Thomas Coburn

Mr. COBURN

Mr. COBURN. I think it is important for us to know, the lady you just described is on Premarin which in this country, a generic has been waiting to be approved by the FDA for 5 years to sell at 20 percent of the price of what she is paying right now, the exact same drug.

Mr. COBURN. Madam Speaker, will the gentlewoman yield?

Mr. COBURN

Mr. COBURN. For one third of the price?

Mr. COBURN. Mr. Speaker, I thank the gentleman for his comments. In closing, the next time my colleagues hear a politician from Washington talk about prescription drugs, ask themselves why they are not treating the pneumonia that this industry has, ask themselves why they are not saying there needs to be competition in drugs, ask themselves why they are not saying the FDA needs to be approving more generics, ask themselves why they are not speaking about the underlying problems associated with delivery of health care and medicines to our seniors instead of creating a new program which our children will pay for but, most importantly, will be twice as expensive as what it should be because we have not fixed the underlying problems. I want to leave my colleagues with one last story. I recently had one of my senior patients who had a stroke. She was very fortunate in that she had no residuals. But the studies of her carotid arteries proved that she had to be on a medicine to keep her blood from clotting. One of my consulting doctors wanted to put her on a medicine called Plavix. It is a great drug. It is a very effective drug. The only problem is it costs over $200 a month. The alternative drug that does just as well but has a few more risks, which she had taken before in the past, is Coumadin. Now, the difference in cost per month is 15-fold. I could have very easily written her a prescription for Plavix. She would have walked out of the hospital, not been able to afford the Plavix, and had another stroke, or I could have done the hard work and said, this is going to do 95 percent of it. It is going to be beneficial. It has a few risks. Here is what this costs. What do you think? She chose to take the Coumadin because that gives her some ability to have some control of her life. So these are complex problems; and I do not mean to oversimplify them, and I do not mean to derange either the physicians, the patients, or the drug companies, other than to say that our whole economy is based on a competitive model and, when there is no competition, there is price gouging. Today I honestly believe in the drug industry there is price gouging. We need to fix it, and we need to fix that before we design any Medicare benefit to supply seniors with drugs, especially since there are free programs out there that are not being utilized that are offered by the drug companies.

Mr. COBURN. Let me clarify that for a minute, because I want to be sure all our colleagues understand that. That is Federal payments for prescription drugs.

Mr. COBURN. Well, I thank the gentleman for making the point on competition, and I think that is the question I would ask of the seniors and those that are out there working today and those that are going to be working tomorrow. Would it not make sense to try to fix competition within the industry, improve the quality of our health care and increase the efficiency and accuracy of the system before we go solve the problem? The question is can we make sure our seniors have available to them the drugs that they need, that will give them effective treatment, and can we do that in a compassionate way so that they are not passing up supper to take a pill or they are not missing a pill to get supper? Can we do that without creating a big government program? I can tell my colleague that I believe we can. It will not be easy, because we will have to attack our friends. We are going to have to say there is not good competition. We are going to have to go back in and make sure that the branches of government that are involved in assuring competition in the drug industry are there. That is not to say that the drug companies do not do a wonderful job in their research. And it is not to say that they are not going to be doing an even better job as we have all these genetically engineered drugs that will come about in the next 10 years. But we hear the drug companies say that they will not be able to do this because all these prices are based on the fact that we spend all this money on R&D. Well, the fact is the pharmaceutical industry spends more money on advertising than they do on research. They have a cogent argument as soon as that number on advertising drops significantly below the amount of money that they are spending on research. Until then, they do not have an argument that holds any water. So our seniors out there tonight that are having trouble getting prescription drugs and affording it, the first thing they need to do is to ask their doctor to make an application for them for the indigent drug program that almost every drug company has. That way they can at least have the drugs. Number two, they should ask their doctor if in fact there is not a generic drug that could be used that will be almost as effective and that will save a significant amount of money each year. Number three, they should ask the doctor if he or he is sure that every medicine they are taking they have to be taking. That way we can make sure that the patients are getting medicines that they need today; that the medicines that they are taking are as effective and cost effective as well, and that they truly need them. That takes care of part of the demand. The other thing they can do is insist that their representatives ask the Justice Department to look aggressively at collusion and anti-competitive practices within the drug industry. They should ask their elected representative to reverse the bill 2 years ago that allowed drug companies to advertise prescription drugs on television. Because we could save at least $2 billion this year, $5 billion next year in terms of the cost of drugs. Finally, they should ask that their representative not steal one penny from Medicare this year to run the Government. And if in fact we do those things, we can meet the needs of our seniors, we can preserve Medicare and extend its life, and we can assure that our children and our grandchildren are not going to be burdened with another program that is inefficient, underestimated in cost, and really does not solve the underlying problem associated with prescription drugs for our seniors. I yield to the gentleman from Minnesota for any additional comments.

