A Medicare Prescription Drug Plan Is Needed
Mr. Speaker, I want to commend the gentleman for having this, staying up here at 10 o'clock at night, talking about this issue because I think the people need to understand the idea of universal health care is that everybody puts into the…
Mr. Speaker, I want to commend the gentleman for having this, staying up here at 10 o'clock at night, talking about this issue because I think the people need to understand the idea of universal health care is that everybody puts into the pot, and then when they get sick, they take out of the pot. Nobody, when they pay for their health insurance, stands around saying, gee, I hope I get sick so I can take something out of the pot. That is not the way people think.
We have given universal health care to senior citizens. We have said anybody over 65 in this country is eligible for Medicare, and we put them all in together; and they put all their money in together collectively, and we put together a Medicare program that has worked very well since 1964. It has not required people's children to pay for anything. They have been able to have their own dignity. They had their own card. They paid for their own health care during all that period.
I sat on the Medicare commission. I was one of the 16 people sitting on that commission for a year back in the mid-1990s, and there is a determined effort by the Republicans to privatize Medicare.
What does privatize mean? It means to separate all the American people from one another and make them deal individually with this particular problem in their life, their health care.
They would be given a voucher, and they could privately go out to a private insurance company and find somebody who would give them a benefit.
Now, if we were to take my mother and myself, my mother is 93 and I am 65, if we were to take those two people and say, send them out with the same amount of money, we know that they are going to get different benefits. Well, they have tried this. They have offered the Medicare through an HMO, and people went and joined, and then the HMO closed, and they lost all the benefits. And people have been jerked around over the last 4 or 5 years by this whole process, but they are determined. And this bill is the real final effort to do that.
It is kind of like when I was a little kid. My mother wanted me to take cod liver oil. There was some vitamins in it, and she wanted me to have those. But cod liver oil tastes terrible, so she would always mix it with orange juice. That is exactly what they are doing here. They want people to take the cod liver oil of privatizing health care, and they are filling the glass with orange juice, which is the drug benefit.
So that is the first thing people have to understand. The drug benefit is not intended to give them a drug benefit, it is to get them to drink the cod liver oil, the privatization of Medicare.
Now, how did they design this? Why do I say they do not intend to give a drug benefit? Very simple. They said, well, let us put up $400 billion. Now, that sounds like a lot of money to people. I mean, it sounds like a lot to me. But if we are going to fix the problem right, to do the deal right, it is going to take way more than that, probably twice that amount. But they just said, well, we will put $400 million in, and we will kind of mix it around so people will not see what we are really doing.
Worst of all, as my colleague pointed out, this does not go into effect until 2006. They can put advertisements on television in the next campaign in 2004, or in 2006 they can put advertisements out and say, we gave you a drug benefit, because it will not go into effect until 2006. Now, most Americans look at politicians and they say, I do not know if I can trust them or not, and I want to see what actually happens. Well, when you put something out there so far, the people will never know that what they see advertised in the 2004 campaign, with all these millions of dollars of ads from the drug companies and from the Members of Congress who voted for this, that, in fact, it was never intended to work.
Now, I will tell you why I know that. I was walking through the tunnel between the Capitol and one of the office buildings today, and one of the Republican Members said to me, do you think this bill is ever going to come out of the conference committee? Do you think the Senate and the House will ever solve it and bring a bill back to the floor? I said, no. He said, I do not think so either, and we hope it does not. This was a Republican talking. We hope it does not. I said, you do? He said, well, it is not a good plan. It does not solve the problem.
So they know it does not solve the problem, but they want to say, I voted for a pharmaceutical benefit, and my opponent opposed it. Or my opponent does not think it is good, but I wanted to give pharmaceuticals to senior citizens. They have no interest in the reality of this bill.
Now, I think there is a couple of things that are really sort of buried in this bill that people have to understand. They said we do not want the Secretary of Health and Human Services to negotiate for all the 40 million old people in this country. We want each little insurance company to negotiate with the drug companies as best they can. Every other country in the world that has an industrialized country like us, France, Germany, Canada, anybody, the government negotiates for everybody. My colleagues know that that works better.
