Tom Allen

Mr. ALLEN

Mr. ALLEN. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, during the debate on this legislation yesterday, there was a great deal of bipartisan concern about the high prices that our seniors pay for their prescription drugs. In fact, we did pass the Crowley-Coburn amendment which would provide for those seniors who are healthy enough and able enough to go to another country to buy their prescription drugs relief for those few. But it is worth remembering that only 2 weeks ago the majority in this House passed by three votes a piece of legislation preferred by the pharmaceutical industry that would rely on private insurance companies for seniors to get prescription drug coverage. At the same time, a Democratic alternative that would have provided a Medicare prescription drug benefit was not allowed even to have a vote in full debate. Today, I rise to offer an amendment that would give taxpayers full disclosure of their investment in the research and development of prescription drugs. In the debate over extending a prescription drug benefit to Medicare beneficiaries, the pharmaceutical industry has repeatedly raised concerns that efforts to make drugs affordable could impact their ability to conduct research and development of new drugs. Mr. Chairman, we all support the industry's breakthroughs that have improved and extended the lives of people with serious illnesses and chronic disabilities, but the explosion in prescription drugs' prices, increased utilization, the widespread lack of prescription drug coverage has left millions of Americans unable to afford the drugs that their doctors tell them they have to take. When Medicare was created 35 years ago, there was no provision for prescription drug insurance, because the pharmaceuticals played a smaller role in health care and that was not a significant cost. But today seniors, who represent 12 percent of the population, consume one- third of all prescription drugs. The lack of adequate coverage, combined with a high price of prescription drugs means that seniors are left to make choices that no American should make. Do they pay the rent or take their high blood pressure medication? Do they buy groceries this week or fill their prescription for an osteoporosis drug? Now, the pharmaceutical industry has been working to stop our efforts to provide a benefit under Medicare or a discount for seniors who need a discount, and it is also true they always make the point that they need these huge profits in order to conduct research and development, but after they spend in 1999, $24 billion in research and development, they still had $27.3 billion in profits. These dozen or more companies. The April issue of Fortune magazine reports that once again, Fortune pharmaceuticals are the most profitable industry in the country by every measure; number one in return on revenues, number one in return on assets, number one in return on shareholder equity. Now, the historical evidence suggests to us that continued R&D will increase despite what the industry says. In 1984, when the Waxman-Hatch Act was passed, the industry predicted that it would lead to cutbacks in R&D; but, in fact, the pharmaceutical companies more than doubled their investment in research and development from $4.1 billion to $8.4 billion over the 5 years following the enactment of that legislation. Finally, I would note that what is going on here is that the pharmaceutical industry is developing new drugs in partnership with the public. Though we do not have exact figures, an estimate by the National Institutes of Health is that taxpayer-funded research, combined with private foundation-funded research, accounts for almost 50 percent of all the medical research in this country related to pharmaceuticals. It is time for the industry to disclose just how much is spent by private industry and just how much is spent by the taxpayers essentially in the development of new drugs. We need real figures from the industry. Our amendment is simple. We are simply asking for disclosure. We should not expend any money for the FDA to approve a new drug application unless the total cost of research and development of the drug is revealed. Mr. Chairman, we are particularly interested in knowing how much taxpayers have contributed to the development of these new drugs.

Mr. ALLEN. Mr. Chairman, I yield the balance of our time to the gentleman from Ohio (Mr. Brown).

Mr. ALLEN

Mr. ALLEN. Mr. Speaker, this is a day of shame for the House of Representatives. The Republican leadership will not allow a vote in a debate on the Democratic prescription drug benefit under Medicare. Instead, Republicans have produced a bill that says to our seniors, HMOs and insurance companies can help you. We will give those companies your tax dollars, and we will hope they will offer you insurance coverage. But the insurance companies are saying loudly and clearly, we will not provide stand-alone prescription drug coverage. Every day in this country seniors do not fill their prescriptions. They cut their tablets in half. They do not take their medicines or do not eat well because the most profitable industry in this country is charging the highest prices in the world to people who can least afford it, including our seniors. Canadians, Mexicans, HMOs, insurance companies, they all pay far less than our seniors. The Republican bill is not relief for seniors, it is a prescription to protect drug company profits and Republican Members of this House from defeat in November. Mr. Speaker, when we look at a person who pays $2,300, they will wind up paying $1,700 out of their own pocket under the Republican plan. That plan is a fraud.

Mr. ALLEN

Mr. ALLEN. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, we simply disagree on this issue. Without the language concerning a presidential certification, we continue to object. Mr. Chairman, I yield back the balance of my time.

Mr. ALLEN. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, the amendment I am offering designates a small amount, $200,000, of the State Department's diplomatic account for bilateral and multilateral activities designed to promote the termination of the North Korean ballistic missile program. Everyone agrees we must address the potential threat of a ballistic missile attack by Korea. The question is, what is the most effective and economical way to deal with the threat? Some argue the best way, the only way, to deal with North Korea is to build a defensive shield and then hope that it can shoot down a missile after it is launched. This approach assumes, of course, that a national missile defense would work as advertised, which has not been proven and could not be fooled by decoy technology, which we may never be sure of. We must continue to research and test national missile defense more rigorously than we are now, but given the technological uncertainties, NMD remains a risky and expensive option to deal with the North Korean threat. It is safer and cheaper to deal with a missile that has never been built than to gamble that it can be hit after its launch. Last year, the administration conducted a comprehensive North Korea policy review led by former Defense Secretary William Perry. It concluded that the urgent focus of U.S. policy toward North Korea must be to end its nuclear weapons and long range missile-related activities for which the U.S. should be prepared to establish more normal diplomatic relations with North Korea and join in South Korea's policy of engagement and peaceful coexistence. We have already seen progress. Last year North Korea pledged to suspend tests of its long range missile in exchange for easing of U.S. sanctions. North Korea reaffirmed the pledge last week. Skeptics say trust their deeds, not their words, and I agree; but the fact is North Korea has not tested its Taepo Dong 1 missile in the 2 years since the first provocative test. Some may scoff at the notion of negotiating with a Stalinist state, but it is worth exploring. In the June edition of Arms Control Today, Leon Sigal, an expert on North Korea and security issues, presents a cogent case that based on past experience cooperation with Pyongyang can work. He finds that the best strategy for ending North Korea's nuclear and missile programs and ensuring peace in northeast Asia is cooperative threat reduction. The historic North-South Korea summit offers the chance to foster improved security conditions in the region. The Perry review found that South Korea and Japan and even China share our interests in reducing the North Korean threat. We should take advantage of the opportunity. This amendment sends a congressional signal of support for continued diplomatic efforts to reduce the North Korean missile threat. This not only makes security sense; it makes fiscal sense. Diplomatic efforts to end the threat can be done at pennies on the national missile defense dollar, which is a $60 billion program. The funding in this amendment is one-hundredth of 1 percent of the amount we will spend next year, $2 billion on national missile defense. There is more than one way to reduce the North Korean threat, and some ways are cheaper than others. Mr. Chairman, I do not want to micromanage and tie the State Department's hands, so I will, at an appropriate time, withdraw the amendment; but I think it is important to indicate Congress' support for diplomatic avenues to end the North Korean missile threat. Subject to any comments on the other side, I ask unanimous consent to withdraw the amendment.

