Frank Pallone

Mr. PALLONE

Mr. PALLONE. And the fact of the matter is, and the thing that really bothers me, and the gentleman is in Maine so he really sees it, and those in Michigan and other border States with Canada, you see people taking buses on a regular basis to go to Canada to buy the drugs at a significant reduction. It is outrageous they have to do that. My understanding is that in some of the border States, like Maine, that is routine. People take a bus once a month or whatever.

Mr. PALLONE. I think that what we need to point out is that we are talking about expanding Medicare to include a prescription drug benefit for all seniors because, practically speaking, we know that Medicare works. The reason this works is it makes sense. If you take the 39 or 40 million seniors that now are eligible for Medicare, all seniors are eligible for Medicare, and you make a huge pool that includes all these seniors, then it basically goes along with the whole idea of insurance. In other words, the idea with insurance policies is to have as many people participate in the plan as possible because then those who run up huge costs are in it, but those who spend very little if anything on drug costs are also in it. That evens the cost. We know that the Republicans have boxed us in, so to speak, in terms of the financing of this. But if you think about it from a practical sense, the best thing to do is to pool all the people, which is really what Medicare is all about. The Republican proposal, which says give a little money to private insurance companies and hope that they will attract some low- income seniors to this benefit, does not make sense, and the insurance companies have said it, because the only people that will seek out that option will be people who have huge drug costs and who figure by paying so much a month, or whatever, they are going to get a huge windfall in terms of their drug benefit. If you do what the Democrats are proposing, which is to analogize our proposal to Part B, where you pay a very low premium per month, I don't know if it will be $25, $35, $40 a month, you get 80 percent under Part B of your doctor bills paid for by the Federal Government, the deductible, I think, is $100, and, of course, the copay is the other 20 percent that the Federal Government is not paying, then you are going to create an incentive for almost every senior to join. I do not know what the percentage is, but it is something like 90-something percent of seniors pay the premium and join Part B, because it is worth doing. So if you have the same phenomena, where you have a very low premium and you get 90-something percent of the seniors to participate in this Part C or Part D Medicare benefit, you have created this huge pool, which I think from a financing point of view makes sense. That is what the insurance pool is all about. Then you go ahead and you say through some way, either you give the Secretary of Health and Human Services the authority to negotiate prices, I do not know if you do something like what the gentleman is proposing, or just give a negotiation ability with a mandate to reduce prices, he or she is going to have the ability to go out with the 40 million seniors and really get a good deal, presumably because he has such bargaining power. So we are trying to address the costs by giving the Secretary that power. We are trying to come up with a guaranteed Medicare benefit that everyone would be able to take advantage of, which is generous enough for people so that they would sign up for it, so that you would have everyone participate in it, and I have no doubt it would be as successful as what we have under Medicare now with Parts A and B. The one thing I would say, because sometimes people say what about the seniors who cannot afford the premium, the Democrats would do the same thing we do with Part B. If you are below a certain income, then the Government pays for your premium, or if you are a little better off, you have to pay a little less than the average premium and the Government subsidizes your premium. Those people would have the advantage now, as they do with Part B.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I rise today to recognize an exceptional young woman from my district that has distinguished herself by winning the March Spelldown 2002, allowing her to advance to the 75th Annual Scripps Howard National Spelling Bee. Katherine ``Kerry'' Close, a fourth grader from Spring Lake, New Jersey, beat 100 other students in Monmouth, Middlesex and Ocean Counties to make it to the final round of the regional spelling bee held in Asbury Park, New Jersey. Winning the bee qualified her and a guardian for a paid trip here to Washington to compete with 249 other nationwide winners who will compete in the four-day national bee beginning May 26. Her study strategies include listening to a couple hundred words each day, then having her parents quiz her on those words. In reality, the possible words she may face can be any word in the English language, a daunting task for a nine-year old. Kerry will also be one of the few contestants her age, but insists that she is not nervous about the event. I and all the residents of the Sixth Congressional District of New Jersey would like to once again congratulate Kerry on her achievement. I urge my colleagues to join me in wishing the best of luck to Kerry and all her fellow spelling bee champions from around the nation as they compete at the national spelling bee championships.