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Prescription Drug and Medicare Improvement Act of 2003 - Continued

Location: Washington, DC


    Mr. BIDEN. Mr. President, after many years of preparation and deliberation, and following weeks of debate and discussion on the floor this year and last, we in the Senate are about to vote on a bill providing some prescription drug benefits for Medicare beneficiaries that is widely expected to pass.

    Seniors have been demanding prescription drug coverage for many years now. They need it and they deserve it, and I believe what we should be passing here today is a bill that will bring the American people the type of prescription drug benefit they have been seeking—one that is easy to understand and use, one that covers a substantial portion of all their costs, and one that is affordable.

    But to the many Medicare beneficiaries who will read the details of this bill and say, "there isn't much in here for me and it will cost me more than I am now paying for drugs," I would say: I hear you. This bill is not enough, not nearly enough.

    I have a lot of concerns about this bill. There is no uniformity from region to region in the benefit package or beneficiary payments. Seniors in the East could be paying far higher premiums than their relatives in the Midwest.

    The drug plan relies on private insurance companies to provide a type of insurance policy that they have already said they are unwilling to sell. I am skeptical that these private plans will stay, and that could mean seniors will have no stability in their coverage. The bill does allow traditional Medicare to step in and fill the gap but seniors might have to move back to a private drug plan if new ones come to the region.

    There is also a gap in coverage which I think is unfair and will surprise a lot of people.

    Finally, the bill falls short in its efforts to induce employers not to abandon their retiree prescription drug coverage, a situation that too many retirees have already faced in recent years.

    In summary, I view this bill not as a situation where we would say that the glass is half full and half empty; to my thinking, the glass is only about one-quarter full. In 2003, prescription drugs are as important in medical care as surgery; consequently, it seems logical to me that if Medicare pays for the bulk of the cost of a heart bypass operation for all beneficiaries, it should similarly pay the bulk of the cost of the drugs used to lower the cholesterol, and which would prevent the need for the bypass operation, for all beneficiaries. This bill does not achieve that commonsense goal. Not even close.

    But we need to start somewhere. This is the first step in gradually moving the health plan that covers nearly 40 million seniors and disabled individuals into the 21st century. And it is, very frankly, the best that we can expect to pass this Congress and that the President will sign.

    There are some good provisions in this bill. All Medicare beneficiaries will have access to a prescription drug plan. Individuals with low incomes, below 160 percent of Federal poverty level, will have access to prescription drug coverage at very little cost. Those with very high prescription drug expenses, in the many thousands of dollars, will have stop-loss protection to help protect them against catastrophic drug costs. And no one is forced to abandon the traditional Medicare Program for their basic health care, with which they are so familiar, in order to obtain prescription drug coverage.

    During the Senate deliberation on this bill, I have voted for amendments that would improve the prescription drug coverage and decrease the cost to beneficiaries. Almost all of these amendments were not adopted, mostly with the rationale that there was not enough money. I do not feel constrained by some arbitrary $400 billion cost limit on this bill. I never agreed to such a limit. In fact, my sense of values tells me that prescription drug benefits are a high priority, and I would be willing to spend more than $400 billion for a good prescription drug plan, while cutting budget items of lower priority, such as tax cuts for the very wealthy.

    In the end, I decided to vote for this bill, despite its severe limitations. Given the many past years of fruitless discussions on this matter, I feel it is critical to put something into law now that can serve as a starting point for development of a true prescription drug plan. But that is not to say that I will accept any lesser of a bill, and my colleagues should not count on my continued support, if the final version of this bill that comes out of negotiations with the House of Representatives undercuts the Medicare Program or moves toward reducing protections for beneficiaries.

    We also need to remember, this bill comes with a warning to all of us: the public is a lot smarter than they are sometimes given credit for, and if we do not work diligently to improve what we have begun, they will rightly take out their anger on us. We need to ensure that this bill is the first step, not the last step.

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