Mr. ALLEN. Mr. Chairman, I yield myself such time as I may consume, and I seek the time in opposition to the amendment. Mr. Chairman, I rise in opposition to this amendment because this issue has come up in previous years. The State Department has opposed it. In the past, the State Department, during conference, has been able to get language added, making it subject to a presidential certification. And that language is not in the amendment of the gentleman from Louisiana (Mr. Vitter) today. This amendment is unnecessary because the administration has already said that it will not implement the September 1997 Memorandum of Understanding on secession to the ABM Treaty prior to its ratification by the Senate. In a letter and report provided to the chairman of the Senate and House Committee on Appropriations dated February 9, 1999, the President certified and affirmed that the United States Government is not implementing the Memorandum of Understanding. The way it is currently worded, without the President's certification language, the State Department would be prevented from sending representatives to meetings because it would prohibit money for any participation. The State Department wants to be able to participate in meetings even though it is not implementing the agreement. If the prohibition is on implementation but the State Department is not implementing, they can attend meetings with the presidential certification. In our view, Mr. Chairman, this is an attempt to obstruct the arms control dialogue. It is unnecessary and it is unjustified. What we are saying is simply that the way this amendment is worded at this particular time will hamper ongoing discussions about arms control unnecessarily. Mr. Chairman, I reserve the balance of my time.

Mr. ALLEN. Mr. Chairman, I offer an amendment.

Mr. ALLEN

Mr. ALLEN. Mr. Chairman, I rise in opposition to this amendment, which could delay health protections for millions of Americans. National ozone standards are a key tool in the fight against respiratory disease. Last year the DC Circuit court ruled that the new 8-hour ozone standards can not be implemented in their current form. However, it did not question their scientific basis, and it recognized that current law requires EPA to designate non-attainment areas for the new standards. Because the case is under appeal to the Supreme Court, the EPA cannot impose sanctions or restrictions or non-attainment areas. EPA cannot enforce the new standards until the Court has ruled on the appeal, so this amendment will not save any counties or states from paying federal penalties. This amendment will only prevent us from knowing just how polluted our air really is . . . . . . And needlessly delay ozone reductions that will improve air quality for every American. Opponents of tighter standards say that designating non-attainment areas will be too costly. They say that gathering air quality information is not worth our time or money. But with rising asthma rates and soaring health care costs, delaying tough ozone standards will be far more expensive. Today 30 million Americans live with lung disease, and their conditions worsen with each breath of unhealthy air. It costs more than $10 billion a year to treat the 17 million Americans who suffer from asthma. Asthma rates are growing most quickly among young children, so there is every reason to believe that costs will continue to climb. But health care costs alone don't tell the whole story. Unhealthy air hurts everyone's quality of life. Last fall, when I introduced a bill to cut toxic emissions from power plants, I was joined at a press conference by Joan Benoit Samuelson, an Olympic marathon gold medalist, and Maribeth Bush, a young woman from Portland, Maine who suffers from chronic lung disease. Ironically, each woman said that she doesn't need to watch the weather report to learn the air quality in Maine that day. One woman has met challenge as a world class athlete, while the other finds every breath she takes a challenge. Yet both need only step outside each morning to determine if the air is unhealthy to breathe. On a bad ozone day, everyone suffers, and this amendment will only delay improvements in air quality that will help us all breathe more freely. The amendment is unnecessary, it is harmful, and I urge its defeat.

Mr. ALLEN. Mr. Chairman, I rise in support of the Frelinghuysen/ Hinchey amendment to prohibit the VA from distributing health care funds through the Veterans Equitable Resource Allocation (VERA) formula. As I have said many times in the past, VERA has negatively impacted the VA's ability to meet the health care needs of veterans in the Northeast. I understand that VERA has benefitted certain regions of the country, but the level of care in those regions has been raised at the expense of Northeast veterans. The situation continues to get worse, not better for the 150,000 veterans in Maine. Veterans in my district rely on Togus VA hospital in Augusta. Those veterans who are treated at Togus cannot say enough about the quality of care. There is no question about it, if you can get in to see a doctor, the care is exceptional. The Doctors and nurses have dedicated their careers and lives to serving this population and recognize the unique care veterans need. But Mr. Chairman, Togus is located within VISN1. Despite this bill's $1.35 billion increase in the fiscal year 2001 VA health care budget, VISN 1 will only receive a $15 million increase. Togus alone already has a $9 million shortfall in Fiscal Year 2000. There is clearly a need for increased funding, and yet VISN 1 is one of only two VISNs that has lost funding since 1996 when VERA was implemented. While the quality of medical care remains high, budget constraints have forced Togus to reduce staff, causing severe strains on access to care, as well as staff morale. The excessive waiting time makes it difficult to enroll new patients. Because funding increases through VERA are tied to the number of patients seen, veterans in the Northeast regions are put at an automatic disadvantage. I am told over and over by the VA Undersecretary for Health, Dr. Thomas Garthwaite, that the VERA numbers work out. I am told that each VISN receives the appropriate amount of money to cover its costs. Mr. Chairman, the numbers are not working out. The former Acting Director of VISN 1 recently said that over the past few years equipment and construction funds were used to supplement funds for direct medical care. VERA simply does not provide the means to cover the facility costs of hospitals in the Northeast and still provide quality care. Recently, two Boston VA hospitals, West Roxbury and Jamaica Plain, began to consolidate their operations. However, there is no money to complete this kind of transition without affecting the care to veterans. Because Boston serves as the major surgical center for the VISN, the patient population of the whole region is going to suffer. The VISN does not have the $40 million required to complete this process smoothly. The cost of providing health care in aging facilities is not adequately accounted for in VERA. The formula must be reexamined. I am tired of hearing, ``the numbers work out.'' Anyone who visits Togus, or any hospital in the Northeast will clearly see that it is not working out for those veterans seeking care. There is simply no excuse, Mr. Chairman, for the hurdles our veterans must now face to access high quality health care. We need to make a greater commitment to funding veterans' health programs and we must find a new and better way to direct those resources to those in need. This Congress' fixation on hugh tax cuts for the wealthy is endangering funding for veterans programs, for housing and for other domestic programs. We must get our priorities straight, and keep our promise to the veterans in this country. Support the Frelinghuysen/Hinchey amendment.

Mr. ALLEN. Mr. Chairman, I thank the gentleman for yielding me this time. Mr. Chairman, I rise in strong support of the Olver amendment which will restore the 1998 agreement that allows the EPA to pursue common sense policies on greenhouse gas emissions. In 1992, President George Bush signed an international agreement that required the U.S. to reduce our carbon dioxide emissions. Eight years later, the U.S. has failed even to make those moderate reductions. Instead, our greenhouse gas emissions have increased by more than 10 percent, and there is no end in sight. Some on the other side seem to favor a ``don't ask, don't tell'' policy on global warming. Unfortunately, silence will not make this problem go away. Even the fossil fuel industry recognizes the threat of global warming. BP-Amoco, Sunoco and Shell International have all joined the Business Environmental Council, a group dedicated to reducing greenhouse gas emissions. These companies have publicly stated their belief that greenhouse emissions directly affect our climate. Instead of fighting common sense solutions every step of the way, we should be improving our energy efficiency, encouraging voluntary reductions, and looking for the most cost-effective ways to cut greenhouse gas emissions. I believe this amendment is a step in the right direction, and I urge my colleagues to support it. Mr. Chairman, I rise in support of the Olver amendment, which will restore the 1998 agreement that allows the EPA to pursue common sense policies on greenhouse gas emissions. Once again, the Republican leadership wants to handcuff the EPA from addressing the threat of global climate change. Unfortunately, this rider is just one more sign that many in this House are in a state of denial when it comes to climate issues. It wasn't always this way. In 1992, President George Bush signed an international agreement that required the U.S. to reduce our carbon dioxide emissions. Eight years later, the U.S. has failed to make even those moderate reductions. Instead our greenhouse gas emissions have increased by more than 10 percent, and there is no end in sight. Despite increasing emissions, it seems that the Republican policy on greenhouse gases has regressed since 1992. Language in this year's VA-HUD appropriations report would prevent EPA from taking any action to stem the threat of climate change. It's questionable if EPA would even be allowed to discuss climate policy with other nations. To make matters worse, this bill cuts funding for voluntary climate change programs by $124 million. Some on the other side seem to favor a ``don't ask, don't tell'' policy on global warming. Unfortunately, silence will not make this problem go away. Each day, the scientific community becomes more united in the belief that greenhouse emissions have an effect on global temperature. It now appears that the 1990s weren't just the hottest decade of the last century, but perhaps of the last millennium. Even the fossil fuel industry recognizes the threat of global warming. BP-Amoco, Sunoco and Shell International have all joined the Business Environmental Council, a group dedicated to reducing greenhouse gas emissions. These companies have publicly stated their belief that greenhouse emissions directly affect our climate. They have even called for cuts in emissions that are more stringent than those required by the Kyoto protocol. Mr. Chairman, with only 4 percent of the world's population, the U.S. emits more than 20 percent of global greenhouse gases. Any solution to global climate change must include U.S. participation. Instead of fighting common sense solutions every step of the way, we should be improving our energy efficiency, encouraging voluntary reductions, and looking for the most cost effective ways to cut greenhouse gas emissions. This amendment is a step in the right direction, and I urge my colleagues to support it.

