Jim Greenwood

Mr. GREENWOOD

Mr. GREENWOOD. That is an issue for our children. How they are going to be able to pay for the costs of our retirement. This issue gets complicated, and I know some of the viewers across the country watching this tonight are maybe trying to decipher all of this language and sometimes we in Washington use language that is a little difficult to decipher. Let me try to give some perspective as to how different folks around the country might see this. First off, if one is retired now or soon to retire, and they have a good prescription drug benefit because they work for an employer, a government employer or a large Fortune 500 employer that provides coverage, and they are in pretty good shape, they do not need to worry about this because they are not going to be forced to buy anything they do not need. They are in good shape. If that changes at any time, we think we are going to create some products in the market that they want to avail themselves of but no one is going to force anything on them. If they are retired or disabled today and they are one of that one out of three who does not have access to a prescription drug benefit, what we are saying to them is we are going to make one available to them and one that they can afford. And we think we can do it very soon. If one is low income, if they are at that 135 to 150 percent of poverty level and they do not already qualify for Medicaid or a State- run lottery program, the Federal Government will pay all of their premium. So this is really a great benefit for them. It is at no cost and it is real coverage and they do not have to wait until they get to some catastrophic level. It is there. If, on the other hand, they do not have the coverage or they expect that by the time they retire they will not have the coverage and they are middle- or upper-income, they just want access to it, they just want to find something they can afford, we think that somewhere at a cost of about $50 a month, as a Medicare beneficiary they will be able to buy this coverage just like they do now, through their part B premium, pay for the extra coverage to go to the physician and the outpatient care and so forth. So from many of those perspectives, it is a good deal. Let me make one other comment before I yield back to the gentleman. If one is a taxpayer out there and they are looking at this saying, yes, it is great for Congress to provide this coverage; but we do not want to see the budget broken again, it has been broken before. This is not free drugs for all, this is a prudent, affordable plan that tries to make it affordable at the low-income level and make it affordable at the middle- and upper-income level with those folks contributing something out of their pocket so that they understand this is a shared responsibility between the Federal Government and the Medicare beneficiary.

Mr. GREENWOOD. Mr. Speaker, security is what all seniors want. It is what we will want when we are seniors, and that is the security, the peace of mind to know that I do not have to worry about whether I can afford the drugs that my doctor says I need. It is as simple as that. I do not have to worry about whether I can afford the drugs, the medicines that my doctor says I need. That is what we ought to be about providing for Americans. I have what I call my Medicare prescription drug advisory group at home. I have seniors, I have disabled folks, I have the local pharmacists. We sit around and meet regularly and talk about this issue and talk about where the hardships are and talk about the people. Particularly, the druggist is an interesting participant because he talks about the people who come into his little store, his corner store, and try to buy a prescription drug, and he has to turn them away if they do not have a plan or they are shocked by the cost of this. For those people, there is no peace of mind; there is no security that the American dream afforded by these miracle products is for them. But the bottom line is that we can do it. We can do it as Republicans. We can do it as Democrats. We can get the job done, and we can get the job done this year.

Mr. GREENWOOD. Mr. Speaker, the gentleman from North Carolina and I happen to be Republicans; and we can say, because we work more closely and more frequently with our Republican Members on our side of the aisle, from the Speaker of the House to the majority leader to the Whip to all of the officers and leaders in our party down to every Member, freshman on up, there is a complete commitment and a desire to get this job done. I think that is true on the Democratic side of the aisle, and I think it is true in the White House. But we know we cannot get it done by ourselves. We can bring a Republican bill out here, a purely Republican bill, and if the Democrats in the House and the Senate tell the President it is a bad bill, he will veto it. That has not helped a single senior. So we have to try to get a bill through the Congress that Republicans and Democrats like. We have to be able to do what most Americans want us to do, compromise, find the middle, accept each other's positive suggestions, get that job done, put the bill on the President's desk. I believe that this President, as he leaves town, can say that is one thing I got done; and I think this Congress can say, come the election, come what may, we got that job done. Because the odds are, even if we did not get this done this election, this year, wait till the next election, we will be back in the same position. There will still be Republicans and Democrats in town. The Congress may be divided. The difference between the White House and the Congress will still be there. So there is no point in waiting. The time to do it, as the gentleman from North Carolina (Mr. Burr) said, is now. The will is here. The financial situation is here to do it and certainly the need to do it is. Mr. Speaker, I thank the gentleman from North Carolina for his participation in the Special Order this evening.