If I were to go into a store and say, I want to buy 100 loaves of bread, I will get a better price. It is going to be less per loaf than it would if I were to buy one loaf at a time. But the Republicans set this up so that Tommy Thompson, the Secretary of Health and Human Services, cannot go and negotiate for them. They made it impossible to save money, or save big money.
We know what happens in the Veterans' Administration, we get a 50 percent discount because they negotiate a price for every veteran. All 5 million of them get the benefit of a negotiated price for 5 million people. But when it comes to seniors, we say, no, no, you are on your own, Grandma. You can go 1 at a time or 2 at a time or 10 at a time, or whatever, but you cannot have the benefit of this. I think that alone should make people sort of wonder about this.
The second thing they do is that they say, well, you can go into a Medicare HMO, some kind of health maintenance organization, and get your benefits, if they will take you; or you can stay in regular Medicare with your doctor that you have known for the last 30 years and knows everything that has ever happened to you, so that when you go in the doctor does not have to say, well, let us start with when you were 6 years old; when did you have the mumps; when did you have the measles?
You know, when you get to be 65, or like my mom, 93, who remembers what year it was that you had the measles? You want a doctor that knows you and that you have dealt with for 30 or 40 years, so that they say, well, Mrs. McDermott, how is X, or whatever the problem is that they have been following. Seniors do not want to have to start over again with a new physician.
But they say if you stay in Medicare, you are going to have to pay more for the drugs. Now, the problem with that is that drives up the premium. Right now the premium for seniors is something under $60. HCFA, the Health Care Financing Administration, that administration says that the premiums next year, if this bill goes into effect, would go up to $90 a month for nothing. It would just go up $90. Why? Because the sick people would stay in Medicare, the old standard Medicare, and the healthy ones would go get into these HMOs where they could get a better deal. So sick people who want to stay with their doctor are going to be stuck paying more money than people who are younger and healthier and are acceptable into some kind of an HMO.
I believe, and what the gentleman is saying, is that it should be a Medicare benefit that everybody gets in the
whole United States. It does not make any difference whether you live in Ohio or New Jersey or Washington or Atlanta, Georgia, or wherever, you ought to get the same benefit. It should not be dependent on whether you can find an HMO that negotiates better or anything else.
For instance, maybe a parent would like to move from Tennessee, where they had a pretty good deal, to Montana where their kids are living. They want to move to Montana because they want to be near the grandkids. That is what my parents did. My parents left Oklahoma in 1972 to live with us in Washington State when my dad retired and there were grandkids. My mother said, hey, we are going out to be near the grandkids. Well, why should there be any difference in the benefit between Oklahoma and Washington State?
This bill will guarantee that there is a difference. It may be better, it may be worse. My parents would not have anything to say. Anybody who moves under this new system will have no idea what they are going to.
And then there is this question of a donut hole. Frankly, the bill mystifies me in that it seems to imply that the Republicans think that old people are not paying attention; that somehow we are going to whistle this past them, and they will not see what this is about. My colleague explained it. First of all, the Democratic plan is the only one that says what the premium will be, $25 a month, and there is a $100 deductible. They spell it out in the law. The Republicans do not give us that. They say there will be a premium, and there will be a deductible, but people are buying a pig in a poke right off the bat. Then you pay for that, and, at a certain point, you do not get any benefits. You are still getting your monthly bill for your premiums. You have to keep paying those premiums. Meanwhile every bit of drugs you pay for you have to pay all out of your pocket.
Now, I tried to explain this at a couple of retirement homes in Seattle, and people just say, that does not make any sense. What are they trying to do? What is this about? The minute you explain to people what this really does, it falls apart flat. And yet they are coming in here, pressing this bill and talking about all the things they have done. But people should remember that it is not passed until it goes into effect. And there, I think, is going to be a very big fight between the Senate and the House on this issue because the Senate does not want to privatize health care. They are resisting the idea of putting the orange juice with the cod liver oil. They said, no cod liver oil. This is orange juice.
