To extend the temporary suspension of duty on Tetraethylthiuram Disulfide.

Mr. Speaker, I yield myself such time as I may consume.

First, I want to apologize to the body. I thought that we went in at 10 o'clock this morning. When I left last evening, that is what it said. My staff did call me last night and tell me I needed to be on the floor by 9:30, but I thought they were gaming me, trying to get me here by 10 and telling me I had to be here by 9:30. Obviously, we did convene at 9, and I showed up at about 10 till. I thought I was 10 minutes early. So I apologize to my brethren for not being here.

There is an old saying that an apple a day keeps the doctor away, and a lot of us try to live by that. But in spite of our best efforts, sometimes we need prescription drugs. I am living proof of that. About a year ago, a year and a month ago, I was in a conference here in this Capitol with my friends in the other body, negotiating budget reconciliation instructions, and I had a heart attack.

Until that day, I had seldom had to take prescription drugs. Since that day, I take five or six. I take a drug to lower my blood pressure. I take a drug to thin my blood. I take all kinds of drugs so that I don't have a repeat of the heart attack that I had 13 months ago.

Now, I am not 65, so I am not covered by Medicare. I am in the standard Federal health benefit plan, Blue Cross/Blue Shield. And it does have a prescription drug benefit that partially pays for those drugs. But if I were to be over 65, which we have some Members of this body that are, I would have to be a part of Medicare and I would have an option under the current law to participate in Medicare part D, the prescription drug benefit program.

Now, when my friends on the other side were in the majority for 40 years, from 1954 to 1994, many of them sincerely, consciously wanted prescription drug benefits for Medicare. For whatever reason, it never quite happened. When the Republicans became the majority in 1994 and took over in 1995, it took us a while, we didn't get it done right away, but 3 years ago, we did pass a prescription drug benefit for part D, and it kicked in in the last Congress.

It is voluntary. Seniors that don't want to participate don't have to. Approximately 90 percent of the seniors that are eligible, we are led to believe, have chosen some plan for a prescription drug benefit.

Now, there are various plans. There are approximately 100 plans. These plans, some of them are very comprehensive. Some are very specific. Some are national, and some are regional. The long and the short of it is that every senior citizen in this country that wants a prescription drug benefit that is covered by Medicare can get one, and about 90 percent have chosen some plan; and of that, somewhere between 75 and 80 percent seem very, very satisfied.

The average cost in monthly premium is $22 a month. Twenty-two dollars a month. There are some plans, I am told, that have zero premiums; you don't have to pay to participate. Within those plans, over 4,400 drugs are covered. In some of these plans, generic drugs are free. In some of these plans, the donut hole does not exist.

So through diversity and market competition, we have created a prescription drug benefit for senior citizens in America that seems to be working very, very well.

Now, my friends on the Democrat side, the new majority, have come in, and they have got this bill up today. They want the government to negotiate prescription drug prices. On the surface, that may seem like a good idea. In reality, it would be a terrible idea. Who is going to do better than market forces with thousands and thousands of people and hundreds of plans and millions of people choosing whether to participate in this plan or that plan? What government bureaucrat, even somebody as smart and distinguished as the current Secretary of HHS, Secretary Levitt, who is going to do better than that?

Now, this concept that the government can negotiate a better price is simply not true. The CBO has come out and said it is not true, various think tanks have come out and said it is not true. But if you think it might be true, think of the products for which the government is the only purchaser and ask yourself, do we get the absolute best price?

There are not many products that the government is the only purchaser, but there are some. Aircraft carriers. There is not much demand for an aircraft carrier in the private market, so the U.S. Government is the only purchaser of aircraft carriers. An average cost of an aircraft carrier right now, I think, is about $5 billion. Now, we get a very quality product. The USS Reagan is the epitome of an aircraft carrier. But I don't believe we could say that we buy it at the absolute rock bottom price.

Now, we may not want to when it comes to some of our military equipment. We may not want to get the absolute best price. We may want to get the absolute best product, and so we are willing to pay a premium for that.

But there is really no way that a person in the Federal Government, or a group of people in the Federal Government, is going to replicate the thousands and thousands of market forces that are in play today.

So of all the ideas that my friends in the new majority have brought forward in their first 100 hours, I would respectfully say this has got to be the worst one. And I don't mean that in a mean way.

We have a program, Medicare part D prescription drug benefit, that is working. The people that can participate are choosing wisely. The premiums are coming down. The cost is coming down. It covers over 4,400 drugs. It is working.

As they say in many parts of our country, if it ain't broke, don't fix it. So I would respectfully urge the body later today to defeat this program.

Mr. Speaker, I rise in opposition to H.R. 4, the Medicare Prescription Drug Price Negotiation Act of 2007. This bill reduces access to drugs, creates a massive new pricing bureaucracy, slows access to drugs, and disrupts a

program that works. Let me restate--this program works. Beneficiary premiums are 42 percent lower than expected, overall costs are 30 percent lower than anticipated, and more importantly, seniors like what they are getting. Beneficiary satisfaction with their drug benefit is 80 percent or higher. So if it works, why break it?

Upon reading H.R. 4 there are some things that I know, some things that I don't know, and some things that I fear to be the case. Here's what I know. I know that there's a prescription drug benefit available in this country for 43 million Medicare beneficiaries. Of those folks, 90 percent now have some form of drug coverage.

I know that premiums are now down to around $22 per month for those that choose to enroll in this new benefit. And that's lower than last year because competition continues to drive the premiums down.

I know that beneficiaries like their new drug benefit. I know that beneficiaries are getting the drugs of their choice at the pharmacies of their choice, all at low costs. And I'm told, sometimes at zero cost for some drugs if they choose generics. Should I say that again? That's zero costs for some drugs. Here's a question--how does the government negotiate a lower price than zero?

H.R. 4 will not produce any savings. Why do I say that? The Congressional Budget Office has stated multiple times the federal government can not get lower prices than those currently achieved through competition. CBO must also know, what I know, and that is competition works.

Here's what else I know--H.R. 4 requires the government to negotiate prices that may be charged for drugs. But what else does H.R. 4 do? That's hard to tell because H.R. 4 doesn't say much more. Is the bill just poorly drafted or is it intentionally silent about the multitude of beneficiary and pharmacy protections in the current drug program that could be eliminated?

Upon reading H.R. 4, I do not know if plans will be able to offer the same wide array of drug choices as under the current program. I do not know if our seniors are protected from being stripped down to just one or two drugs offered from the many they may now choose from to best suit their health needs. I do not know if there are protections in place to assure access to robust pharmacy networks, and I do not know if pharmacy reimbursement associated with dispensing drugs could be limited, eliminated, or otherwise restricted.

What I fear is that H.R. 4's silence on these very important questions means that such beneficiary and pharmacy protections have not been considered. What I fear is the effect H.R. 4 may have on beneficiary access to drugs and pharmacies. Unfortunately, there have been no hearings or mark-ups to discuss and debate these important issues.

And even with knowing that H.R. 4 produces no savings, that beneficiaries overwhelmingly like this benefit, that the benefit works, that pharmacies are participating, and that premiums and overall costs are down, Democrats--led by Speaker Pelosi--feel compelled to blindly undermine this program with no legislative record to back up their claims. I am saddened. I am sad today for America's seniors because H.R. 4 serves no purpose other than a political one. We should not be playing politics with our seniors' access to drugs and pharmacies. We should be encouraging more seniors to enroll in this benefit, not tear it apart. Sadly, that is not what the Democrats have chosen to do in their first 100 hours of power.