Mr. GREENWOOD

Mr. GREENWOOD. Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days within which to revise and extend their remarks on H.R. 4444.

Mr. GREENWOOD

Mr. GREENWOOD. Mr. Speaker, I thank the gentleman for yielding me this time. As the previous speaker, I do not think there is a moment that I have been more proud to be a Member of this body than I am today. The Children's Health Act is Congress's Mother's Day present to the Nation as well as an early Father's Day present. What makes us good mothers and fathers is our devotion to our children. Nothing so sharpens, focuses and deepens a parent's devotion as when their children are ill. When the child's illness is chronic, the parent's devotion becomes life long. Parents will do whatever they can for their children, but sometimes they need our help. They need Congress to fund research about the treatment and the cure for these diseases. They need us to help educate physicians and to monitor the incidence of these diseases. This bill will provide new hope to parents of children with the long list of diseases that the gentleman from Florida (Mr. Bilirakis) laid out in the beginning. In addition, it creates a brand new pediatric research initiative at the National Institutes of Health. I would like to focus my remarks on the story of autism in this bill. Autism is the third most common childhood disorder in America. It affects 400,000 people in the United States. One out of every 500 babies born in this country has autism. Parents with children with autism see their children grow and develop normally and suddenly they seem to vanish. They lose their communication skills, their language skills. It is an agony for the parents. This disease was misdiagnosed for a generation. Parents were told that their children were autistic because they had been poorly parented or traumatized. It was a cruel misdiagnosis on the part of these physicians. But the parents of these children formed an organization called Cure Autism Now and they did what the civics books told them to. They came to Washington, they told their elected representatives of their experience and they asked for our help. We put together an autism bill and we began the long process. These parents came to press conferences, sometimes press conferences without press. They came and they did everything humanly possible to make the country and to make the Members of the United States Congress aware of their children's special needs. They came to the hearings and they testified. It is a scary thing to come to a hearing before the United States Congress and talk about your child, but they did that. Then they suffered the agonies of the congressional clock, and they waited month after month, year after year for Congress to slowly get around to this bill. Today that day has finally come. Then finally in the last few days, they suffered the agonies of watching the possibility that this bill would get hijacked by other agendas, perfectly good agendas but agendas that would make the bill controversial. Finally, today, just about when they had been ready to give up hope, the system worked and today we take up their bill, and we should be proud to do so.

