and Europe. If we did that, the price for all Americans would go down dramatically.

The drug trade group plans to spend $1 million for an intellectual echo chamber of economists, a standing network of economists and thought-leaders, to speak against Federal price control regulations through articles and testimony, and to serve as a rapid-response team. A rapid-response team, that sounds like a military action. Well, we want to make sure that we do not have to have price controls.

If we had fair pricing across the spectrum, around the world, then I think the Americans would get a fair price when they buy their products. But unfortunately, the products are a lot lower in other countries, in Europe, in Germany, in France, in Spain, in Canada, in Mexico; much, much less than they are here. Yet they want to keep those prices higher here in the United States so they can keep their profits high.

The trade association and its tactics have become an issue. In debate on the floor of the Senate last summer, Senator Durbin, Democrat of Illinois, said PhRMA, this lobby has a death grip on Congress. After seeing what I have seen over the past month, month and a half, I am not so sure he is wrong. The influence that the pharmaceutical industry has in the halls of Congress and in the executive branch mystifies me. We are supposed to be sent here to represent the people of this country, to make sure they get a fair shake across the board. Yet the pharmaceutical industry has been loading huge, huge profits on the backs of the American people while making much smaller profits right across the border in Canada by selling their products at a more competitive rate.

If Americans try to buy them up there now, now they are trying to stop them. The day after the pharmaceutical giant GlaxoSmithKline said they were going to pull out of Canadian pharmacies that were selling across the border through the Internet, the FDA I think the next day or the day after said there may be a concern about the safety of these pharmaceutical products. And so they were marching in lockstep with the pharmaceutical industry to stop Americans from getting these lower- priced pharmaceutical products, the same products they can get here, from Canada.

Dues from the pharmaceutical industry will go to $144 million, an increase of 24 percent or $28.3 million over this year's dues. In its budget for the fiscal year that begins July 1, the pharmaceutical lobby earmarks $72.7 million for advocacy at the Federal level directed mainly at, you guessed it, the Congress of the United States. $72.7 million to lobby us; $4.9 million to lobby the Food and Drug Administration. I do not know if they have to spend that much because I think the FDA is pretty much in their pocket already. And $48.7 million for advocacy at the State level. In addition, the budget sets aside $17.5 million to fight price controls and protect patent rights in foreign countries and in trade negotiations. The PhRMA budget allocates $1 million to change the Canadian health care system and $450,000 to stem the flow of low-priced prescription drugs from online pharmacies in Canada to customers through the Internet here in the United States. I think it is kind of funny. They are going to spend $73 million to lobby Congress and only a million to do it in Canada. I think that is because they feel like it is a lost cause up there.

In a memorandum for the PhRMA board, it says the industry is on the defensive, facing a perfect storm whipped up by several factors, expanding government price controls abroad, resulting in politically unstable crossborder pricing differences; increasing availability of medicines from abroad via Internet sales; State ballot initiatives to make drugs more affordable in the United States; increasing State demands for drug discounts in the Medicaid program; and false perceptions that drug prices are increasing by 20 percent a year. I do not know whether they are going up 20 percent a year, but they are a heck of a lot more here than they are in Mexico, in Canada, in Spain, in Germany, in France and elsewhere.

Let me go into this breakdown a little bit further, and then I will yield to my colleagues. At least $2 million, and perhaps $2.5 million, in payments to research and policy organizations to build intellectual capital and generate a higher volume of messages from credible sources sympathetic to the industry. They are going to hire a bunch of people to be their mouthpieces that are supposedly credible to convince us that we ought to let the American people be saddled with these huge prices while

these same products can be sold elsewhere for a lot less.

$9.4 million for public relations, including $1 million for inside- the-Beltway advertising. $555,000 for placement of op-eds. They are going to buy the op-ed pieces in the newspapers? $555,000 for placement of op-eds and articles by third parties. They are going to hire people to put these articles in and pay them $555,000. I suppose if I wanted to, I could write an op-ed on behalf of the pharmaceutical industry, and they would pay me to do it.

$600,000 for polling; $1.3 million for local publicity in 15 States. I suppose that is congressional districts. For instance, in my district this last week, PhRMA went into Kokomo, Indiana, and talked to one of the writers; and they went to the Louisville Courier Journal, on both ends of my congressional district, to try to make the case that I did not know what I was talking about and that I was hurting the people of this country by trying to make sure they get a fair shake on these pharmaceutical prices, and they did that to try to discredit me and hurt me in my congressional district. I have to tell you something, PhRMA PR people, you are making a big mistake. A big mistake.

The Federal affairs staff at PhRMA has quadrupled since 1999. The organization plans to spend $5 million for outside lobbyists at the Federal level. In their campaign contributions, drug companies have favored Republican candidates, but PhRMA has retained a diverse group of lobbyists to ensure access to Democrats as well. I am sure of that. I will not go into who some of their lobbyists are, but my colleagues in the House know that we have a lot of our former colleagues out there that are on the payroll of the pharmaceutical companies. Big, big bucks.