And for what? We know from the experiences in other countries that government mandated drug formularies and interference in drug pricing leads to substantially less drug innovation and rationing of access to the new medicines that do come to market. Under the current program, a senior can choose a plan that will provide access to new drugs that slow heart disease, ease pain, keep families together longer, cure disease, and provide a longer and higher quality of life. In other countries with government run prescription drug plans citizens must wait years for new therapies. That's if the government chooses to provide the drug at all, just ask the cancer patients in the United Kingdom who waited years for the new breakthrough drug Herceptin to be covered.

How big and slow will this Big Government Pricing bureaucracy be? It's hard to tell with no hearings. With over 4,000 drugs, different economic conditions every year, new drugs entering the market all the time, and incredibly complicated questions about how this would work, the Pelosi plan will create a bureaucratic nightmare, but more importantly will endanger access to life improving and lifesaving medications and therapies. If you are as frustrated as I am about the unfairness of how the government pays physicians under Medicare, be prepared for more frustration on getting this political pricing scheme to work.

What about the effect of H.R. 4 on taxpayers receiving health coverage through private insurance or other federal purchasers? The non-partisan Government Accountability Office (GAO) said in a 2000 report entitled Expanding Access to Federal Prices Could Cause Other Price Changes that this type of system could raise drug prices for non- governmental purchasers. So according to the GAO, government negotiation in Medicare could lead to higher insurance costs for people with an employer sponsored health plan, a labor union plan, or even an individual insurance policy. Yet the Democrats have not held one hearing on this bill.

I ask what we are doing here today. Research firm after research firm has shown that large majorities of beneficiaries have a positive view of the prescription drug benefit. That is probably what is galling the Democrat leadership. A Republican Congress and President has passed and worked hard to administer a very popular program.

Within 100 hours the Democrat leadership has reneged on its campaign statement of bipartisanship, reneged on their campaign statement of open and considered legislative process, flip-flopped from a position of non-interference that they held in numerous bills, made hollow their statement of supporting an innovation agenda, and again shown their penchant for favoring Big Government mediocrity over choice, competition and accountability.

I was here for Contract with America. Those bills we passed with the Contract had hearings with many witnesses, Committee mark-ups and amendments, and opportunities for amendments on the floor. Who is hurt by lack of process on H.R. 4? Beneficiaries. Taxpayers. Pharmacists. Everyone. Without hearings on H.R. 4, without opportunity to develop solutions to concerns and understand the consequences of our actions, everyone loses. Particularly seniors.

In Speaker Pelosi's district there are over 81,000 Medicare beneficiaries and 103 pharmacies. How many hearings have there been to consider whether there are any beneficiary and pharmacy protections under H.R. 4? Zero.

Let's build that out a little more. The total number of Medicare beneficiaries represented by Members of the Energy and Commerce Committee is 5.4 million and there are 6800 pharmacies.

The total number of Medicare beneficiaries represented by Congress is close to 43 million. There are over 53,000 pharmacies. The consequences of this legislation are potentially grave and yet there has been absolutely no process given to determine how it would affect these important constituencies.

I don't mind an open discussion on the new Medicare drug benefit. We have had hearings on the benefit when I was the Chairman of the Energy and Commerce Committee. I like the fact that the Energy and Commerce Committee plans to hold more hearings this year. It gives me an opportunity to tout the program's successes. Seniors are seeing real savings and the cost of the program continues to decrease thanks to choice and competition. What I don't like is the purely political exercise we are being put through today that will jeopardize the access to needed drugs that the 63,000 beneficiaries in my district currently enjoy. I urge all members to oppose this process and oppose this ill conceived piece of legislation.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield 3 minutes to the distinguished member of the full committee, Mr. Upton of Michigan.

Mr. Speaker, I yield 3 minutes to the distinguished ranking member of the Health Subcommittee, Mr. Deal of Georgia.

Mr. Speaker, I am going to yield 2 minutes to one of our most distinguished Members, Dr. Price, for 2 minutes.

(Mr. PRICE of Georgia asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I would like to yield 2 minutes to the distinguished Congresswoman from Florida (Ms. Ginny Brown-Waite).

Mr. Speaker, I would like to yield to the distinguished gentleman from Nebraska, a member of the committee, Mr. Terry, for 2 minutes.

Mr. Speaker, I wish to recognize the distinguished gentleman from New Jersey (Mr. Ferguson) for 2 minutes.

Mr. Speaker, I yield myself 2 minutes to put into the Record the Democrat vote on the motion to recommit to H.R. 4680, rollcall 356 back in 2000. This was a Democrat motion to recommit to the Republican drug benefit that later went to the Senate and was not acted upon. 205, and I assume that was the total number of Democrats in the House, all 205 Democrats voted for it, including Mr. Dingell, Ms. Pelosi, Mr. Rangel, and every member of the Energy and Commerce Committee who is currently serving who was in the body at that time. This was a recommit motion by Mr. Stark of California, and I am going to read what it says:

``Noninterference by the Secretary. In administering the prescription medicine benefit program established under this part, the Secretary may not:

One, require a particular formulary, institute a price structure for benefits or in any way ration benefits;

Two, interfere in any way with negotiations between benefit administrators and medicine manufacturers or wholesalers; or

Three, otherwise interfere with the competitive nature of providing a prescription medicine benefit using private benefit administrators, except as is required to guarantee coverage of the defined benefit.''

This is exactly the opposite to the bill that is currently before us, exactly the opposite.

Back in 2000, every Democrat currently in the House at that time, I think, or at least 205, voted for it, including all of our senior members who are leading the fight 180 degrees opposite this today.

Democrats That Voted in Favor of Representative Stark's ``Non-

Interference'' Provision in 2000

Abercrombie

Ackerman

Allen

Andrews

Baca

Baird

Baldacci

Baldwin

Barcia

Barrett (WI)

Becerra

Bentsen

Berkley

Berman

Berry

Bishop

Bagojevich

Blumenauer

Bonior

Borski

Boswell

Boucher

Boyd

Brady (PA)

Brown (FL)

Brown (OR)

Capps

Capuano

Cardin

Carson

Clay

Clayton

Clement

Clyburn

Condit

Conyers

Costello

Coyne

Cramer

Crowley

Cummings

Danner

Davis (FL)

Davis (IL)

DeFazio

Delahunt

DeLauro

Deutsch

Dicks

Dingell

Dixon

Doggett

Dooley

Doyle

Edwards

Engel

Eshoo

Etheridge

Evans

Farr

Fattah

Forbes

Ford

Frank (MA)

Frost

Gejdenson

Gephardt

Gonzalez

Gordon

Green (TX)

Gutierrez

Hall (OH)

Hall (TX)

Hastings (FL)

Hill (IN)

Hilliard

Hinchey

Hinojosa

Hoeffel

Holden

Holt

Hoyer

Inslee

Jackson (IL)

Jackson-Lee (TX)

Jefferson

John

Johnson, E. B.

