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USA Patriot Act Additional Reauthorizing Amendments Act of 2006--Motion to Proceed

Location: Washington, DC




Ms. STABENOW. Mr. President, I came to the Senate back in 2001 focused in part on lowering the cost of prescription drugs and the importance of making sure every American senior, every person with disabilities on Medicare, had the opportunity to receive their medicine through the Medicare system, which has been so very successful. We had a lot of work, a lot of effort go back and forth on the Medicare bill as time went on, related to Medicare Part B, and it changed from being about our seniors to being about what was best for those in the industry, particularly the pharmaceutical industry. We began to see a bill that was written, in fact, for the industry rather than for our seniors.

I stand here this evening calling on my colleagues to join with us on this side of the aisle to fix this, to get it right for people. We have a Medicare prescription drug plan that has been adopted that costs twice as much for the American taxpayer as it should, much more for most seniors than it should, and provides less in options and less in medicines than it should. It makes no sense to continue with something which is so confusing, with the cost gaps, which does not allow our poorest seniors to get the medicines they need or, if they do, they are paying more than they did last year. It makes no sense.

We stand here getting ready to go on a recess next week without having fixed the basics of what is wrong with this program. We know that at the beginning of January, our poorest seniors on Medicaid were switched over to the Medicare Program. But too much of the time the computers didn't work, the pharmacists did not have records in the system, and seniors didn't know what plans they were in. They were arbitrarily put into a plan that may not cover their medicines today or costs much more than it should. We saw the administration indicate that while this was being fixed, the pharmacists should go ahead and give people their medicines for the first 30 days. In many cases, States have stepped in to try to continue to help our seniors to get the life-saving medicine they desperately need while all of this gets figured out.

At the end of 30 days, it wasn't figured out. That was the end of January. Here we are now on February 15, and we are into a 2-month extension, a 60-day extension to try to figure out this mess for our seniors.

Pharmacists are told to continue giving people their medicine. Of course, it is the right thing to do. People should not be losing their medicine. But now I am getting calls from pharmacists who are deeply concerned because they are trying to decide whether their small family-owned pharmacy, for example, will be able to continue to pay its own bills without reimbursement or they are going to have to choose whether to help the people in the community they care about, whom they were set up to serve, and want to serve and are serving.

The question is, What is going to happen? Are the pharmacies going to get paid? Are the States going to get reimbursed? What happens to the seniors at the end of March? Are we going to see another 30 days or another 60 days because of a failed system that is confusing? We need to fix this, and it can be fixed.

On this side of the aisle, Senator JAY ROCKEFELLER has legislation many of us cosponsored to make sure that States are reimbursed. We need to make sure those who are providing the medicines now will get this worked out and will be reimbursed.

We also have another series of issues that need to be addressed with this system. People have until May 15, 3 months from today, to decide whether they are going to sign up to be a part of the Medicare system in terms of their prescription drugs and wade through all of this. In Michigan, there are about 65 plans. God bless them if they can get through it, or their children or friends can help them get through all of this and figure out the plan they are going to be on. But once they figure it out, they are locked into the plan after May 15 for a year. Shockingly, the people they sign up with aren't locked into the same agreement for a year. The drug companies can change what is covered. They don't have to cover the plan.

If my mother has worked through a plan that covers four medicines, for example, after May 15 if they decide they will only cover two, or maybe they decide not to cover any of them, that is OK under the current system. It is not OK for the American people. It is not OK for people who are counting on us to have a plan that works.

What if they want to raise the price? You lock into a system, looks like a good deal, figure out the premium that works for you, figure out the copay, what is covered, after May 15 you are locked in for a year. But the plan could change the price, and it could change it every day, if they wanted to. That is outrageous, absolutely outrageous.

A colleague of mine, Senator Bill Nelson, introduced a bill I am cosponsoring with others to extend that May 15 date to the end of the year to at least give people a year to figure out what is going on.

But in addition to that, we need to say once somebody is locked into a plan, everybody is locked in. You can't say I am obligated or my mother is obligated to pay a monthly premium and a copay on a plan they sign up for but the other side can change the contract, change the price, and no longer cover the medicine. That is outrageous. It makes absolutely no sense whatsoever.

I have an example of a gentleman with MS who called my office a couple of weeks ago. He worked through all of the plans and made a determination on a plan that would cost him $50 a month for his medicine. He got ready to go to the pharmacy and thought he would call to make sure the price he had was right. He called and found out that, no, that has been changed now. It is over $500. He is fortunate because he could and did drop that plan because it is not May 15. If that were after May 15, this gentleman with MS would be locked into a plan costing him over $500 for something he thought he was getting for $50. Who in their right mind would say that is OK? We can do better than that. We have to do better for our seniors and for the people with disabilities.