The State government affairs division of PhRMA will spend $3.1 million to retain more than 60 lobbyists in 50 States. The number of State legislative proposals dealing with prescription drugs has doubled since 1999. The drug industry says many of these bills are seriously negative, have a high probability of enactment, and require major attention on our part. They want to get it stopped.

They hire 600 lobbyists here in Washington, D.C. That is more lobbyists than we have in Members of the House and the Senate. That is overkill. They only need one for each one of us. What are they going to do with the other 65? I guess they will all go to lunch, have a triple martini lunch. I hope PhRMA is watching this. I really do.

PhRMA said it would spend $12.3 million to develop coalitions and strategic alliances with doctors, patients, universities, and influential members of minority groups. The organization has earmarked several million dollars to foster ties with groups like the National Black Caucus of State Legislators; the National Hispanic Caucus of State Legislators; and the National Medical Association, which represents the interests of African American doctors. The budget includes $500,000 for efforts to educate and activate Hispanic-Latino organizations at a State and Federal level.

In other words, my colleagues, and I think my colleagues who are here on the floor tonight already know this, they are pulling out all the stops to keep their profits very high here in the United States, to saddle the American people with huge prices while they are selling these pharmaceutical products for a lot lower elsewhere, and they are going to lobby us to death to try to make sure those profits remain high.

I am a free enterprise advocate. I believe in keeping our nose out of the private sector as much as possible; but when an industry starts beating American taxpayers to death and American consumers to death with exorbitantly high prices while at the same time they are selling these same products around the world for less and still making a profit and then they say, we cannot buy them abroad and they threaten the people who sell them to us from abroad with closing them down, then that is wrong. That is bullyism and that is something that cannot be tolerated.

The free enterprise system, God bless it, should not tolerate that kind of activity from any industry. I will say to the pharmaceutical industry right now and I believe the pharmaceutical products have given us the highest quality of health care in the history of mankind, and God bless you for that; but you have gone too far when you start raping the American people; and that is what is going on with these prices right now and it ain't going to work.

The Internet is here to stay. If you push in on one side of the balloon, it is going to pop out someplace else and you better get with the program. Make a profit, but make sure it is fair for everybody. Make sure it is fair for everybody. If you do that, I will be one of your biggest supporters as I have been in the past, and I am sure my colleagues will as well.

We have the gentleman from Maine (Mr. Allen) here, the gentleman from Vermont (Mr. Sanders), the gentleman from Minnesota (Mr. Gutknecht), and the gentlewoman from California (Ms. Watson). Let me get this straight here. I want to make sure that everybody that is paying attention in their office understands this. Congressman Allen is a Democrat. I am a Republican. Congressman Sanders is an Independent. I am a Republican. Congressman Gutknecht, God bless him, is a Republican. I am a Republican. I like you a lot. And Congresswoman Watson is a Democrat from California. But we all see eye to eye on this. This is not a partisan issue. That is why I think the pharmaceutical industry spending hundreds of millions of dollars ain't going to win this battle because they cannot beat us when we are united.

With that, let me yield to my colleague, the gentleman from Maine (Mr. Allen).

Before the gentleman departs, let me just say there are five of us here tonight, and I hope that we will all use our influence to educate the rest of our colleagues who are not as conversant with this problem as we might be. You, being one of the leaders on the Democrat side, I hope you will talk to your colleagues, along with the gentleman from Vermont (Mr. Sanders) and the gentlewoman from California (Ms. Watson.)

I yield to the gentleman from Minnesota (Mr. Gutknecht).

Mr. Speaker, let me say to my colleague, who has been the leader on this issue for a long time, we all appreciate your hard work. And I understand your saying, shame on us. But the Food and Drug Administration, which we pay for with taxpayers' dollars, should not be protecting the pharmaceutical industry and making sure that these exorbitant profits are made year in and year out, and then coming to the rescue of the pharmaceutical industry when they are trying to stop the reimportation of pharmaceutical products from Canada by saying that there is a safety issue.

It is unconscionable what they are doing over there, and we need to keep the heat on them. So maybe not, shame on the pharmaceutical industry by itself, but shame on them and the FDA and us for not being more responsive.

I think that needs to be dealt with along with the prescription drugs benefits we are going to talk about. I do not want to pass a prescription drug benefit that is going to guarantee the taxpayer paying for these huge profits being realized by the pharmaceutical industry.

Let me go to my colleague, the gentleman from Vermont, Mr. Sanders, and then go to the gentlewoman from California (Ms. Watson). The gentleman from Vermont (Mr. Sanders) has been working on this for a long time as well.

Mr. Speaker, I thank the gentleman from Vermont (Mr. Sanders), and I would like to say to my colleagues that not this Thursday but next Thursday we are going to have a hearing in the Subcommittee on Wellness and Human Rights of the Committee on Government Reform.

I anticipate and hope we will all be there, because we are going to have some witnesses come in from the pharmaceutical industry, and more witnesses come in from areas that can show that these products will be safe coming into the United States. We are going to have people from HHS and FDA there. I think it will be a very illuminating meeting; plus, we have some surprise information that will be coming out of that meeting, as well.

