Date: 2003-11-21
Speaker: VAN HOLLEN (democrat)
Chamber: H

Mr. Speaker. with regret. I rise in opposition to the Medicare conference report now before us. Rather than giving seniors the simple. comprehensive and affordable prescription drug benefit they deserve. this bill recklessly undermines the Medicare program. threatens many seniors existing drug coverage and fails to bring down skyrocketing drug costs. Lets be clear: This Is not about whether we ought to add a prescription drug benefit to Medicare. Democratsincluding myselfhave been calling for a meaningful Medicare prescription drug benefit for years. Now that the Republican party has dropped its historic opposition to modernizing Medicare. there is broad consensusat least rhetorically--on the importance of this goal. Additionally. this is not about whether doctors should receive a positive payment update for services rendered under Medicare. I think everyone in this chamber understands we could pass a freestanding positive payment update for physicians todayand by a wide margin. Frankly. I would be first in linebecause I dont think you can ask providers to participate In a program without adequate reimbursement. But if we were really Interested In giving doctors a fair reimbursement rate. we would end this untenable ritual of dodging the next round of scheduled payment cuts with stopgap. bandaid measures and finally get around to fixing the obviously flawed Medicare reimbursement formula once and for all. Unfortunately. thats not what we are doing here today. Instead. after months of secretive negotiations and much highly publicized bickering. the majority is now presenting this House with a prescription drug bill that blatantly violates the first tenet of responsible medicine: Do No Harm. If this conference report is enacted into law. as many as 7 million seniors will be forced to pay more for Medicareunless they agree to give up their doctor and join an HMO. according to analysis done by the House Ways and Means and Energy and Commerce Committee minority staff. Additionally. over 2 million retirees who already have private prescription drug coverage stand to lose that coverage. according to the same report. That Is also the conclusion reached by the former Republican Majority Leader of the House Dick Armey. who called on Conogress to reject this misguided bill in todays Wall Street Journal. saying in part: "(T)his bill is going to cost millions of seniors their current prescription drug coverage." In my home state of Maryland. an estimated 60.000 Medicarebeneficiaries could lose their existing private prescription drug benefits. according to analysis based on CBO data prepared by the Senate Health. Education. Labor and Pension Committee minority staff. Moreover. similar analysis from the Senate HELP Committee minority staff using CRS data projects that 75.000 Maryland Medicaid beneficiaries will pay more than they do now for the prescription drugs they need. This legislation puts seniors with existing coverageand the future of the entire Medicare programat risk. And for what? A prescription drug benefit thatalter all the premiums and deductibles and copays and coverage caps and outofpocket costs are accounted forprovides $1 of assistance for every $4 that seniors with significant drug costs will still have to pay themselves. There are smarter. more efficient ways to spend $400 billion on a Medicare prescription drug plan. For starters. we should eliminate the $12 billion subsidy being offered the private insurance Industry as an inducement to participate in the Medicare market. If PPOs and HMOs are really more efficient than traditional than traditional Medicare in delivering high quality care at a lower cost. they dont need a $12 billion taxpayer handout to do It. Additionally. we should scrap the Administrations illconceived and deceptively named "Health Security Accounts". which amount to little more than a $6 billion tax break for the wealthy. And finally. we should get serious about making drugs affordable for seniors and for all Americansthrough such common sense steps as permitting reimportation from our industrialized trading partners and allowing the federal government to negotiate for lower drug prices on behalf of Medicares 41 million beneficiariessomething. the bill before us today actually forbids the government to do. The ultimate value of allowing the Center for Medicare and Medicaid Services (CMS) to negotiate for lower prices will obviously turn on the outcome of those particular negotiations. But we know from the experience of the Veterans Administrationwhich does currently have the ability to negotiate for lower pricesthat the savings can run upwards of 60 percent. In the absence of meaningful steps to curb the exorbitant cost of drugs. this bill does more for the pharmaceutical Industry than it does for consumers. I believe seniors deserve a real Medicare prescription drug benefit plan. one that is comprehensive. affordable and easy to understand. one that will strengthen Medicare rather weaken it. and one that will not reduce the benefits of seniors who already have prescription drug coverage. Mr. Speaker. we should defeat this fatally flawed conference report. come together on a bipartisan basis and give seniors the meaningful prescription drug assistance they are askIng for and need.