Jones (OH)

Kanjorski

Kaptur

Kennedy

Kildee

Kilpatrick

Kind (WI)

Kleczka

Klink

Kucinich

LaFalce

Lampson

Lantos

Larson

Lee

Levin

Lewis (GA)

Lipinski

Lofgren

Lowey

Lucas (KY)

Luther

Maloney (CT)

Maloney (NY)

Mascara

Matsui

McCarthy (MO)

McCarthy (NY)

McDermott

McGovern

McIntyre

McKinney

McNulty

Meehan

Meek (FL)

Meeks (NY)

Menendez

Millender-McDonald

Miller, George

Minge

Mink

Moakley

Mollohan

Moore

Moran (VA)

Murtha

Nadler

Napolitano

Neal

Oberstar

Obey

Olver

Ortiz

Owens

Pallone

Pascrell

Pastor

Payne

Pelosi

Peterson (MN)

Phelps

Pickett

Pomeroy

Price (NC)

Rahall

Rangel

Reyes

Rivers

Rodriguez

Roemer

Rothman

Roybal-Allard

Rush

Sabo

Sanchez

Sanders

Sandlin

Sawyer

Schakowsky

Scott

Sherman

Shows

Sisisky

Skelton

Slaughter

Smith (WA)

Snyder

Spratt

Stabenow

Stark

Stenholm

Strickland

Stupak

Tanner

Tauscher

Taylor (MS)

Thompson (CA)

Thompson (MS)

Thurman

Tierney

Towns

Turner

Udall (CO)

Udall (NM)

Velazquez

Visclosky

Waters

Watt (NC)

Waxman

Weiner

Wexler

Weygand

Wise

Woolsey

Wu

Wynn

Representative Stark included this language in his motion

to recommit on H.R. 4680 (roll call vote 356):

Section 1860(b)--NONINTERFERENCE BY THE SECRETARY

In administering the prescription medicine benefit program

established under this part, the Secretary may not B (1)

require a particular formulary, institute a price structure

for benefits, or in any way ration benefits; (2) interfere in

any way with negotiations between benefit administrators and

medicine manufacturers, or wholesalers; or (3) otherwise

interfere with the competitive nature of providing a

prescription medicine benefit using private benefit

administrators, except as is required to guarantee coverage

of the defined benefit.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, could I inquire as to the balance of the time amongst the many people on the floor today.

Mr. Speaker, I yield 3 minutes to a distinguished member of the Energy and Commerce Committee and also a member of the Veterans Committee, Mr. Stearns of Florida.

(Mr. STEARNS asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I would like to yield 2 minutes to a distinguished member of the committee, the gentleman from Michigan (Mr. Rogers).

Mr. Speaker, I want to yield myself 1 minute just to reply to Mr. Waxman.

The Congressional Budget Office, as far as I know, is not in the pocket of the drug companies. They say there are going to be no savings to this. The Heritage Foundation, which is admittedly conservative, but I don't think they are in the pocket of the drug companies, says there are going to be no savings. The Veterans Affairs Administration, which is the executive branch part of the Federal Government that is currently operated by President Bush, is opposed to this. They don't think there are going to be any savings. You can go to Wal-Mart right now, whether you are in Medicare or not, and get any number of generic drugs for, I think, a fee of $3 a month. Some of the plans that are out there in the marketplace give generic drugs away. Some of the plans that seniors can choose from have zero premiums. The average premium is $22.

I just think it is flat wrong to think that the Federal Government is going to negotiate a lower price than a competitive marketplace.

Mr. Speaker, I yield 1 minute to the distinguished gentleman from California (Mr. Campbell).

Mr. Speaker, I would like to yield 1 minute to a distinguished congressman from Georgia (Mr. Westmoreland).

Mr. Speaker, I yield 1 minute to the distinguished gentleman from West Texas (Mr. Conaway).

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Florida (Mr. Keller).

Mr. Speaker, I yield 2\1/2\ minutes to the distinguish gentleman from Arizona, a former chairman of the Republican Policy Committee and a member of the Energy and Commerce Committee, Mr. Shadegg.

Mr. Speaker, I yield 1 minute to a distinguished member of the committee who is currently on leave from the committee, the gentlewoman from Tennessee (Mrs. Blackburn).

Mr. Speaker, I yield 2 minutes to another distinguished member of the Energy and Commerce Committee, the gentleman from Oklahoma (Mr. Sullivan).

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from Georgia (Mr. Gingrey).

Mr. Speaker, I yield 1 minute to the gentleman from South Carolina (Mr. Wilson).

Mr. Speaker, I ask unanimous consent that the gentleman from Michigan (Mr. Camp) be allowed to control the minority time for the Ways and Means Committee, which I believe is 40 minutes.

Mr. Speaker, I yield myself such time as I may consume.

I will be submitting for the Record an editorial from today's New York Times which concludes by suggesting that the bill, H.R. 4, does not require the Secretary to negotiate prices for all 4,400 drugs used. A smart Secretary could simply determine which prices paid by the plan seem most out of line with prices paid by other purchasers and then negotiate only on those drugs. The private plans are exclusively allowed to negotiate even lower prices, if they can. This sort of flexibility would pose no threat to the free market.

It is time for the Medicare drug program to work harder for its beneficiaries, without worrying so much about the pharmaceutical companies.

Then, I would also like to respond to what I am sure was not, by one of the previous speakers, an intentional fabrication or misstatement, just probably a remark due to the inability to read a bill and understand what it means. And it is quite correct that in 2000 our motion to recommit had some wording that limited interference by the Secretary. But it is also important to note that it was a completely different bill; and as such, the motion to recommit had no relationship to this bill. And to suggest otherwise is an outright lie. And I will let it stand with that. If anybody would like to see the previous bill, we have information that will cover it.

I rise in support of H.R. 4. It is a simple, straightforward bill that should pass by unanimous consent if the Members of Congress want to help senior citizens, rather than the special pharmaceutical interests.

The bill rights a wrong included in the prescription drug act passed in 2003. And it takes away the special interest protection that prohibits the Secretary from negotiating to get better prices for Medicare beneficiaries.

The present law includes a flat out prohibition against using the negotiating ability and clout of 43 million Medicare beneficiaries to get better prices. That is wrong. We don't prohibit the government from negotiating prices for airplanes, even for oil royalties in the gulf, for highway construction or for anything else the government purchases.

Our bill today eliminates that prohibition and goes one step further. It requires the Secretary to use the market strength of Medicare's 43 million beneficiaries to negotiate better prices for seniors and people with disabilities. We had to go further than simply eliminating the prohibition because the current administration has been so vocal in their opposition to using this tool,

even if given the authority. Indeed, they have threatened to veto.

Countless studies show that Medicare beneficiaries are not getting very good deals on their prescription drug prices. The Bush administration has shown their ability to negotiate discounts on other drugs. Secretary Thompson did this twice, once when we had the anthrax attacks and then again when we faced the flu vaccine shortage.

This change shouldn't be controversial at all. It is a change that is supported by over 90 percent of the American public, and it is a change that should lower taxpayers' and seniors' expenses. It is a change supported by advocates for Medicare beneficiaries, the physicians who care for them, and the community pharmacists who fill their prescriptions.

It is a change that is even supported by AARP, which I continue to contend wrongly endorsed the Republican bill in the first place. But even they agree that the government should be empowered to negotiate better drug prices.

The only interests standing up against that legislation are the same interests who got the prohibition on negotiation included in the first place, the pharmaceutical drug lobby and those whose campaigns they funded.