The gentlewoman from California (Ms. Watson) has been very patient. I thank her very much for being with us. She has been a leader in California on a number of issues involving health. I am happy to say she is my ranking member on our committee, and she does a great job. I yield to the gentlewoman from California (Ms. Watson).

Mr. Speaker, while the gentlewoman was talking, I talked to the gentleman from Minnesota (Mr. Gutknecht), and one of the things in the law that the gentlewoman cited was that the FDA had to show that the products coming in were safe.

Why do we not turn that around by amendment and say that the FDA has the burden of proof placed upon it to prove that pharmaceutical products coming into the country are not safe? And if we did that, that would open up the borders so people could buy these pharmaceutical products, and the FDA would have the burden of proof on its shoulders to prove they are not safe in order to stop them from coming in.

I will have a bill drafted; and if Members would be willing, I would like them to cosponsor this change.

I think maybe that would be a good idea. Mr. Speaker, I think that it is a great idea to make the FDA respond by having a GAO study that does exactly what the gentleman is saying, to show how many people have suffered or died or worse because they could not get the prescription drug benefits. So that should be in our request to GAO.

Mr. Speaker, I yield again to the gentlewoman from California.

We are just about out of time, but the gentleman from Ohio (Mr. Brown) came down to the floor and requested a few minutes.

Mr. Speaker, I thank the gentleman for coming down and joining us. We hope that he, along with a lot of our colleagues on both sides, will join with us in this fight to get this job done.

We are just about out of time. If the gentleman from Minnesota (Mr. Gutknecht) needs time, I will yield to him.

Let me just say one more time to the PhRMA people, if they happen to be following this discussion tonight, the people in the pharmaceutical industry, we all agree that they have done a great deal for mankind and they have

given us the highest quality of health in the history of man; but at the same time, there is a limit to how much they can expect out of our veins as far as the price of pharmaceutical products, especially when we know those products are being sold for a lot less elsewhere. This fight is not going to end until we obtain victory.

I want to tell them there are a lot of people here, besides those tonight, who are committed to making sure that we get these prices of pharmaceutical products down to a level that is acceptable for the American people, as they are in other parts of the world. No matter how much money the pharmaceutical companies spend or PhRMA spends, they ain't going to win this battle.

So I think they need to get with the program instead of trying to stop Niagara Falls with a sieve. It is not going to work. I think Lincoln said it the best. He said, ``You can fool all of the people some of the time and some of the people all of the time, but you cannot fool all the people all the time,'' and this is so transparent the American people are going to get it and they are going to get it very quickly.

I now yield to the gentleman from Minnesota (Mr. Gutknecht).

One-sixth.

I thank my colleagues, and we will be taking special orders in the future. I hope they will join with me when we do that, and I look forward to even the gentleman from Ohio (Mr. Brown), if he has the time, to come to our hearing, which is a week from Thursday, because it is going to be a very important hearing on this entire subject.

I would like to thank the gentleman from Illinois for taking a leadership role on this important issue. This is a huge issue. Members need to know that the estimate that the Congressional Budget Office is currently using is that seniors alone over the next 10 years will spend $1.8 trillion on prescription drugs. As the gentleman alluded to, I have been doing research. I should not say I have been doing research; there have been groups who have been sending me research for the last 4 or 5 years in terms of these great disparities between what Americans pay for name-brand prescription drugs versus the rest of the world. We have heard a lot about Canada; we have heard a lot about Mexico. But what has intrigued me the most is the differences between what we pay in the United States and what they pay in the European Union.

What I have here is a chart of about 12 or 13 of the largest-selling prescription drugs. This chart is old and the numbers have changed, but the percentages remain the same. This information is confirmed by research that I have done, that others have done, several groups have done this; but let me just run through a few of these examples. Augmentin, sold in the United States for an average of $55.50. You can buy it in Europe for $8.75. I have examples of these drugs. We actually went to Germany and bought some of these drugs. This is Augmentin. This is Cipro. Cipro is made by the German company Bayer. They also make aspirin. As you can see, it is a very effective antibiotic and especially in the days when we had anthrax here in the Federal buildings, we bought an awful lot of Cipro. In the United States it sells for an average of $87.99. In Europe you could buy that same package of drugs for $40.75 American. Claritin, $89. It is $18 there. Coumadin, this is a drug that my father takes. He is 85 years old. It is a blood thinner, a very effective drug. Coumadin in the United States at that time was selling for about $64.88. In Europe you can buy it for $15.80.

And the list goes on, but let me give an example, and the gentleman from Illinois, I think, made a great point about the amount that American taxpayers spend to develop these drugs. This is a drug that really chaps my hide. This is a drug, Tamoxifen. In many respects, this is a miracle drug. It is probably the most effective drug against women's breast cancer that has ever been invented. This drug we bought at the Munich airport pharmacy for $59.05. We checked here in the United States. This same package of 100 tablets of Tamoxifen in the United States sells for $360; $60 in Germany, $360 here.

