Frank Pallone

Mr. PALLONE

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

Mr. PALLONE. Mr. Speaker, again I have not seen the bill because it has not been given to the Democrats, but my understanding is that the Medicare program that the gentleman has talked about, the comprehensive program, is not effective until the year 2006. Could the gentleman explain to me, if it is true that all these problems are out there and all these changes need to be made to Medicare, why the Republicans are going to wait until the year 2006 to have this program kick in?

Mr. PALLONE. But generally, Mr. Speaker, it does not kick in until 2006.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I plan to be joined tonight by some of my colleagues on the Democratic side, and I appreciate the fact that they are here to join me. I did listen to much of what was said by my colleagues on the Republican side in the last hour. One thing that bothers me the most about some of their statements is that they seem to color everything based on ideology. I hear constant references to conservativism, even if it is compassionate. I hear references to market forces and the private market. They suggest that they are not privatizing and somehow Medicare has been privatized for some time going back to Lyndon Johnson. First of all, it is very important to understand that I personally, and I know this is true about my colleagues, we do not look at this from an ideological perspective. I do not think we really care whether it is conservative or liberal or market or regulatory. We are only interested in providing a prescription drug benefit to senior citizens, and, practically speaking, the best way to do that. My concern about the Republican side is they seem to be ideologically driven: there have to be market forces or this has to be some kind of conservative approach, and the notion that everything has to be privatized or really has been privatized all along. It is just not the case. When we talk about Medicare when it was first started under Lyndon Johnson, he started Medicare because he realized that if a senior citizen, practically speaking, wanted to go out and buy insurance in the private market, which is all that existed at the time in the early 1960s, that they could not get health insurance. They could not buy it. There was no way to do it. The reason that Medicare, which is a government program, not a private industry program, was set up was because of the failure of the private insurance market to accommodate and provide affordable, comprehensive health care for senior citizens. I do not care how it is provided, but the bottom line is that the private market could not provide the health insurance. There is no indication that that has changed in any way today. To suggest that somehow Medicare now is private is simply not true. I think that Republicans are spending so much time trying to make sure that Medicare is privatized in order to provide a prescription drug benefit that they are losing sight of the fact that the purpose is to provide the benefit. If we look at what this Republican bill, this Medicare conference report that we are going to get, and we have not seen it yet, if we look at what we are told that it is going to include, and we are going to vote on Friday or Saturday, we find that there is an attempt to privatize Medicare; and the way that they do it is by providing the HMOs and private insurance companies a huge amount of money, plus-up money, if you will, so they can, what the Republicans say, compete with traditional Medicare. The bottom line is that if we had a true competitive market between traditional Medicare or HMOs, the market should take care of itself and they should not have to add all of this extra money to boost up the HMOs and make sure that the HMOs and the private market are going to cover seniors. The irony is what they are doing here is forcing the seniors into managed care, into HMOs. You are not going to get this drug benefit unless you essentially sign up for an HMO. You are going to lose your choice of doctor; and as a consequence you are suffering, and traditional Medicare as we know it is going to disappear. What is this drug benefit that they are going to provide? Well, I would maintain that it is such a meager benefit, and it is going to cost senior citizens so much money out of pocket it is essentially meaningless. Since it is voluntary, most seniors will not even sign up for it. In July when this bill came up in the House, the