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…
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 the balance of our time over here.
Mr. Speaker, I can understand how my Republican colleagues are distressed about this legislation. But I would remind them, first of all, that we are simply taking steps to correct earlier abuses of the most outrageous sort.
This legislation part D was crafted in the dark of night, and it was done by Republican Members and by lobbyists for the insurance companies and the pharmaceutical houses. That is why it is here. And now I can understand why my Republican colleagues are so distressed, because we are going to take all of those wonderful goodies away, or some of them, from the drug houses that so carefully saw that they got them without a single Democratic Member appointed by our then-Republican Speaker to appear here in the Capitol to address the question of what went into that.
Now, we have been getting a lot of excuses from our Republican colleagues. They tell us the bill is working well. Simple fact of the matter is it is not. One Federal program pays 60 percent more than other Federal programs for procurement of prescription pharmaceuticals, that is, part D pays more than the VA pays for the same prescription pharmaceuticals. But the reason is no one is able to negotiate on behalf of the citizens. You have got a bunch of good-hearted or cold- hearted prescription pharmaceutical people who have written this legislation and who are fixing the prices that are paid by senior citizens.
This says that the Secretary of HHS, a servant of the American people, will negotiate prices on prescription pharmaceuticals so that the senior citizens can get something other than excuses from our dear Republican friends and the insurance companies about why we ought to disregard what our common sense tells us, and that is that 43 million people can have the purchasing power to perhaps encourage these drug houses to give the government and the American retirees a better price.
Now, let's take a look at that. That is a chance to do real good for the people. I would tell you that we are tired of the excuses on these matters. Consumers, and particularly those who are living on disabled or fixed or limited incomes, watch their pennies. They have to. We should watch them too because we owe that to the people.
Now, the Secretary says it isn't going to save money. CBO says it isn't going to save money. But the reason is because they know full well that this Secretary probably won't negotiate on their behalf.
But I will tell you one thing. On this side, we will see that this Secretary does negotiate for better prices for our people. We will have him up before the committees, and we will give him and the others in the administration the oversight which they have lacked for 6 years.
Now, who is in favor of this legislation?
Before I say that, the people opposed are the Republicans, the administration, the drug houses and the insurance
companies, certainly a logical collection of opponents to a proposal of this kind.
Who favors it? AARP, the National Committee to Preserve Social Security and Medicare, Medicare Rights Center, the Alliance for Retired Americans. It is also supported by organizations representing people with disabilities. The National Council on Independent Living, AIDS Action, Breast Cancer Action.
Consumer groups support it. Consumers Union, Families USA, U.S. PIRG. No insurance companies support it, but that is no surprise.
Provider organizations support it. The National Community Pharmacists Association, people who work with the recipients of this. The American Nurses Association, the American Medical Association. The doctors say this is the thing that we should be doing. The Association of Community Pharmacists.
And, of course, organizations representing tens of millions of hardworking Americans. The American Federation of Teachers, the National Education Association, SEIU, United Steelworkers, the AFL-CIO, and the UAW.
Some say part D is working well. And for a few lucky folks, that is true. The insurance companies are cutting the fat hog on this. And the pharmaceutical houses are able to do just what they want on their pricing.
It is time that we correct this. Let's pass this legislation and do what we should have done before to protect our senior citizens.