Mr. ALLEN. I yield to the gentlewoman from Missouri.

Mr. ALLEN

Mr. ALLEN. I thank the gentleman for yielding, Mr. Speaker. Here we are again, back in the well of the House, talking about a problem that is a matter of immediate concern to seniors and others all across the country. A little history. I want to talk in a few minutes about the debates that are going to come up this week and next week here in the Congress over the issue of prescription drugs, but a little history is worth recalling. It was almost 2 years ago when I released the first study done by the Democratic staff of the Committee on Government Reform which shows that, on average, seniors pay twice as much for their prescription medications as the drug companies' best customers, being big hospitals, HMOs, and the Federal government itself buying either for Medicaid or through the Veterans Administration. That is an astonishing difference, a difference of about 100 percent of the most commonly-prescribed prescription drugs. We released that first study on July 2, 1998. In September I introduced legislation, September of 1998, that would provide a discount to every senior who is on Medicare, to all Medicare beneficiaries. The bill would work very simply. It simply would provide that pharmacists would be able to buy drugs for Medicare beneficiaries at the best price given to the Federal government. It is called the Prescription Drug Fairness for Seniors Act, H.R. 664, in this Congress. Then, in October of 1998, we did the first of the international comparisons. That was a study to show that Mainers pay on average 72 percent more than Canadians and 102 percent more than Mexicans for the same drug in the same quantity from the same manufacturer. Those two studies have been replicated in the first place in over 115 districts around the country, and in the second case, by dozens. I want to thank the gentleman from New Jersey (Mr. Pallone), who has done so much to help drive this issue, being here night after night after night and organizing the Health Care Task Force as the gentleman does. It is very clear what Democrats are advocating for. On the one hand, we are saying we need a discount. It is very simple, it does not cost the Federal government any significant amount of money, it does not create any new bureaucracy, but it would yield about a 40 percent discount for seniors who are already on Medicare paying out-of-pocket for their own prescription drugs. Let us remember that over half of all seniors have either no coverage at all, 37 percent, or very inadequate coverage from HMOs or through MediGap itself, so we are dealing with over half of the senior population which does not have adequate coverage for prescription drugs. Now, 2 years after we began this effort, the Republicans are finally coming up this week and next with a plan. It is interesting what that plan is, because we have been advocating for the kind of discount I described, and also a benefit to make Medicare updated, to make it more like what the plans of Aetna, Signa, United, the Blue Cross companies provide employees, a health care plan with prescription drug coverage. That is what we want for Medicare. Those plans negotiate lower prices for their beneficiaries. Medicare beneficiaries should get lower prices. But also, a discount is not enough. We have to have the benefit under Medicare. It all seems very simple, but in Washington not much is very simple. What we notice are two things happening this week. On the one hand, the Republicans are coming up with a prescription drug plan that relies on HMOs and private insurance companies. On this foundation is built a plan that, the truth is, will not help America's seniors, because instead of updating Medicare, instead of strengthening Medicare, instead of providing a Federal prescription drug benefit, what the Republican plan does is turn to HMOs. It says that they have been so successful in providing benefits for Medicare beneficiaries that we should let them provide prescription drug coverage, as well. Then it says that the plan provides that there should be room for private insurance companies to offer prescription drug coverage, stand- alone prescription drug coverage. So one of the things we notice is this is the plan that the Republicans are rolling out in the House this week. What we also notice is that, not by coincidence, the pharmaceutical industry is running ads suggesting that what this country's seniors really need is private insurance. What we can see is the Republicans in Congress are working hand in glove with the pharmaceutical industry, hand in glove with the HMOs and the private insurance industry. Here is the most interesting ad. This ad has appeared as a full-page ad in the Washington Post. This is either from Roll Call or the Hill magazines here. It is in Congress Daily. Everywhere we go in Washington we see this particular ad. I have never seen it in anything less than a full page in whatever publication it has been in. It is an interesting ad. It says, ``Read label before legislating. Private drug insurance lowers prices 30 percent to 39 percent. Shouldn't seniors have it?'' Now, I think seniors should get that kind of discount. That is exactly the kind of discount that is reflected in the Prescription Drug Fairness for Seniors Act. But my bill would provide that Medicare would negotiate lower prices for all 39 million Medicare beneficiaries. Under that kind of plan, Medicare would have real leverage to drive down prices. What is interesting about this particular plan, this particular advertisement, is that a portion of it reads as follows: ``12 million senior Americans now have no prescription drug insurance coverage. As a result, most of them pay full price for their medicines. That is because they don't have the market clout that comes with a drug insurance benefit.'' Now, it is interesting, until last week the pharmaceutical industry was attacking my proposal and others on the grounds that if it provided a 20, 30, 40 percent discount to seniors, that they would have to cut back on research and development costs. Here is an advertisement sponsored by PHARMA, the pharmaceutical industry, basically calling for a 30 to 39 discount. The question that might arise is, why do they not simply give seniors a 30 to 39 percent discount now? They set the prices, they can lower them tomorrow. But they do not. This is an industry ad saying, protect us from ourselves. We are charging seniors far more than we charge insurance companies, big hospitals, and HMOs, and the way to do that is to give private insurance to seniors. Now, to some extent we might say, well, does that not make sense? But the truth is, there is a glitch. There is a problem. The insurance industry says, we are not going to provide private insurance for prescription drugs. They have said it over and over and over again. Yet, the Republicans in this House are bringing forth a plan that depends on HMOs and private insurance companies. How does this work? What does it mean? Well, the private insurance, Chick Kahn, head of the Insurance Association of America, has said, we are not going to provide private insurance for prescription drugs because it is like ensuring against haircuts. There are so many claimants, in other words. They say to people up in Maine, if Maine were a low-lying State and 85 percent of the people every year put in a claim for flood insurance, we would not be able to buy flood insurance in Maine at any price. But 85 percent of seniors in this country take some form of prescription drugs. So despite the fact that the insurance industry is saying, we will not provide prescription drug insurance for seniors, the Republicans in this House are bringing up a plan that depends on private insurance for seniors. It will not work. Why are they doing this? What is the purpose of the plan? The only conclusion we can come to is that the Republican plan is not a plan to help seniors afford their prescription drugs. What it is is a prescription for Republican Congressmen. It is a prescription to help them in November by having the appearance of a prescription drug plan for seniors but not the reality of a prescription drug plan for seniors. It is an illusion. That is why it does not matter to the Republican leadership in this House whether the plan works or not, whether the insurance industry will actually provide insurance or not, or whether the plan will ever become law or not. It is designed as political cover. It is designed as a prescription drug theme for the fall elections, but not a prescription drug plan for seniors. It is America's seniors who need the help. It is America's seniors who write to me, and I am sure to the gentleman from New Jersey, and send us a list of the cost of their prescription drugs. Then they show us what they are earning. I have had people in my district say, ``Here is the list.'' I can remember a couple of women who wrote to me with basically the same kinds of numbers. They both said, ``My husband and I take about $650 of prescription drugs a month, but our two social security checks only come to $1,350. We cannot make do,'' so they do not take the medicines that their doctors tell them they have to take. I have other women who have written to me and said, I do not want my husband to know, but I am not taking my prescription medication because he is sicker than I am, and we cannot both afford to take our medication. That is wrong in this country. It is absolutely wrong. We have the power in this Congress this year to do something about it. As the gentleman knows, our task forces on the Democratic side have been working away developing plans that are not good politics, just good policy, policy that will help America's seniors, a benefit under Medicare that will help so people can get payment for their prescription drugs; so they are not driven to the hospital because they cannot afford to take their medications; so they can pay their rent and their food and their electric bills and still get medications that they need. That is what we are trying to do on this side of the aisle, but on the other side of the aisle what we have is private insurance. An astonishing ad, this one is. It says, in effect, protect us against ourselves. We are charging seniors too much and we know it, and if only the private insurers would come in and cover America's seniors, then we would reduce our prices to seniors. But they know that this will never happen. Here is the pharmaceutical industry with its own misrepresentation yet again to the people of the country. They are advocating a plan that will never happen because in fact the insurance industry will never provide stand-alone prescription drug coverage to seniors. This ad is a fraud, and the Republican plan is a fraud. It will not work. It will not happen. It is a prescription for Republican legislators in the fall. I think what we need in this country is a recognition that this issue will not go away. This problem that seniors face today will not go away until it is fixed. Every year, prescription drug spending goes up 15 to 18 percent year after year after year. So if we think we have got a big problem this year, a year from now, it will be 15 to 18 percent larger than it is right now. That is what we face in this country. I just want to thank the gentleman from New Jersey (Mr. Pallone) because this is a battle. We have a raid against the pharmaceutical industry and the HMOs. What we need to do, there is no reason, there is absolutely no reason to say that the only way we can give seniors prescription drug coverage is to pay private insurers to pay HMOs to provide that coverage when the insurers say they will not do it anyway. I mean, it makes no sense. We need a stronger and better and more comprehensive Medicare. We need a plan that will provide continuity and predictability and stability and equity. That is what we need. All the talk about choice and all the talk about private insurance is really a smoke screen. It is not about policy that will work for America's seniors. That is what we need to be doing. Seniors need help. They need it now. We can give it to them if we handle this issue right in the coming weeks. I thank the gentleman from New Jersey very much for yielding to me.

