Mr. President, I rise to talk about the bill before us. When the Senate first voted on a prescription drug benefit for seniors back in June I offered an amendment. My amendment was simple. I proposed that we give seniors a prescription…
Mr. President, I rise to talk about the bill before us.
When the Senate first voted on a prescription drug benefit for seniors back in June I offered an amendment. My amendment was simple. I proposed that we give seniors a prescription drug benefit sooner rather than later. But that amendment was voted down by the Republican majority.
So now, under this conference report, the drug coverage doesn't start until January 2006 23 months from now. Yes, 2006.
So why so long? One clue is illustrated on this chart. Notice that Election Day is 11 months from now. And notice that the prolonged effective date for the drug benefit is conveniently well past election day.
I would like to remind my colleagues that the original Medicare plan was signed into law by President Johnson on July 30, 1965 and 11 months later July 1, 1966--all the people who were eligible for the program were enrolled in the program.
The entire system was created from scratch in 11 months.
I know the President is desperate to take credit for passing a prescription drug bill when he faces voters next year. But he does not want the many shortcomings in this plan to be fully evident to seniors until well after the election. My Republican friends are hoping that seniors won't find out what they don't get from this legislation until it is too late. It is almost a cruel joke.
When a prescription drug benefit is signed into law, all of our offices will be flooded with calls by seniors asking a simple question: ``How can I sign up for this benefit?'' They will have seen President Bush sign a bill with great fanfare, and they will have seen many Members of Congress crowding the stage with him, and everyone will say ``we have put a prescription drug benefit in place.''
And when seniors call to find out how soon they can receive the benefit, we will have to tell them ``2006.'' Sorry, President Bush's 2003 Medicare Prescription Drug plan will not start until 2006.
No one wants to provide a real Medicare prescription drug benefit to seniors more than the Democrats. After all, Democrats created Medicare, and we have protected it for decades.
Everyone knows that Republicans resisted the creation of Medicare and have opposed it ever since. It wasn't too long ago that former House Speaker Newt Gingrich expressed his desire to see Medicare ``wither on the vine.''
Well, the bill before us today is the first major step toward the disintegration of Medicare as we know it.
In reality, this bill isn't as much a benefit for seniors as it is a big benefit for HMOs and other private sector special interests who want to tear the Medicare program to pieces.
So, what is it specifically that the President is afraid seniors will find out before 2006?
Is the President afraid that seniors will realize they are going to pay at least $810 before they break even and get any benefit from this plan?
For many seniors that is more money than they spend on prescription drugs right now. Up to 30 percent of beneficiaries would pay more for enrolling in the plan than they would receive in actual benefits.
Is the President worried that seniors are going to discover that there is a huge gap in coverage?
Under this plan, a senior will pay a premium estimated at $35 a month, a $250 deductible, and 25 percent coinsurance payments until reaching $2,250 in drug expenses. What happens then? Seniors get no coverage. You heard me correctly nothing, zero.
That is right. At that point, seniors will continue to pay their premiums but they will also pay 100 percent of their drug costs. Only until they have reached the catastrophic limit of $5,100 in drug costs does any benefit return. And by that time, seniors will have incurred $3,600 in out-of-pocket spending. This is called the ``hole in the doughnut'' and it sure doesn't sound like such a good deal to me.
And remember that nowhere in this bill does it say that the premium is only $35. It could be significantly higher. The $35 figure is an estimate. We all know how good this administration has been at making estimates.
Is the President afraid that seniors will figure all this out? You bet he is.
Seniors deserve a much better program than what the Senate is considering right now, and they certainly deserve it before 2006.
There are some who will say we must have this gap in coverage because we only have $400 billion to work with. Well, I say if there are insufficient funds in the budget to give seniors real drug coverage, then it is the result of choices made by the President and his party. They chose to provide a massive tax cut to the wealthy the people who need it least and they chose it at the expense of Medicare.
What else is in this bill that the Republican's don't want seniors to find out about until 2006?
This bill will effectively destroy the Medicare program that has worked for almost 40 years. That is right. Say goodbye to Medicare as we know it.