As I say, the evidence is overwhelming that most of the research,

and I have a report if any of the Members would like a copy, this is a Senate report done in May of 2000, and in the Senate report, if I could just read into the Record, the National Cancer Institute, part of the NIH, has sponsored 140 clinical trials of Tamoxifen. It also participated in preclinical trials consisting of both in vitro, laboratory and live-subject tests. In other words, here in a Senate report we have confirmed that the taxpayers paid for much of the testing that was done on this drug.

He also referred to the drug Taxol. There was a story just a couple of weeks ago in The Washington Post. Let me just quote some of these numbers about what the taxpayers paid to develop this drug and what the pharmaceutical company got out of it.

Bristol-Myers-Squibb earned $9 billion from Taxol, which has been used to treat over a million cancer patients; but the National Institutes of Health received only $35 million in royalties. You go down the article a little bit further and it says, the GAO, the investigative arm of Congress, said that the NIH spent $484 million on research on Taxol through the year 2002. So the taxpayers invested $484 million, took it most of the way through the research pipeline, and we got $35 million back.

Unfortunately, on Taxol I do not have that comparison. I do not think it is on my list, but the comparison is essentially the same. It is about three times more, or at least it was when it came off patent in the United States; it was more than three times more in the United States than they paid in Europe, and the American taxpayers paid for most of the R&D costs. By the GAO's own estimate, the taxpayers spent at least $484 million developing the drug, and I yield to my friend.

No. I have plenty of information, but the interesting thing about these charts and these comparisons, if people doubt what they paid for these drugs, we have the receipts. So we can literally go through and say, yes, this is what we paid for Tamoxifen, $59.05 in Germany, and we did not have a special discount card. We are not German citizens; so we were not going in for socialized medicine. These are drugs that we just bought off the shelf or from the pharmacist at the Munich airport. So it is not as if they are being subsidized by the German Government. The truth is they are being subsidized by us, and what I have always said is that Americans should be prepared and we are prepared and willing. I think most Americans are willing to subsidize the research for these miracle drugs. In fact, I think we are willing to subsidize people in developing countries like Sub-Saharan Africa, but we should not have to subsidize the starving Swiss.

And finally, let me just make one last point, and I will yield back. I am with the gentleman. I happen to be a Republican. The gentleman is a Democrat, but we are both capitalists. We both understand that there is nothing wrong with the word ``profit,'' but there is something wrong with the word ``profiteer,'' and there is growing evidence now that the big pharmaceutical companies are actually spending more on marketing and advertising than they are on basic research.

Mr. Speaker, if the gentleman would yield.

I think he used the word earlier and I think it is the critical word. He said that we are a captive market, and if we look around the world, whether it is beef and Japan or blue jeans in the former Soviet Union, anytime there is a captive market, what will happen is they will create an artificial price barrier which will guarantee that the consumers will pay outrageously higher prices, and that is what has happened here in the United States. The German pharmacist has the right to go anywhere within the European Union and buy this Tamoxifen where he can get it the cheapest for his consumers. That is part of the reason that Tamoxifen is $60 in Germany and $360 here in the United States. In fact, the companies are protected by our own FDA from any real competitive pressures which would help to keep prices down. And I do not say shame on the pharmaceutical industry; I say shame on us. They are only exploiting a market opportunity which our government has given them.

Let me just share with the gentleman and other Members from a book called ``The Big Fix'' because I think it helps tell the whole story by Katharine Greider, and she quotes a study that was done in 1998 by the Boston Globe, and they looked at the 35 highest-selling prescription drugs in the United States; and they claim, the Boston Globe, and then is repeated in the book ``The Big Fix,'' that 32 of the 35 largest- selling drugs in the United States a few years ago were actually brought through the research and development chain by the taxpayers through the NIH, the NSF, the Defense Department, or other Federal agencies, principally the NIH. So it is not shame on them, but it is shame on us. We do not get a rate of return. We get nothing except for millions of our consumers the highest prices in the world, and it is time for us to change that.

Mr. Speaker, let me just talk about a couple of things, and I think as we talk about this new benefit, and I think we all recognize there are far too many seniors that are not getting the prescription drugs that they need, there was a study done several years ago by the Kaiser Foundation, and they found in their survey that 29 percent of seniors responded that they have had prescriptions which they did not have filled because they could not afford them, 29 percent.

About one third. And I say shame on us because we have the power to do something about that.

I spoke several weeks ago to the Community Pharmacists, and I just had received this report from the Kaiser Foundation. I asked them as I looked out over this audience of roughly 300 pharmacists from all over the United States, ``Has this ever happened to you, where seniors come into the pharmacy, they hand you a prescription and you tell them how much it is going to be, and they drop their head and they say, `well, I will be back tomorrow,' and they never come back?''

Shame on us. Shame on us. We need to do something about that.

But as has been mentioned by several of my colleagues, if we go about this in the wrong way, we may not do enough to really help those seniors who really need the help. But, worse than that, we may bankrupt our children, and there is something wrong with that.

