Mr. Speaker, I thank the gentleman for yielding. The gentleman and I did have an opportunity to listen to the last group speaking on the floor, and while they seemed very sincere, and I say this respectfully, they are freshmen Members, and…
Mr. Speaker, I thank the gentleman for yielding. The gentleman and I did have an opportunity to listen to the last group speaking on the floor, and while they seemed very sincere, and I say this respectfully, they are freshmen Members, and they have been here for 6 months. The gentleman from New Jersey and I have been here for over 10 years, we sit on the Subcommittee on Health, and we have been through this debate a number of times.
When we look at it, much of the emphasis by the last group that spoke simply is not found in the bill that will be put forth before our committee starting at 1 p.m. tomorrow. It will be before the full committee starting at 1 p.m. Last year, we went 24 hours around the clock, actually it was 36 hours, we ended at 6:30 in the morning. The other group before us said the debate has begun. There will be no debate. When we start our markup tomorrow at 1, we will do our opening statements. Then we will start presenting amendments. We both have some amendments, other Democratic Members will have amendments. Some Republicans will have amendments. But I can tell Members standing here right now, of the Democratic amendments, none of them, or at least any meaningful Democratic amendment that is put forth will be accepted by the majority party. There will not be a debate. It will be their way or no way.
Mr. Speaker, let me be very clear. A few hundred feet from here the Senate is putting forth a bill that seems to have some bipartisan support, and many of us on the committee, Democrats and Republicans, have looked at it and we think there is an area which we can work with in the Senate bill.
The bill we start marking up tomorrow is not the Senate bill. It is not even close to the Senate bill. It does not reflect the Senate bill. The bill we see tomorrow that we will have in our committee and begin to markup will say this: It will privatize Medicare by 2010. It will force seniors into a voucher plan. In other words, seniors are going to get a voucher to purchase not only their prescription drugs, but also their Medicare.
If you cannot afford anything over and above that voucher, you are going to be left behind as they privatize a system that has served our seniors for so many years.
Thirdly, it will not cover every senior. This plan that is going to be put forth tomorrow, we looked at it tonight to get ready for it tomorrow, has a gap in it. Once you hit $2,000, you go off the coverage. You continue to pay your monthly premium, which is anticipated to be about $35, and you get no coverage for it, and you stay there until you incur up to $3,700 out of pocket, and then you kick back in. There is a gap. The gap is designed for most seniors who fall between the $2,000 and
$3,000, that is their out-of-pocket expense for prescription drug coverage, so you are going to be paying a premium and getting no coverage? It does not make any sense. It is truly a gap policy. We have had this debate before. So look very closely and watch the markup in the Committee on Energy and Commerce.
The last group talked about, the last group of Members wanting to debate it, I am happy to come down here Wednesday evening, I am sure the gentleman from New Jersey would, too, and let us talk about it. The reason why I say Wednesday is because Tuesday we start the markup at 1 o'clock; we will still be going most of the day Wednesday. So why not come back here and have a real good, honest debate about this bill, because the bill described, and again I think with all sincerity to the other group that was here earlier, just is not the bill we are working on tomorrow.
The House Republican prescription drug plan is not the Senate bill. Many of us have looked at the Senate bill. There are some areas we can work with, and we look forward to doing that. So while we seem to have some negotiating going on a few hundred feet away by the other body in the Capitol here, we will not even get a simple amendment to be offered tomorrow by many of us, will be defeated on a party-line vote, there will not be any debate, there will not be any negotiations, there will not be any working together.
Why is this bill suddenly coming on our calendar? I think the House Republican leadership realized that the Senate was gaining a little momentum, they do have a bill that is starting to take on some bipartisan cooperation here and they are farther ahead than the House is on Medicare. So what do they do? They roll out the plan they had last year which barely passed this House and did not go anywhere because it really does not provide prescription drug coverage for all Americans. It is not affordable. Many of us will be left behind.
