Medicare Prescription Drug, Improvement, And Modernization Act Of
Mr. President, I have listened closely to the debate over providing prescription drugs and improving other benefits under the Medicare Program. This debate has not been limited to the last few days, as we all well know. This debate has…
Mr. President, I have listened closely to the debate over providing prescription drugs and improving other benefits under the Medicare Program. This debate has not been limited to the last few days, as we all well know. This debate has been waged for 38 years.
Providing Americans with access to prescription drugs at an affordable cost has been one of the most vexing issues facing Congress in recent years. Many ``solutions'' have been offered to ``fix'' the problems of high cost and lack of access, and Congress has explored and debated various approaches. Of these approaches, providing a Medicare prescription drug benefit is the most important and perhaps the most challenging to accomplish.
For years, progress has been delayed over significant policy differences, not the least of which was the question of whether or not the Government could even afford to create a new and expensive entitlement program. But that question shifted and our debate this week wasn't focused on the question of whether the Government should provide a prescription drug benefit but rather on the details of how to structure a prescription drug benefit.
Last Congress I had the privilege to work with several of my Republican and Democratic colleagues in the Senate to develop a Medicare drug benefit program that became a key option in the ``how to'' debate. Our proposal, which became known as the tripartisan effort, embodied the principles that I believed must be part of a Medicare drug program.
First, the program must make a universal benefit available to all Medicare beneficiaries. It would be unfair to use much needed medicines as a carrot to lure seniors into managed care programs they don't want. We should also avoid providing a benefit only to the poorest of the poor and those with catastrophic costs. Virtually all seniors, regardless of income, need help to make their medicines either outright available or more affordable, and most have indicated a willingness to pay their fair share to support the program.
Second, the program must be comprehensive so that elders would have as generous a benefit as possible, from their initial spending to their catastrophic costs, and they shouldn't have to forego the best medicines for the cheapest ones just in the name of budget savings.
Third, a Medicare drug benefit must be affordable for both beneficiaries and the Government. Seniors should be able to get the best medicine available at the best possible price and the Government must derive the best cost savings through open competition. We should expect to realize as much savings in our pharmaceutical purchase for Medicare as foreign governments realize today.
Finally, for a drug benefit to be truly successful it must be sustainable. It will do little good to repeat the catastrophic failure of years past by beginning a program that we cannot carry on. That is why this must be a shared responsibility of beneficiaries and the Government. A program that combines seniors' contributions with a Government guarantee will have the best chance of enduring into the future.
Since last year, I have listened to the concerns of my colleagues, and I have weighed those concerns seriously. In the last few days of debate, I have given great consideration to the points raised by my colleagues and good friends in this body. I acknowledge their sentiments and I agree that this is not the bill I would have written if I had infinite resources to do it. This bill is not perfect. However, 38 years is just too long for American seniors to wait.
Turning this legislation away would have been a missed opportunity to provide seniors with the most significant modernization of their Medicare benefits since the program's inception in 1965. I believe this bill meets these four standards: It is universal, comprehensive, affordable, and sustainable. Could it be improved? Certainly. But this plan is a good compromise. It offers a respectable and responsible plan within the budget limitations we faced. It is a good compromise. I support this bill.
The conference report includes many significant features for the citizens of my home State of Vermont. It provides a sustainable, universal, and comprehensive prescription drug benefit to all 93,000 Medicare beneficiaries in Vermont.
For 40,000 seniors in Vermont with limited savings and incomes below $13,470 for individuals and $18,180 for couples, the Federal Government will cover most of their drug costs.
In addition, Medicare, instead of Medicaid, will now assume the prescription drug costs of 21,767 Vermont beneficiaries who are eligible for both Medicare and Medicaid. According to the Centers for Medicare and Medicaid Services, this will save Vermont $76 million over 8 years on prescription drug coverage for its Medicaid population.
This bill recognizes the high cost of providing quality care in rural settings and finally puts an end to years of unfair reimbursement gaps between rural providers and their urban counterparts. Specifically, this Medicare package provides $25 billion for rural providers, netting $41 million in additional funds for Vermont hospitals over the next 10 years and $18 million for underreimbursed physicians over the next 2 years.
I am also glad Chairman Grassley and Ranking Member Baucus have worked with me to address another inequity in the system. Critical access hospitals provide care in the some most underserved regions of Vermont as is the case throughout rural America. These hospitals are small yet serve
as critical resources to their communities.
I am very pleased to see that the conferees retained a provision from the Senate measure that will allow critical access hospitals, like the Mount Ascutney Hospital in Windsor, VT, to expand access to psychiatric and rehabilitative services to the most vulnerable citizens in that community.
This bill contains a provision that will allow us to better understand how to provide quality health care, culminating several years of work in concert with Dr. Jack Wennberg at Dartmouth to measure care by the quality of patient outcomes rather than utilization of resources.
In closing, I especially want to salute the efforts of Senator Baucus, Senator Grassley, and Senator Breaux and the other without whose hard work and commitment to working through an agreement we would not have accomplished passage of this legislation and they deserve our accolades. I also thank several of my other colleagues who have contributed so much to this debate over the years. I have worked for more than 3 years with my good friends, Chairman Grassley and Senators Snowe, Breaux and Hatch. In many meetings over many months, we delved into the details of what came to be called the tripartisan bill. This has been one of the finest experiences of my many years in Congress. I am very proud to have been a part of that group and that our efforts led the way to our success today.
A bill such as this is the result of great effort on the part of many different people who are not elected to this body but upon whom we all rely. I would like to recognize the staff members who have worked so hard on this bill and deserve much of the credit for its successful passage.
On Senator Grassley's staff: Ted Tottman, Linda Fishman, Colin Roskey, Mark Hayes, Jennifer Bell, and Leah Kegler, and on Senator Baucus' staff Jeff Forbes, Liz Fowler, Jon Blum, Pat Bousliman, Kate Kirschgraber, and Andrea Cohen deserve considerable recognition for their tireless efforts. Catherine Finley, Tom Geier, and Carolyn Holmes from my friend Senator Snowe's staff; Patricia DeLoatche and Patricia Knight of Senator Hatch's office; and most especially Senator Breaux's legislative director Sarah Walters and his staff Michelle Easton and Paige Jennings deserve enormous credit for this bill.
On my own staff, I particularly want to recognize the contributions of Sherry Kaiman, Eric Silva, and especially Sean Donohue who took up the effort on the tripartisan bill and who has continued to see it through to today's success. Each and all have worked tirelessly to gather the input, analyze the issues, and build a consensus toward achieving this final product.