Those days are over. Congress is no longer about special interests. It is about the interests of the American people, and that is why we brought this bill up as part of the first 100-hour agenda. We urge the President to reconsider his opposition to it, and to work with us to get Medicare beneficiaries a better deal on their prescription drug prices, and to get a better deal for the American taxpayers.

It is an important first step in our goal to improve the Medicare prescription drug program for seniors and people with disabilities. I look forward to working with my colleagues and with the administration to improve the Medicare program.

[From the New York Times, Jan. 12, 2007]

Negotiating Lower Drug Prices

From all the ruckus raised by the administration and its

patrons in the pharmaceutical industry, you would think that

Congressional Democrats were out to destroy the free market

system when they call for the government to negotiate the

prices of prescription drugs for Medicare beneficiaries. Yet

a bill scheduled for a vote in the House of Representatives

today is sufficiently flexible to allow older Americans to

benefit from the best efforts of both the government and the

private rug plans.

The secretary of health and human services should be able

to exert his bargaining power with drug companies in those

cases in which the private plans have failed to rein in

unduly high prices--leaving the rest to the drug plans. The

result could be lower costs for consumers and savings for the

taxpayers who support Medicare.

Under current law, written to appease the pharmaceutical

industry, the government is explicitly forbidden from using

its huge purchasing power to negotiate lower drug prices for

Medicare beneficiaries. That job is left to the private

health plans that provide drug coverage under Medicare and

compete for customers in part on the basis of cost. The

Democrats' bill would end the prohibition and require--not

just authorize--the secretary of health and human services to

negotiate prices with the manufacturers. That language is

important since the current secretary, Michael Leavitt, has

said he does not want the power to negotiate.

No data is publicly available to indicate what prices the

private health plans actually pay the manufacturers. But

judging from what they charge their beneficiaries, it looks

like they pay significantly more for many drugs than do the

Department of Veterans Affairs--which by law gets big

discounts--the Medicaid programs for the poor, or foreign

countries. The administration argues, correctly, that the

private plans have held costs down and that there is no

guarantee the government will do any better. The bill, for

example, prohibits the secretary from limiting which drugs

are covered by Medicare, thus depriving him of a tool used by

private plans and the V.A. to win big discounts from

companies eager to get their drugs on the list. The secretary

does have the bully pulpit, which he can use to try to bring

down the cost of overpriced drugs.

The bill also does not require the secretary to negotiate

prices for all 4,400 drugs used by beneficiaries. A smart

secretary could simply determine which prices paid by the

plans seemed most out of line with the prices paid by other

purchasers and then negotiate only on those drugs. The

private plans are explicitly allowed to negotiate even lower

prices if they can. This sort of flexibility should pose no

threat to the free market. It is time for the Medicare drug

program to work harder for its beneficiaries without worrying

so much about the pharmaceutical companies.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I am pleased to yield 1\1/2\ minutes to the gentleman from Connecticut (Mr. Larson) who, like the National Committee to Preserve Social Security and Medicare, knows that H.R. 4 would be an important step to improve part D.

Mr. Speaker, I am pleased to yield 1\1/2\ minutes to the distinguished gentleman from California, who agrees with AARP that the Secretary can achieve additional savings for beneficiaries under H.R. 4.

Mr. Speaker, I am pleased to yield 1\1/2\ minutes to the gentleman from Washington (Mr. McDermott), who agrees with AIDS Action that an effort to ensure the Secretary of Health and Human Services has authority to negotiate drug prices is important to the continuing success of part D.

(Mr. McDERMOTT asked and was given permission to revise and extend his remarks.)

Mr. Speaker, prior to recognizing the distinguished majority leader for 1 minute, I would just like to remind my friend from Missouri that at least in California we require law students to be able to read well enough to understand that bills they wave in the air are different from the bill we are considering today.

I wouldn't call it a lie to suggest that what we passed in 2000 is different from what we have today, but I would consider it close to shysterism in terms of at least dealing with law.

Mr. Speaker, I am pleased at this point to recognize the distinguished majority leader for 1 minute.

Mr. Speaker, I would like to recognize the gentleman from California (Mr. Costa) for a unanimous-consent request.

(Mr. COSTA asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I am pleased to yield 1\1/2\ minutes to the gentleman from California (Mr. Becerra), who agrees with the Reliance for Retired Americans that, by harnessing the bargaining power of 40 million Medicare beneficiaries, H.R. 4 will bring relief to older and disabled Americans.

Mr. Speaker, I remind my good friend from Wisconsin that he is quite right about the motion to recommit, but it was to a different bill. It was to H.R. 4770, which has no relationship to the bill that we are discussing today.

Mr. Speaker, I yield 1\1/2\ minutes to the distinguished gentleman from Texas (Mr. Doggett).

Mr. Speaker, could I inquire of the time remaining on both sides.

Mr. Speaker, I am delighted to yield 1\1/2\ minutes to the distinguished gentleman from Georgia (Mr. Lewis) who, like the Medicare Rights Center, knows if this bill becomes law, lower prescription drug prices will help millions of Medicare beneficiaries.

Mr. Speaker, at this time I am happy to yield 1\1/2\ minutes to the distinguished gentleman from Oregon (Mr. Blumenauer).

Mr. Speaker, at this time I am delighted to yield 1\1/2\ minutes to the distinguished gentleman from New Jersey (Mr. Pascrell).

Mr. Speaker, I am pleased to yield 1\1/2\ minutes to the distinguished gentlewoman from Nevada (Ms. Berkley), who agrees with the American Nurses Association that the direct negotiation authority in this bill is a commonsense means of improving access to needed prescription medications.

Mr. Speaker, I am happy to yield 1\1/2\ minutes to the distinguished gentleman from Wisconsin (Mr. Kind), who agrees with the National Senior Citizens Law Center that H.R. 4 is an important step toward making the prescription drug benefit simpler, more affordable, and reliable.

(Mr. KIND asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I am delighted to yield at this point 1\1/2\ minutes to one of the authors of the bill, the gentlewoman from New Hampshire (Ms. Shea-Porter).

Mr. Speaker, I am pleased to yield 1 minute to the gentleman from Connecticut (Mr. Murphy), who concurs with Consumers Union that government-priced negotiations on behalf of consumers could cut pharmaceutical drug prices roughly in half.

Mr. Speaker, I am delighted to yield 1 minute to the distinguished gentleman from Tennessee (Mr. Cohen).

Mr. Speaker, I am delighted to yield 1\1/2\ minutes to the distinguished member of our Ways and Means committee, the gentleman from New York (Mr. Crowley), who agrees with Families USA, the national voice of health care consumers, that H.R. 4 is an important first step in improving part D.

Mr. Speaker, before recognizing the next speaker, I would like to concur with the remarks of the gentleman from Illinois. Many of us on this side of the aisle shared his concern with the rapidity with which we had to bring this to the floor. I want to commend both the ranking member and the chairman of the Ways and Means Committee as well as the ranking member of the Health Subcommittee for attempting to have as much time as we could for Members on both sides of the aisle to work on this bill before its coming to the floor today, but I do concur with his statement.

Having said that, I would like to recognize the gentleman from Connecticut (Mr. Courtney) for 1 minute.