When you take a look at it, I come from northern Michigan, a very rural district. I have half the State of Michigan. I am a very rural district. This scheme put forward by the Republicans tomorrow starting in our Committee on Energy and Commerce simply will not work. This plan puts seniors in the same dilemma as we saw last year. They will be asked to give up traditional Medicare and be forced into an HMO with a private insurance plan backing it up.
An HMO is nothing more than a private insurance plan. They want to take traditional fee-for-service Medicare, force you in this HMO and they say, when you do this, you will have choice. You can stay in your traditional plan, pay a heck of a lot more, or you go into our HMO. I am from northern Michigan. I do not have the Federal employees health insurance program. I said when I ran for office, I would not take any kind of health care from the Federal Government until all Americans had it. So I do not accept even their prescription drug plan we have here.
I have a plan that I have had in place for a long time. Unfortunately, this year this plan is doing much like the Republican plan. It has decided to put me in an HMO, a PPO, preferred physician organization. I can stay in my traditional plan, or I can go into the PPO. Being from northern Michigan where we have a small population base spread out over many, many miles, there are not enough people there to go into an HMO, or a PPO. So while I have this insurance card that says I get this 80/20 coverage, the reality is that none of the doctors or the pharmacies in my area participate in this PPO. Therefore, I have to pay out of pocket what the PPO will not pay. Since I am not in their plan, they do not get the reduced rate for me. So instead of being 80/ 20, I am paying about 50/50. Every time myself or my family have to go to the doctor, we have to shell out 50 percent and the so-called insurance or private insurance company will pay the other 50 percent. My deduction has gone up, they cover less; and since I am in a rural area where they do not have PPOs or HMOs, I have to pay more.
Look what happens when you go to these HMOs or PPOs. They are nothing but insurance plans. What has happened to the cost of insurance in the last couple of years? It has gone up 25, 35 percent. If we allow them to put in this voucher system and give every senior in this country a voucher and say, you would have your choice, go buy the plan you want, you are buying private insurance. They are not going to be able to afford it. Seniors are on a fixed income. They cannot afford a 25, 35 percent increase. No matter where I go in my district, and I was in my district today talking to the credit union league, the Blue Ox Credit Union chapter out of Alpena, Michigan, and what were they telling me? The cost of the health insurance has gone sky high. Not only are they concerned about prescription drug coverage that they would like to see for their parents and grandparents, but just the simple cost of insurance has gone up 25, 35 percent.
The local credit unions cannot even afford to cover their employees anymore. So we are going to force seniors, take away traditional Medicare, put them into this insurance plan, if you will, give them a voucher; whatever your voucher pays for, that is what you get. If you want anything more than that, you are going to have to pay for it. How are they ever going to keep up with these costs of insurance that we see in a private plan? It does not make any sense to me. Medicare is sound. Ninety-seven percent of all seniors in this country are part of Medicare. It is one of the best-run programs. Less than 1 percent of every dollar, less than one penny is used for the administration of the program. Sure it costs a lot of money. Seniors are living longer. That is the success of the Medicare program. Should we have a prescription drug benefit plan? You bet. We Democrats will be in the markup fighting for it. We are going to take a look at that Senate plan, and hopefully we can make it part of it.
I have always advocated the Federal Supply Service. In this country, the biggest purchaser of prescription drugs is the Federal Government. We provide drugs for the Veterans Administration, we provide drugs for Medicaid, we provide drugs for Indian Health Services and government services. There is an agency within the Federal Government called Federal Supply Service, FSS. The Federal Supply Service sits down and negotiates with the drug companies. Since we are the biggest purchaser, the Federal Government is, we get the best possible price, and we negotiate it with the drug companies for no matter what the medication is. We negotiate that price.
In a survey done by the Committee on Government Reform in my district, I am sure they have done it in the district of the gentleman from New Jersey, found that if we could use the Federal Supply Service price, use the purchasing power of the Federal Government and have the seniors go buy their drugs at their local pharmacy, we could reduce the cost of those drugs by 40 to 50 percent. For instance, if I do not have any insurance, let us take Zocor, to lower your cholesterol. The last time we did this survey which was in 2000, it was just over $100 for a 30-day supply of Zocor. If I am under the Federal Supply Service, the FSS, it costs $42.