Mr. GREENWOOD

Mr. GREENWOOD. Mr. Speaker, this evening some of my colleagues from the Committee on Commerce, as well as from the Committee on Ways and Means, are going to spend the next hour talking about a subject that is the subject of a lot of talk lately, and that is usually a good sign, because right before the Congress gets around to legislating, the level of rhetoric picks up and the amount of speeches on the floor increases. So I think we are getting actually very close to the point where we will, in fact, enact a prescription drug benefit for Medicare. In 1965, when Medicare was created, it was a big step in the American health care history. Prior to that time, if one is a retiree, if one was elderly or if one was disabled and one could not afford their own health care, they did not have any. So in 1965, the Congress of the United States, in a historic moment, decided to provide Medicare coverage for the elderly and ultimately for the disabled, and then what it covered was that which is most obvious, hospitalization and visits to physicians. No one really gave serious consideration in 1965 to extending that Medicare benefit to prescription drugs, for a couple of reasons. Number one, it was a huge step to do what the Congress did in 1965 in providing coverage for hospitalization and physicians; and, secondly, Americans were not relying upon prescription drugs anything like they are today. Today, we are blessed as a Nation, and indeed as a world by an industry that has created miracle drug after miracle drug; wonderful, brilliant scientists in laboratories who have cracked the mysteries of the human genome, who have cracked the mysteries of the human body physiology to the point where we can prescribe and create drugs for a variety of illnesses that used to not only cause great pain and suffering, but premature death. Today, if one does not have access in the year 2000, if one does not have access to a good prescription drug benefit plan, one simply does not have good access to good health care. So the Congress of the United States, although it has been talking for years about the need to provide this coverage, has heretofore, so far, not accomplished that. Why can we do it today and why are we talking seriously about it today? We are talking about it today because the Congress, in fact, since the Republicans have taken over the majority of the Congress, have taken the necessary fiscal steps to end the endless deficit spending that our Nation was experiencing for so many years. We have balanced the budget. We have reformed Medicare itself to bring the costs into a reasonable level. We have reformed welfare, and we are going to save something on the order of $55 billion, or probably $200 billion over the next 5 years in welfare costs alone. We have taken just this year, just in the last several months, we have taken Social Security finally off budget. We have said that no longer will we spend the Social Security surplus on a host of other causes, but, in fact, we will use Social Security payments only for Social Security and the rest of the surplus will be used to pay down debt; and we are now paying down the Nation's debt. So finally, now that the budget is balanced, now that we are paying down debt, now that we have a surplus, we are in a position to responsibly, to responsibly provide a prescription drug benefit for Medicare for the Nation's elderly and for the disabled. About two- thirds of the Medicare population already has access to some kind of prescription drug benefit, but a fully one-third does not, and those are disproportionately low-income individuals. What are our goals in doing this? Number one, we do want to provide affordable coverage to every American who is a Medicare beneficiary by virtue of their age or their disability. Secondly, we want to do that in a way that does not break the bank all over again. We do not want to create a runaway spending program that is unregulated and causes the Federal Government to go back into the bad old days of deficit spending and budgets in the red. Thirdly, we want to reduce the cost of prescription drugs for everyone who is now paying the highest price. And today, if one does not have a prescription drug plan and a doctor provides a prescription, one walks into a pharmacy and they pay the highest price that anybody pays in the world, you may if you are all alone in the marketplace and do not have anyone to bargain for you. Finally, we do want to make sure that when we have accomplished this, that the industries, the pharmaceutical companies and their brilliant scientists, the biological industry that is doing so much to create new miracle cures will be vital enough to continue to provide those products for us into the next generation, the drugs that will eventually cure cancer, that will cure AIDS and so many other ailments. Mr. Speaker, I am joined this evening first off by a colleague from the Committee on Ways and Means who is working on a joint task force that the Speaker has put together, drawing on members of the Committee on Commerce on which I serve and the Committee on Ways and Means, the distinguished gentlewoman from Connecticut (Mrs. Johnson), who is an expert on health care, and I yield the floor to her.

Mr. GREENWOOD. Mr. Speaker, if the gentlewoman would yield briefly on that point, the question is why should the Congress not just say to every retiree, everyone on Medicare, every beneficiary: we will pay 100 percent of all of your prescription drugs benefits. The answer is, in part as you said, the younger generation asked to pay that bill would be wiped out. But, secondly, two out of three seniors today already have a prescription drug benefit, many of them provided by their former employer. As I travel to the senior centers around my district I say, How many of you already have some kind of a prescription drug benefit? And there is a show of hands. How many of you receive them from your former employer? And a goodly number of hands go up. Usually, it is either the big Fortune 500 companies that were able to provide these generous benefits, or they worked for a governmental entity, a school district or a State or the Federal Government. If we moved in and started to pay all the prescription drugs, employers would drop that coverage like a rock and all of a sudden the two-thirds of the seniors who already have a benefit, albeit maybe not the perfect one and we might be able to supplement their benefits, but those would all of the sudden be shifted from the private sector to the public sector and be enormously expensive.