This bill does not expand Medicare; it opens the door for HMOs to take over the program. And that means that seniors will be at the mercy of these HMOs. And as everyone knows, HMOs will not pay for all prescription drugs.
Under this bill, seniors will be limited to the prescription drugs covered by their drug plan or HMO. In order to keep costs down, these drug plans and HMOs will use something called a ``formulary.'' A formulary is a list of drugs that are covered under the health plan. If a particular drug is not on the formulary then it is not covered.
That means that after a senior has paid her premium and her deductible if she needs a certain medication not on the list used by her drug plan or HMO, then she will pay 100 percent of the cost of that medication.
Where is the benefit in that?
Mr. President, this bill goes to great lengths to prop up and protect HMOs at the expense of seniors. Included in this bill is something called the ``Stabilization Fund.'' It should be called the ``HMO Slush Fund.'' This fund is designed to ensure that HMOs succeed by offering artificially lower premiums and better benefits than traditional Medicare. This bill hands over $12 billion of taxpayer money for this effort.
This is $12 billion that could be used to close the coverage gap or lower the deductible but our Republican friends have made a choice to create a $12 billion slush fund for the insurance industry.
I want to spend a few minutes talking about the overall impact of this bill on seniors in the State I represent--New Jersey.
The most important reason why I am voting against this bill is because I am convinced that more seniors in my State will be hurt by this legislation than helped.
There are approximately 1.1 million seniors in New Jersey.
Currently 430,000 New Jersey retirees receive prescription drug coverage from their former employers. Because this bill provides a disincentive to employers to continue offering coverage to retirees, over 90,000 seniors in New Jersey will lose their existing drug coverage, which often offers more generous benefits.
This bill is also going to make poor seniors in my State worse off. In New Jersey, Medicaid covers the drug costs for seniors up to 100 percent of the federal poverty level. That is an income of approximately $9,000 a year for an individual or $12,000 a year for a couple.
In New Jersey, low-income seniors currently on Medicaid have access to whatever drugs they need and they don't have any co-pay for their prescriptions. Under this bill, however, they will now pay $1 per prescription for generic drugs and $3 per prescription for brand name drugs.
Low-income seniors tend to be in worse health and, as a result, they have higher annual drug spending. A senior with an annual income of $7,000 or $8,000 simply doesn't have the discretionary income to shell out $15 or $20 or $25 for the prescriptions that he or she may need.
That may not sound like a lot of money to my colleagues, but for low- income Americans, it can force them to choose between buying medication and buying food or buying medication and keeping the heat turned on in the winter.
Mr. President, this bill represents an enormous opportunity squandered. We had a real chance to do something right here. We had $400 billion to improve the lives of 34 million seniors, 14 million of whom don't have any prescription drug coverage right now. Frankly, we blew it.
When I look at this bill, I see a bill that makes seniors in New Jersey worse off.
I see a bill that makes poor seniors worse off.
I see a bill that takes away choices from seniors.
I see a bill that wastes taxpayer money on a slush fund for HMOs.
I see a bill that ``hides the ball'' until 2006.
And I see a bill that I cannot, in good conscience, support.
I yield the floor.
I have a question, Mr. President, about the process. Is the time available under the cloture rule divided between two sides in equal parts?
So that any speeches now are made under cloture.
I thank the Chair.
I thank my colleague from New York for her eloquent statement and her perception about what is really taking place in front of us. We both have the good fortune to share one of the most interesting areas of this country, the center for finance, industry, and trade, and people, yes, who have to work hard to maintain their living in this high cost area that we share.
One of the problems we see in both of our States is that unemployment is unreasonably high; that people who used to work in manufacturing in the New York City region, in New Jersey, have lost jobs that are not available to be regained. It is a pity, but what has happened is that they were sold out to cheaper prices. We are looking for things cheaper while many of us revel in the fact we can live by such luxurious standards.
What does it tell us? It tells us there is a significant imbalance out there in the way people earn their livings, live their lives. That is one of the things that is so much in our view today when we talk about the outcome of the vote thus far on this purported Medicare bill. It does not have the ``care'' and I am not sure it even has the interest.