Mr. Speaker, I am delighted to recognize the distinguished gentleman from Illinois (Mr. Hare) for 1 minute and comment that, before joining us, he served for 24 years as Mr. Lane Evans' district director, a man who is known on both sides of the aisle for his support for veterans' issues.

Mr. Speaker, I yield to the gentlewoman from Texas (Ms. Jackson-Lee) for the purpose of a unanimous consent request.

(Ms. JACKSON-LEE of Texas asked and was given permission to revise and extend her remarks.)

Mr. Speaker, I am delighted to yield 1 minute to the gentleman from Pennsylvania (Mr. Altmire), one of the cosponsors and coauthors of the bill.

Mr. Speaker, I yield to the gentleman from North Carolina (Mr. Etheridge) for the purpose of a unanimous consent request.

(Mr. ETHERIDGE asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I am honored to yield 1 minute to the gentlelady from Hawaii (Ms. Hirono), a lady for whom I serve as an honorary district representative on the island of Lanai.

Mr. Speaker, at this time I am delighted to yield 1 minute to the gentlewoman from Ohio (Ms. Sutton).

Mr. Speaker, I am delighted to yield 1 minute to the gentleman from California (Mr. Baca), who agrees with the National Community Pharmacists that the non-interference clause has directly disadvantaged independent pharmacies throughout the implementation of part D.

Mr. Speaker, for the purpose of a unanimous consent request, I yield to the gentleman from Massachusetts (Mr. Lynch).

(Mr. LYNCH asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield 1 minute to the distinguished gentlelady from California (Mrs. Davis).

Mr. Speaker, I am pleased to recognize the distinguished gentlewoman from Connecticut (Ms. DeLauro), who agrees with the Center for Medicare Advocacy Assessment that H.R. 4 will keep drug prices from skyrocketing. And I yield to the gentlewoman for 1 minute.

I appreciate the gentleman yielding.

Mr. Speaker, my colleague from the State of Washington mentioned medical school. Let me recount an old axiom that with learned in law school. We were told: If the facts are against you, argue the law. If the law is against you, argue the facts. If the facts and the law are against you, pound the podium.

Ladies and gentlemen, there has been a lot of podium pounding on the other side of the aisle today. The question is this, shall the government interfere with or intervene in a prescription drug plan that is working?

Now, the majority seeks through H.R. 4 to strike this nonintervention clause. First of all, is anyone having a flashback to 1993 and 1994 talking about government taking over health care?

But, more importantly, my colleague from the State of California, the incoming chairman of the Health Subcommittee, and 203 of his colleagues are about to do an abrupt, en masse, about face. Because in the Congressional Record of June 28 of 2000, you had this nonintervention clause, and 204 Democrats said, we don't want to give the Secretary the ability to negotiate in roll call 356.

Now, what could possibly explain this inconsistency? Could politics be at play?

The gentleman from Washington talked about some history. Let us go back over the committee history, because my colleagues from Ways and Means are here.

First of all, during committee action we were chided there would be no plans available under the Republican plan.

Then, of course, when we saw the plethora of plans, we heard the complaints from your side, there are too many confusing choices that seniors have across the country. Then you wagged your finger at us and said, well, we need to legislate the premium at $35, and then the total cost of the program is going to explode the deficit. Remember hearing that?

Yet, on the other hand, as has been discussed, the average premium is $22. In the State of Missouri, you could even have a premium for under $15 if you choose it. Of course, we have seen how those program costs have come down.

We heard from your side that the drug companies were going to do a bait-and-switch, that we were going to have low ball that first year and then we would see those prices being jacked up. Lord help us, what's happened? Drug prices have gone down. Imagine premiums and prices coming down in health care.

Then my colleague from the State of California said to his colleagues, it is okay, once the seniors hit the donut hole, they will be angry, and they will be outraged. Then we have seen, of course, that every senior at least has had the opportunity to have full coverage, including coverage for the donut hole. You just can't find it within yourself to say we got one right.

Just like welfare reform, surely, Mr. Leader, once every 10 years, you can say the Republicans got it right. We are witnessing cost containment and competition by incorporating private sector market principles within the public sector programs provision of drug coverage. Let us lighten up on the podium pounding, say no to government interference and no to H.R. 4.

Mr. Speaker, I rise in opposition to H.R. 4, and I would like to divide my remarks into two main thoughts: first, ``if it ain't broke, don't fix it,'' and second, the laws of intended and unintended consequences.

Mr. Speaker, the Medicare Part D Benefit ain't broke.

But Medicare was broken before there was a drug benefit. When I came to Congress, one of the issues I heard about most often from my constituents was the need for prescription drug coverage for seniors. In 1965, when Medicare was created to ensure that seniors had some access to health care, prescription drugs were not a primary mode of treatment, and thus not covered.

But as medical science advanced, and miraculous treatments became available via prescription drugs, Medicare still languished without a drug benefit, and many seniors were faced with the brutal decision between buying their medicine or paying for food, clothes, housing, and other necessities.

Seniors do not have to make that brutal decision anymore.

Under the law, millions of seniors who previously could not afford prescription drugs are now receiving the medicines they need.

More than 40,000 volunteers in communities across the country worked during the enrollment period, counseling beneficiaries and sponsoring events to help people with Medicare. I would like to commend these volunteers, volunteers like Debbie Catlett from the Hannibal Nutrition Center, who lovingly helped her friends and neighbors sign up for drug coverage.

The system the Republican Congress set-up has been remarkably successful: The average premium in 2006, originally projected to be $37 per month, was only $23; and rather than increasing to the projected $40 per month in 2007 it lowered to $22 for this year. In Missouri, we have even less expensive options available, the lowest costing only $14.90 per month. Imagine that, health care premiums going down!

Seniors are saving, on average, $1,200 a year on prescription drugs. At the same time, Part D recipients saw a 13 percent increase in the number of medications available. According to polls, about 80 percent of America's seniors are satisfied with their prescription drug plans.

All that is on the micro level, what individual seniors are enjoying and saving; but let's look at the macro level. Over 90 percent of seniors now have drug coverage--if these seniors are paying less, the government must be paying more to pick up the slack, right?

Wrong.

The Medicare drug benefit cost nearly $13 billion less than expected in its first year, 30 percent below the $43 billion that had been budgeted.

Long-term savings are even greater. HHS Secretary Leavitt just announced that the independent CMS actuaries are lowering their estimate of the cost of the benefit over the next decade by another 10 percent, with almost all of the new savings resulting from competition. The actuaries' new estimates show that total net Medicare costs are 30 percent lower, or $189 billion less, for the same budget window (2004- 2013) than the actuaries originally anticipated before the Medicare drug benefit was implemented.

The long and the short of it is, Medicare Part D is a big, fat success.

Look, the majority is upset that the Republican Congress enacted a successful, popular program, and the ``let Medicare negotiate low prices like the VA'' polled well for them (I've seen the polling numbers). But a bumper sticker phrase aimed at coopting that success isn't good policy.

I've discussed how the program isn't broken and doesn't need fixing, now onto the intended and unintended consequences of this bumper sticker bill.

Best case scenario if this Democrat attention grabber of a bill becomes law is that

Medicare proves unable to negotiate lower prices than the marketplace currently does--and two non-partisan entities, the Congressional Budget Office and the CMS Office of the Actuary have said the Democrat plan yields no savings for this reason--and no harm is done. But worst case scenario is overactive bureaucrats or the next President take this negotiating authority and use it to force price controls, ration drugs, and deny doctor and patient choice of what medicines are allowed for seniors.