Mr. GREENWOOD. Mr. Speaker, if the gentlewoman will yield, what is interesting, of course, is that no matter who we speak to in this town, talk to Republican Members of the House or Democratic Members of the House, Republican and Democratic Members of the Senate, the President, et cetera, we all agree on one thing: let us provide a prescription drug benefit to Medicare beneficiaries, and let us do it this year. So there is wide agreement, which is historic. It has not really happened before. Now what happens? We have different opinions. The President has a plan. There are numerous plans in the House. Republicans in the House, like the gentlewoman from Connecticut and I, have a plan that we have proposed. And now we get into the business of deciding how to work these different ideas and merge them into one. What I find so frustrating is that it is an election year. It is not only an election year for the entire House and a third of the Senate, but for the presidency of the United States. And this issue is so easy to demagogue. If we listen to C-SPAN regularly and listen to the rhetoric on the floor, it is easy to accuse the other party of not really caring about seniors, and of course that is nonsense. We would not be here doing this job if we were not interested in the welfare of our constituents, particularly the elderly and those disabled who do not have a prescription drug benefit. So we are going to have a good discussion about methodology. How do we do this? What we do, what the Republican House plan does is say let us use the insurance model, since we know that pouring money and paying everything ourselves will not work for the reasons we have discussed. Let us create an insurance model. How do we do this? First off we want to make sure that that insurance premium is affordable for middle-class Americans. And as we look at this chart, again, insurance companies have been reluctant to provide affordable drug-only plans because of this end over here, because of that high end of the chart. Because they can sell a prescription plan tomorrow and the next day a brand-new drug comes out that costs a $1,000 or $2,000 or $3,000 a month; and it comes onto the market, and now the insurance company is losing money hand over fist. What we have said in our plan is we will stop the loss at somewhere in this range, somewhere between $6,000 and $8,000 is about where we will cut off the insurance company's exposure to risk, and the Federal Government, through Medicare, will pay for all of that. Now, we have a plan that only has to cover the first several thousand dollars of exposure, which most Americans will fall under that, and it becomes affordable. Now, how does it become affordable to the lowest end of the socioeconomic ladder? What we would do is we would pay 100 percent of the premium for everyone below 150 percent of poverty. So the poor elderly and the poor disabled would get free insurance. Talk about giving everything for free, they would get the whole plan free at no cost. For those middle-class-and-above Americans, they would have a small, relatively affordable monthly premium that they could pay and could choose between plans out there in the market to buy the plan that is best for them. An elderly person with very little in the way of prescription drugs might want a plan that has a low premium and a high deductible. If someone has a lot of expenditures, they might want a different plan. We enhance choice with our approach. Mr. Speaker, that is our idea in a nutshell, and we can go on later about some of the details. The President has a plan, as I say. But for goodness sake, what must happen this year is that Republicans and Democrats, the Congress and the President have to get together and say: let us roll up our sleeves, let us get the best of your ideas, the best of our ideas, merge them into a bill, get it signed into law. Because at the end of this year, either we will have done that and done a tremendous service to the people of this country, President Clinton will have some legacy, something that Presidents want to have before they leave office, and the system will have worked. On the other hand, if all we do is point our fingers at one another and try to take political advantage of the issue, shame on all of us. And what I recommend to the voters at the next election is vote us all out of office if we do not figure out how to work together collaboratively.

Mr. GREENWOOD. Mr. Speaker, reclaiming my time, as we have discussed a little bit, there have been criticisms of the plans. And one of those criticisms has been, what part of the debate has been, what are we really going to do to lower the cost of prescription drugs? A lot of the debate and rhetoric that we have heard about this issue has been focused on strictly the cost of prescription drugs, how do we bring down the cost of prescription drugs. There are those who think that the answer to that question is to have some sort of governmental price controls on prescription drugs. That is a pretty scary proposition, because once we start down the road of price controls in a free enterprise market like the American system, we run the risk of killing the very industries that are providing these miracle drugs. So how do you do it? Well, the answer is that, for that one-third of the Medicare beneficiaries, the elderly and the disabled who do not have this coverage today, that one-third walks into a drug store with the prescription, they have an illness, they have an ailment, they are suffering from something, they go to their doctor, their doctor writes a prescription for them, they take that prescription, they go into the drug store, and they have to pay full retail price out of their pocket with nobody's helping them at all. Of course that is the most expensive way one can buy a prescription drug. Some seniors order the drug. The pharmacists fills the prescription, hands them the bottle, and the price tag. When they see the price tag, which is often, it is not anything for one prescription to cost $100 or $200, they are embarrassed and have to walk away from the drug store and say I do not have that kind of money. Others may be able to scrape together the money to pay for the drug. But then they take it home, and the label says take four times a day or six times a day, and maybe it is a prescription that they are going to need for the rest of their lives every month, week after week, for the rest of their lives, they know that they cannot afford to go back and fill that prescription over and over again. So, instead of taking the pill four times a day, they will take it two times a day. That does not do them any good because the prescription is not providing the kind of physiological response that it was sustained to provide. So that senior is really held hostage, and those are the seniors we are trying to help. So how do we help them and bring down the prescription drug costs at the same time, by allowing these elderly to join in a group health care plan. That is what we are doing, we are providing a group prescription drug plan for them that would cover large groups of Americans at a very affordable cost. Again, if one is low income at zero cost, if one is middle income and above at a very affordable monthly cost. Those individuals gain from the fact that they are now part of a big group. The spokespersons for that group, the leaders of the insurance companies, the managers of the insurance companies will then negotiate with every pharmaceutical company as to what price they are willing to pay. That is how we bring down the cost of prescription drugs because we are now having the big insurance plans that are buying drugs for our seniors and for our disabled, negotiating tough prices with the pharmaceutical companies so that we get and they get affordable prices. I have been joined now by the gentleman from Louisiana who is on the Committee on Ways and Means and on the Speaker's Task Force and has been the leader in drafting this prescription drug program. Mr. Speaker, I yield to the gentleman from Louisiana (Mr. McCrery).