One of the things we are looking at is whether or not people who have had the good fortune, as I have--as said by the Senator from New York, I have had very good fortune. My father died when he was 43. His father died when he was in his middle fifties. His brother died when he was in his early fifties. I think the cause of death was probably occupational. They all worked in the same factories in the city of Patterson, NJ, where I was born. My father's death left a permanent imprint on me because of the circumstances of how and when it occurred.
My father was 43 in the year 1943. He lived his life by the healthiest of standards, including the food that he ate. He disavowed smoking in a very vigorous way. He was not someone who drank a lot of coffee. In fact, he did not drink any coffee. He enjoyed his nonworking time by being in a gymnasium. They did not call it ``workout'' then. They called it exercise. They called it the ``gym.''
So he would spend time down there. He used to like to lift weights, wrestle, and play basketball. One day, he was not feeling well and he went to a doctor. The doctor informed our family that my father had colon cancer, a condition that gets ever rarer with the medical care we have today, if it can be afforded. No matter what we did, without the advances that we have today and medical technology and medicines, he suffered for 13 months. From a well built, muscular man, who was a picture of health to behold, he disintegrated before our very eyes until he died 13 months later.
My mother was 36 when my father died. She was a very young widow. I was 18. I had already enlisted in the Army. Why this story? Because it is seared so deeply in my memory. Not only were we grieving, we were poor, and my mother strained to make a living as my father was in his illness. I had a job loading trucks. That was my skill. That was my experience. We just about kept ends together.
When my father died, imagine a family of four--I had a little sister who was 12--grieving over the loss of a father at age 43, so young, and also at the same time worrying about bills that had to be paid, about obligations that occurred as a result of hospital treatment, bills that occurred because of doctors' visits, bills that we had to pay because we owed pharmacists money. That is what I remember. I thought, oh, my goodness, if only we could find the money to pay the bills so my mother and I didn't have to worry so much about our existence and at the same time honor our obligations. We were that kind of a family.
Then, as time passed, we saw developments in America that made us all proud and that, frankly, I think should have caused us in this body to be more tender, to be more understanding, to be more sensitive to the people who have been able to live long enough to be eligible for Medicare and Social Security and all of that that is intended to reward people for their work to build this country. Many of these people come from what has been described as the greatest generation. If they weren't exactly in that generation, they were in the generation that continued to build our country through the 20th century
to make this a stronghold of industry and business and technology and education. That is what these people did who are now concerned about how they continue their life.
Oh, of course, a lot of them can get jobs if they want them at school crossings, at $5.50 an hour, $206 a week--have a good time, go to a restaurant and have dinner. Not on your life.
That is what should have been thought about as we debated this issue. There was a certain degree, I saw, of smugness, as they pirated votes, giving lots of money--$11 billion, $12 billion to a special interest here, special interest there, here a special interest, there a special interest. It reminds me of a nursery rhyme. But that was no game that was being played. They held open the vote in the House of Representatives way beyond the rules. They did anything they could to bypass the process as it was normally.
I wish to show those who can see what I am holding, if I have the strength to hold them--I do. Those who witness this stack, who see it, this pile of paper, may say: What is the Senator talking about? This describes what was in this Medicare proposal in which the Democrats were not invited to participate. That is against the rules. The participation was limited. This was a stealth affair: Sneak it out, get it out there. Why? Because they don't want people to know what is in here.
Do you know what else? Here is a little smaller part of this whole package. This says: ``Joint Explanatory Statement.'' This tells the audience who might read this what is really in this stack here. It is all mysterious. It is all arcane--can't really understand what is happening.
Why is this debate so acerbic? Why is it that those of us, along with the senior citizens of this country, look as if we are losing this debate? It looks as if we are going to lose control of this issue. It is true, that we will have suffered a day in infamy, to steal an expression, because what happens here is we are going to assess poor people more costs.
