Federal News Service
HEADLINE: NEWS CONFERENCE
SUBJECT: MEDICARE PRESCRIPTION DRUG BILL
PARTICIPANTS: SENATE MINORITY LEADER TOM DASCHLE (D-SD); SENATOR EDWARD KENNEDY (D-MA); SENATOR DEBBIE STABENOW (D-MI); SENATOR JON CORZINE (D-NJ); SENATOR BYRON DORGAN (D-ND)
LOCATION: SENATE RADIO/TV GALLERY
SEN. DASCHLE: Thank you for joining us this morning.
There have been reports in the last 24 hours that some agreement may have been reached with regard to the Medicare prescription drug conference. I think those reports are overly optimistic and, I would say, mischaracterized. There is no agreement. In fact, 41 senators have now signed a letter, that I will share with all of you, that says very clearly that, to merit our support, we have to address far more consequentially than what the conferees have a number of issues that are of great concern to us.
Perhaps one of the greatest issues of concern is that proposed by many Republican members, especially those in leadership, that advocate the privatization of Medicare and, therefore, higher premiums for Medicare for all senior citizens beginning in the year 2010. That is virtually a show-stopper.
There is also the need for a good fallback -- that is, access to the Medicare drug benefit, especially in rural areas -- one that concerns many of us and one that has to be included in the bill.
We feel very strongly about the concern that many have expressed about retirees and their loss of benefits. Perhaps as many as 37 percent of all retirees could lose their benefits unless we address that issue in a consequential way.
Low-income assistance has to be provided in a meaningful way to all of those who can't afford even the most basic of the premiums suggested in the bill.
We also think that putting caps on Medicare spending eliminates the very character of Medicare itself as an entitlement program.
And finally, we have to deal with the issue that some of my colleagues behind me have been such leaders on, and that is, bringing down the cost of drugs themselves. Generics, reimportation, approaches like that have to be addressed in the bill as well.
So we have a long way to go and a very short period of time within which to deal with all of these issues. But they are critical, and that's why we felt the need to send yet another letter explicitly stating these concerns and the need to address these issues in a consequential way.
With that, let me introduce one of our extraordinary leaders on the issue, who's been involved in this from the very beginning, our friend Ted Kennedy.
SEN. KENNEDY: Thank you very much, Leader.
I've joined with the Democratic leader, although the proposal that is being sent to the president of the United States also includes a Republican, some 41 members of the Senate, and does not include four members that actually opposed the measure that passed the Senate. So there's a very substantial group, including bipartisan, that believes very strongly that this conference on Medicare, on the Medicare prescription drugs, which is so important to our seniors, the part of the Medicare agreement from 1969 that was not included, and at costs now which are out of sight for our seniors, is so necessary for our seniors but is at grave risk at this time.
And I believe that what we need to understand is that the proposals which are continually being advanced by the other side on these issues are proposals that would never pass the United States Senate today in a bipartisan way.
We're reaching the final hours. We call on the president to intervene and to exercise judgment in this conference to indicate that they want a bipartisan bill.
It's still possible, but we're further away from that possibility today than any time since the conference first began. The American people, our seniors, deserve a good prescription drug benefit. We are committed to sitting down and working out the kind of benefit that would have the broad bipartisan support that would be affordable, dependable, reliable, and that will be built upon the Medicare system.
We recognize foremost that the doctrine of "do no harm" to the Medicare system is something that is guiding all of us. We will not support a conference report that is going to do harm to the Medicare system. We cannot be clearer than that. And for proposals to be continuously advanced and continuously fought for in that conference report, which would threaten the Medicare system, effectively would deny to our seniors the doctors that they trust for the prescriptions that they need, is a nonstarter in the United States Senate.
SEN. DASCHLE: Debbie Stabenow.
SEN. STABENOW: Well, thank you, Mr. Leader.
Fundamentally, what we are fighting for right now is Medicare as we know it. The majority in the House continues to put forward a plan that not only would privatize prescription drug coverage, but the entire Medicare system.
And I was looking last night at some of the headlines from Michigan papers over the last number of months: "Michigan HMOs slam doors on seniors," "Seniors to vent HMO gripes." Less than 2 percent of the Michigan seniors today can even find a private insurance plan.
Fundamentally, what we have is the difference between a universal system under Medicare, where you can go to the website, you can pull off Medicare Part A, Medicare Part B, what it will cost you, what it will cover, and it doesn't matter where you go in Michigan, it doesn't matter where you go in the United States, whether it's an urban community or a rural community, you know you can choose your own doctor and you will have access to Medicare for the same premium and the same co-pays.
Now, what are our colleagues in the House saying? We're going to do away with that system. Instead, we're going to give you what I call a voucher. We're going to give you "X" amount of dollars to go purchase insurance. If it's more expensive in your area, you'll pay more. In fact, the actuary for Medicare has said that there will be wide disparity. If you are in a small state, you could pay less; if you are in a larger state, you could pay more.