Democrats had a substitute. What we said is this. If you, as Republicans, feel that you want to provide a certain amount, pot of money to provide a prescription drug benefit, we know that the traditional Medicare program works very well, and nobody on the other side is saying that that is not true, then why do you not just add the money and add the drug benefit to traditional Medicare the way you added a benefit to pay your doctor bills. Seniors know that part A pays for their hospitalization, part B Medicare pays for their doctor bills. With their doctor bills, they pay about a $50 per month premium, they have a $100 deductible on the first visit to the doctor, 80 percent of the doctor bills are paid for by the Federal Government, 20 percent copay and after you reach a certain amount that you pay out-of-pocket, the Federal Government pays 100 percent. We as Democrats said, let's just emulate that and extend it to prescription drugs, call it part C, part D, whatever you want, you pay a $25 per month premium for your prescription drugs, you pay a $100 deductible for the first drugs, whatever, and then you would have 80 percent paid for by the Federal Government, 20 percent you would pay, copay, and then at a certain threshold just like in part B, 100 percent of the cost of your drugs would be paid for by the Federal Government. That is not what the Republican bill does. The Republican bill, first of all, says that you are probably going to pay $35 a month premium but there is no set premium. It could be $75, $85 a month. Who knows? The deductible is not $100 but $275 a year. And 75 percent of the cost is paid for by the Federal Government, 25 percent by you, up to the first $2,200. But from $2,200 to $5,000 for your drug costs, you get nothing from the Federal Government. You pay the whole expense. I would maintain that you are going to have to shell out so much money for this premium and get so little of a benefit that most seniors would not even sign up. Keep in mind, you are only going to get it if you sign up for an HMO and give up your choice of doctors, and they are giving all this extra money to the HMOs to try to make sure that they will provide a prescription drug benefit because many of the HMOs in the past few years that have initially provided prescription drug benefits decided to drop the seniors, and now many of the seniors who signed up for them do not have it anymore. That is 100,000 people in my home State of New Jersey alone. I have my colleagues here. I would like to yield some time to them. First, I wanted to make two more points, because I have had seniors ask me this question. Number one, they say what are you doing about cost? Republicans are doing nothing about cost. They specifically have in their bill language that says that the Medicare administrator cannot negotiate lower prices, unlike what we do for the VA or we do for military personnel. Democrats, of course, in our substitute, we had negotiated prices on the part of the Medicare administrator. That is because of the prescription drug industry. Just like the Republican bill will help the insurance companies, help the HMOs, it is also going to help the drug industry because they will not be any cost containment. The other thing that is in the Republican bill that a lot of seniors have told me they are concerned about is no reimportation, no opportunity to reimport drugs from Canada or other countries to try to create a competitive market and lower cost. The third thing that some of my seniors have said that I wanted to mention and just throw out to my colleagues is that the Republican bill does not even take effect until the year 2006. We are going to go through an election for President, we are going to go through another election for Congress, 3 years from now, before this bill kicks in. I hear my Republican colleagues say, oh, this is only the beginning, we're going to have to do more down the line. If this is such a great thing, why is not starting at the beginning of the year? If they pass it this week and the President signs it, why is not effective January 1? Why do we have to wait another 3 years? In any case, I see some of my colleagues would like to speak. I yield to the gentleman from Texas (Mr. Rodriguez) who has not only done a lot of work in general on the health care issue but I know has particularly paid attention in the context of the Congressional Hispanic Caucus with health care and this issue. I appreciate the gentleman being here tonight.