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I come to the House floor this evening to discuss the slow progress being made over the Cyprus conflict. Yesterday, United Nations Secretary-General Kofi Annan traveled to Cyprus to meet with both Cyprus President Clerides and Turkish-Cypriot leader Denktash in an attempt to speed up negotiations between the two leaders. Secretary Annan said he hopes an agreement can be reached between the two sides by the end of June. Secretary Annan's pleas come during the same week that a high-ranking Turkish official said the time has come for Turkey to establish new proposals that would be based ``on parameters which are acceptable by Europe and the international community.'' Turkish Deputy Prime Minister Yilmaz was also critical of Turkish-Cypriot leader Denktash saying ``the proposals by Denktash are inadequate.'' Mr. Speaker, in the past I have come to the House floor to voice my extreme displeasure over the way Denktash negotiates. Last year when peace negotiations were at a standstill, I criticized the Turkish side's well-known negotiation tactics that can best be described as nothing more than delay tactics. The Turkish side would agree to peace negotiations on the Cyprus problem only for the purpose of undermining them once they began and then blaming the Greek Cypriots for their failure. In recent months, however, Mr. Speaker, hopes have been raised that a just and durable solution to the Cyprus problem can be reached and Cyprus President Clerides and Denktash have been meeting since the beginning of this year. The third round of these talks resumed last month. I am confident that the leadership of the Republic of Cyprus will continue to negotiate in good faith until a comprehensive settlement is reached as they have tried to do all along. Mr. Speaker, I now hope the Turkish Cypriot leadership will listen to the statements of the Turkish Deputy Prime Minister and finally respond by putting aside its unreasonable and unacceptable demands and negotiate in good faith. The most effective way for Turkey to expedite its membership into the European Union is for the Nation to finally support Cyprus' own accession into the EU and to drop its threats of annexing the Turkish-occupied northern third of the island if Cyprus' accession occurs. Turkey could also help its cause with the European Union by listening to its own Deputy Prime Minister and undertaking new initiatives on Cyprus. Mr. Speaker, given the instability in the adjacent region of the Middle East, now is a great time to heal the wounds in Cyprus that have been poisoning the relations between Greece and Turkey for nearly three decades. I am hopeful that the U.N. Secretary's visit to Cyprus and the statements of a high ranking Turkish official will move us closer to a just resolution of the Cyprus problem.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I come to the House floor this evening to reiterate once again that President Musharraf of Pakistan is failing to root out terrorism in Kashmir. This past Tuesday, more than 30 Indian soldiers and members of their families fell victim to a deadly attack in Kashmir at the hands of three Pakistani-based militants. Mr. Speaker, this type of terrorism is tragic and is exactly the type of terrorist activity that President Musharraf so valiantly claimed he would eliminate. It seems clear that President Musharraf has paid no regard whatsoever to preventing infiltration of Islamic militants into Kashmir. As a result of the October 1 attack on the Jammu and Kashmir State Assembly and the December 13 attack on the Indian parliament last year, Musharraf stated that action would be taken against Islamic militants. He proceeded to outlaw two organizations responsible for terrorism in Kashmir, Jaish e-Muhammad and Lashkar-e-Taiba. He also arrested nearly 2,000 men supposedly linked to terrorists and ordered madrassahs to be closed. This supposed crack down on terrorists and closing of extremist religious schools was a sham. Most of the militants that were arrested are now free and madrassahs continue to recruit and train young boys in Islamic fundamentalism and terrorist activities. Although Musharraf made claims that he is cracking down on terrorists throughout Pakistan, he has always referred to the Pakistani-based militants in Kashmir as freedom fighters. At the times he has referred to these terrorists, with deep, close connections to groups like al Qaeda and the Taliban, I have tried to highlight that Musharraf is operating under a double standard of siding with the U.S. against terrorism, while allowing terrorism to continue in Kashmir. More and more, the world is able to see that President Musharraf has dedicated himself to continuing military rule in Pakistan and allowing terrorism to occur in Kashmir. President Bush stressed in his address to Congress after September 11 that there would be no shades of gray. A country either supports us in our war against terrorism, or it does not. The Bush administration praises President Musharraf for joining the U.S. effort again the Taliban, but this support does not extend to countering terrorism in Kashmir. There are more indications daily that the terrorist elements are regaining ground in Pakistan, and the Musharraf government is doing very little to condition constrain it. I believe the U.S. should rethink its support for Musharraf in light of these events.