Mr. ALLEN. Mr. Speaker, the gentleman from New Jersey is exactly right. It is interesting. The Republican plan, because of its reliance on the private sector to deal with the problem of Medicare beneficiaries, is incredibly complex. I mean, basically they create a whole new bureaucracy to deal with this, and then they expect a variety of different private insurance companies and HMOs to pick up and deal with this particular problem. Well, let us look at what is going on in Medicare right now, in Medicare, managed care. Remember, we passed Medicare Plus Choice plan in 1997. The thought was, well, the HMOs will come into Medicare, and they will save us money because the private sector is always more efficient than the public sector. But in truth, the Medicare system, when one is in Medicare, there is no money being paid for profit. The overhead expenses and administrative expenses are far lower than in any private sector health care company. Look at what is happening with Medicare managed care right now. What we see is, every year, the benefits change. The prescription drug benefits, which in some cases were free, free prescription drugs essentially for no additional premium when Medicare managed care was created. Now the caps keep coming down every year. Now 62 or 70 percent of all plans have an annual prescription drug cap of $1,000 or less. The premiums go up. The copays go up. The benefits go down. But most striking, it is not available in most places. In seven out of ten counties in this country, Medicare managed care is not even available. It really only works, to the extent it works at all, in larger urban areas. Rural America gets left out. Frankly, maybe that is a good thing right now. But it is only very limited in my home State of Maine. I mean, no more than 1,500 people in the State of Maine have Medicare managed care plan. Managed care is not working very well with this particular population. We know that because, every July 1, the health care plans report to HCFA, and, again, last year, they dropped 400,000 people because it simply was not cost effective. They could not make a profit on those 400,000 Medicare beneficiaries. So they just dropped them from the plan. July 1 is coming up again. My colleagues are going to see plans all across this country, managed care plans, simply dropping their Medicare beneficiaries because they are not making money on this. So what do the Republicans do? They say we have got a prescription drug plan, and it relies on HMOs and private insurance companies. With all of the complexity, with all of the inequity, they are saying what we really need is more of a system that is not working. That is why I keep coming back to the thing that this is bad policy. It is terrible policy. At a recent caucus, a Republican pollster made a presentation, and that material got out and has been published and so on. Now it is very clear that the Republican pollster said for Republicans it is more important that people think, that people believe you have a plan than the content of the plan. So the appearance of the plan is more important than the content of the plan. That is bad. Basically, if we get the policy right, we will be doing the right thing. That is why, if we are going to make changes to Medicare, if we are going to deal with the Medicare population, if we are going to deal with the biggest problems that Medicare beneficiaries have today, which is the inability to pay for their prescription drugs, then we need to do it through Medicare. Medicare is reliable. It is universal. It is equitable. It is simple. It is cost effective. I find the cost of providing a benefit would be significant. But there is not anybody in this Chamber who says it is too expensive who does not support a tax cut that is much larger than the annual cost of providing a prescription drug benefit under Medicare. We can do this. We can do this this year. But we cannot do it with sham proposals, with private insurance companies who say we are not going to provide the insurance. Let us get to a real proposal. Let us get the Democratic benefit and the Democratic discount on the floor for a debate. Then I think we can do the right thing for America's seniors.

Mr. ALLEN. Mr. Speaker, will the gentleman yield?

Mr. ALLEN

Mr. ALLEN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I rise in strong support of the Waxman-Hansen-Evans- Meehan amendment. This amendment will remove the rider in this bill that prohibits the Department of Veterans Affairs from aiding the Justice Department in its suit against Big Tobacco. And in response to my friend, the gentleman from Pennsylvania, I would say that tobacco is addictive. It has been proven to be addictive. And alcohol has caused all sorts of problems in this country, there is all sorts of abuse of alcohol; but it is not addictive in the same way. No industry, no industry deserves a special exemption from Federal liability, and without help from the VA, the Justice Department will have to drop its suit against the big tobacco companies. We should not be legislating special protections for an industry that has lied to the Congress and deceived the American people. The VA spends more than $4 billion annually treating tobacco-related illnesses. If the Justice Department's suit is successful, and I believe that it will be, the VA will recover billions of dollars spent on health care for veterans. If this amendment fails, then the bill will prevent the VA from obtaining billions of dollars to help veterans who suffer from tobacco-related illnesses. Why should we not help those veterans? They need our help, and we ought to stand with them. We should not be trying to bail out Big Tobacco. This amendment does not take $1 away from veterans' health care. It uses money in the VA's administrative and legal expenses account to help fund the suit against Big Tobacco. Yet the tobacco companies are spending enormous amounts of money and working hard to convince Members that the Waxman amendment takes away from veterans' health care. That is absolutely false. In 1998, we passed a highway bill here in this House that became law. And in that legislation is language that urges the Attorney General and the Secretary of the VA to sue the tobacco companies so that money could be recovered to go to veterans' health care. And what we see in this bill today is a provision that would nullify what we did in 1998. It would prevent that money from being used, the litigation money, from being used to recover money for our veterans. Since when, Mr. Chairman, have the tobacco companies cared about the health of the American people? They make a product, which used as directed, kills people. Their future prosperity depends on enticing young people to take up smoking. They swore they were not doing that just a few years ago, and we have found since that it was not true. The tobacco companies want relief from a legitimate lawsuit at the expense of our veterans. A vote for this amendment is a vote for veterans' health care and against the unlimited greed of the tobacco industry. Vote ``yes'' on the Waxman amendment.