To add insult to injury, we have a situation where negotiating for group prices is actually prohibited in this new Medicare bill. How does that make any sense at all? You are talking about over 31 million people on Medicare. That would be a pretty good group discount if they were negotiating together for a group discount. But that is prohibited. So we are locking in the highest possible prices. The taxpayers are paying more, the seniors are paying more, and people with disabilities are paying more because they are not allowed to do group pricing.

The VA, on behalf of veterans, doesn't pay top dollar. They get about a 40-percent discount. That makes sense. There is no reason why that should not be happening here with a plan that in fact is written for seniors and the disabled.

What happened? What happened when people didn't get the choices they wanted, which is the one I am advocating for, which is a real benefit to Medicare--sign up, go to your pharmacy, know what your prices are, like Medicare. What happened? Why didn't that plan get enacted instead of this privatized approach forcing people to go through private insurance companies or HMOs to get the help

they need? How did that happen? How did it happen that Medicare is stopped from negotiating the best deal? How did that happen? How did it happen that seniors have to sign up for a plan and be locked in for a year, but the people on the other side providing the benefit, getting the premium and the copay, don't have to have prices that are locked in for a year or the range of medicines they will cover locked in for a year?

When you look at what happened, unfortunately, this is the legislative process at its worst. Unfortunately, for somebody who came here wanting desperately to make sure that we are providing low-cost medicine for everybody through various means but certainly for our seniors, this was an extremely disturbing process that occurred that resulted in this new law.

The reality is while we were negotiating on the Senate floor, the head of the Centers for Medicare and Medicaid was at the same time negotiating himself a job with a pharmaceutical industry. We now know that at least 10 people from the administration working in Medicare and Medicaid have now gone out to work with the industry. We also know that in the House, one of the committee chairs, at the same time he was negotiating this bill, was negotiating a salary for himself of $2.5 million to go to work for PhRMA, which is a lobbying arm for the brandname pharmaceutical industry. That is outrageous. When we talk about reform, when we talk about what needs to be done here, we need to start with that. That is the kind of thing that, in fact, we address in our honest government bill that has been passed and submitted by the Democrats in the Senate. We need to deal with that.

But the reality is we have a bill that was written for the interests of people in the industry, not for seniors and the disabled in this country, and not for the taxpayers either.

When you lock in the biggest prices possible, you are not looking out for taxpayers' interests any more than looking out for the interests of seniors or the disabled. This needs to be fixed. There needs to be a sense of urgency about this.

I know at home there is an outrage about this. This needs to be fixed. There are those potentially who can be helped by this bill. I hope everybody who can receive assistance under this new benefit will be able to wade through the bureaucracy and figure out or have somebody help them get some help for themselves. Every day, there is a sense of urgency for people, but we have to fix this overall.

In my book, we need to start over and get this right and decide we are going to worry about the person right now, at almost 7 o'clock tonight, on a Wednesday night, who has probably had dinner already and is sitting down maybe deciding what medicine they take tonight--or do I have my pills for tomorrow? Do I cut them in half so they will last longer? Maybe I can take them every other day. Maybe I am a wife whose husband takes the same blood pressure medicine and can share, even though it is dangerous for your health to do that.

This is the United States of America. We can do better than that. We can do better than a Medicare bill that costs too much and provides too little and does not put Americans first. We can do better than that.

My colleagues on this side of the aisle stand ready and are going to speak out every single day to create a sense of urgency about getting this done. We need to work together. Things only happen when we work together on a bipartisan basis. We need to do that. But we cannot let another month or two go by without having fixed the things that are right in front of us. We can't let time go by and not have dealt with the issues that lock people into a system that can raise their prices and take away their medicine while they have to continue to pay. That is outrageous.

There is a better way to do this through Medicare. That is the way it should have been done from the very beginning. There is absolutely no reason we can't go back and get this right.

I hope everyone who cares about this issue will be speaking out, will do everything they can to raise this issue and call on us to act and get this right. This is not the finest hour of this Congress or this administration. We can do much better than what has been done.

I am going to continue to do everything in my power to both fix this in the short run for people and then make sure we have a real prescription drug benefit for people as we go forward. Medicine isn't a frill. This is about life and death for too many people. We need to go back and get this right. I am hopeful that, working together, we will.

Thank you, Mr. President.

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