Let me also mention that we are moving ahead with this, and we have heard some of the sponsors of the various bills say, oh, but we will have these groups, and get very significant discounts and really good deals on prescription drugs.

Well, this is a study recently done by one of the cardinals of the Committee on Appropriations, and they literally went through and found out how much the Federal Employees Benefit Program is paying for some of these drugs. It is rather eye-opening.

There are some areas where they are actually getting good discounts and are competitive with the prices they get in Europe. But let me give you some examples. The Blue Cross-Blue Shield plan, for example, on Coumadin mentioned earlier, even with their discount, the combination of what the Blue Cross-Blue Shield plan cost is, and you add in the beneficiary cost, the total cost for Coumadin under the Blue Cross Blue Shield plan for a Federal employee is $73.74. Now, Coumadin can be bought for $15.80 in Europe. So $73, that is the Federal plan. You read down the list of all kinds of other drugs. It is very similar.

Zocor, the total cost for Zocor under the Federal plan, Zocor is one area where it actually is cheaper, but not much cheaper. With their deep discount, the total cost is $17.48. That same drug in Europe would be $28.

But as you go through the list, what you find is in virtually every category, even with these ``deep discounts'' that the Federal employees' plan is able to get, it still is significantly more than the average consumer gets them for in Europe.

One final point, if I could, the argument that many people make against reimportation is safety. But what about safety?

We import every day thousands of tons of food. It surprises me how many tons. In fact, the number I remember is we import roughly 318,000 tons of plantains every year, and every time we eat a plantain that comes in from a foreign country, we take a certain amount of risk, because that could contain some food-borne pathogen.

We keep very good records on how many people get ill from eating imported foods. Let me give a couple of examples. In 1996, 1,466 Americans became seriously ill eating raspberries from Guatemala, 1,466. The next year they did a little better. Only 1,012 Americans became seriously ill from eating raspberries from Guatemala.

The point I am really trying to make here is we take a certain amount of risk. I believe that the risk, particularly with the new technologies, and I am holding in my hand a tamper-proof, counterfeit- proof package for pharmaceuticals.

Here is one that is currently in use by the company Astrozenica. This is the first version of the tamper-proof, counterfeit-proof packaging. So this whole issue of safety relatively speaking, even today, it is very, very safe.

But with the new technology that is going to be coming on line, I am holding in my hands, and you cannot see this, but a little vial, and inside this vial there are 150 microcomputer chips. They are so small you can barely see them with the naked eye. But this literally is the next version of the UPC code.

Within 2 years they will be embedding these chips into packaging, so that we absolutely can know that this package of drugs was produced at the Bayer plant in Munich, Germany, on September 8 of this year, and was shipped to so and so.

So the whole idea that we cannot do this safely, it seems to me, is a specious and almost goofy argument. So I do not think we should even engage in it. It can be done, it is being done. It is far more safe to import drugs than it is raspberries from Guatemala.

I appreciate the gentleman mentioning the bipartisan nature of this, because we did a special order last week, and we had Democrats and Republicans. We had some of the most conservative Republicans, and what I think most of us would agree are some of the most liberal Democrats, agreeing on this issue, and that is Americans should not have to pay

the world's highest prices when we are the world's best customers and when we spend more for the development of those drugs.

I am also the vice chairman of the Committee on Science. Just to share with my fellow colleagues how much we spend on research, and we should be proud of this, this year in this budget we will spend almost $29 billion on various kinds of basic research. In fact, we represent as Americans less than 6 percent of the world's population; we represent more than half of all of the basic research done in the world. I am proud of that. But we should not have to pay for these drugs a second and a third time when we helped develop them.

We are not asking for special breaks. All we are asking for is fairness. Reimportation or importation is not a perfect answer, but we do know that markets are more powerful than armies, and ultimately markets, whether it is the market for grain or the market for diamonds, has a tendency to level prices all over the world.

Let me just mention one other thing, and I mentioned this in a 5- minute special order I did earlier. This is the June 9 issue of U.S. News and World Report. In it there is a true American patriot. Her name is Kate Stahl. She is 84-years-old and she describes herself as a drug runner.

The tragedy is that the American government treats her as a common criminal because she helps her fellow seniors through the Senior Federation of Minnesota acquire drugs from other countries at affordable prices. In the article she says, and this is why I think she is a patriot, ``I would like nothing better than to be thrown in jail.'' That is a patriot. She is willing to do that for her fellow seniors so that they can get affordable prices on drugs.

Mr. Speaker, just one last comment, and I thank the gentleman for this Special Order tonight. As we mentioned earlier, this is not a matter of right versus left, this is right versus wrong. It is simply wrong to make American consumers pay the world's highest prices for drugs which largely the American taxpayers helped develop in the first place.

The gentleman mentioned one other thing, and I think it is a very serious concern. Some people are saying, well, through these plans in Medicare, we will squeeze down the prices, but if we do not do something to bring market forces to bear on the overall cost of prescription drugs, what may well happen is the price for these prescription drugs will go up even more for those 41 million Americans that are currently uninsured. They are the ones who have to pay cash, they are the ones whose kids get sick with tonsillitis or ear infections or conjunctivitis, and they need those prescriptions as well.