Mr. PALLONE. Mr. Speaker, maybe my colleague was going to say it, but we have done some statistical analysis that shows the majority of the seniors fall into the donut hole. So some people might think, well, I am not going to fall into that, but most seniors will be in that situation where they are paying a premium and getting nothing at some point.

Mr. PALLONE. When I have posed that to the Republicans and I have said, the private market does not want to come in, even the HMOs do not come in, their answer is, we'll just give them more money. We know they have these plus-ups. I guess about $20 billion of the $400 billion is extra money going to the HMOs and the PPOs, the private sector, to offer this kind of drug benefit. Then I say to them, what if the $20 billion doesn't work? They say, we'll just give them more money. That is their response, but it is the absolute opposite of what true competition is. If you are going to have to keep giving them more and more money in order to get them to enter into this market, how is that free enterprise and market economy?

Mr. PALLONE. This is what I envision is going to happen here in counties like yours or in my own State of New Jersey. We had 100,000 people dropped by HMOs in the last few years. Because they keep giving all this extra money to the HMOs that are in this bill, I will use New Jersey as an example, but I think it could be true in Texas or anyplace. Because they are getting all this extra money, some HMO is going to step forward and say okay, look, you're giving me all this extra money, I'll offer a prescription drug benefit. If your seniors enter my program, you're giving me all this extra money, I'll offer a prescription drug benefit, but I'm going to charge, who knows, for the cost of the premium, not $35, $65, $75, $85 a month, whatever. According to this bill, as long as there is one HMO in the area, in my district or in your county, that is willing to provide the benefit, regardless of what they are going to charge for a premium, that will preclude a senior from getting any kind of drug benefit under traditional Medicare. So if they have traditional Medicare and there is some lousy HMO that comes in and wants to offer them this plan because they are getting all this money, but charging a high premium that they cannot afford, or they see no benefit because they have to lose their choice of doctors, then they are out of luck because you can only get, maybe, I am not even sure, but you can only get drug benefits with traditional Medicare or without joining an HMO if there is not an HMO in the area that is going to offer it. But it does not have to be an HMO if it offers a reasonable plan or a reasonable price. It just has to be anyone that happens to be there.

Mr. PALLONE. I want to thank the gentleman from Ohio and the rest of my colleagues. I think we may only have another minute or so left, but I started out by saying early this evening that I just want to provide a prescription drug benefit, as we all do on the Democratic side, for our seniors. We do not care about the ideology. We do not care about the different labels, conservative, liberal, progressive, whatever. But the problem is, the Republicans are providing a sham bill. They are doing all kinds of twists and turns and whatever rather than just providing a straight drug benefit, and yet it is so easy, as my colleague said, to do just that. We just need to add it to traditional Medicare, just like we do with part B now. I go around and explain that to seniors, and that is what they think they are getting. They think this is going to be a new part C or part D. And just like they receive their pay, the Federal Government pays for their doctor bills, that it will be the same way. They have no idea that they have to go through all these twists and turns and have to join an HMO or find some drug-only policy and end up paying a variable premium. It is going to be so shocking to them when they finally figure it out. But as the gentleman said, the Republicans have figured this out. They have figured, let us pass it, get through the 2004 election, and then 2 years later, when they finally figure it out, well, we will deal with that later. Mr. Speaker, I see my colleague from Arkansas is here, and so I will yield to him.

Mr. PALLONE. Reclaiming my time for a moment, Mr. Speaker, I know what the Republicans say. They say, oh, you can stay in traditional Medicare, but you do not get the drug benefit. And the only way you get it is if these plans the gentleman is talking about are not available in their particular area. But, as I said before, it is very easy with all this money that they are throwing to these private plans to get one in an area that would provide the semblance of coverage at a very high cost, and then you are totally precluded from getting the drug benefit under traditional Medicare.

Mr. PALLONE. Mr. Speaker, I want to thank the gentleman for his comments. And I have to tell him that most seniors think this is going to take place immediately, within a few months; and when I mention to my seniors that it does not take effect until 2006, they are shocked. They think how could they be talking about this 2 or 3 years from now? And when I mentioned it to one of the Republicans from Florida who spoke on the motion to instruct tonight, he said it would take that many years for the insurance companies and everybody to adjust to put this in place, which does not make any sense. We can have the structure changed in a month or two if we really want to do it.

Mr. PALLONE. Exactly. Mr. Speaker, I yield to the gentleman from Texas (Mr. Sandlin).

Mr. PALLONE. Mr. Speaker, I listened to everything the gentleman said, but I want to just take it one step further. The gentleman pointed out that we have no bill, and that is certainly true. The gentleman from Florida, earlier on the Republican side tonight, actually challenged some of us on the Democratic side on the motion to instruct and said that we had not read the bill. And the gentleman from Ohio (Mr. Brown), from our Committee on Energy and Commerce said, well, where is the bill? We have not received it. And, of course, the Republican Member from Florida had no response because they have not shown it to us, if it even exists. But imagine, as the gentleman said, not only do we not have the bill, not only has there been no conference participation by the Democrats, but now these organizations like AARP, AMA, the PhRMA, the drug manufacturers, all mentioned on the other side as endorsing the bill, some of them are even running ads for a bill that does not exist. So I mean the guy who is the legislative chairman, he did not say it in the letter there, but one would almost have to resign knowing that your organization has endorsed legislation that is not even available to look at. It is unbelievable.