And in states like Michigan, where you have the rural communities up north, they would pay differently than the urban areas. And if, in fact, they wanted to drop you, they could, and you'd have to start over again.
What they're talking about, fundamentally, is taking away the promise of Medicare: the dependability, the affordability of this system. And from my perspective, this is absolutely wrong, and I stand with my colleagues in saying we will not agree to a system that rolls back the clock prior to 1965 and does away with Medicare, which has been a great American success story.
SEN. DASCHLE: Jon Corzine?
SEN. CORZINE: Thank you, Mr. Leader.
I was one of those senators that voted for the bipartisan approach that the Senate passed last summer. But what I hear developing in the conference report breaks that rule that Senator Kennedy talked about, the first rule of medicine, which is do no harm. There are 12 million seniors that have employer coverage health benefits. As Senator Daschle said, about 37 percent, or about 4 million, potentially are estimated to be dropped from these programs. The reason being is that the contribution towards the catastrophic cap is just not included. And there is nothing that we hear being developed to try to encourage employers to stay with their prescription drug benefit for seniors.
In fact, in sort of convoluted reasoning, there is an expectation that employee income of the companies that are benefitted would go up $25 billion. And instead of using that for a tax credit to try to encourage employees to stay with their retiree benefits, we're actually talking about doing these health savings accounts, which doesn't have anything to do with Medicare beneficiaries; doesn't have anything to do with trying to improve the program for seniors. That is doing real harm, and it is misdirecting funds that were designed in this $400 billion cap to undermine senior coverage with regard to prescription drugs.
That's about 140,000 people in New Jersey, and I can tell you when I go to town hall meetings with my seniors, the first thing they say is, "Don't do anything that's going to take away my health coverage that I have, my prescription drugs that -- as a private employee."
And I'll tell you, there's a second element that I have a bug on. There are about four or five states in this country that provide better programs than is being generated. And there is no support coming out to make sure that state programs continue. Again, harm. About 225,000 seniors in my state.
So it strikes me that if we're trying to deal with a problem that we want to put this $400 billion on the table -- which by the way, seniors are going to spend about a trillion-eight over the next decade, not $400 billion -- we ought not to make it worse for the seniors that actually already have coverage, whether it's employer programs or state programs. And I'm not going to support a program that doesn't take into account trying to keep people in programs as opposed to dropping them to a much, much less satisfying program.
SEN. DASCHLE: Byron Dorgan.
SEN. DORGAN: Thank you, Tom.
Last week, there was an urgency expressed by the administration for Congress to act to take care of things in Iraq. The question is, will the president and the majority here in the Congress express the same interest in taking care of things here at home?
At the top of the list of items that need taken care of is to put a prescription drug benefit in the Medicare program. My colleagues have expressed some principles that are critically important in the way that is done. Let me express one additional, and that is cost containment.
If we just pass a piece of legislation that does not include cost containment, including generics, perhaps the generic bill that our colleague, Senator Schumer and McCain have advanced; reimportation -- if we don't have those provisions dealing with cost containment, we're just going to break the bank. This would just be hooking a hose up to the tank and sucking the tank dry. There needs to be cost containment. It needs to be real.
And my colleagues and I, Senator Stabenow and I and many others, are introducing today the identical language on reimportation that passed the House of Representatives earlier this year. That's been back and forth like a ping-pong ball, as you know, in the last few years, and the majority has managed to stop it, so far. But it needs to be put in this provision, in the bill that is being done in conference now to put a prescription drug benefit in the Medicare program. Cost containment needs to include provisions on generics and also on reimportation.
SEN. DASCHLE: Thank you, Byron.
Q Senator Daschle, today is the anniversary of the death of Senator Wellstone. What about the -- (off mike) -- to get mental health parity up on the floor? Or is that involved in any of this, perhaps as another vehicle?
SEN. DASCHLE: I can't think of a better way to pay tribute to the memory of Paul Wellstone than to pass the Mental Health Parity Bill. He was a champion of many causes, but there was no cause greater or more dear to him than the passage of this legislation. We've waited too long. I can't think of a better time, a better day, to renew the commitment this Congress ought to make in his memory, but also in recognition of the great need there is in the country than to pass this legislation.
Ted Kennedy has been a real stalwart advocate of the effort to get this legislation passed. He may have an additional comment to make on the bill.
SEN. KENNEDY: Leader Daschle has insisted that we're gong to address this issue this year.
This legislation has 66 cosponsors of it. Sixty-six cosponsors. And effectively, we've passed it at other times. And it is basically a question whether the leadership is going to listen to the insurance companies, that talk about how this is going to raise insurance premiums. But if you look at -- the facts are that, the 8 million people that have mental health coverage under the federal program, there hasn't been any indication of increase at all.