So this is not just about helping to keep down the price of prescription drugs for seniors; it is for all consumers and particularly for those uninsured or partially insured Americans who pay the world's highest prices. Hopefully, on a bipartisan basis, we will ultimately begin to get at those issues, whether it is the whole issue of importation of prescription drugs or bringing the generics to market faster

so that Americans have those drugs at affordable prices.

But again, this is not a partisan issue as far as I am concerned. I look forward to working with the gentleman and other Members on the other side of the aisle because ultimately we owe it to every American to make certain that we get fair prices for the drugs that they desperately need.

Mr. Speaker, I thank the gentleman from Illinois (Mr. Emanuel) for this Special Order.

Mr. Speaker, I want to thank the chairman for putting this special order together tonight, and I want to thank my colleagues on both sides of the aisle for joining us.

As has been mentioned, this is not a matter of right versus left, this is right versus wrong, and it is wrong to force Americans to pay the highest prices in the world.

The gentleman from Maine was talking about Tamoxifen. I am also now the chairman of the Congressional Study Group on Germany, so I was in Germany about a month ago. While we were there, we went to the pharmacy at the Munich Airport and we bought some of the most commonly prescribed drugs. Now, most people know that if you want to get a bargain, you probably do not go to the airport to buy it, so this is probably not the cheapest place in Germany to buy drugs.

Incidentally, compared to what you hear all the time, Germany really does not have price controls in the sense of setting the prices that the pharmacist in Germany can sell the drugs for. What they do allow is for German pharmacists to shop to get the best price. If they can buy their Tamoxifen cheaper in Sweden, they buy it in Sweden. If they can buy it cheaper in Spain, they buy it in Spain. They use market forces to help keep prices down in Germany.

We bought this Tamoxifen. It is 100 tabs of 20 milligrams. I am going to tell the whole story about Tamoxifen. We bought it at the Munich Airport pharmacy for $59.05 American. This same box of drugs here in the United States sells for $360; $60 in Germany, $360 here.

What makes the story even worse about this particular drug is, this was developed with taxpayers' dollars. This was developed essentially by the National Institutes of Health. Almost all of the research and development costs were paid for by the taxpayers.

As the vice chairman of the Committee on Science, here is something we should all be proud of. We in the United States represent less than 6 percent of the world's population, but we represent over 50 percent of the basic research done in the world. This year, this Congress will authorize and spend $29 billion taxpayer dollars on basic research.

In fact, there was a study done, and I want to recommend a book, if you have not seen this book, I hope every one of my colleagues will pick up a copy of this book. The title is ``The Big Fix.'' The subtitle is ``How the Pharmaceutical Industry Rips Off American Consumers.'' It is written by Katharine Greider. What is in this book is compelling, and every American ought to read some of the things that are in here.

You talk about the research. A study was done by the Boston Globe just a few years ago, and they found that of the 35 largest selling drugs in the United States, 33 of them had most of their research and development costs paid for by the taxpayers.

Now, it is one thing to say we have all these research costs, and therefore American consumers have to pay all the freight. But the bottom line is, we subsidize the pharmaceutical industry in three separate ways.

First of all, in that $29 billion we will spend this year in basic research through the NIH, the National Science Foundation and even DOD; we do an awful lot of basic research in the DOD that ultimately benefits the pharmaceutical industry. We do all of that on that side.

Secondly, we subsidize them in the Tax Code. They get very generous write-offs for the amount of research and the other expenses that they have.

Finally, we subsidize them in the prices we pay.

Let me share with you some of the other prices that we got at the pharmacy at the Munich Airport in Munich, Germany.

Glucophage, a miracle drug. I want to pay homage to the people who helped develop it. Millions and millions of Americans and people around the world are living better quality lives because of Glucophage. So I am not here to beat up on the pharmaceutical industry. They have done a lot of wonderful things.

But how do you justify this difference? This package of Glucophage here in the United States, we checked the price, is $29.95. We bought this one month ago in Munich, Germany, for $5 American.

Let us look at Cipro. We all know a little more about Cipro in the last couple of years because of what happened with the anthrax scare. We bought Cipro in Germany. This is actually made by a German company called Bayer. They also make aspirin. But Bayer makes this drug. We bought Cipro in Germany for $35.12. Here in the United States this same package sells for $55. $20 does not seem like much, but it adds up.

We bought Coumadin. My 86-year-old father takes Coumadin. This package of Coumadin we bought in Germany, we paid about $14 for this drug. Here in the United States, it is about $64. Those numbers just go on and on.

Zocor, very commonly prescribed, we bought it for $41.20. Here in the United States, $89.95.

As Will Rogers said, all I know is what I read in the newspapers. Well, read the newspapers. Read today's Wall Street Journal, the front page, about what the drug companies and PhRMA are doing, not only to make certain

that Americans keep paying the highest prices in the world, but they are literally now saying to sub-Saharan Africa, well, we will subsidize AIDS drugs for you, but we will not let you have access to many other drugs, including insulin.