I come from the corporate sector. I was fortunate to be able to create one of America's great companies with two other young fellows who lived in the same area as I did. Both of them, like me, had fathers who worked in the silk mills. That was the trade in the city in which we lived. They had no money. Their parents had no education. But it gave them the incentive to create something for themselves.
So we created a company. The company is called ADP. A lot of people know it. It is an international company with 40,000 employees. We started with nothing.
One of the things I learned as the CEO and chairman of that company, before I came to the Senate, was that the most important asset my company had was not its customers. The most important asset we had was its employees, because if the employees did their job, the customers were there for us. We could render a service that was an invaluable beginning to outsourcing, to giving specialists opportunities to do jobs that they could best do. But one of the things we had to do was to make sure the employees were considered in everything we did, including health insurance, including an early start with daycare, to make certain our employees were happy and thus productive.
I am happy to yield, with the proviso that I regain the floor.
I assume the time that would have been credited to me for my 1 hour, whatever time remains, is still available.
I thank the Chair.
What I got today was a request from one of America's largest companies. I will not identify them because they are not unique. But they wanted us to pass this bill. They don't make pharmaceuticals; they don't do anything in the health care field; they are not an HMO. They are a manufacturing company, a gigantic company by any standards. They are hoping we are going to pass this bill.
The reason they are hoping we would pass it is because then those retirees who are dependent on their health care continuation could be kicked off the system. Then, because of what we are saying in this bill--this hocus-pocus language that there will be some money to provide premium support for HMOs--go there and you will be able to get it cheaper, and this giant company, this unnamed giant company will be able to say: Whew, we are finally rid of those retirees who we promised we would give this care to all those years they worked for us. But now we don't have to keep that promise--no. All we have to do is say goodbye, thank you, we are eliminating coverage.
In New Jersey, it means that about 90,000 people are likely to lose their company-provided health care.
Coming from a State as I do--a State often called ``the Medicine Chest;'' it is a great State--we produce terrific products that make people feel better and help them live longer. I know because I use a couple of their products here and there. But the entire debate here is the result of the irrefutable fact that prescription drugs cost too much in this country. This bill doesn't do anything to fix that fundamental problem. All over the world, people pay less money for the exact same prescription drugs that they can buy cheaper in other countries.
In Italy, Acoplex is 40 percent less than here in the United States. In England, it is 31 percent less than here in the United States. And just to the north of us, our friendly neighbor, Canada, the price is 37 percent less.
No wonder seniors are getting on buses and making the trip to Canada to get their medication.
If you look at the things that we talk about, and see what happens when prices are not negotiated, the prices keep rising. From 2001 to 2002, drug prices rose 17 percent. The only way to lower drug prices is to give Medicare bargaining power--just the opposite of what this bill does. This bill says they want to prohibit giving what is normally called volume discounts. Instead of taking this step to lower prices, this bill explicitly forbids it.
The company I was talking about with a health plan has over 1 million employees. They want us to pass this bill. Imagine what happens when they say to their retired employees that they will be off their health care system.
We know from experience that allowing agencies to use bargaining power brings down prices. A good example of this is the health care system run by the Veterans' Administration. The VA is encouraged to negotiate prices. In this bill, as it presently exists, they forbid Medicare to negotiate prices.
I want to follow up on a point that our friend and colleague, Senator Bob Graham, made earlier today. This chart really tells the story. The chart compares VA-negotiated prices for medication with what it costs to buy from a local pharmacy.
By way of example, Acoplex, a stomach acid product, in the drugstore it is $4.37. At the VA it is 22 cents.
Let us take a product such as Zocor, to guard against high cholesterol which is very damaging to one's heart. If you want to buy it in the drugstore, you have to pay $3.77 per tablet, and if you are a member of the VA, their price is 66 cents. The list goes on.
At the drugstore for aspirin at 325 milligrams, the cost is 20 cents. If you buy it in the VA, it costs a penny.
Plavix to guard against heart attack and strokes, $3.63 per tablet; $2.01 if you go to the VA.
The list goes on with even better known products. The price comparison is ugly at best when you consider what happens with people on Medicare.