Mr. PALLONE. Mr. Speaker, I appreciate the gentleman's comments and particularly those quotes that he has from some of the conservative groups at the end. Because, as my colleagues know, when I started out this evening, I wanted to make the point that I do not really care about the ideology. I just think this thing is not going to work and not deliver any benefit to seniors and they are going to lose their choice of doctors by having to join an HMO. It is great to see some of the conservative groups, which I normally do not agree with, are essentially saying the same thing: it is not going to work. It is not going to provide a benefit. Seniors are going to be forced out of their traditional Medicare. Mr. Speaker, I yield to the gentleman from Arkansas (Mr. Ross), who probably knows more about the prescription drug issue than anybody else because he is an owner of a pharmacy with his wife, or his wife is an owner. And he really knows how this works, practically, in the shortcomings.

Mr. PALLONE. Mr. Speaker, I know the gentleman is familiar with the pharmacy industry. The bill avoids any cost containment. It actually says the Secretary of Medicare administrator cannot negotiate price reductions. There is nothing in the bill with these discount cards that would have any impact on the drug companies' ability to raise prices. So you might not save anything, right, if they raise the price and you get the same discount? You may end up paying more.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, as stated by the previous speaker, the overall purpose of this valuable legislation is to improve visitor services within our National Wildlife Refuge System. Annual public visitation to the refuge system is expected soon to surpass 40 million people. It is critical that we address the growing public use of refuge lands by ensuring that our refuges have facilities that are safe, well maintained, and inviting to the visiting public. But we should not forget that our refuge lands are set aside by statute exclusively for the benefit of fish and wildlife. I want to compliment the bill's sponsor, the gentleman from Indiana (Mr. Souder), and the gentleman from Maryland (Mr. Gilchrest), chairman of the Subcommittee on Fisheries Conservation, Wildlife and Oceans, for their respectful consultation throughout the process. I commend them for a final product that strikes an appropriate balance between public use and resource protection. The bill before the House will finally provide a comprehensive concession policy for our national wildlife refuges that will not detract from the ``wildlife first'' mission of the system and which will provide new standards and incentives for concessionaires to enhance the visitor's experience. I would also note that while the legislation grants an exemption from these contract requirements to all permitted outfitters and guides operating on refuge lands and waters, these operators will still be required to secure a Federal permit to access refuge lands. I am hopeful that the Fish and Wildlife Service will be able to clarify through its rulemaking process precisely what types of operations and what kinds of structures will be permissible for guides and outfitters to qualify for the exemption. Mr. Speaker, I include for the Record a November 17, 2003 letter from Mr. Steve Williams, director of the Fish and Wildlife Service. The letter addresses the director's concerns regarding some details of the exemption for permitted guides and outfitters included in this legislation. U.S. Department of the Interior, Fish and Wildlife Service, Washington, DC. Hon. Richard Pombo, U.S. House of Representatives, Washington, DC. Dear Chairman Pombo: The U.S. Fish and Wildlife Service (Service) would like to provide comments on H.R. 1204, which would establish a National Wildlife Refuge System concessions policy. Although the Service supports this legislation as reported by the Committee on September 24, 2003, and testified to that effect at a June 26, 2003, hearing before the Resources Subcommittee on Fisheries Conservation, Oceans and Wildlife, we have serious concerns with the amended legislation that will be brought to the House floor. Generally, H.R. 1204 would amend the National Wildlife Refuge System Administration Act of 1966 (16 U.S.C. 668dd- 668ee) to authorize the Secretary of Interior to provide for maintenance and repair of buildings and properties located on lands in the Refuge System. We support the goals of this legislation; however, we have strong concerns about the overly broad exemption given to outfitters and guides in the amended version of H.R. 1204 that will be brought to the floor. The new language under Section 5(b)(2)(E) could jeopardize the Service's goal of a consistent policy for management of recreational activities on National Wildlife Refuges. The Service supports the goals of H.R. 1204 and looks forward to working with Congress to develop a workable concessions policy for the National Wildlife Refuge System. As the NWRS celebrates its Centennial anniversary this year, the Fish and Wildlife Service is working hard to ensure that visitors find National Wildlife Refugees welcoming, safe, and accessible, with a variety of opportunities to enjoy and appreciate America's fish, wildlife, and plants. Providing quality wildlife-dependent recreational opportunities is part of the Fish and Wildlife Service's vision for the NWRS, and concession operations can provide the visiting public with a means to access and interpret our refuges. If you have any questions or concerns, please do not hesitate to contact me. Sincerely, Steve Williams, Director. In closing, Mr. Speaker, this is good legislation. I urge its adoption on a bipartisan basis by the House. Mr. Speaker, I yield back the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. (Mr. PALLONE asked and was given permission to revise and extend his remarks.)