Mr. GREENWOOD. Mr. Speaker, as the gentleman from Louisiana talked about, the fundamental goal is to provide coverage for everyone. What has been discouraging and frustrating to me is that we have crafted this plan so that it benefits everyone regardless of income. If one is at the lowest end of the scale, we cover 100 percent of one's premiums. We think we can go up to 150 percent of poverty and cover that. The President's rhetoric and language has suggested that that is all we do, that we are only providing a benefit for the really poor; and it is really not the case.

Mr. GREENWOOD. Mr. Speaker, the mechanism that we use by stopping the loss for everyone is what makes the premium affordable. Maybe the gentleman from Louisiana could share his thoughts on that as well, because that is so important to get straight with the American people.

Mr. GREENWOOD. And when this plan is enacted into law, as we hope that it will be this year, the average middle-class American who does not have a prescription plan now, who has one next year because of this program, will wonder, okay, so what was in this for me? What did I get out of this? They will know what they got out of this when they go to write their check for their insurance to cover their prescription plan. That check will be a heck of a lot smaller. The amount they have to write that check for will be very small compared to what it would be if we had not decided to cover this top end of the exposure.

Mr. GREENWOOD. By all means. I thank the gentleman for his participation and would now yield to the gentleman from California, who is, in my mind, the leader on this issue in the House of Representatives, and has been leading us for a number of years now.

Mr. GREENWOOD. I think what is important, as we compare the President's plan to the House Republican plan to other plans that may be in the Senate and elsewhere, what is important to understand is that there are some similarities. The low-income folks in both plans would have no cost and would have access, for the first time many of them, to a prescription drug plan.

Mr. GREENWOOD. Mr. Speaker, reclaiming my time, just if I can comment on the gentleman's point for a moment. It has been my experience that, the older I get, the more cautious I become. As we go through life, we bump up against enough things that, by the time one reaches the age of 65 years of age and one is ready to retire one is not looking for any more risk. One wants to pretty much know what one's life is going to be like for one's golden years. The problem that, the criticism that we do have with the President's plan is, as one said, one is sitting there with this big risk over one's head; and that is, maybe when one is 65 and when one is 66 and when one is 67, one will be able to have low drug costs that are under the $2,000 threshold, or I think the President's threshold increases over time. But still there is always a cap on it. Now one day, one can come down with some terrible disease, and go to the doctor, and the doctor says, Guess what, the good news is there is a drug that will solve your problem and keep you alive for another, you know, another 5 or 10 years. But the bad news is it costs $10,000 or $20,000. Well, that senior suddenly has exposure to a risk that there was no way that he or she could have planned for. So what we provide with our plan is the peace of mind, the peace of mind of knowing, no matter how expensive your prescription is, no matter whether you are on one drug or 10 or 15, you will be covered. The sky is the limit on one's coverage because that is where our plan comes in for everyone. Every American pays all of their costs above that ceiling.

Mr. GREENWOOD. And since Americans are not used to buying drug- benefit insurance, this is a little alien to them. But if we think about buying automobile insurance, if we went to buy automobile insurance that would provide liability coverage for $10 million, that would be expensive. The premium that we would pay on a monthly basis or annual basis would be quite expensive to get that coverage. And if it were unlimited, if we had unlimited liability protection, of course it would be unaffordable and the insurance industry would have a hard time putting a price on that. That is almost the way it is with prescription drugs now, because we cannot predict the exposure with these new modern expensive drugs. So what we are saying here is, if it was automobile insurance and the Federal Government said we will cover everything over, let us say $50,000 of liability, then we know that the premium is going to go way down and we would have the coverage covered by the Federal Government. It is the same thing here. By the Federal Government, by our House Republican plan proposing to pay for that top, from the cap to the sky being the limit, suddenly now we have an affordable product that every American can afford to purchase.