This is about the defining issue that Paul Wellstone led this country on, to ensure that we were going to not only treat those that have the physical ailments, but those that are mentally challenged. And it is unacceptable, when we have two-thirds of the members of the United States Senate, not to have an opportunity to vote on it. So we have requested the leadership to schedule this; and if not, we're going to add it as an amendment on the continuing resolution.
Q (Off mike) -- (speaking ?) for Senator Breaux on this matter, Senator Baucus on this matter, they're not on here?
SEN. DASCHLE: Well, Senator Breaux and Senator Baucus obviously have been engaged in this from the very beginning and have done an outstanding job of articulating these very concerns on a daily basis. They're in the room, as you know. And I think they feel as strongly as we do about these issues.
Q Are they on the letter that you're talking about?
SEN. DASCHLE: They are not. But they're in the room; they can say it directly. We're going to say it through the letter.
Q Senator Daschle, earlier this week, you and Senator Rockefeller and the three Democratic House conferees who were not in on negotiations asked to be allowed back into the room. Have you had any response to that letter?
SEN. DASCHLE: We have not, no.
Q Do you expect any?
SEN. DASCHLE: No, I don't.
Q Senator Dashcle, this letter says that you're not in favor of including controversial tax provisions. But to keep employers from dropping their drug plan, wouldn't you be in support of the tax cut, as Senator Corzine was saying? What other plans would you have to keep employers from dropping it?
SEN. DASCHLE: Well obviously, what we need to do is commit the resources. And there are a lot of different ways with which -- other vehicles with which to address that. I think Senator Corzine has a very good amendment, I strongly support it, but there are other things that we can do as well. We need to provide the kind of incentives to employers, and we can be innovative on how it's done. But to lose 37 percent of all retirees is unacceptable. To lose 4 million people who are currently getting prescription drug benefits is not something that we can support.
So we will look for ways with which to do it. We're confident that they can and should be addressed.
Q Senator Daschle, be blunt. You've got 41 signatures on this letter. Does this mean that if your concerns are not addressed, that the bill, conference agreement, whatever, will not move forward unless they are addressed?
SEN. DASCHLE: Well, we are simply saying that there are 41 senators, and then four others who are not on the letter, who strongly support these principles but who voted, as you've noted before, against the legislation initially. There is a strong belief that there is a growing consensus among many of us that these issues have to be addressed satisfactorily. We'll consider what our options are once we see the final draft.
But we want to put our colleagues on notice, we want to put the administration on notice, and, as Senator Kennedy noted, we want to see more engagement on the part of the administration and the president himself. The president can solve this problem. There is absolutely no reason why, if this is important to him, he can't insist with our House colleagues that they acknowledge the importance of these issues and help us resolve them successfully.
Q Would it be too blunt to say that you would filibuster any proposal that looks like the one that was in the paper today?
SEN. DASCHLE: It's not my intention today to say we're going to filibuster anything. What we want to say, in a positive context, is that these issues are very, very important. And when you see the numbers associated with the letter that we've just released, you can see that I don't stand alone, that our colleagues are growing in number with regard to the importance of these issues. Obviously, that's an option, but we're not threatening a filibuster today. We're simply saying we want to get this job done right.
SEN. KENNEDY: Can I add just one point to that? First of all, I don't think the measures would pass the Senate. It doesn't have to be a question of a filibuster. I just don't believe that the kinds of measures that are being advanced now in that conference would pass the Senate. So that's number one.
The most important point is, this is about our seniors. This isn't just about the Democrats or Republicans. This is a question about how our elderly are going to be treated and whether we're going to meet our responsibilities to the seniors.
They don't care, the seniors, whether it's a Republican plan or a Democratic plan. They just want to be able to assure that they're going to be able to get the prescription drugs, as a matter of right, as a part of our Social Security system; that it's going to be affordable and it's going to be reliable; that it's going to be universal; it's going to be quality; it isn't going to be able to be taken away from them; and they're going to be able to retain their relationships with their doctor and the health care system.
That isn't a radical proposal!
That is the heart of Medicare. And that is the frame which we embrace. And we -- as the leader has pointed out, the -- our conferees, Senator Breaux and Senator Baucus, have welcomed the opportunity to advance those in the conference. But they're not there now, and we have continued, as I mentioned earlier, to just see continued advancing of proposals which are not based upon a bipartisan consideration and would never even pass, I don't think, the Senate.
Q Senator? The target adjournment day is November 7th. Are you going to get this done? (Laughs.) And how will it play out politically if you go home without this finished? (Off mike.)