Right now, you cannot get insulin in Chad at any price. Read the article. In fact, if I have time, I will read one of the paragraphs here, just a few sentences.

They talk about how all of the countries, 148 countries in the world, were ready to come up with a trade agreement, some language, to deal with some of these problems about drugs going across borders. But last December, when all of the other 148 countries in the World Trade Organization had lined up behind a new plan on the trade of medicines, the United States blocked the proposal. As you read, it gets worse, why they blocked it. It was all about the big pharmaceutical companies afraid that they might lose some profits.

This is not a matter of right versus left; this is right versus wrong. The time has come for Congress to stand up and say we are not going to be played the fool any longer. It is time that Americans have access to world-class drugs at world-market prices. That is not too much to ask. That is not a Republican idea, that is not a Democrat idea; that is an American idea.

We have what is called NAFTA. Many of us believe in free trade. But, it is interesting, we have free trade when it comes to plantains, have free trade when it comes to pork bellies, we have free trade with things called pears. In fact, we import hundreds of thousands of tons of fruits and vegetables every year, hundreds of thousands of tons; and that is regulated by a group called the FDA, the Food and Drug Administration.

Do you know how much inspection they do of all of those fruits and vegetables crossing our borders every year? Almost none. Do you know how many people get sick every year from imported fruits and vegetables? Thousands. In fact, one estimate is, thousands die as a result of eating contaminated foods that have come from other countries, that have food-borne pathogens. The FDA's own study said that 2 percent of all fruits and vegetables that come into the United States are contaminated with food-borne pathogens, including things like salmonella. Salmonella will kill you.

But we have to stop these prescription drugs because our own research says people could get sick and die. Do you know how many people have died? The FDA keeps records of all the people who have taken legal FDA- approved drugs coming in from other countries. It is an easy number to remember. It is a nice round number. It is zero. Zero.

More importantly, we are going to introduce a bill sometime by the end of the week that is going to require the FDA to begin to put counterfeit-proof blister packs in place, whether they come from the United States or wherever they come from.

Once we begin to require this, this whole safety thing just goes out the window, and we begin to realize it is not about safety, it is about profits; it is about making American consumers pay the highest prices in the world.

Let me just close with one other thing, because I say, shame on us. I do not say, shame on the pharmaceutical industry; shame on us. We let this thing happen. But the most shaming thing of all was a study done by the Kaiser Foundation a few years ago. What they found out was 29 percent of seniors say that they have let prescriptions go unfilled because they could not afford them.

Two weeks ago, I spoke to the Community Pharmacists, and I asked them, we had hundreds of pharmacists from around the country here in Washington, and I asked them, has this ever happened to you, where a little old lady comes up, hands you a prescription, and you tell her how much it is going to be, and she drops her head and she says, well, maybe I will be back tomorrow, and she never comes back. And every head in that place shook like this.

It has happened. It happens every day. And I do not say, shame on the pharmaceutical industry as much as I say, shame on us, because we have the power to do something about that.

Twenty-nine percent of prescriptions go unfilled. That is an outrage, and we can do something about it. And the reason is they cannot afford it. They can afford $14 for Coumadin; they cannot afford $64.

If I could have one additional minute, I do want to mention to all my colleagues, we have been working for a year trying to come up with a bill that would make sense. We think we have it. It is called the Pharmaceutical Affordability Act of 2003. Now, some may not like the acronym; it works out to PHARMAA. But the bottom line is, we think we have come up with language which really deals with the issues that people have raised, ultimately safety. I hope that Members will join me in cosponsoring that bill. Hopefully, if we put enough pressure on all of the people here in this body, we will get a vote on it this year. If we do, it will pass.

Mr. Speaker, the gentleman quoted one of my favorite Presidents. Let me quote another one. Ronald Reagan said, ``Markets are more powerful than armies.'' This idea that American consumers should be charged $360 for these pills when we can buy them in Munich, Germany, at the airport pharmacy for $59.05.

One-sixth. That will not stand. That is defending the indefensible, and sooner or later, it may not happen this year, may not happen next year, but sooner or later this wall will collapse just like the walls of Jericho.

I want to thank the gentleman for his leadership, and I want to thank my colleagues on both sides of the aisle. As I said at the beginning, this is not a matter of right versus left. This is right versus wrong. This is wrong, and we should do something to stop it.

Mr. Chairman, I am at a disadvantage. After hearing you and the gentleman from Maine (Mr. Allen) and the gentleman from Minnesota (Mr. Gutknecht) and I am sure the gentlewoman from California (Ms. Watson) soon after, there is not much that I can add to what you have said.

Let me reiterate a point that you made. I hope the viewers appreciate this.

You are a Republican, the gentleman from Maine (Mr. Allen) is a Democrat, the gentleman from Minnesota (Mr. Gutknecht) is a Republican, I am independent, and the gentlewoman from California (Ms. Watson) is a Democrat. Two Democrats, two Republicans and an Independent. And there are a lot more of us who are not here tonight.