They are doing a drug benefit over there, and in some ways that makes it a little better. It is not as generous maybe as ours is, but neither one of them works very well. The only bill that really works is the one the House Democrats put out which gives people a fixed payment and a fixed deductible and a fixed amount that they have to pay 'til whenever.
And nobody wants this benefit. This idea that you are going to get an insurance company running in to offer an insurance policy to all the seniors, just ask yourself, and you do not have to be a rocket scientist to know why this will not work, who buys an insurance policy? You do not buy an insurance policy unless you have a car, right? You do not buy fire insurance if you do not own a home. Why would you buy this, paying month after month for a drug benefit, if you did not need any drugs? As soon as you need them, boy, you want to run in right away and get it. But why would seniors, if they had something else or they were tight with money, they would say, why should I buy it?
So the only people who are going to buy are people who have big drug bills. Maybe they have cancer and their cancer treatments are very expensive, or maybe they have had a kidney transplant and they have drugs that are very expensive. There are a whole raft of conditions which require people to spend an awful lot on pharmaceuticals. Those are the people who are going to buy it. So an insurance company is sitting there saying to themselves, no way.
The way insurance companies work is you sell a premium to everybody, and then you hope nobody gets sick so you can give all the money that is left to your stockholders. That is how they work. It is no mystery, and it is not wrong. It is the way they operate. Well, why would you want to take in a bunch of sick people who want drugs and give them a drug benefit?
Well, the government, these guys recognize that. They realize the insurance industry will not do it. So what they said was, I know what, we will let them offer the plan, and then we will take 99 percent of the risk. The Congress will take it. And if there is any profit to be made, the insurance company can take it out the door.
This is absolutely a fraud for the government to use all of its money and not try and control it, not look for the fraud and the waste and the abuse; turn it over to the insurance company, who has no risk. None. There is no explanation for why they would come up with a plan like this except that they hope it does not pass.
And I hope it does not pass. I would like a real bill to pass, because God knows people are really having trouble, and there are so many things we could do that would not be hard to do.
I see my colleague has brought some things here about the Canadian plan, and I will just say one or two more things and then turn it over to her.
The Canadian Government did not go through any big plan or anything, they just passed a law that said that the price you pay in Canada is going to be the average of the G-7 countries. Now, the G-7 countries are the seven most vibrant economies in the world, Japan, Germany, France, Great Britain, the United States, and so forth. So whatever the price is in Germany, they write that down, write down the price in France, add them all together and divide by seven, and that is the price in Canada. They never pay above the median. They always pay in the middle.
Now, that is why people leave my State on buses on a weekly basis to go up to Canada. Anybody who lives near the Canadian border knows about this. Or they have pharmacies up there, and they mail in up there, and they have it all worked out so they can get them filled and have them sent back. What the pharmaceutical companies are doing now, just to show you how much they hate that, they have cut off the amount of drugs going to these pharmacies in British Columbia, which is north of Washington State.
Mr. Speaker, they say to them you could not possibly sell this many drugs in British Columbia, so we are only going to give you 40 percent of your order so they cannot ship the other 60 percent down to the United States. They are cutting off their supply. It is incredible the lengths to which the pharmaceutical industry will go.
In closing, in case Members would like to shed a tear for pharmaceutical companies, the Fortune 500, which is the 500 biggest companies in the United States, 10 of those companies are pharmaceutical companies. Those 10 companies last year had a profit of $38 billion. That was 50 percent of all 500 companies. Ten companies produced 50 percent of the profit of the whole of the Fortune 500.
Now, I believe in research, and I believe in all of the things that pharmaceutical companies do, and I am not against pharmaceutical companies; but I think enough is enough. I think my colleague who has some Canadian prices here will make a very interesting case on this point.