Mr. GREENWOOD. That is a very good point. And then for every one of the elderly and the disabled above that 150 percent of poverty, under both plans there will be out-of-pocket expenses. Under both plans, whether paying for a premium in our case, or whether paying 50 percent of the cost of every drug, there is cost out of pocket. So the middle class and above will have to pay something for their prescription plan. We have two systems by which we try to figure out how to make that most manageable, most affordable, most flexible, and to provide the most security at the end of the day from catastrophic, potentially ruinous costs, where someone would have to choose between literally selling their home to buy the medicine they need or doing without and having their life foreshortened as a result. In the course of this debate, in fact in the course of this last almost hour here, I think my colleagues and I have been very careful. Not once have we questioned the motives of the President or the motives of the other party. We have started with the assumption that every Member of Congress in the House and the Senate, that the President and the Congress have the same goal, to provide affordable health care. What I think the public needs to watch for and be most critical of is not the fact that we have differences of opinion and not be judgmental about a Member who takes this tack or that tack, but rather be judgmental about Members of Congress or other politicians or the President, to the extent that he does it, when they begin to question the motives of the other party. Because if we avoid that, we will get this job done. Certainly the President has some ideas that are worthy of our consideration and we have some worthy of his. And certainly if we are going to get this done, at some point in the process there is going to be an amalgamation of the President's best ideas and our best ideas, and we ought to be able to learn from each other.

Mr. GREENWOOD. Mr. Speaker, reclaiming my time, I thank the gentleman from California (Mr. Thomas) for his participation and his leadership, as usual. The experience that I had not too long ago was I visited a senior center and asked a group of my elderly constituents whether they had or had not coverage and what their experiences were. I met a woman who told me that she was taking 18 different prescription drugs and that she was working three jobs in order to pay for those drugs because she had no coverage. And at the end of the day the question for those Americans is not is this a Republican plan, is this a Democratic plan, is this the President's plan, is this the Congress's plan, but the question at the end of the day is can the Republicans and the Democrats in the House and the Senate and the Congress and the President figure out how to solve this problem so we do not have a single elderly person in America, not a single disabled person in America having to make that awful choice between their health and their finances so that they do not get to the point where they have to say to a doctor, do not bother writing that prescription for me because I cannot afford to pay it, or taking a prescription home and not being able to take all of the pills that they need to take in a given day and not being able to renew that prescription because of their inability to afford it. I am convinced that, at the end of the day, Republicans and Democrats will join together on this, we will negotiate a bill with the President and it will mark the point in our history, the history of Medicare, of which we all can be proud. Mr. Speaker, I yield to the gentleman from Kentucky (Mr. Fletcher). I am glad to have him here to join. He has been a real leader in this issue, as well, and I am glad to have his participation.

Mr. GREENWOOD. Mr. Speaker, the gentleman from Kentucky (Mr. Fletcher) is one of the few physicians in America who has chosen to leave his practice behind temporarily and come to serve in Congress. His leadership is greatly appreciated.

Mr. GREENWOOD

Mr. GREENWOOD. Mr. Speaker I thank the gentleman for yielding me this time. Why are we here today? What are we doing here? The advocates of this legislation have said that we are here to save lives, to prevent abortions. But that is not true. It is not what we are doing here. This bill is going to be vetoed, as it has before. And there are not the votes in the United States Senate to override that veto, and there is no one in this Chamber who will honestly argue otherwise. No one will stand up after I do and say, oh, this is going to become law; this will have an effect in America, because they know it is not true. No, this is all about politics. It is not about saving lives. It is not about winning hearts. It is about saving seats in the Congress. It is about winning seats in the Congress. It is not about making law. It is about making noise. If the advocates of this bill wanted to make law, they had their chance earlier today. They would have supported the right of the gentleman from Maryland (Mr. Hoyer) and myself to offer our amendment. That is how we make law. Our amendment would ban the so-called partial- birth abortion and all form of late-term abortions. But it would have made exceptions, reasonable exceptions that Americans support; exceptions to prevent the loss of life of the mother and exceptions to protect the health of the pregnant woman when it is seriously, seriously, and that was the emphasis of our amendment, seriously at risk. But the problem that the supporters had with our amendment is it probably would have passed; would have been signed into law. We would have made progress in reducing the number of abortions in this country. We actually would have accomplished something besides a lot of sound and fury. But, instead, once again, we play abortion politics. We confuse the American public, and we prove once again that politics overrides policy.