What that should tell the American people is that there is widespread anger, frustration and disgust with what the pharmaceutical industry is doing to the people of this country.

Three years ago, I became the first Member of Congress to take a group of American citizens over the Canadian border in order to buy medicine. We went to Montreal. The reason that we did that is, I wanted not only to help hard-pressed Vermonters, mostly women, who are having a very difficult time paying for their prescription drugs, but I wanted to help show the country the absurdity of the situation, where the same exact medicine manufactured by the same exact company is sold in Canada for a fraction of the price that it is sold in the United States.

As we have discussed, it is not just Canada. It is Europe; it is Mexico. The American people pay, by far, the highest prices in the world for prescription drugs. In that trip to Canada, one of the moments that I will not forget is that we had women with us who were struggling with breast cancer, something I know the gentleman from Indiana (Chairman Burton) has a personal interest in. Women fighting for their lives were able to pick up Tamoxifen, a

widely prescribed breast cancer drug, for one-tenth of the price that is being charged in the United States of America. Of course, it is not just Tamoxifen; it is drug after drug after drug sold for a fraction of the price.

I think the gentleman said it well, the gentleman from Indiana (Mr. Burton), and the gentleman from Minnesota (Mr. Gutknecht) made the point, too, and the gentleman from Maine (Mr. Allen), it seems to me we are looking at two separate things.

On the one hand, we are seeing researchers who are making enormous breakthroughs; and the result of that is that we are saving lives, we are easing pain, we are prolonging life. That is the good news. All of us here have a great deal of respect for those researchers in the drug companies and in the United States Government, in universities, foundations who are doing that work. I thank them so much for what they are doing.

But then there is another side of the pharmaceutical industry. Those are the people who sit at the heads of these corporations who are concerned about one thing alone, that is, making as much money as they possibly can. They do not lose a night's sleep if elderly people die because they cannot afford the medicine they need or if their health deteriorates.

Of the many outrages that we have talked about here, the huge amount, hundreds of millions of dollars, that floods Washington or State capitals in order to maintain high prices, there is another outrage that I do not think has been mentioned tonight. While elderly people cannot afford the high price of medicine, the CEOs and the top dogs of these companies receive huge compensation packages.

In 2001, C.A. Heimbold, Jr., former chairman and CEO of Bristol- Meyers-Squibb, ended up his compensation with $74,890,000. Not bad; but that is not all. Mr. Heimbold also received stock options that same year amounting to over $76 million. One year, one man, $150 million. Then they tell us they just cannot lower the cost of medicine so that seniors in Vermont or Indiana can ease their pain or protect their lives.

Year after year while we continue to pay the highest prices in the world for prescription drugs, year after year the pharmaceutical industry is the most profitable industry in the country. More profitable than media, more profitable than banks. The pharmaceutical industry leads the list.

The issue here, and the gentleman has touched on this, I say to the chairman, the issue really here is will the United States Congress have the guts, and it is going to take some guts, to stand up to what I believe is the most powerful force in the United States of America.

I was interested, Mr. Speaker, to hear the gentleman from Indiana (Mr. Burton) say they have already gone down to Indiana and tried to work against him because of his willingness to stand up on this issue. If I am not mistaken, the gentleman from Minnesota (Mr. Gutknecht) told the same story, that they had gone to Minnesota, as well.

The gentleman and I know that when Members of Congress fight hard for consumers, lots of money comes into a campaign, mostly against Democrats; but I am sure they will go after Republicans, as well.

What we have to deal with now is to ask our colleagues in the Congress to have the guts to stand up to the campaign contributions, the advertising, the visiting of the editorial boards, the TV ads, all that we will see, the unlimited sums of money, hundreds of millions of dollars. Do we have the courage to say no to those people and protect the American consumer?

I believe that if tonight is an example of the potential of what we can do, standing together, regardless of philosophy or party, we can protect the American people and take on this industry. I thank the gentleman very much for calling this Special Order.

If the gentleman will yield further, Mr. Speaker, I think the point the gentleman from Minnesota (Mr. Gutknecht) made and we all made is that over 1 million Americans now purchase their meds in Canada, and the number is growing every day.

The chairman and I and the gentleman from Minnesota (Mr. Gutknecht) and the gentlewoman from California (Ms. Watson), we said to the gentleman from the FDA who was before the subcommittee, okay, you tell us you are very concerned about the safety aspect. We have a million Americans. Tell us how many of them have been made sick by receiving adulterated or counterfeit medicine. Out of 1 million people, the answer is zero.

Now, we are all going to sign or we are on a request to the GAO to do something a little different. I think that if the FDA is concerned about health and safety, they should do a study telling us how many Americans are dying or seeing a deterioration of their health because they cannot afford the prices that the industry is charging them today. I have the feeling we are going to see a number a heck of a lot larger than zero. So maybe the FDA should worry about health and safety in terms of prices, rather than hounding people who are buying affordable and safe medicines in Canada.