Why can we not use the purchasing power for those seniors who do not have some kind of prescription drug coverage or MediGap policy and pass that on to them? We do not need a part D of Medicare. We do not need a new program that costs billions of dollars. The infrastructure is already set up. Why can we not do that? That will be one of the amendments we will be offering in our markup on prescription drug coverage. And I am sure like last time, the Democrats will vote for it, all the Republicans will vote against it, and we will end up losing that argument. But here is just a simple idea without creating more Federal Government, bigger bureaucracy: take the purchasing power of the Federal Government and pass it on to our citizens. It makes sense to me. But instead, we are going to have this big scheme, they are going to call it part D of Medicare, they are going to give you a voucher and move you into a private insurance company. They are going to provide you with this policy that has a gap in it between those who have 2 to $3,000 worth of coverage, you are going to pay your monthly premium but you get no coverage, it is called a gap policy, and then they are going to privatize Medicare with this voucher and it is not the Senate plan.
I would have thought they would at least bring forth the Senate plan, attempts to privatize Medicare by relying upon health insurance companies to offer Medicare benefits in rural areas. We already know it has failed. Rural areas are smaller, less population, we are spread out. These areas just are not appealing to big private insurance companies when they can operate with higher profits in densely populated areas.
Plus, let us face it. The HMOs, the PPOs, these private companies, if they are not forced to take everybody, they will cherry pick. They only want the healthiest seniors in their plan. They do not want those who have chronic illnesses or disease, or maybe cancer or heart disease running in their family; they do not want them part of their plan. Why? Because it costs too much money. So these programs of Medicare+Choice and HMOs and all this really just do not exist in rural areas for that reason, because the private companies pulled out when they realized they could not make any more money. They cherry pick and only want the healthiest ones. In fact, I think in the last year, if my memory serves me correctly, 400,000 Americans have lost their insurance coverage under Medicare, Medicare+Choice in this country, because they pull out. As soon as they stop making money, they pull out and they leave you. If you look at the Republican proposal that will be before our committee tomorrow, there is no way you get back in. If your HMO or PPO or Medicare+Choice plan pulls out of your area, what remedy do you have to get back into the system? There is not one. That is one of the problems with this bill.
So when we walk into the Committee on Energy and Commerce meeting starting at 1 o'clock tomorrow, you can be sure that we will be there to fight this amendment to protect Medicare so that it will be available to all seniors and all disabled Americans no matter where they live and no matter what their income is.
When you take a look at it, another part of this bill that bothers me tremendously is the Republican bill. Again we saw it last year. We debated it for 36 hours in committee. None of our amendments were made in order. But if you take a look at it, there is nothing there to reduce the price of prescription drugs. You give people a voucher, you have nothing to reduce the cost in increase of insurance, there is nothing there to reduce the price of your prescription drugs. The voucher might work for a year or two, but then the insurance is going to catch up to you and you are going to have to pay more for that voucher, and you are going to get less coverage for your pharmaceuticals.
The bill does not include any provision to hold down pharmaceutical prices that the big drug companies charge. There is not even a guarantee in the Republican bill as to what your monthly premium is going to be. In fact, I am glad the gentleman from New Jersey brought it up, there is also language in this bill that states, the Secretary of Health and Human Services will be forbidden from negotiating for better drug prices on behalf of the American people. What happened when we had the anthrax coming in here? Remember we had Cipro; we had companies who were willing to make Cipro for us. They wanted $3 a tablet. The Secretary of Health and Human Services did his job, went and negotiated; we have got Cipro now being produced to provide us all over the country. What did he do? He negotiated a price to about $1 a tablet, two-thirds of a savings they achieved just through simple negotiation, again going back to Federal Supply Service, used the purchasing power of the Federal Government to bring down the cost.