Mr. ALLEN

Mr. ALLEN. Mr. Chairman, I move to strike the requisite number of words. Mr. Chairman, I rise in strong support of the Sanders-Boehlert-Kind amendment, which cuts corporate welfare and boosts energy efficiency programs that benefit consumers and the environment. This amendment restores $45 million to programs that help low-income families reduce energy costs, that help States implement efficiency programs, and that foster investments in new efficiency technologies. All of these programs have been cut in recent years just as America's energy needs have been rising. This amendment renews our commitment to energy efficiency as a cornerstone of our energy policy. The offset is the fossil fuel R&D account which has been identified as corporate welfare by consumer and taxpayer watchdogs, including the National Taxpayers Union and Citizens Against Government Waste. On top of direct appropriations, we also subsidize the fossil fuel industry through exemption from environmental laws. For instance, America's oldest and dirtiest coal-fired power plants are still exempt from Clean Air Act emissions standards that were enacted 30 years ago. These grandfathered power plants continue to spew tons of pollution into our air, adding to smog, acid rain, mercury poisoning, and global warming. While industry profits from this exemption, the public suffers increased respiratory problems and expensive environmental cleanups. If America is to create a sustainable and cost-effective energy policy, we must reduce our dependence on highly polluting fossil fuels. Improving energy efficiency is an important first step toward that goal. Mr. Chairman, as we begin the summer months with the threat of brownouts and rising fuel costs, now is the time to make a commitment to energy efficiency. This amendment is a small but significant step toward a 21st century energy policy that lowers consumer costs and protects public health and the environment. I urge my colleagues to support this amendment.

Mr. ALLEN

Mr. ALLEN. Mr. Speaker, I thank the gentleman for yielding me this time. Here we go again, another week, another irresponsible Republican tax cut. Now, I believe that we do need to provide immediate estate tax relief for those who own family businesses, but this Republican repeal of the estate tax costs so much, $50 billion a year when fully phased in, that it does threaten Social Security and Medicare, and makes much less likely the chance that we will provide prescription drug coverage for our seniors. Now, I have talked to a lot of small business owners in my district of Maine, and the stories they tell are compelling, and Congress should do more to lift the tax burden on these essential family businesses, family businesses that make up a large part of the life of our smaller communities. The Democratic alternative would provide immediate tax relief to closely-held businesses and family farms by reducing all estate tax rates 20 percent across the board and increasing the small business exclusion to $4 million per family. This Democratic alternative is a step in the right direction and provides more immediate relief than the Republican plan. Now, let us be clear. The President will veto H.R. 8. So the choice for us today is clear: An irresponsible tax plan, with costs that explode in the future, threatening Medicare and Social Security for the baby-boom generation; or a bipartisan plan that will provide immediate tax relief to those who truly need it. Vote ``yes'' on the Democratic substitute and reject H.R. 8.

Mr. ALLEN

Mr. ALLEN. Mr. Speaker, I thank the gentleman for yielding me this time. The gentleman from Ohio was saying earlier this is a partisan effort. Well, there is no reason why this should be a partisan effort. It is our democracy that is at stake. Republicans and Democrats have a stake in restoring some credibility to this system, and we cannot have that credibility, we will not gain that respect unless we have full disclosures for these stealth organizations, these section 527 organizations, that are out there raising unlimited amounts of money with no accountability, no disclosure. If it is a fundamental principle on the other side that they want disclosure, this motion to recommit will give it.

Mr. ALLEN. Mr. Speaker, I thank the gentleman for yielding me this time. Mr. Speaker, I rise in support of this bill. It is time we repealed this outmoded and regressive tax. I hope we will make another change to the Tax Code through the motion to recommit. Section 527 organizations simply should disclose their contributors. One of those organizations is called Citizens for Better Medicare, though it is not really made up of citizens. It is funded with vast, but undisclosed, sums from the pharmaceutical industry; and they run ads to persuade Americans or try to persuade Americans that it is okay to price prescription drugs at twice the level that they charge HMOs, big hospitals, the Federal Government, Canadians, Mexicans, and the rest of the world. Citizens for Better Medicare is a political organization, it runs political ads that urges people to call your Congressman. It has secret funds, and it spends some of its money attacking the Canadian health care system. Well, last year, the gentleman from Texas (Mr. DeLay), during the debate on campaign reform said what reform can restore accountability more than an open book? It is incredible and baffling that we will not support this motion to recommit today. We have a chance to require disclosure, to open the books and to let the sunshine in on big money and politics.

Mr. ALLEN

Mr. ALLEN. Mr. Speaker, I thank the gentlewoman from New York (Ms. Slaughter) for yielding me this time. Mr. Speaker, I welcome this reform to the Tax Code, and I am pleased that this motion to recommit will be the first vote on campaign finance reform this year. The shadowy political hit squads being set up under section 527 of the Tax Code should be required to disclose their contributors. I agree with the majority whip, the gentleman from Texas (Mr. Delay), who during the campaign finance debate last year said, and I quote, ``What reform can restore accountability more than an open book?'' So it is baffling why he opposes opening the books on these section 527 groups. The gentleman from Kansas (Mr. Moore) and the gentleman from Texas (Mr. Doggett) have legislation to require disclosure of these stealth political groups. Good government demands that we approve that bill. One section 527 organization is called Citizens for Better Medicare. This is a front group set up by the pharmaceutical industry designed to give the impression that regular citizens want to keep seniors' drug prices as high to maintain the industries profit margins. Here is how they work. Citizens for Better Medicare gathers the database of names that it claims are concerned citizens and then sends postcards on their behalf, often without their knowledge, to Congress with the message that seniors do not deserve prescription drug discounts. Then they hire a telemarketing firm to make unsolicited phone calls to these seniors to tell them why their drugs should not be cheaper and then swiftly connect them to Members of Congress. This practice is confusing and deceptive. The latest telephone scheme by Citizens for Better Medicare is to prey on children. A new web site, callyourgrandma.com, offers children phone cards with 10 free minutes of long distance so they can call their grandmother and explain why she does not deserve cheaper drugs. The catch, the kid has to submit personal information, a name, address, and phone number. Developing a database of children to exploit and in order to justify their discriminatory pricing practices, that is what the drug companies are doing through Citizens for Better Medicare. I am pleased that we are going to have a chance today to stop that practice.

Mr. ALLEN

Mr. ALLEN. Mr. Chairman, I rise in opposition to the Cox-Markey amendment. All of us agree that North Korea is a dangerous rogue state, but this amendment is about whether or not we can promote policies to make North Korea less of a threat or we just sit by and let the threat develop. We all agree we want to make North Korea less dangerous, and that is why we should reject this amendment. In 1994, the closed North Korean government opened up just enough to sign an agreement with us to eliminate its nuclear weapons program. The agreed framework has given us a great opportunity to reduce the threat from that country. The Cox- Markey amendment could jeopardize that opportunity by causing the United States to renege on its end of the bargain, which was to work with South Korea and Japan to build civilian nuclear reactors in North Korea. The amendment would, in effect, construct an insurmountable barrier to our cooperation in the framework. Now any businessperson knows the importance of dealing with liability issues before the deal goes forward. If we block the possibility of the U.S. Government assuming some, and certainly not all, of the liability for the reactors, we likely sink this deal. The proponents are claiming to speak for the American taxpayer, but the rush to deploy a national missile defense is premised on defending against the North Korean missile threat, and that system's price tag is $60 billion. Those are real dollars to the American taxpayer. But the proponents of this amendment are rejecting a sensible effort to reduce the North Korean threat before it becomes a problem. The agreed framework is far from perfect, but it gives us the opportunity to eliminate North Korea's nuclear weapons program and to make their missile program less threatening, and it is far, far cheaper than $60 billion. Our national security policy is not served by a policy that says let us sit idle while they build it, and hope that some untested, unproven antimissile shield will work after the missiles are launched. I urge my colleagues to think of the consequences of this vote, to think of the long-term security interests in Korea, and vote against the Cox-Markey amendment.