Mevacor reduces cholesterol--four bucks in the pharmacy and 26 cents at the VA.
Many of these medications make the top 50 list of drugs used by the elderly. We ought to learn from that and not prohibit the VA from negotiating volume prices.
Another troubling part in this bill is the effective date. When the Senate first voted on a prescription drug benefit for seniors back in June, I offered an amendment to make this benefit effective within 1 year. But it was voted down with strong Republican assistance. Eleven votes made the difference. We passed that amendment with bipartisan effectiveness to make this benefit effective within 1 year.
Under this conference report, the drug coverage doesn't start until January 2006, 23 months from now.
We have to ask the question: Why is this taking so long? One clue is illustrated on this chart. Notice election day in the yellow box; the original Medicare Program was processed in 11 months. President Johnson signed the law on July 30, 1965, and 11 months later, July 1, 1966, all of the people who were eligible for the program were enrolled in the program. I know something about computer processing. I literally had my career grow in the computer development stage. They had to create the files. The identification had to be punched into cards. They weren't read electronically in 1965 as they are now. It took 11 months and the whole deal was done. It was created from the beginning in 11 months.
Now we are asking for a toleration of 25 months to get it into place. But election day is here, and Heaven forbid that the public at large should find out about this bill. When they learn about it, they are going to be mad as could be.
If they can get safely past election day, the rhetoric is out there flooding the country. They even have the American Association of Retired Persons supporting the bill. That is a mystery that we are going to have to find out about one day. A lot of people we get calls from--Medicare recipients and beneficiaries--are ripping up their cards. We got one batch that was 75 to 2 against the bill. There were two who were doctors also who are concerned about whether they will be able to continue their practice as it was. It is a reasonable question. But 75 to 2--that is while this bill is being discussed. The bill is not yet in place.
Once the phone calls start coming into my office, I know what is going to happen. They are going to ask: When can we sign up? What are the benefits?
We are going to say: Hold your horses. What is the rush? It costs you a lot of money later on. Right now, we have your temper down. Not so much your temperature but your temper is going to go up once you find out after election day that this bill is going to take place with higher prices for medical care and prescription drugs.
The Democrats created Medicare. We protected it for decades. The Republicans never really liked it. They resisted the creation of Medicare and have opposed it ever since.
It wasn't too long ago that a very well known leader of the House, Newt Gingrich, expressed his desire to see ``Medicare wither on the vine.'' That is what he wanted to see happen. He represented a view that was generally accepted.
We may see it wither but not without a strong fight on our hands, even if we have lost step 1 here. The senior citizen population in this country has to raise the alarm and shout it out to those who are in this building and those who are in the House of Representatives. Tell them: We don't like that bill. It is going to cost us more. You are not helping us, you are hurting us. We worked our lives away with certain promises in place, and the promise included a proposition that said as you get older and as we see things develop, we are going to help you get those things to keep your health going.
The bill before us today is the first major step toward disintegration of Medicare as we know it.
In reality, this bill is not as much a benefit for seniors as it is a big benefit for HMOs, the private health care organizations, and other private-sector special interests who want to tear the Medicare Program to pieces. Get them in corporate hands so we can charge more, make more. I wonder whether we could limit the incomes of some of the guys at the top of these companies, in the interest of public service? We regulate lots of industry.
So what is it specifically the President is afraid seniors will find out before 2006? Is the President afraid the seniors will realize they will pay at least $810 before they break even and get any benefit from this plan? For many seniors, that is more money than they currently spend on prescription drugs. Up to 30 percent of the beneficiaries would pay more for enrolling in the plan than they would receive in actual benefits. Is the White House worried seniors will learn there is a huge gap in coverage? Under this plan, a senior will pay a premium estimated at $35 a month, a $250 deductible, 25 percent coinsurance payments until reaching $2,250 in drug expenses.
What happens then? Seniors then get no coverage. I have been heard correctly: Zero coverage. At that point, seniors continue to pay their premiums but they will also pay 100 percent of their drug costs. That is a double whammy, as we say in New Jersey. Only until they have reached a catastrophic limit of $5,100 in drug costs does any benefit restart. By that time, seniors will have incurred $3,600 in out-of- pocket spending. This is the so-called hole in the donut. It does not sound like a good deal to me.