In this bill we will be marking up tomorrow, it is called the noninterference clause, which prevents the Secretary of Health and Human Services to negotiate on your behalf to lower your drug prices. When you get that voucher, who is going to stand and negotiate for you? The drug companies? The insurance companies? No, they have got a vested interest. So you would look to the Secretary of Health and Human Services, and you would think the Federal Government would be there, it is their plan, that they would be negotiating a price for you. They are forbidden from doing it.
There are many, many more interesting provisions in this Republican scheme that we will see over the next few days. This plan intends to, with all due respect, bribe private insurance into a scheme, that rural areas will be shunned under this plan, just as we have been in Medicare+Choice. This idea could result in rural seniors getting stuck with higher premiums compared to our counterparts or beneficiaries who live in the cities.
I will introduce an amendment just like I did last year, because we saw the same thing. My amendment last year ensures that seniors, no matter where they live, rural, urban, will not pay higher premiums than their counterparts in the cities. No matter where you live, my amendment will say, you will pay the same monthly premium, whether you live in New Jersey or Michigan, Detroit or Menominee, Michigan or Alpena, you are going to pay the same monthly premium. That will be an amendment we will bring. I can predict right now on a party-line vote, we will lose that amendment. So urban areas would pay less than the rural areas under the Republican scheme. If you are going to subsidize these companies, whether it is insurance companies or the pharmaceutical companies in the name of undercutting Medicare, it is reprehensible that you are going to stick it to the poor rural seniors who will have to pay more for a doomed experiment in privatization with Medicare, a system that has worked so well.
As I said earlier, the Republican plan has no set premium or cost sharing. In other words, insurance companies would design a prescription drug plan, deciding what to charge you and what drugs they want to cover. The Republican plan will in many cases deny coverage for medicines that a doctor may choose to prescribe for you and would really require seniors to change pharmacies or change coverage.
The Democratic plan that we will put forth, and there are going to be two or three of them, will guarantee prescription drug coverage under Medicare. It will guarantee fair drug prices. It will guarantee a premium of only $25 per month, $100 yearly deductible, and the maximum our beneficiaries would pay under the Democratic plan out of pocket is $2,000 per year. Some people say that we cannot do that, that is just too expensive. We just provided universal healthcare service for Iraq, in the Iraqi bailout bill. $79 billion we spent. In there was a provision to provide universal health service in Iraq. If we can provide universal health service and prescription drug coverage in Iraq, can we not do it here in this country? And will it cost us a few bucks? You bet, because we are a much better country, but I think it is something our seniors deserve and we will be there.
The Republican plan is not a real Medicare benefit. It is based upon a privatization model that has failed in my district and will fail throughout this country. We will continue to fight in the Committee on Energy and Commerce to ensure that every senior, regardless of where they live, will be able to obtain prescription drugs they require to live a healthy life and that this coverage will be provided through the Medicare program. No gimmicks, no so-called reform, which really means privatize it. It is going to be a straight-up proposal put forth by the Democrats. And I hope we can have a meaningful discussion in the committee, but having been here more than 10 years and having sat on this committee now for 9 years, the Health Subcommittee, when one party gets control, unfortunately any amendment put forth by the other party in good faith to even negotiate or bring forth a point is usually voted down on a party-line vote.
So once again, as I started tonight, and I appreciate the gentleman yielding to me, I would ask our Republican friends who spoke a little earlier, let us sit down Wednesday night here and let us have a debate on this, what plan really covers who, what, when, where and how. And I think that is only fair. By then we would have a day and a half debate in the Committee on Energy and Commerce. We can see the shape of the bill, and let us come back before the American people and debate the merits of the plan because there is no doubt in my mind, the plan that we will be seeing on this House floor is not
the plan the Senate is negotiating in a bipartisan manner. It is a bill that we saw last year which is a voucher system, which privatizes Medicare, has a gap in coverage, and for those of us in the rural areas it certainly will be discriminatory towards us not only in coverage, but also in price.