Mr. ALLEN

Mr. ALLEN. Mr. Speaker, I thank the gentleman for yielding me this time. Mr. Speaker, for reasons stated by the gentleman from Mississippi (Mr. Taylor) and the gentleman from Missouri (Mr. Skelton), I rise in opposition to this rule, although I believe the underlying bill is a good bill. I want to commend the chairman of the Committee on Armed Services, the gentleman from South Carolina (Mr. Spence), and the ranking member, the gentleman from Missouri (Mr. Skelton), for their hard work in putting together such complex and important legislation. I urge particular support for the health care provisions. The gentleman from Hawaii (Mr. Abercrombie), the gentleman from Mississippi (Mr. Taylor), the gentleman from Missouri (Mr. Skelton) and the gentleman from Indiana (Mr. Buyer) have done a great job of putting together a bipartisan package that improves the Tri-Care system and increases health care access for retirees. I want to focus on the provision to extend the pharmaceutical benefit to military retirees over the age of 65. Prescription drug coverage is a vital issue for all seniors, and I am pleased this committee has made a small but important contribution to provide affordable and meaningful coverage to a segment of the Medicare eligible population. I hope that other committees will follow suit. The Tri-Care Senior Pharmacy Program in this bill allows all military retirees to participate in the DOD pharmacy program. Under this government-run prescription drug benefit, the Defense Supply Center in Philadelphia negotiates prices for its beneficiaries that are as low or lower than those obtained by other Federal agencies. The Defense Supply Center receives some drugs off the Federal supply schedule and negotiates pricing agreements with more than 200 manufacturers, using as a starting point the mandated 24 percent VA discount. DOD estimates that these negotiated prices are 24 percent to 70 percent lower than the average private sector price. My bill, H.R. 664, the Prescription Drug Fairness for Seniors Act, would give the rest of the Medicare eligible population the same discounts that this provision provides. We have 153 cosponsors, but none so far are Republicans. I hope that they will now embrace my bill as warmly as they have embraced the Tri-Care Senior Pharmacy Program. Now, I do not accept the accusation that H.R. 664 involves price controls. But those who do must also conclude that this prescription drug benefit for military retirees is, indeed, a price control. Like the Democratic Medicare prescription drug plan, the Tri-Care Senior Pharmacy Program is administered by a Federal agency making good on the government's promise to provide health care for life for military retirees and the promise to provide health care in the golden years for the over 65 population at large. It uses the government's volume purchasing power to negotiate and achieve the same price discounts that favored large purchasers obtain. Unlike the Republican prescription drug plan, this program does not throw military retirees to the whims of the private insurance market leaving them guessing about whether they can get prescription drug insurance from an industry that says it cannot offer such insurance anyway. As we cast our affirmative vote for this legislation, and I hope we all will, please consider these questions. If Congress can provide a government-administered prescription drug benefit with negotiated price discounts to one segment of the Medicare eligible population, military retirees over 65, why can we not offer the same benefit to the rest of our Nation's seniors? If Congress can give 1.4 million Medicare eligible military retirees access to the best prices the government can negotiate, why is Congress not giving the other 38 million seniors the same access to the best prices that the government can negotiate? I urge support for the bill and for affordable and meaningful prescription drug benefits.