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume. (Mr. PALLONE asked and was given permission to revise and extend his remarks.)

Mr. PALLONE. Mr. Speaker, as the gentleman from Maryland (Mr. Gilchrest) said, H.R. 1006 is a noncontroversial bill that was passed and reported by voice vote by the Committee on Resources on September 11. The final language incorporates some minor, noncontroversial changes that were made by the other body to further refine the bill passed by the House. Recent news reports have repeatedly demonstrated that the holding and unsupervised breeding of large cats, such as lions and tigers, is not only dangerous to the handlers and the general public, but this growing trend is also extremely harmful to the welfare of these magnificent predatory animals. The limited provisions in this legislation will finally provide a straightforward strategy to address this problem by prohibiting the interstate trade in these animals or hybrids derived from these animals. Moreover, this legislation will ensure that in the future, only those facilities that are Federally or State licensed or have the requisite capabilities to care for these animals are allowed to do so. We can only hope this transition will be short. I commend the bill's sponsors, the gentleman from California (Mr. McKeon) and the gentleman from California (Mr. George Miller) for their tireless leadership in bringing forward this sensible animal welfare legislation, and I urge Members to support this bill. Mr. Speaker, I reserve the balance of my time.

Mr. PALLONE. Mr. Speaker, I yield such time as he may consume to the gentleman from California (Mr. George Miller), a sponsor of the bill.

Mr. PALLONE. Mr. Speaker, I yield back the balance of my time.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I think the gentleman from Massachusetts is making a very good point, which is essentially this bill is nothing but an election-year gimmick. The bottom line is if they are really serious about providing a prescription drug benefit, and I will grant I do not like what they are suggesting, because I do not think it is a real benefit, why are they not doing it now? Why are they not doing it in 6 months? Why are they not doing it in a year? They wait until 2006 because they do not have any intention of doing anything, and they are hoping people do not find out until 2006 what a terrible bill this is. As the gentleman from Indiana (Mr. Burton) said, even if you bought into the idea we could wait until 2006, and I do not, why not let reimportation take place in the meantime, so at least people can get the cheaper drugs from Canada? But they are not going to do that because they want the drug companies to have the windfall, and the drug companies are against reimportation.

Mr. PALLONE. Reclaiming my time, Mr. Speaker, they will get nothing. They will get nothing, because under the Republican proposal, and I think it is very important that you mentioned it, this plan does not go into effect until the year 2006.

Mr. PALLONE. Absolutely, for President, Senate, and House.