Remember, nowhere in the bill does it say that premiums will be only $35. It could be significantly higher. The $35 is a current estimate. We know how good this administration has been at making estimates. Is the President afraid that seniors will figure all this out? You bet. Seniors deserve a much better program than that which the Senate is considering right now. They certainly deserve it before 2006.
I will spend a few minutes more talking about the overall impact of this bill on seniors in the State I represent, New Jersey. The most important reason I am voting against this bill is I am convinced more seniors in my State will be hurt by this legislation than helped. There are approximately 1.1 million seniors in New Jersey. Because this bill provides a disincentive to employers to continue offering coverage to retirees, it is estimated that over 90,000 seniors in New Jersey will lose their existing, more generous retiree drug coverage from their former employer.
This bill is also going to make poor seniors in my State worse off. In New Jersey, Medicaid covers drug costs for seniors with incomes of less then $9,000 a year for an individual or $12,000 a year for a couple. In New Jersey, low-income seniors currently on Medicaid have access to whatever drugs they need and they do not have a copay for their prescription. Under this bill, however, they are now going to pay $1 per prescription for generic drugs and $3 per prescription for brand name drugs.
Low-income seniors tend to be in the worst health and have higher annual drug spending. A senior with $8,000 annual income does not have the discretionary income to shell out $15 or $20 or $25 for the prescriptions he or she may need.
I will long remember the battles we have had in the Senate to try to raise the minimum wage. It is the old rhyme that says: Try, try again. We tried, we tried, and we tried, but we could not raise it. So there are people out there who are working for $5.15 an hour, $206 a week. Having to pay these extra burdens for their prescription drugs is going to be a torturous outcome for them. The low-income Americans can be forced to choose between providing medication or buying food, providing medication or keeping the heat on in the winter.
This bill represents an enormous opportunity squandered. We had a real chance to do something right. We had $4 billion to improve the lives of 34 million seniors, 14 million of whom do not have any prescription drug coverage right now. Frankly, we missed the opportunity. We ought to scrap this plan and go back to the drawing board to give seniors a real prescription drug
benefit in the Medicare Program. Let's not try to move seniors into HMOs. Let's not leave that enormous gap in coverage. We should give seniors a plan that starts now, not in 2006.
I yield the floor.
Mr. President, I thank the leadership of the Committee on Commerce, Science, and Transportation for their resolve in pushing forward with reauthorization for Federal railroad safety programs. The bill reported out of committee, S. 1402, the Federal Railroad Safety Improvement Act, will reauthorize the Federal Railroad Administration, and make many important updates to continue to ensure safety on the Nation's railroads.
In particular, I thank the chairman for his commitment to work with me to address a problem that has been brought to my attention regarding the use of railroad police officers. These railroad employees, who are commissioned by States with law enforcement authority on the railroad property, are given certain police powers for protecting railroad employees, railroad property, and the general public. The Federal Government, recognizing that these personnel perform important functions, has taken steps to extend this authority across States borders, as many North American railroads are extensive and traverse State boundaries.
In this reauthorization, we look to extend this authority even further, to allow rail police officers to conduct law enforcement activities with respect to railroads other than the rail police officer's employing railroad, as our national system of rail transportation is an interconnected system. While I welcome this extension, as these officers perform an important security function to protect our rail system, I feel we should take a closer look at a related problem--the potential for abuse of this police power. As a special case of law enforcement officer, rail police officers answer to private sector employers and are not directly accountable to the public like most law enforcement officers. I am mindful that this could present potential for abuse--that under guide of State law enforcement authority, these rail police officers could engage in activities unrelated to law enforcement, such as enforcing railroad company policies or even labor agreements.
Given the potential for abuse, I was prepared to offer an amendment to the bill during the committee's executive session to address this problem. However, the chairman has graciously committed to working with me to resolve the issue, and I look forward to working with him.