Mr. ALLEN

Mr. ALLEN. Mr. Speaker, many of my Democratic colleagues tonight are headed to Michigan to be with our colleague, the gentleman from Michigan (Mr. Stupak) and his family in a moment of great trial for them. The Stupaks have suffered the tragedy most feared by all parents. They have lost one of their sons, and our thoughts and our prayers are with them tonight. Mr. Speaker, I am here tonight to talk about the problem that many of our seniors are facing with the high costs of prescription drugs. This is a problem that is becoming more and more apparent to a majority of Americans. Seniors in my home district in Maine and across the country are finding it increasingly difficult to pay for the drugs that their doctors tell them they have to take. And over the last 2 years, as I have listened to people in my district, as I have conducted studies in my district that show that seniors pay on average twice as much for their medications as the best customers, the pharmaceutical companies, that is, the big hospitals, the HMOs and the Federal Government itself through Medicaid or the VA, as those studies have rolled out first in Maine and then around the country, we have had more and more correspondence, more and more phone calls from people who say they simply cannot do it any more. They cannot take their medication because they cannot afford their medication. I have had letters from women who tell me I do not want my husband to know, but I am not taking my prescription medication, because he is sicker than I am, and we both cannot afford to take the medicines that our doctors say we must. I have had letters from people who describe how much they are paying, in many cases hundreds of dollars a month, when their only income is a Social Security check for $650 a month. The math does not work. They cannot make it. And I regret to say that the response in this Congress has not been fast enough. It has not been quick enough to deal with this particular problem. Part of the answer lies in the tremendous power of the pharmaceutical industry, this industry which has done so much good in this country, developed new medicines that prolong lives, that enhance the quality of life for so many people in this country, if, and only if, they can afford to take the medication that the industry has developed. Here in Washington, this is the industry that spends the most in campaign contributions, that spends the most in lobbying, and anyone who watches television knows this is an industry that spares no expense when it comes to advertising its products on TV or trying to influence public opinion through TV. When we watch those ads, $1.9 billion last year in direct-to-consumer advertising, all of that costs gets wrapped into the costs of the pills that our seniors and that others need to maintain their quality of life and simply to stay out of the hospital. We need to take some action, and there are two ways to go at this problem fundamentally, two sensible ways to go at this problem. One is to update Medicare and to provide a prescription drug benefit under Medicare. When Medicare was created in 1965, over 50 percent of our seniors had absolutely no coverage at all for their hospital coverage. They had no health insurance at all. So if they got sick and had to go to the hospital, they either had to pay out of their own pocket or they could not get the care that they needed. That is why Medicare was enacted. And today in the year 2000, no one in his right mind would create a system like Medicare and not provide prescription drug coverage. Many employees across this country have coverage for their prescription drugs, but then they get to 65, they retire, they fall under Medicare, and they do not have coverage for their prescription drugs. Some get Medigap policies, about 8 percent get Medigap policies, but they have limits on the amount of the benefit that they provide and they are often very expensive. Mr. Speaker, 37 percent of seniors in this country have no coverage at all for prescription drugs and when we add those who do not have any coverage to those who have Medigap insurance, to those who have some coverage of prescription drugs through an HMO plan, that group is again 50 to 60 percent of the country which really does not have adequate coverage. Why do I say that those who are covered by Medicare Plus, Choice or other managed care plans do not have adequate coverage? Well, look at what happens with these private sector plans. What happens is that the benefits change every year. And lately the benefits have been going down. The cap on prescription drug coverage has been going down each year. And today 62 percent of all Medicare managed care plans have an annual benefit of a $1,000 or less. Now, people need help. We have got a couple of different approaches here that I will talk about a little later: One, an approach to create a benefit under Medicare; secondly, a bill that I have sponsored and has 153 cosponsors in the House, to provide a discount to everyone who is a Medicare beneficiary who buys prescription drugs and pays for it out of his or her own pocket, a discount for everyone. That is one approach; the benefits another. What I wanted to start with tonight are some of the new developments that are occurring. Today, on the floor of the House we have the defense authorization bill, and this is a very important piece of legislation, $310 billion to provide for our national security. It covers a wide range of different topics. And what I want to do is to reflect on one of the provisions in that legislation. It is a provision to extend pharmaceutical benefits to military retirees over the age of 65. Now, as I have said, prescription drug coverage is a vital issue for all seniors, and I am pleased that the Committee on Armed Services, on which I sit, has made a small but important contribution to provide affordable and meaningful coverage to a segment of the Medicare eligible population. What we need to do is go beyond providing this benefit to military retirees, which I support, to make sure that everyone on Medicare has this kind of benefit. Now, to describe the military retiree program, the TRICARE Senior Pharmacy Program in the bill would allow all military retirees to participate in the Department of Defense pharmacy program. And under that government-run prescription drug benefit, the Defense Supply Center in Philadelphia negotiates prices for its beneficiaries that are as low or lower than those obtained by other Federal agencies. Now, the Defense Supply Center receives some drugs off the Federal supply schedule and negotiates pricing agreements with more than 200 pharmaceutical manufacturers around the country and uses as a starting point the 24 percent mandated discount that is specified in the Veterans Administration statute. The Department of Defense estimates that these negotiated prices are 24 to 70 percent lower than the average private sector price. Now, the bill I have does much the same, gives the same kind of discount to all Medicare beneficiaries, not just military retirees. What it does is it allows pharmacies to buy drugs for Medicare beneficiaries at the best price given to the Federal Government, and that best price is usually a price obtained through the Veterans Administration or a price obtained by Medicaid. Now, what we have done in this defense authorization bill is very much like the Democratic Medicare prescription drug plan. The TRICARE Senior Pharmacy Program is administered by a Federal agency and basically makes good on a part of the government's promise to provide health care for life for military retirees, only, unfortunately, part of the promise, and the promise to provide health care for the over 65 population at large. Now, the TRICARE Senior Pharmacy Program uses the government's volume purchasing power to negotiate and achieve the same drug price discounts that favored large purchasers obtain. This is very different from the Republican plan which is emerging from this Congress. This program, unlike the Republican plan, does not throw military retirees to the whims of the private insurance market, leaving them guessing about whether they can get prescription drug insurance from an industry that says it cannot offer such insurance anyway. Let me make that point clear. What we believe will be the Republican prescription drug plan, after 2 years of talking about this issue on our side of the aisle, the Republicans are believed to be coming up with a plan that involves a government subsidy to seniors to buy private prescription drug insurance. There are a couple of problems with this approach. Number one, there is no cost containment, no way to hold down prices, and no leverage over price, which means that probably drug prices will go up. But there is a second problem. As the head of the Health Insurance Association of America has said, insuring seniors against prescription drugs is like covering people for haircuts. There are too many claimants. Everyone is a claimant. The industry is basically saying, we are not going to provide stand-alone prescription drug insurance, and yet that is what the Republican prescription drug plan is based on, both in the Senate and here in the House. And you cannot get there from here, as we say in Maine. So I am arguing that military retirees deserve the kind of coverage that is set forth in this defense authorization bill that we discussed today and will vote on tomorrow, but I do ask all people in this Congress and across the country this question: If Congress can provide a government administered prescription drug benefit with the Defense Supply Center in Philadelphia negotiating lower prices, why can we not do the same thing for all of the Medicare population across the country? If Congress can give 1.4 million Medicare eligible military retirees access to the best prices that the government can negotiate, why can Congress not give the other 38 million American seniors the same access to the best prices that the government can negotiate? I mean, this is very, very simple. Here we have a plan, a discount plan, reflected in my bill, which is H.R. 664, the Prescription Drug Fairness for Seniors Act, which involves no significant Federal expense, involves no new bureaucracy, but would provide seniors with up to a 40 percent discount on their prescription drug prices simply by organizing seniors into a block to negotiate lower prices. This is exactly what happens in the private sector. Aetna, Cigna, United, the Blue Cross plans, all of the private sector health care plans negotiate lower prices for their beneficiaries. Why should Medicare not do the same? Well, I can tell my colleagues what is happening here. What is happening here is the pharmaceutical industry is saying this is price controls. This is price controls. And my argument is nonsense. It is not true. Because what we are talking about is a price that is negotiated and that reflects a price that is a percentage below what is called the average manufacturer's price, which is a market price. The pharmaceutical industry controls that. All we are saying is there is no reason, there is no reason why seniors in this country should pay the highest prices in the world. This problem, in summary, is very simple. The most profitable industry in the country is charging the highest prices in the world to people who can least afford it, people without coverage for their prescription drugs. And in this country seniors are 12 percent of the population, but they buy 33 percent of all prescription medications. That is why we have a national crisis, that is why this is a national scandal, and that is why it needs to stop. One of the recent developments besides the defense authorization bill is what has happened, I am proud to say, in my home State of Maine. The State legislature and the Governor have agreed on a bill which breaks new ground. It is very much like the bill that I have introduced here and which has 153 cosponsors, unfortunately no Republicans yet, but in Maine what the State legislature has done is basically to provide that the State of Maine will, in effect, be what is called a pharmacy benefit manager. The State will negotiate lower prices for 350,000 people in Maine who today have no prescription drug coverage. It is very simple. Buy in bulk and save money. Very simple concept. Since these people have no insurance plan to negotiate for them, they will get something called the Maine RX card, and the State Department of Health and Human Services will negotiate lower prices with the pharmaceutical industry for those people in Maine. We are confident that we can get lower prices because the State will be representing so many different people. Now, once again the pharmaceutical industry is saying this is a terrible step to take, but people are fed up. People are fed up in Maine and they are fed up around the country. They know that price is the problem. They know that this industry charges the highest prices in the world to people here. Let me elaborate on that for a moment. The study that I did first in Maine and now has been replicated in probably 140 districts around the country showed that seniors, on average, pay twice as much for their medications as the drug companies' best customers. And the best customers, as I said, are the big hospitals, the HMOs, and the Federal Government itself. That study was done first in July of 1998. In October of 1998, I released a second study, and it was the first to do these international comparisons. What it showed is that Mainers pay 72 percent more than Canadians and 102 percent more than Mexicans for the same drugs in the same quantity from the same manufacturer. There is no justification for that. None. The fact is that the industry charges whatever the market will bear. And because seniors, and more generally people who do not have prescription drug insurance, are not organized, do not have anyone to negotiate for them, they pay the highest prices in the world. It needs to stop, and Maine is doing something about that. What is going on here in Congress is also worth noting. What the Democrats have done is come up with a plan, it was announced last week, a plan in which the Senate Democrats, the Clinton-Gore administration, and the House Democrats can agree. That plan is simple. It provides a universal but voluntary prescription drug benefit under Medicare. Enrollment is voluntary but anyone can sign up when they are ready to enroll in Medicare. The coverage basically works this way. There are two parts to the coverage. First, the basic benefit and, secondly, a catastrophic benefit. The basic benefit works like this: At the beginning, for a small monthly fee, an individual will get a reimbursement for up to $1,000 on a 50 percent copay basis for their prescription drugs. In other words, if an individual spends $2,000 on prescription drugs in the course of a year, and many seniors do, they will be reimbursed $1,000 from the Federal Government. Not reimbursed, but the Federal Government will pick up 50 percent of the cost as they go along. If at some point they hit $3,000 in out-of-pocket expenses, at that point our plan will pick up all of the subsequent costs. Medicare will pick up all of the subsequent costs. What we are trying to do is make sure that those who are hurt the most get the most help, but that everyone benefits. And everyone benefits in another way as well, because the discount concept, which is reflected in my legislation, has been incorporated into this Democratic Medicare Prescription Drug Act of the Year 2000. Because for those people, when they are not entitled to a benefit, when they run over the price a bit, then they still get a discount, they still get the buying power of Medicare behind the price. So there will be a negotiated reduction in price. Now, the important thing is the goal, and the goal is very simple. We would use private-sector pharmacy benefit managers to administer this particular plan. And that is what they do for Aetnas, the Cignas, the United HealthCares of the world right now. But they would be charged, very clearly, with getting the same deal for Medicare beneficiaries as they do for their own. In other words, the goal is simple. We are going to get the best price for Medicare beneficiaries. And within 2 years, there would be a review by the GAO to see whether or not the Health and Human Services is meeting that goal. It is very important that we meet that goal. And if we do not, then we will have to go back and try another approach. There are benefits here for employers. Because employers who are now providing drug coverage to their employees would get an incentive payment to keep continuing that coverage. And there is low-income protection, as well. Some people simply cannot afford their prescription medication at all. So for those below 135 percent of the poverty line, what the Democratic plan does is provide all the co-pays and all of the premiums, so that at that level people would get the full coverage for their prescription drugs. Between 135 percent of the poverty level and 150 percent of the poverty level there would be a subsidy-based on a sliding scale. But the important point is this: Everyone would get the benefit of a discount and everyone would get covered under Medicare. That is very different from the Republican plan, because the Republican plan really relies on private-sector insurance companies. And if we know one thing about private health care insurance, it is that the premiums change every year. In fact, they almost always go up every year. Talk to any small businessman or woman, talk to any of the self- employed around the country today and what they will say is, my premiums went up 15 percent, 20 percent, 25 percent, 30 percent this year and about the same amount the year before. They cannot afford it. The small business community is having a terrible time affording health care and largely because of the rapid increase in the prices of prescription drugs. We have to get some control over this system, some level over the system, some ability to hold down prices so that small businessmen and women can afford their health care premiums, and seniors in this country can afford to buy the drugs that their doctors tell them they have to take. Now, this is, as I have found, a very long struggle, a very long struggle. What is going to happen, I suspect, over the next few months, is we will have a lot of battles back and forth over whose plan is best. But it is clear now that there is a growing consensus that we have got a problem, we have got a major problem, not a small problem, but a major problem for millions of Americans all across this country. And their problem does not vary with their income. This is not a case where we can say, well, let us help those who are low income, because there are lots of Americans, middle-income seniors, who cannot afford their prescription drugs because their prescription drug costs are so high. The size of their problem depends less on their income and more on the amount of prescription drugs that their doctor tells them they need to take. That is the problem. So we have to deal with price. We have to deal with price. To contrast for a moment what appears to be the Republican plan with the Democratic plan, the Democratic plan is designed to cover everyone both with a benefit and with a discount. The Republican plan is aimed primarily at low-income beneficiaries. The Democratic plan has a way to contain costs, to use pharmacy benefit managers contracting with Medicare as a way to negotiate lower prices with the pharmaceutical industry. The Republican plan relies on private insurance companies, which have not been successful at holding down costs. There is no real cost containment in that plan. Thirdly, the Democratic plan is an improvement in updating of Medicare, the foundation of health care for seniors, one of the most successful programs that we have that the Federal Government has ever adopted, a plan that needs to be strengthened and reformed but not weakened. The Republican plan relies on private insurance companies. What we need in this country for our seniors is stability and continuity and predictability. We do not want plans where every year the co-pay changes, the benefit level changes. And in many cases, as we are finding with Medicare managed care, whole areas in this country are simply dropped by the insurance industry. That is not what we want in Medicare. We want stability and continuity and predictability and equity in this system. That is what we need and that is what we can get with the Democratic prescription drug plan. I urge everyone who cares about this issue to make their voices known. One of the things I found in my 4 years in this place is that what we do here depends on the amount of public energy, public concern outside these halls. This is a case where those who care about this issue need to speak up. In the weeks and months ahead, what we will find in this debate, I believe, fundamentally is that we can find common ground, if not this year, next year. But we need to reach across the aisle and come to a conclusion about how best to approach this particular problem. People who cannot afford their prescription drugs are Democrats, Independents, Republicans. They are people from all walks of life, all parts of the country. And this is a case where although we have partisan differences over proposed solutions, we do not have partisan differences over the problem. The problem is the same for everyone. If we can find a way to work across the aisle to pull these two different approaches together, then I think we can find success, as others have done in this House on a Patients' Bill of Rights and in other areas. We can do it with prescription drugs, as well.