Mr. COBURN. That is an anti-diabetic drug.

Mr. COBURN. Augmentin is a very effective antibiotic.

Mr. COBURN

Mr. COBURN. Mr. Chairman, I just want to point out that the gentleman's intent is a good intent, because the gentleman from New York just made the argument in Atlanta that if one is a school teacher or fire fighter, but if one is a nurse making the same amount of money living in the community, one does not have the opportunity. We just rejected an amendment, two votes for it on a floor vote, we did not ask for a recorded vote, that said this house is overwhelmingly decided we are going to subsidize the purchase of homes for municipal employees. That is what we have just said. So if we are going to do that, why do we not share subsidization with the people that are paying the taxes that also need help buying a home who would also qualify for that? I believe that is the gentleman's point, plus the fact that a nurse in these areas is a qualified health professional that would also be of great advantage to the community. So what we are saying is the base bill gives us a $5 billion plus up; and we are saying, let us make it $300,000. Let us do the rest of the homes.

Mr. COBURN. Mr. Chairman, will the gentleman yield?

Mr. COBURN. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, I have listened this morning as speaker after speaker has come to this floor to discuss how important this bill is, to provide the necessary assistance to allow city employees to live where they work, and I would agree with that. I think that is an important consideration. I have a question for my colleagues. Is it not also equally important that factory workers, union members, small businesses owners, Federal employees, the clergy, and nonprofit employees live where they work? The same help provided under this bill to municipal employees is not provided to any of these individuals that I listed. If we are facing the housing crisis that we described, which I believe that we may be, then why help just some individuals? Why not help them all? Why are some Americans more worthy of receiving Federal housing assistance than others? This amendment is about fairness. I want to walk through with my colleagues for a minute who benefits under this law and who does not. Who qualifies for government-funded down payment assistance? Closing costs, support mortgage? Anyone, provided they make less than 80 percent, that is what the answer is. Local government employees making up to 115 percent of area median income or 150 percent in areas with high housing costs, what is the lowest down payment an individual can make to qualify for an FHA loan under the current law? Under H.R. 1776, 3 percent of the total purchase price, that is the current law, or 1 percent for teachers, fire fighters, rescue personnel, or law enforcement officers, under the new bill. At what price can you buy a HUD home? 100 percent of appraised value. Under this new bill, 50 percent if you are a teacher, a fire fighter, rescue personnel, or a law enforcement officer; but that is not applied to you if you are the union worker building the home in that area or if you are the preacher that has a community church in that area. That is not forwarded to you. I believe that this is a question about fairness. This amendment is designed to strike all but the 50 percent discounts that are directed in this bill. Mr. Chairman, I reserve the balance of my time.

Mr. COBURN. Mr. Chairman, I yield myself 30 seconds. Mr. Chairman, what the gentleman just made a logical argument for is to say that pastors and union members and small business owners are going to default at a higher rate than the groups they have selectively placed out, because in fact, earnings through this program are based on default rates. The lower the default rate, the more increased the earnings are. The assumption of his argument is that that is what would happen. The other part of his argument, which I find completely inaccurate, is that a firefighter has more impact in a community than a pastor. I think that is wrong. Mr. Chairman, I yield 30 seconds to the gentlewoman from Florida (Mrs. Meek).

Mr. COBURN. Mr. Chairman, I yield the balance of my time to the gentleman from South Carolina (Mr. Sanford).