Mr. PALLONE. Mr. Speaker, I just tell my colleague from Massachusetts that I will be glad to have him join in and make some comments during the course of my 10 minutes if he likes. I just wanted to follow up on some of the debate that was held this evening on the motion to instruct from the gentlewoman from Nevada and particularly pay attention to some of the comments that were made by some of my Republican colleagues who I know are well-intentioned but I think were very wrong in what they said about this Medicare conference report that we are going to be voting on in a few days. First of all, I mentioned earlier when the gentlewoman from New Mexico said that Medicare is very successful, and I said to her at the time, well, if it is very successful, then why are the Republicans in this Medicare conference report trying to essentially change and gut and I think destroy Medicare the way we know it? Now, what the Democrats have been saying all along is, if you have a pot of money and you want to provide prescription drugs to senior citizens pursuant to the Medicare program, which you admit is a successful program, then why not just add the prescription drug benefit to the existing Medicare program? We know right now that all seniors are entitled to Medicare, because if they are over a certain age, they are entitled to Medicare. It is an entitlement. We have a program for hospital care; we have a part B program for doctor care. And what the Democrats have been saying is we can simply do for prescription drugs the same thing we do with the physician care, the physician payment. Like part B, which right now says if you pay $50 a month, and after the first $100 deductible, 80 percent of your doctor bills are paid for by the Federal Government, up to a certain amount, at which time 100 percent of your bills are paid for by the Federal Government. Democrats have been saying we can add a prescription drug benefit to Medicare in the same way. And what we actually proposed and voted on here in the House of Representatives during the summer was exactly that, a program that would say you pay $25 a month premium, after the first $100 deductible on your drug bills, 80 percent of the cost is paid for by the Federal Government. You have a 20 percent copay. And at a certain point, after you have paid a certain amount out of pocket, 100 percent of the costs are paid for by the Federal Government. Very simple. It builds on the existing Medicare program. That is not what the Republicans are doing here. This is not even about a prescription drug benefit any more, because they are not providing a meaningful benefit. And I want to associate myself with the remarks made by the gentleman from Indiana (Mr. Burton) when he said this is not even a benefit you will want to sign up for because you will end up paying more out of pocket than you will get back in actual benefit. So it is not a real benefit. It is not a meaningful benefit. It is not an affordable benefit. It is not a comprehensive benefit. Most importantly, the only way you get this prescription drug benefit under the Republican proposal is if you join an HMO. You are forced, contrary to what some of my colleagues said on the other side of the aisle, you are forced under this Republican plan to join an HMO. Because the only way you could get any kind of prescription drugs without the HMO or the private plan is if it is not available in your area. What the Republicans have done is they are putting so much money, they are giving $12 million, $1 billion, they are adding all this money to the private plans, to the HMOs, giving them all this extra money so that certainly there is going to be someone who is going to offer this managed care HMO plan, this private plan in your particular State or your particular jurisdiction, so you will be shut out. You will not be able to have traditional Medicare and get any kind of prescription drug benefit. Now, I know that some of the discussion here tonight is, well, why does the AMA, the doctors support this? Well, why does the AARP support this? Why do the drug companies support this? There is a very simple answer to that, and it is that they are all getting a piece of the action. The AARP is essentially an insurance company, so they want to sell insurance. They think it is great. The insurance companies are all getting extra money, HMOs, private insurance companies, all getting big windfall profits from the Federal Government under this bill. And the doctors? Well, they have been suffering. They face a 4.5 percent cut in their reimbursement rate. So what the Republican bill does is wipe out that cut and give them a 1.5 percent increase, I think. So, naturally, they feel well it is better to have a 1.5 percent increase than a 4 percent cut, so they get a piece of the pie. They think it is great. Then what about the drug companies? Well, it is a windfall for them because there is no competition. There is no price controls. There is a specific provision in the bill that says that the Secretary of Health and Human Services and the Medicare administrator cannot negotiate price reductions. We do it for the Veterans' Administration. We