Mr. ALLEN

Mr. ALLEN. Mr. Chairman, I thank the gentleman for yielding time to me. Mr. Chairman, I rise in opposition to the amendment for all of the reasons set forth by my friend, the gentleman from New York (Mr. Boehlert). I rise in strong support of the underlying bill. Mr. Chairman, this bipartisan compromise plan is a historic opportunity to preserve America's natural resources for future generations. It will protect endangered wildlife and improve coastal habitats. It will help towns build new ballfields and help States preserve scenic hiking trails. It encourages urban parks and protects rural farmland. CARA does all this without creating new taxes or fees. Instead, it simply rededicates offshore oil and gas revenues to the conservation programs they were intended to fund. In this time of budget surpluses, there is no reason that these fees should be diverted from their original purpose. This commonsense idea enjoys unprecedented support, with the backing of all 50 Governors and communities across the Nation. In my home State of Maine, a coalition of more than 230 business, conservation groups, municipalities, and sportsmen's groups has rallied behind this bill. These unusual allies recognize that when we invest in our natural resources, we improve our communities, our health, and our quality of life. In Maine, CARA funding will be used to supplement the $50 million Land Conservation Fund that Maine voters approved with overwhelming support. It will allow us to realize once in a lifetime opportunities to protect tracts of the northern forest that have been targeted for development. CARA will help us preserve those pristine areas for traditional outdoor recreation that we in Maine have enjoyed for generations. Mr. Chairman, this landmark bill is perhaps the most important piece of environmental legislation we shall see in the 106th Congress. By passing this measure, we can ensure that Congress meets its commitment to help States and communities preserve their natural resources for generations to come. I urge my colleagues to reject the amendment and support the underlying bill.

Mr. ALLEN

Mr. ALLEN. I thank the gentleman for yielding me this time. Mr. Speaker, I rise in strong support of H.R. 4040, the Long-Term Care Security Act. The bill before us today is the product of bipartisan cooperation. I applaud the efforts of the gentleman from Florida (Mr. Scarborough) and the gentleman from Maryland (Mr. Cummings) in bringing it to the floor today. As the baby boom generation ages, the need for long-term care will become acute. For example, the average cost of nursing home care is expected to double in the next 30 years. We cannot expect Medicare or Medicaid to absorb such costs and still pay reasonable benefits for acute care needs. It is therefore essential that individuals begin to plan for an almost certain increase in health care costs in their later years. To plan for their retirement needs, younger employees need information about long-term care insurance and access to private sector insurance plans through their employers. The private sector must be involved in planning for employees' long-term care needs. H.R. 4040 allows the Federal Government to act as a responsible employer by offering its employees the opportunity to acquire group long-term care insurance with no significant cost to the taxpayer. Under the provisions in this bill, long-term care insurance will be made available to all Federal workers, military service members and retirees at group rates. Employees will pay the full cost of the premium but have the advantage of a reduced rate. I hope that the example set by the Federal Government will encourage all employers to offer group long-term care insurance to their employees. This program has the potential to create a national model for long-term care insurance and for retirement planning. I again want to thank the gentleman from Florida (Mr. Scarborough), the gentleman from Maryland (Mr. Cummings), the gentlewoman from Maryland (Mrs. Morella), the gentleman from Indiana (Mr. Burton) and the gentleman from California (Mr. Waxman) for all their hard work in bringing this legislation forward. H.R. 4040 is an example of the kind of work this House can do when we act in a fair and bipartisan manner. I thank them for their leadership and urge the swift passage of this bill.