Chuck Hagel

Mr. HAGEL

Mr. HAGEL. Madam President, I yield my colleague from Nevada 5 minutes.

Mr. HAGEL. Mr. President, I yield to the Senator from Pennsylvania 1 minute.

Mr. HAGEL. Mr. President, I yield 3 minutes to the senior Senator from Texas.

Mr. HAGEL. I yield 1 minute to the Senator from Idaho.

Mr. HAGEL. I yield myself such time as I consume. Mr. President, this debate in which our body has engaged over the last 5 days I believe has been helpful for our country because it has focused on a critical need, a need to come forward with a Medicare prescription drug plan, a plan that is focused on those who need it most and that is responsible. None of the programs we have debated over the last few days have been perfect. The proposal that Senator Ensign and I and others have brought to the floor is not perfect. We were not given much of an opportunity to work through these issues where we normally have opportunities to work through issues, and that is in committee. So we debated something so critical to our seniors, to the future of our country on the floor of the Senate. When we do it that way, we have to rush. We slam things together. There are imperfections in that process, but nonetheless, again, I believe this has been an important, enlightened, educational, and helpful process. We now have one option before us. We voted down two options yesterday. We have the Hagel-Ensign plan that we will vote on within the hour. What this plan does is give our seniors a very significant benefit. I ask: Would we really deny our seniors not only the benefit-- the real, practical, relevant, tangible benefit--of this program, but also something maybe more important, and that is the peace of mind that they will not be ruined by catastrophic drug costs? Let's again review quickly what this amendment does. This is immediate. It can be up and running on January 1, 2004. It is permanent, unlike the Democratic plan that we voted down yesterday. It offers discount drug card programs with 20- to 40-percent discounts for all who enroll. It is affordable. Seniors pay only a $25 annual fee and then a small copayment after they have reached their out-of-pocket expense level. It provides catastrophic coverage. We use the market system. We do not invent more government, bigger government, impersonal government. We propose a real-world solution to a real-world problem with this proposal. This bill gives our seniors the protection they need and for those who need it most. I encourage my colleagues to look seriously and closely at what we are proposing today. It is accountable, it is responsible, it fits within the $300 billion budget resolution that we passed last year for a prescription drug plan over the next 10 years. We are giving the seniors an opportunity for peace of mind and real benefits that will enhance their quality of life and enhance the ability for not just this senior generation but future generations to pay for their health care costs, at the same time taking into consideration the generations ahead who will have to pay for this program. Someone will pay for this program. We need a program, but let us use some common sense. Let us find a center of gravity, an equilibrium, and do it right. We believe our amendment accomplishes that. I yield the floor.

Mr. HAGEL. Mr. President, I yield 6 minutes to the Senator from Nevada.

Mr. HAGEL. Madam President, I yield 5 minutes to my colleague from Tennessee.

Mr. HAGEL. Mr. President, I yield to my friend and colleague from New Mexico 10 minutes.

Mr. HAGEL. Mr. President, I yield my colleague from Nevada 1 minute.

Mr. HAGEL. Madam President, I ask that I be notified when I have spoken for 5 minutes.

Mr. HAGEL. Mr. President, I yield 6 minutes to the senior Senator from Idaho.

Mr. HAGEL. Mr. President, how much time remains on our side?