SEN. DASCHLE: Well, that's our intention, to get it done prior to the time we leave. That's why these days now are so critical. If we are going to get it done -- as Senator Kennedy noted, we aren't going to get it done if we have a vote on the principles as we've had them described to us through the newspaper, and they look as threatening to Medicare and to senior citizens as they apparently are. To go home on a defeat would be the worst possible defeat of the legislation. We can't accept that as a real possibility. We've got to work to make this the kind of bill we can all support, and that's our purpose in calling attention to these deficiencies today. I wouldn't hold my breath on November 7th, but there is a real possibility that before Thanksgiving, we could complete this legislation successfully.
Q (Inaudible) -- sitting down and talking. I mean, it seems like the normal conference process -- (off mike) -- if you can't even get in to do it, and then saying that you read what the proposals are in the newspaper. Isn't that a little odd?
SEN. DASCHLE: Well, it is odd --
Q And now you're communicating to them through us.
SEN. DASCHLE: Absolutely. There's no other way that we're given an opportunity to express our concerns, other than this. But it isn't just -- as I emphasize -- it isn't just the concern of the conferees, or now, just of the Democrats. There is bipartisan concern for a lot of these issues. And that's why we wanted to say with an exclamation point these issues have to be addressed adequately, successfully and thoroughly if we're going to take it up successfully before we leave here today -- or, this year.
Q Senator Daschle, a premium support language seems to be critical to getting this through the House. Is there a middle ground there; you could accept a demonstration project? Or could there be a way that the private plans are paid that you would find that acceptable in any way? Or is it just not going to happen, period?
SEN. DASCHLE: It is such an anathema to most people, because it really means the demise of Medicare as we've known it.
It is the end of the Medicare system, as Senator Stabenow noted, that's been in existence now for almost -- well, over 40 years. There is no question in our minds that that is the essence of what it is we're fighting for; to ensure that Medicare is protected so that seniors themselves are protected. To make them vulnerable to higher premiums and to create the possibility that we would see the actual elimination of Medicare as a result of this bill is just unacceptable to us.
SEN. STABENOW: Tom, could I -- might I add just one thing?
SEN. DASCHLE: Sure.
SEN. STABENOW: I would argue that we already did a demonstration project. When Medicare Plus Choice was put in place in 1997, that was to give the choice, the option of going to an HMO or private plan. Eighty-nine percent of our seniors chose not to do that. So they already spoke; 89 percent said no, we don't want this choice.
So now, instead of listening to them, what we're hearing from the House is we want to force them to have to choose that choice. And we're saying no to that.
Q Senator Frist has said repeatedly that he wants a bipartisan bill. Is he partly responsible for your being excluded from the core group negotiators? I mean, the House doesn't dictate whom -- (inaudible) -- can bring to a conference.
SEN. DASCHLE: Well, I have had -- I just spoke again this morning with Senator Frist. And I will let others decide who holds the responsibility. Of course he's not the chairman of the conference and he doesn't dictate, I suppose, the conditions.
We're simply saying that if we're going to complete this, if we're going to pass a bill that has meaningful, bipartisan support, there are a lot of ways with which to make that happen. One is to ensure that there is bipartisan consideration of these issues in the room itself. And that's only partially been achieved. But there's also, far more importantly than who's in the room, that is really a secondary issue to what the final result is. The final result has to be a good product. If I'm locked out of the room and we get a good bill, we'll live with that and deal with conferees in other contexts down the road, which is going to be an important part of our agenda.
But I will say, we're far more interested in making sure this product, the result of these efforts can be one that we can support. That's our primary interest, and we're going to do all that we can to make that happen.
Q Senator, what about reimportation in this bill? Is that going to be something that you think is going to progress in this, or do you think it's going to be out?
SEN. DASCHLE: I can't think of an easier and better way, a more effective way of bringing down the cost of drugs than through reimportation. That and the generic approach that has been proposed by Senator Schumer and others are the two quickest ways to bring about results in a meaningful way. I think given the broad, broad bipartisan support for reimportation and generic drug coverage, it would be a real shame to lose that opportunity and not include it in this conference report.
Q But that's not -- (inaudible) -- concern, either. I mean, some members on the dais have signed a letter saying that they oppose that concept. So, that's not -- is that going to pass the Senate?
SEN. DASCHLE: Well, there's a difference between that concept and the concept of reimportation generally. I think that we can find compromise that would allow us an opportunity to resolve that issue.
I'll take one last question. Yes?
Q Well, Senator, there are some provisions that haven't been discussed very much that are very important to physicians, such as the proposed 4.2 percent cut in their reimbursements, as well as whether or not they can invest in ambulatory surgery centers. I wonder if those are things you can tell us a little bit more on?
SEN. DASCHLE: Well, again, we haven't seen any language, so we really don't know what their intentions are. Obviously, that would pose some real serious issues, as well. And we're trying to find ways with which to reach consensus on them. But until we see the language, it would be very hard to comment.
Thank you all very much.