So friends, pick your poison: On the one hand an impotent outcome as CBO and the CMS Actuary have foretold, on the other, Medicare setting prices and rationing seniors their medicine. I will remain agnostic as to which is the intended and which the unintended consequence.

The reason the two economic models I've mentioned concluded no savings via H.R. 4 is that, fundamentally, the government cannot negotiate any better than the thousands of prescription drug plan managers in the private market. Under current law the millions of Medicare beneficiaries, via their prescription drug plans, are coupled with the 200 million other health insured Americans. Caremark negotiates for 70 million lives, Medco for 54 million, and Express- Scripts for 51 million. Medicare Part D allows our Medicare beneficiaries to piggyback on that huge buying power with professional negotiators. And the other side would rather untrained government bureaucrats negotiate for my constituents? No thank you.

So let's look at the worst case scenario under this bill, where Medicare commands and controls seniors' medicine.

Yes, H.R. 4 seems to disallow formularies, but in law school they taught me to look closely at the law. Page 3, line 20: ``nothing . . . shall be construed to authorize the Secretary to establish or require a particular formulary.''

But banning a national formulary does not protect beneficiaries from other government access controls to prescription drugs. For instance, the Medicaid program has no national formulary, however, it employs various strategies such as a ``preferred drugs list'' to limit access of medications. If beneficiaries want to receive a medication that is not on the preferred drug list, they must go through a lengthy and confusing authorization.

If the authors of H.R. 4 didn't have this in mind, why did they strike the underlying MMA language that would seem to protect against this, that said ``The Secretary may not require a particular formulary or institute a price structure for the reimbursement of covered part D drugs''?

The Ways and Means Chairman was thoughtful enough to hold a forum on this matter yesterday for our committee members, and both his and Mr. McCrery's invited witnesses agreed that to get VA prices, you have to set a formulary, and a strict one at that.

Again, the Democrats' bumper sticker slogan is fraught with bad consequences--intended or unintended.

Most importantly, the plan offered by Democrats would limit choice. Veterans have access to less than one third the drugs Medicare beneficiaries do--the VA formulary covers 1,300 drugs while the Medicare drug benefit covers 4,300 drugs. Drugs like Lipitor, Celebrex, Flomax, and Prevacid are unavailable in the VA plan. In fact, 20 of the top 33 most commonly prescribed drugs for seniors are excluded in the VA plan.

Pharmacy access is another pitfall of the Democrats' slogan. In reality, the VA distributes 80 percent of its medications by mail. Medicare uses mail for less than 2 percent of its medications. Seniors appreciate the opportunity to talk to their local pharmacist and ask questions about their prescriptions, and we have 1,077 pharmacies in Missouri where they can do just that. The VA has 6 pharmacies in the entire state of Missouri (and only 332 nationwide); the Democrat bumper sticker slogan loses a lot of its luster when looked at through that lens.

Simply put--seniors would find many of their favorite drugs unavailable and that's unacceptable.

The price control plan offered by the Democrat majority does not guarantee that seniors have access to ``all or substantially all'' drugs to treat cancer, mental illness, HIV/AIDS, and Lou Gehrig's disease. These important protections are in place in the current drug benefit and our motion to commit will offer the majority a chance to continue to protect drugs for these vulnerable populations.

While the plan being debated may be labeled ``price negotiation,'' it is more accurate to call it ``price fixing.'' Every time price fixing has been tried in other countries, it has failed. It has resulted in limited therapies and reduced innovation. And if the government saves the money from price fixing, the economic models show the cost will be shifted to the higher prices for the over 250 million non-Medicare Americans. In fact, the Democrat witness at yesterday's forum stated ``if Medicare gets a better price, some people will have to pay more.''

It's an easy campaign slogan to say ``let Medicare negotiate low prices like the VA.'' But, to get there, you have to make that deal with the devil and allow Medicare to set prices and force strict formularies.

In conclusion, in attempting to fix an unbroken system, H.R. 4 faces the unintended consequence of either being lamely impotent at negotiating lower prices, or dangerously controlling by price fixing and restricting seniors access to drugs. Bad outcomes, whether intended or not; therefore, I urge a ``no'' vote.

Mr. Speaker, pursuant to section 510 of House Resolution 6 and as the designee of the majority leader, I call up the bill (H.R. 4) to amend part D of title XVIII of the Social Security Act to require the Secretary of Health and Human Services to negotiate lower covered part D drug prices on behalf of Medicare beneficiaries.

Mr. Speaker, I ask unanimous consent that all Members have 5 legislative days in which to revise and extend their remarks and include therein extraneous matter.

Mr. Speaker, I ask unanimous consent to yield 40 minutes

to the distinguished gentleman from New York (Mr. Rangel) and 10 minutes to the gentlewoman from Missouri (Mrs. Emerson), and that they each be permitted to control their own time in their own way.

Mr. Speaker, I yield myself 5 minutes.

Mr. Speaker, I rise today in support of H.R. 4, the Medicare Prescription Drug Price Negotiation Act of 2007. This legislation is bipartisan. It is an overdue step to improve part D drug benefits for the millions who depend on that section.

The bill is simple and straightforward. It removes the prohibition that prevents the Secretary of Health and Human Services from negotiating discounts with pharmaceutical manufacturers, and ensures that our friends in the executive branch take this opportunity seriously. It requires the Secretary to negotiate.

This legislation is simple and common sense. It will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers. The American public subsidizes more than three-quarters of the part D benefit, paying the bulk of premiums and 80 percent of catastrophic costs. They also pay for most or all of part D medicines used by the lowest-income Medicare beneficiaries. These savings add up.

It is equally important to understand that this legislation does not do certain things. H.R. 4 does not preclude private plans from offering drug coverage under Medicare from getting better or additional discounts on medicines they offer seniors and people with disabilities. H.R. 4 does not interfere with the ability of doctors to prescribe a particular drug for their patients by establishing a national formulary. In fact, page 2 of the legislation reads: ``Nothing in paragraph (1) shall be construed to authorize the Secretary to establish or require a particular formulary.'' I do not think that there is any clearer way to state these matters than in that fashion.

I have confidence that Secretary Leavitt can cut a good deal with the bargaining power of 43 million beneficiaries of Medicare behind him without restricting access to needed medicine.

H.R. 4 does not require price controls. Quite the contrary, the bill gives the Secretary an additional power and makes him an additional player with whom drug companies must negotiate. And I say with some sympathy for the drug companies that they have been doing so well that I can understand their opposition to this matter.

H.R. 4 does not hamstring research and development by pharmaceutical houses. The most recent Securities and Exchange Commission filings by the seven largest drug manufacturers based in the U.S. show that, on average, these companies spend more on marketing, advertising and administration than they do on research and development; and those who insist that the sky is falling if the drug companies negotiate lower prescription prices are arguing that those drug companies should continue to skin a fat hog at the expense of the taxpayers and the beneficiaries.

I further note that H.R. 4 does not require HHS's Secretary to use Department of Veterans Affairs' price schedule or to adopt a VA-like system. In fact, you will not find the words ``veterans'' and ``affairs'' in this legislation.