Mr. GREENWOOD

Mr. GREENWOOD. Mr. Speaker, this evening the gentleman from North Carolina (Mr. Burr) and I are going to talk about prescription drug benefits and the Medicare program. In 1965, when Medicare was created of course it was created without a prescription drug benefit. It seems unimaginable now in the year 2000 that the Congress would create a program to provide for the health care of the elderly without providing a prescription drug benefit, but those were different times. In 1965, a far smaller percentage of Americans in general and American seniors used prescription drug benefits on a regular basis, and so Congress did not include prescription drug benefits in the creation of Medicare. But today, as we stand at the millennium in the year 2000, the world is a very different place, and today's seniors, as we all do, benefit from health care innovations that were inconceivable just 35 years ago, and particularly in the area of pharmaceutical products and biological products. Today if you do not have access to the latest miracle drugs produced by the pharmaceutical industry and you do not have access to the latest biological products that are being produced, that are creating cures for diseases that could not have been imagined 35 years ago, if you do not have access to these products, you really do not have good health care in America. Yet 35 percent, over one-third of all of the seniors in the United States, as well as the disabled, who also receive their health care through the Medicare program, do not have access to these products. This chart to my left here, the pie chart on the right, describes which Americans do and which Americans do not have access to prescription drugs through the Medicare program and other similar programs. About 31 percent of American seniors receive a prescription drug benefit from their former employer. They worked long enough to receive a lifetime of benefits and their employer was in a position and perhaps the union negotiated for a benefit that would be a good prescription drug benefit that would last for the rest of the life of the retiree. About 11 percent of today's elderly population purchase a prescription drug benefit when they purchase a Medigap policy, the Medigap policies that cover those costs of health care not covered by the regular Medicare program. Then there are about 10 percent of America's senior citizens who are of such low income that they are eligible for the Medicaid program, health care for the poor, and they have through that program a pretty good prescription drug benefit. Then there are about 8 percent of the elderly who choose to receive their Medicare in what is called Medicare Choice Plus plans, and that is that they have a managed care package, and that managed care package provides them with the benefit. But the yellow piece of the pie there, the largest piece of the pie, represents the 31 percent, the chart says, and the estimates are between there and 35 percent, of America's seniors who do not in fact have any Medicare prescription at all. Let me change charts for a moment. This is a chart that demonstrates of those that do not have, the 35 percent of Americans's elderly who are without prescription drug benefit, who they are in terms of income levels. As this chart readily indicates, the likelihood that one is covered with a prescription drug benefit is in direct proportion to one's income at retirement. So those American retirees who have incomes in excess of $50,000 per year, 95 percent of them are able to in one way or another meet their prescription drug needs. That figure climbs for those between $25,000 and $50,000 to 16 percent. Between $15,000 of income and $25,000 of annual income those uncovered by a prescription drug benefit is 22 percent. Between $10,000 and $15,000 the number is 20 percent. For those Americans below $10,000 and yet with enough income so they do not qualify for the Medicaid program or a State-operated Medical Assistance Program, 37 percent of those elderly do not have a prescription drug benefit. As this chart indicates, this problem is going to be exacerbated by time. In 1999, 13 percent of the American population was older than 65, and of those over the age of 65, 33 percent were taking some form of medication on a regular basis. Thirty years from now, when the baby-boom is fully retired, about 20 percent of Americans will be of retirement age, over 65 years, and more than half, 51 percent of them are expected to require daily medications. So clearly this problem will get worse in time unless the Congress acts to solve this problem. As this chart indicates, the problem is being exacerbated because of the increasing costs of prescription drugs, the total prescription drug costs for any given elderly person. In 1993, this is the price increase per year, these are year-over- year percentage changes, so in 1993 the price of pharmaceuticals increased by 8.2 percent, while the consumer price index was only 2.7 percent. As the chart shows, the annual increase in the total cost of all pharmaceuticals, this is not the per item cost, but the total cost of all pharmaceuticals, has risen to the extent that just the one year change between 1998 and 1999 was a whopping 18.5 percent, while the CPI was still down at 2.7 percent. I wanted to bring up one other graph. This is a very important graph, because it begins to break down the components that cause this dramatic increase in the total cost of all pharmaceuticals. The purple parts of each bar are the percentage increase in each of the years between 1990 and 1998 that were related to the actual percentage increase in the cost of the pharmaceutical products on the market. So in 1990, products in general went up 8.4 percent. That has been on the decline; it is at a slight increase in the last few years. But as we can see, the percentage of increase in products on the market is a relatively small percentage of the total cost increases. The green part of the bar shows the volume from the mix of new products. What that means is that this part of the increase was driven by the fact that seniors were getting more prescriptions, taking more medications, and new products were coming on to the market, adding to the costs. So when we look to methodologies to bring down the cost of prescription drugs, we need to understand that it is not just a freeze, for instance, on all prescription drug prices, which will not solve the problem, because as long as new products come on to the market, seniors will have access to them, and that will drive up the total cost of pharmaceuticals. Mr. Speaker, we Republicans are committed to solving this problem. My colleagues on the Committee on Commerce have been working hard at this for some time, as have our friends on the Committee on Ways and Means; and we have been meeting together. We will have a prescription drug benefit plan in legislative form probably next month, in March, and we will bring that to our committees for consideration, and to the floor. I am convinced that the capacity is here in the House for Republicans and Democrats to work together for the Congress, and for the House and the Senate to work together, and for the Congress, the Republican Congress and President Clinton to work together so that by the end of this year 2000 we will have been able to provide a legislative solution to this that is sound, this is reasonable, that makes sense, and that solves the problem of many seniors today where they have to choose between whether to buy groceries or whether to buy a prescription drug, or whether to take their prescription from their doctor and then never have the opportunity to fill it at all. At this time, I yield to my colleague from North Carolina (Mr. Burr), who knows as much about this issue as any of my colleagues.