do it for the Department of Defense for our military. But we are not allowed to do it under this bill because the drug companies want a windfall. Well, all that I have been saying and all the Democrats have been saying is if you really believe that HMOs and private plans can compete with the traditional Medicare, then why not just have pure competition? Do not give them all this money. Do not give the HMOs all this money, the insurance companies all this money. Do not give the windfall and prohibit the Secretary of Health and Human Services from negotiating prices. Have real competition. Say that the private plans have to really compete with the private plans and do not get any additional money. Or, in the case of the drug companies, have the Medicare administrator essentially negotiate through competition price reductions. That is what negotiation is all about. It is a form of competition. Do not say that they do not have the power to negotiate. The one thing I want to say, and then I will yield to my colleague from Massachusetts, I listened to what the gentleman from Indiana (Mr. Burton) said and he talked about reimportation. Reimportation is a form of competition. If you say that Canadian drugs can come in here, you are creating a form of free-market competition with the companies here that want to charge the higher prices. But, no, we cannot have competition, we cannot have free market, we have to prohibit the Canadian drugs from coming in here. This bill is not competition. This is a windfall for the HMOs. This is a giveaway to the drug companies and the insurance companies. And I want to yield to my colleague from Massachusetts because he wants to talk about the date.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I have a great deal of respect for the gentlewoman from New Mexico, and also the gentleman from Georgia, but I have to say I feel like I am listening to Alice in Wonderland when I listen to what the two of them are saying about this Medicare conference report that we are about to vote on in a few days. The gentlewoman said that Medicare is very successful, and she pointed out that we are adding $400 billion to the program. But I would ask a very simple question: If it is so successful, why do we not just add it as a drug benefit and give the seniors the $400 billion for their prescription drugs? That is what the Democrats proposed. We said, right now you have part B where you pay so much, I think it is about $50 a month for your doctor's care, a $100 deductible, 80 percent of the cost paid for by the Federal Government, and 20 percent copay. That is what the Democrats proposed. We said, do the same thing with prescription drugs: have the seniors pay $25 for a premium, a $100 deductible, 80 percent of the cost paid for by the Federal Government, 20 percent copay up to a certain amount, and then it becomes catastrophic. But that is not what the Republicans did. The reason that the gentlewoman from Las Vegas is proposing this motion is because she does not want to give money to the HMOs. She does not want to force seniors to have to go to an HMO to get their prescription drugs. She says, let us give this money in this case to the doctors or let us give it to the seniors in some way so they benefit from it. I totally agree with the gentlewoman that we need to provide prescription drug coverage and preventive care for seniors, but then why are the Republicans giving away money to the HMOs? Why are they forcing seniors to go to an HMO to get their prescription drug coverage? Sure, if someone wants to join an HMO, like in my State, some people do get their drug coverage, I have no problem with that; and I know the gentlewoman does not. But this forces the seniors into the HMO. My colleagues are saying they have to join an HMO in order to get the prescription drug coverage. And that is not fair. That is not choice. That is not voluntary. Now, the gentleman from Georgia, said, well, we are providing with this Medicare agreement meaningful, affordable, and comprehensive coverage. That is simply not the case. First of all, seniors are being forced into an HMO. The Republicans are privatizing Medicare in the long run. But think about this benefit that you are giving the senior citizens. First of all, we do not even know what the premium is, so it may not be affordable at all. There is no set premium. We know that the deductible is $275, not $100, like it is for part B. And then there is, in fact, as the gentlewoman mentioned, this huge donut hole when you do not get any coverage at all. So the seniors in the long run are going to be paying more out, in my opinion, than they are going to get back. Now, yes, this is a voluntary program. But what good is it if nobody sees fit to sign up for it because they will be forced into an HMO or they will have to pay so much money out of pocket that they do not get a meaningful, affordable, or comprehensive benefit the way the gentleman from Georgia described? None of that is the case here. Finally, why can we not have real competition? Let us have the Medicare administrator negotiate price reduction. That is not in this bill either.