Independent studies confirm that Medicare overpays drug companies in purchasing medicines. I will repeat that: Medicare overpays drug companies in purchasing medicines. One study has found that half of the top 20 drugs used by senior citizens fall into that category. Medicare drug plans paid at least 58 percent more than the prescription program of the Department of Veterans Affairs. Even if the Secretary does not get those same discounts, it is clear that Medicare can do better, and we must see that they do so.

Senior citizens and people with disabilities deserve better, and after the past 6 years of pillaging the Treasury of the United States, our taxpayers deserve better.

While this legislation is an important step forward, H.R. 4 does not address other problems with part D. I anticipate we will be doing so at an early time. The list of wrongs that need righting in connection with this legislation is long, and, as I said, we will introduce legislation and deal with these matters in other ways.

I urge my colleagues to vote for H.R. 4, the Medicare Prescription Drug Price Negotiation Act. Let the Secretary of Health and Human Services use the power of 43 million beneficiaries to get a better deal for their prescription medicines, for them, and for the taxpayers

[From the New York Times, Jan. 12, 2007]

Negotiating Lower Drug Prices

From all the ruckus raised by the administration and its

patrons in the pharmaceutical industry, you would think that

Congressional Democrats were out to destroy the free market

system when they call for the government to negotiate the

prices of prescription drugs for Medicare beneficiaries. Yet

a bill scheduled for a vote in the House of Representatives

today is sufficiently flexible to allow older Americans to

benefit from the best efforts of both the government and the

private drug plans.

The secretary of health and human services should be able

to exert his bargaining power with drug companies in those

cases in which the private plans have failed to rein in

unduly high prices--leaving the rest to the drug plans. The

result could be lower costs for consumers and savings for the

taxpayers who support Medicare.

Under current law, written to appease the pharmaceutical

industry, the government is explicitly forbidden from using

its huge purchasing power to negotiate lower drug prices for

Medicare beneficiaries. That job is left to the private

health plans that provide drug coverage under Medicare and

compete for customers in part on the basis of cost.

The Democrats' bill would end the prohibition and require--

not just authorize--the secretary of health and human

services to negotiate prices with the manufacturers. That

language is important since the current secretary, Michael

Leavitt, has said he does not want the power to negotiate.

No data is publicly available to indicate what prices the

private health plans actually pay the manufacturers. But

judging from what they charge their beneficiaries, it looks

like they pay significantly more for many drugs than do the

Department of Veterans Affairs--which by law gets big

discounts--the Medicaid programs for the poor, or foreign

countries.

The administration argues, correctly, that the private

plans have held costs down and that there is no guarantee the

government will do any better. The bill, for example,

prohibits the secretary from limiting which drugs are covered

by Medicare, thus depriving him of a tool used by private

plans and the V.A. to win big discounts from companies eager

to get their drugs on the list. The secretary does have the

bully pulpit, which he can use to try to bring down the cost

of overpriced drugs.

The bill also does not require the secretary to negotiate

prices for all 4,400 drugs used by beneficiaries. A smart

secretary could simply determine which prices paid by the

plans seemed most out of line with the prices paid by other

purchasers and then negotiate only on those drugs. The

private plans are explicitly allowed to negotiate even lower

prices if they can. This sort of flexibility should pose no

threat to the free market. It is time for the Medicare drug

program to work harder for its beneficiaries without worrying

so much about the pharmaceutical companies.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield to my distinguished colleague and friend, the gentleman from California, for a unanimous consent request.

(Mr. GEORGE MILLER of California asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield now to the distinguished gentleman from New Jersey, the chairman of the Health Subcommittee, Mr. Pallone, for 3 minutes.

Mr. Speaker, it is with great pleasure that I yield to the distinguished gentlewoman from Florida, a very able Member of this body, 1 minute to our distinguished friend and colleague from Florida, Kathy Castor.

Mr. Speaker, I am delighted at this time to yield to the distinguished chairman of the Oversight and Investigation Subcommittee, my distinguished colleague from Michigan (Mr. Stupak) 2 minutes.

Mr. Speaker, I yield to the distinguished gentleman from Rhode Island (Mr. Kennedy) for 1 minute.

Mr. Speaker, I am delighted to yield to the distinguished gentlewoman from California, valuable member of the committee, Ms. Eshoo, 2\1/2\ minutes.

Mr. Speaker, I yield 2 minutes to our able colleague and dear friend, Mr. Gene Green of Texas.

Mr. Speaker, I am delighted to yield to the distinguished gentleman from Wisconsin (Mr. Kagen) 1 minute.

Mr. Speaker, I am delighted to yield to the distinguished gentlewoman from California (Mrs. Capps) 2 minutes.

Mr. Speaker, I yield to the distinguished gentleman from Maine (Mr. Allen) 2 minutes.

Mr. Speaker, I am delighted to yield 1 minute to a distinguished Member of this body, our colleague from New York (Mr. Hall).

Mr. Speaker, I am delighted to yield at this time 2\1/2\ minutes to the distinguished chairman of the Government Reform Committee, a member of the Committee on Energy and Commerce, my friend from California (Mr. Waxman).

Mr. Speaker, I am delighted to yield to the distinguished gentlewoman from Illinois (Ms. Schakowsky) 2 minutes.

Mr. Speaker, I am delighted to yield to the distinguished gentlewoman from California (Ms. Solis).

Mr. Speaker, I am delighted to yield to the distinguished gentlewoman from Oregon, a member of the committee, Ms. Hooley, 2 minutes.

Mr. Speaker, I am delighted to yield to Dr. Christensen, the distinguished representative of the Virgin Islands, a leader in health care, 1 minute.

Mr. Speaker, I yield at this time 2 minutes to the distinguished gentleman from New York (Mr. Engel).

Mr. Speaker, I am delighted at this time to yield 1\1/2\ minutes to our distinguished colleague, the gentleman from Utah (Mr. Matheson), a member of the committee.

Mr. Speaker, at this time I reserve the balance of my time on behalf of the Energy and Commerce Committee.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today in opposition to H.R. 4. It is a flawed piece of legislation. If there was ever a bill that should have gone through regular order in the committee process, it is this one, because we find as we look at it more carefully that there is much more to it than might appear at first glance.

First and foremost, we should recognize that Medicare part D is working. Ninety percent of seniors are covered. Thirty-eight million seniors now have prescription drug coverage.

Additionally, due to private competition, the cost of this program is continuing to fall. Estimates from the Center for Medicare and Medicaid Services have predicted that this program will cost $373 billion less over the next 10 years than was expected in 2005. Seniors are saving an average of $1,200 dollars a year because of those declines.

Market-driven reforms in the 2003 Medicare Modernization Act are working to provide more choices and lower prices.

Rather than establishing a one-size-fits-all government benefits package, the part D program allows beneficiaries to choose from a range of plans that meet their unique needs and circumstances.

It is also important to note that the current private sector negotiating power of part D is greater than a government-run Medicare program. We have heard much from the other side about a government-run program having a bargaining power, but in fact, the four top pharmacy benefit managers cover over 200 million individuals. So they not only negotiate on behalf of the seniors in part D but also on behalf of all the other beneficiaries in their programs throughout the United States, including most Members of Congress in the Federal Employees Health Benefit Plan. So this is over 10 times the number of Medicare beneficiaries than the Secretary would negotiate on behalf of.