Mr. COBURN. Mr. Chairman, I yield myself such time as I may consume. This is the amendment that we spoke about. I just want to outline basically for the Members of the body and those people at home what this amendment does. What we have already said is if we pass this bill, we are going to subsidize middle-income America to buy homes at a cheap rate, certain groups at a lower rate than others, and that the other people who are making that same amount of money will not have the same opportunity as the people that have been ferreted out through social engineering in this bill. So what this amendment does is it allows 1 percent down payments on FHA homes, and it would allow HOME funds to be used for down payment and closing cost assistance, as well as mortgage subsidies for the following individuals: those employed on a full-time basis for a tax- exempt authority. That means preachers, youth ministers, social workers, members of an organization under the jurisdiction of the NLRB. That means any union member would have exactly the same opportunity to buy a home, especially those that are building the homes; they are paying the taxes, they make the same amount of money; but if one happens to be a carpenter for the city, you get to buy that home, but if you happen to be the carpenter working to build that, you do not have that advantage. Those employed on a full-time basis by the Federal Government; those employed on a full-time basis by a small business, the very heart of these communities that we are trying to enhance; those who have a financial interest in a small business, as well as those who would qualify for a child-care tax credit. In addition, the amendment would allow CDBG funds to be used for down payment and closing cost assistance as well as mortgage subsidies for any resident of a community, provided that they meet the income restrictions. This is about fairness. If, in fact, we are going to subsidize, and that is the will of this Congress, we should not at the same time pick winners and losers out of people who have exactly the same income status in this country, and that is what we are doing, regardless of our social goal. What we are doing is saying, if one is not a fire fighter, then one cannot have this advantage, even though one may do something just as valuable in the community; or if one is not a policeman, if one is not a teacher, if one is not a municipal employee, and what we are actually saying when we do that is we are saying a municipal employee has more value than any other employee in the city who makes the same income. To me, I think that is unfair, and I think that is one of the great flaws with this bill. I would hope that the gentleman from New York would support the expansion of this. Mr. Chairman, I reserve the balance of my time.

Mr. COBURN. Mr. Chairman, I yield 2 minutes to the gentleman from South Carolina (Mr. Sanford).

Mr. COBURN. Mr. Chairman, I yield myself such time as I may consume. The gentleman's argument is that the city should not have to live with the consequences of their own rules on their own citizens and, therefore, the Federal Government should make up that difference. That is what we are talking about. The question that I would have for the gentleman from New York and the gentleman from Massachusetts, if in fact that is true and they do not want to support this amendment, then surely they will consider the next amendment. The reason that that is, is because if in fact we are going to take the premise that a city can require people to live within their district and then say the housing costs are so high we cannot afford to pay to fulfill this rule, that the Federal Government ought to come along, is it not fair to create in that mix a broad spectrum of people? The gentleman from Illinois (Mr. Rush) is going to say it is equally important to have a nurse there, a health care professional there. What can be wrong with that? Why would we not want to advantage nurses?

Mr. COBURN. I yield to the gentleman from Massachusetts.

Mr. COBURN. Reclaiming my time, the gentleman from New York (Mr. LaFalce) just told us that this would enhance HUD by $5 billion. Would enhance. Your own testimony from your side of the argument has already said that you will enhance this program by $5 billion according to the CBO. So why not allow the gentleman from Illinois' amendment? Mr. Chairman, the gentlewoman from California (Ms. Waters) has an amendment to bring this back to 80 percent. If we are really concerned about fairness and spreading this money out, bring it back to 80 percent and expand the pot to everybody. Expand the pot to the people that are paying the taxes who are not going to get any advantage out of it. Let us expand it to the union worker who actually builds a house, the union plumber who puts the plumbing in the house. He is disadvantaged. It is interesting to note that the American Homebuilders Association is opposed to these amendments. They are up here lobbying for certain people to be advantage when their own employees who are paying the taxes for it will get no benefit other than a job.

Mr. COBURN. Mr. Chairman, the only question I have is the Federal Government did not set any mandates on any city that their employees be a resident.

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

Mr. COBURN. Mr. Chairman, I just want to continue the point related to this amendment, which is that the vast majority of the people I think in this House are going to want to increase this limit. The point the gentlewoman from California made is there is not enough money to go around if, in fact, we increase the limit. My reason for objecting is we ought to have a vote of the House if we are going to do that, and that was the purpose.

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

Mr. COBURN. My union record is not all that bad if the gentleman will look at it.

Mr. COBURN. I guess the point is, the testimony is that it is going to be enhanced by $5 billion just what we do. And if you really think it ought to be broadened, then let us broaden it to everybody. We will defeat my first amendment but you support the second one which does broaden it and does create fairness in the housing market.

Mr. COBURN. Mr. Chairman, will the gentleman yield?