Mr. HAGEL. Madam President, I want to cover some areas of concern and questions that have been addressed, appropriately so, regarding the amendment, but let me generally make a comment in response to my friend from Massachusetts. One of the results the distinguished senior Senator from Massachusetts is not factoring in in our amendment is the discount that all Medicare beneficiaries would derive. The estimates of those discounts, which are real, which, in fact, are in existence now, those discount card programs, are anywhere from 25 to 40 percent. That is one piece of this that has not been addressed, and it is important to factor that back in. That is but one part of our complete prescription drug program. Obviously, another part is the catastrophic cap. I have been asked about pharmacies and how this legislation might affect pharmacies, because, as the Senator knows, we do not invent a new bureaucracy. I am sorry to have to say that again to some people who like big government, who think big is better, and the more money we throw at anything always makes everything better. That is aside from the debate about deficits in this country, which I hear an awful lot about in this body, about irresponsible spending. We do have to ask a question about the affordability. That may be painful for some of my colleagues but, in fact, that is reality. This program is not just about addressing what we must address--and the senior Senator from Massachusetts is exactly right; we need to address this. For too long we have deferred it. It is not just about addressing the problem. The other end of that is, who pays for the program? Who eventually is going to wind up paying the bill for the program? We have tried to develop a program that focuses on those who need it most. I know most people would like to have a program where they pay nothing; let somebody pay for it all. Well, that is not a bad life, I suppose, but the reality is someone is going to pay for this. When we look at the huge numbers that we are dealing with in this country today on entitlement programs, everybody better stop for a moment and think through the consequences of what we are doing. There is a consequence to whatever action we take, and the consequence is going to be on the next generation and the next generation, as we add a new entitlement program to Medicare. We need to do this, but it must be done in some way that is responsible and accountable for those who now have no say in it but we are saddling them with this burden. We cannot just merrily skip along and say, well, we have given you everything free, aren't we great, let's send out a press release out and hold a press conference: oh, Senator Hagel, you are so good to us. I have a 9-year-old and an 11-year-old. Many of my colleagues have children and grandchildren. They are the ones who will pay. When we look at the numbers--Senator Gramm was on the floor yesterday, talking about those numbers--they are significant. With a $2 trillion Federal budget today in this country, about two-thirds is consumed by entitlement programs. We cannot do anything about that. The growth path we are on, even if we do not add any new programs, is immense. I don't know how we are going to ask this next generation and the generation after that to carry that burden. Something will happen. The choices are either that you cut benefits at some point or you continue to raise taxes on the workers, the young people, to pay for my drugs. We have tried to accomplish some center of gravity, some responsible balance in addressing the problem. It is real. We need to address it but at the same time address the consequences. Who pays? That is the painful part of this process. Who pays? We don't like to talk about that. When I talk about using a market system in place, not developing or building a new Government program, what do I mean? I mean using the market system in place. It is imperfect. Absolutely. But it is the market system in place today that has given America this remarkable lifestyle, quality of life, longevity. Imperfect and flawed? Absolutely. Are there people who do not benefit from some of this because they are at the bottom? Absolutely; that is what we are trying to deal with. But do not destroy the system that has produced this remarkable quality of life. Why would we throw out a market system that works pretty well? We use the existing structure in place: Pharmacies, pharmacy benefit managers, insurance policies, systems, programs, administrators to administer the program at the direction of the Secretary of Health and Human Services. Pharmacies are a big part of this. They must be a big part of it. In this system, we have worked with the pharmacist. We preserve that beneficiary/pharmacy relationship. Seniors and other Medicare beneficiaries will continue to get most of their drugs at the pharmacy. Any proposal that seriously disrupts that relationship would not work for Medicare beneficiaries. I point this out because beneficiaries' relationships with pharmacies will be strengthened. A system such as this could not work without bringing in the pharmacies. There will be a greater emphasis on discounts provided by pharmaceuticals and manufacturers than the pharmacy discounts. It is the pharmaceutical companies that provide the discounts. Those are negotiated by the private plans at the direction of the Secretary. Pharmacies would be free to choose whether or not to participate. It would be voluntary. Right now, pharmacies are involved in many of these discount drug plans. They do well. It brings in traffic. They have consulting fees. They are a big part of the process. Our bill would make them more a part of a process. Our legislation prohibits mail-order-only programs; therefore, it does not eliminate pharmacists. That is an option. Pharmacies could directly compete as administering entities. Pharmacies, as some pharmacies do today, could administer these programs. I make this point because there have been questions raised about the role of pharmacies. I understand that. We have spent a lot of time listening to pharmacists from all over the country. I understand their concern. The way we have crafted this, it would enhance the pharmacists. I yield the floor to my colleague from Nevada for 3 minutes.

Mr. HAGEL

Mr. HAGEL. I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. HAGEL. Madam President, I yield to my distinguished colleague from Nevada 1\1/2\ minutes of our 2\1/2\ minutes.

Mr. HAGEL. Madam President, my friend and distinguished colleague, the senior Senator from Massachusetts, talks about a common ground. This proposal is the common ground. As my colleague, Senator Ensign, has just stated, this addresses those who need the help the most. We do prioritize. We do focus on those seniors who need the help. Yet we do it in a responsible way. We stay within the $300 billion budget cap that this body voted on for a prescription drug plan over the next 10 years. It is immediate, it is permanent, and it uses the present market system. We don't build a new government bureaucracy. It is not impersonal. It is direct. It caps the catastrophic dark cloud that hangs over all senior citizens. We are doing something for this generation of seniors as well as the next generation of seniors. I hope our colleagues give this consideration and will vote for our amendment.

Mr. HAGEL. Mr. President, I move to waive the respective sections of the Budget Act, and I ask for the yeas and nays.

Mr. HAGEL

Mr. HAGEL. Madam President, the Senator from Michigan has a more difficult case to make. She needs more time.

Mr. HAGEL. Madam President, I ask unanimous consent that Senators Frist and Nickles be added as cosponsors of amendment No. 4315. I yield the remainder of our time to the distinguished Senator from Tennessee.

Mr. HAGEL. Mr. President, I call up amendment No. 4315, which is at the desk.

Mr. HAGEL. I thank the Chair. Mr. President, I allocate 5 minutes of our remaining time to the Senator from Oklahoma.

Mr. HAGEL. And how much time does the other side have remaining?

Mr. HAGEL. Mr. President, could the Chair tell me how much time this side has remaining?

Mr. HAGEL. I yield to the Senator from Kansas 10 minutes off our time, Mr. President.

Mr. HAGEL. I ask unanimous consent reading of the amendment be dispensed with.