Mr. GREENWOOD. Mr. Speaker, the gentleman made reference to the miracles of some of these more modern pharmaceutical products; and he also, in his remarks, has been talking about the cost and how do we devise a plan that, given the finite resources, will provide this wonderful benefit to all of our seniors. We have to remember that it is not a zero sum game, that when we add a pharmaceutical benefit, it does not simply and only add to the costs of Medicare. Because in many ways, using a pharmaceutical product, using a medicine, is the least expensive way to treat an illness as compared to surgery. I have a chart here on my left that demonstrates an instance of that. This is the cost of treating stroke patients. If we use a treatment that consists of a pharmaceutical approach, which uses a clot-busting drug, it costs about $1,700 to treat that patient on an annual basis. Yet, by doing that, we are keeping that patient from having to go through the pain and the expense of rehab and often nursing care. So the difference here is that we save $6,100 that otherwise Medicare would have been paying for.

Mr. GREENWOOD. Mr. Speaker, the gentleman from Michigan (Mr. Upton) has joined us, and with my colleague Mr. Burr and myself, along with the gentleman from Virginia (Mr. Bliley) and the gentleman from Florida (Mr. Bilirakis), and others, we have been working for all of this year and beyond that, earlier than that, to devise a prescription drug plan that makes sense. I would like to now yield to the gentleman from Michigan (Mr. Upton).

Mr. GREENWOOD. Mr. Speaker, clearly what we want to do is we want to provide choice. One of the first charts I held up demonstrated that a significant portion of America's elderly, two out of three already have prescription drug coverage and about half of those, or about a third of the senior population, receives those benefits from their employer. Now, what we do not want to do is do anything that is going to cause either those retirees who have a nice prescription drug benefit to suddenly have to pay for something they already have, nor do we want to do anything that would create a disincentive for the employers to provide that. So we have to be careful that we fix what is broken and we do not fix what is not broken in the world of prescription drug benefits.

Mr. GREENWOOD. Mr. Speaker, I yield to the gentlewoman from New Mexico (Mrs. Wilson). She is a member of the Committee on Commerce, as we all are here doing this special order, and she will be playing a critical role in determining what kind of prescription drug benefit we can provide to our elderly and to our disabled.