So with that I yield back to the gentleman from New Jersey. I thank him for the opportunity to be here tonight, and if he has any questions, I will stay for a little while longer. But I also see the gentleman from Washington (Mr. McDermott) has joined us. I am sure he has a lot of insight on this, being a physician, or a psychiatrist, I should say.
As you were saying, if the Secretary of Health and Human Services cannot negotiate, so we give your mother, who is 93 years old, this voucher, who negotiates for her? It is $4,500. There is no guarantee it will not go up. What happens if it does go up?
So how do these plans, who are not under the care of the government, keep your costs down? They will restrict the access to the pharmaceuticals, because that is the most rapidly rising part of health care. So instead of providing that benefit, they will provide you with a voucher to take care of all your health care needs and then for the prescription drugs, if you have some left over, but only if that plan will cover the prescription drug you need.
It is really crazy. Any drug that is not in the plan's formulary would not be covered. Beneficiaries would have to pay then 100 percent out-of-pocket of the costs of that drug because it is not in their plan, it is not in that voucher that they got. I think the gentleman from Washington makes a great point, how do we know what mine, yours or your parents' health care needs will be 3 or 4 years from now? Once you go into these plans, can you come back in to traditional Medicare? Probably, but at a cost you cannot afford.
So, the points brought up tonight are well taken, and I appreciate the gentleman coming and joining us from the Committee on Ways and Means. As you do your markup, we will be doing ours. And do not feel too bad. Those on the Democratic side, we have not seen the Republican proposal. We know we will see it tomorrow at 1 o'clock. Then we will make some statements about it, and then when the real markup begins, they will slip a substitute in there so we will be scrambling to make sure our amendments are corresponding to the bill, but we do not even have the courtesy to see it before we even begin this markup. Probably the greatest program we can put forth right now is prescription drugs. Our parents, we, everyone needs it. But yet here we are, the night before the beginning of the markup, whether it is the Committee on Ways and Means or the Committee on Energy and Commerce, and we cannot see the bill.
We are basing it upon past years' experience.
The gentleman from Washington said when we get these bills tomorrow, we will start working on them, and we are not sure where we can go with them.
I think we can guarantee the American people a number of things we will not do. We will not provide a voucher system. At least the Democrats will fight to make sure there is no voucher system.
We will not privatize Medicare and shift you into an HMO or some other
insurance company plan, Medicare-Plus, Medicare-Choice, whatever it is going to be.
We will make sure that any prescription drug plan, at least from our side of the aisle, will not have a gap in it, so those who have from $2,000 to $3,700 out-of-pocket cost will not be paying a premium and get nothing in return for it.
We know that the plan we will be seeing tomorrow, whether it is Ways and Means or Energy and Commerce, is not the bipartisan plan being put forth by the Senate. In fact, in Energy and Commerce we will probably put that plan forth in a bipartisan manner to try to get a plan that will truly work.
We Democrats will continue to fight to make sure and ensure that every senior, regardless of where they live, will be able to obtain prescription drugs that they require to live a healthy life, and this coverage will be provided through a Medicare program that cannot be taken away or you are priced out of it.
Well, we have sat through the budget battles, the gentleman and I, and through the committee now for about 10 years; and we have seen first to start out was Medicare Choice, Medicare+Choice, Medicare Access; they always have these nice names. They said, okay, so many seniors can go into it. Every year we have never hit the target yet for what we have provided as an experiment. Because what happens is that they come in, start to insure in an area, see the costs are going up a little too much, and then they pull out, and then the seniors have to scramble to try and get coverage, and it just has not worked at all.
Mr. Speaker, it is not going to work for prescription drugs; and let us face it, they are going to get a prescription drug plan and if they take their plan, they are going to give up traditional Medicare, get a privatization of it, a voucher with a gap for prescription drug coverage. It is not going to work. It is not the Senate plan. They are not even guaranteed a price, and no one is there to help them out. They are on their own. This choice sounds great; but what seniors want is the security that Medicare provides, not some choice that they cannot understand or be able to predict what is going to happen 3 or 4 years from now.