Despite these facts, Democrats are continuing to push a bill that could significantly disrupt and dismantle the successful and popular Medicare prescription drug program. They want to remove private competition forces from this successful equation and, instead, have the Secretary of Health and Human Services interfere in and implement a price control system.

Medicare part D is successful because seniors are able to choose plans that cover their drugs and best meet their health needs. Government bureaucrats, instead, would be replaced and would choose what drugs seniors would get, and these bureaucrats would be allowed to set prices for Medicare covered drugs.

The government should not be responsible for making decisions that should be left to seniors. Currently, seniors are able to choose plans. I think we should continue to allow seniors to make their own choices and keep bureaucrats out of seniors' medicine cabinets. The Medicare prescription drug program is working, and we would be wise to resist the Democrats' plan to fix what is not broken.

We can continue to improve prescription drug programs, but we must closely examine these changes so Congress does not do more harm than good by enacting new policies. I encourage my colleagues to vote ``no'' on this bill.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield for purposes of controlling time to the ranking member of the full Ways and Means Committee, the distinguished gentleman from Louisiana (Mr. McCrery).

Mr. Speaker, I yield 2\1/2\ minutes to a distinguished member of the Ways and Means Committee, the gentleman from Wisconsin (Mr. Ryan).

At this time, Mr. Speaker, we reserve our time.

Mr. Speaker, I yield for the purpose of making a unanimous consent request to the gentleman from Iowa (Mr. Latham).

(Mr. LATHAM asked and was given permission to revise and extend his remarks.)

Mr. Speaker, at this time I yield 2 minutes to a distinguished member of the Ways and Means Committee and the Health Subcommittee, the gentleman from Texas (Mr. Sam Johnson).

Mr. Speaker, I yield 2 minutes to the gentleman from Texas, the distinguished member of the Ways and Means Committee, Mr. Brady.

Mr. Speaker, I would like to place into the Record four letters, from the American Legion, the Lou Gehrig's Association, the National Alliance on Mental Illness and the American Autoimmune Association, all opposed to H.R. 4, concerned about its effect on the prescription drug benefit for seniors.

The American Legion,

Washington, DC, January 11, 2007.

Hon. Nancy Pelosi,

Speaker, House of Representatives,

Washington, DC.

Dear Speaker Pelosi: The American Legion urges you and your

colleagues to reevaluate the ``noninterference'' provision of

Chairman Dingell's proposed legislation, H.R. 4, The Medicare

Prescription Drug Price Negotiation Act of 2007. It would

amend part D of title XVIII of the Social Security Act to

require the Secretary of Health and Human Services to

negotiate lower covered part D drug prices on behalf of

Medicare beneficiaries.

Each time the Federal government has enacted pharmaceutical

price control legislation, the Department of Veterans Affairs

(VA) has experienced significant increases in its

pharmaceutical costs as an unintended consequence. A

fundamental principle in the price negotiation process so

that the ``lowest price'' establishes the baseline. By simply

raising the baseline, it sustains or possibly increases the

corporate bottom line based on the projected increased volume

in sales. An increased baseline minimizes the margin in

future price negotiations.

The American Legion strongly urges you and your colleagues

to seriously consider the collateral damage that would result

from listing the current ``noninterference'' provision in

section 2 of H.R. 4 on VA's formulary and the Federal Supply

Schedule. This ``noninterference'' provision is not in the

best interest of America's veterans and their families. VA is

a health care provider, whereas Medicare is a health insurer.

Any possible Medicare savings would likely result in a

reciprocal cost to VA.

Sincerely,

Paul A. Morin,

National Commander.

Mr. Speaker, I yield 1\1/2\ minutes to the gentleman from New Jersey (Mr. Frelinghuysen).

(Mr. FRELINGHUYSEN asked and was given permission to revise and extend his remarks.)

Mr. Speaker, I yield 1 minute to the gentlewoman from Illinois (Mrs. Biggert).

Mr. Speaker, I yield 1 minute to the gentleman from Nebraska (Mr. Smith).

Mr. Speaker, I yield 1 minute to the gentleman from Georgia (Mr. Gingrey).

Mr. Speaker, I yield 1 minute to the gentleman from Texas (Mr. Sessions).

Mr. Speaker, I would include in the Record a letter from the Congressional Budget Office saying that CBO estimates H.R. 4 would have a negligible effect on Federal spending.

U.S. Congress,

Congressional Budget Office,

Washington, DC, January 10, 2007.

Hon. John D. Dingell,

Chairman, Committee on Energy and Commerce,

House of Representatives, Washington, DC.

Dear Mr. Chairman: At the request of your staff, the

Congressional Budget Office has reviewed H.R. 4, the Medicare

Prescription Drug Price Negotiation Act of 2007, as

introduced on January 5, 2007. The bill would revise section

1860D-11(i) of the Social Security Act, which is commonly

known as the ``noninterference provision'' because it

prohibits the Secretary of Health and Human Services from

participating in the negotiations between drug manufacturers,

pharmacies, and sponsors of prescription drug plans (PDPs)

involved in Part D of Medicare, or from requiring a

particular formulary or price structure for covered Part D

drugs.

H.R. 4 would require the Secretary to negotiate with drug

manufacturers the prices that could be charged to PDPs for

covered drugs. However, the bill would prohibit the Secretary

from requiring a particular formulary and would allow PDPs to

negotiate prices that are lower than those obtained by the

Secretary. The bill would also require the Secretary to

report to the Congress every six months on the results of his

negotiations with drug manufacturers.

CBO estimates that H.R. 4 would have a negligible effect on

federal spending because we anticipate that the Secretary

would be unable to negotiate prices across the broad range of

covered Part D drugs that are more favorable than those

obtained by PDPs under current law. Since the legislation

specifically directs the Secretary to negotiate only about

the prices that could be charged to PDPs, and explicitly

indicates that the Secretary would not have authority to

negotiate about some other factors that may influence the

prescription drug market, we assume that the negotiations

would be limited solely to a discussion about the prices to

be charged to PDPs. In that context, the Secretary's ability

to influence the outcome of those negotiations would be

limited. For example, without the authority to establish

formulary, we believe that the Secretary would not be able to

encourage the use of particular drugs by Part D

beneficiaries, and as a result would lack the leverage to

obtain significant discounts in his negotiations with drug

manufacturers.

Instead, prices for covered Part D drugs would continue to

be determined through negotiations between drug manufacturers

and PDPs. Under current law, PDPs are allowed to establish

formularies--subject to certain limits--and thus have some

ability to direct demand to drugs produced by one

manufacturer rather than another. The PDPs also bear

substantial financial risk and therefore have strong

incentives to negotiate price discounts in order to control

their costs and offer coverage that attracts enrollees

through features such as low premiums and cost-sharing

requirements. Therefore, the PDPs have both the incentives

and the tools to negotiate drug prices that the government,

under the legislation, would not have. H.R. 4 would not alter

that essential dynamic.

I hope this information is helpful to you. The CBO staff

contacts for further information are Eric Rollins and Shinobu

Suzuki.

Sincerely,

Donald B. Marron,

Acting Director.

Mr. Speaker, I yield 1 minute to the gentleman from Alabama (Mr. Bachus).

Mr. Speaker, at this time I yield 1 minute to the gentleman from Texas (Mr. Hensarling).

Mr. Speaker, at this time I yield 1 minute to the gentlewoman from West Virginia (Mrs. Capito).