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I rise today to draw attention to a recent statement by the Bush administration confirming Cuba's development of a biological warfare program and the possible transfer of this knowledge to other rogue nations. Mr. Speaker, Cuba is designated by the State Department as one of seven nations who sponsor international terrorism. However, since the collapse of the Soviet Union many Americans make the mistake of believing that Cuba is no longer a threat to our national security. Recent votes here in the House have reflected this shift in public perception. Just 3 weeks ago we voted on a motion to instruct conferees on the farm bill to include a provision that would lift part of the trade embargo to allow for public financing of agricultural trade with Cuba. I opposed this motion because I feel that it is short-sighted to lift economic sanctions when the Cuban government has done little to prove their worthiness of an economic partnership with the United States. In fact, Mr. Speaker, Fidel Castro shows only his open hostility to the United States by pursuing biological warfare research. He has what are considered to be the most sophisticated biomedical capabilities in Latin America. Cuba stands as one of the few developing nations who plays a significant role in drug and biotechnology activities. Mr. Speaker, there is evidence that Cuba is experimenting with anthrax, as well as a number of other deadly pathogens. Some experts believe that Cuba is even capable of making genetically modified germ weapons that are able to defeat vaccines and antibiotics. Unfortunately, the possibility that a rogue nation only 90 miles from our shores is producing biological weapons is not the worst of our problems. Mr. Speaker, intelligence officials have evidence that Cuba may be selling its bioterrorist knowledge to other nations hostile to the United States. Last year, Castro visited Iran, Syria and Libya, three nations that occupy spots on the State Department's terrorism list, along with Cuba and three nations that are currently attempting to develop weapons of mass destruction. During his visit to Tehran University, Castro stated that together Iran and Cuba could ``bring America to its knees.'' An unnerving thought when we consider that Cuba is closer to the United States mainland than Washington, D.C., is to my home in New Jersey. Mr. Speaker, it is time that we put the debate about Cuba and the Castro regime into the proper perspective for the American people. Too often people are only willing to see the economic benefit of trade with Cuba and lifting the trade embargoes. They do not understand that by lifting the embargo, without agreements by Castro to stop biological weapons production and without commitments on human rights or civil liberties, that we are giving Castro exactly what he wants. Mr. Speaker, it is time we see Castro and his regime for what they really are, a continued threat to the security of the United States.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, reclaiming my time, this came up in the other body, I cannot mention the name of the other body, other side of the Capitol and the point was, as my colleague knows, is the drug companies, the brand-name drug companies always say that they need to charge more because of research and development, when in reality what we know is a lot of the extra cost is just for advertising so that they can advertise the name-brand drug rather than the generic drug; and one of the ways that they could reduce costs is if they tried to encourage more use of generics, obviously; or I think in the Senate there was a proposal, which I think is a great idea, to say that that someone cannot take a tax deduction for advertising. In other words, someone can take a tax deduction for money they expend on research and development, but not for advertising. We, essentially, through the Tax Code, I am talking to a Ways and Means member now so I want to be careful here, but essentially encourage through the Tax Code that they advertise as much as they like because they get some sort of credit or deduction for it. I do not know exactly how it works. I wanted to say, if I could, to comment on what the gentlewoman talked about when she talked about the costs and the pricing because I started out tonight saying that the biggest sort of sham out here is that when the President about a year ago talked about promoting the discount card, which a lot of the drug companies are now offering, he talked about that as sort of an interim measure. In other words, we have not got a prescription drug program now, so until we do, until Congress passes it, let us promote this discount card because at least there will be some savings, which I questioned, but in case it is not the government helping in any way, this is what the drug companies are doing. Now, when the Republicans unveiled their sort of principles last week, the card became their cost-containment mechanism, which is ridiculous because the government is not doing anything; and then as my colleague says, the Republicans act as if there is no way they can influence the price. That is nonsense. If we set up the guaranteed benefit under Medicare, we now have 40 million seniors, and the Secretary of Health and Human Services has an incredible bargaining, negotiating ability because he represents those 40 million seniors, and he can certainly take actions that would result in lower prices.

Mr. PALLONE. Mr. Speaker, I want to thank my colleague from Illinois for joining us. I know we only have a few minutes left. I just wanted to, in ending this Special Order tonight, if I could just develop a little bit one of the points that he made. Part of the reason why the Democratic proposal and what the Democrats have been talking about tonight is so much better than what the Republicans have been proposing is because of its simplicity. We know that right now under the existing Medicare program it is very easy for the average senior to sign up, be part of the program and benefit from the program. All seniors and even the disabled who are under 65 that are eligible for Medicare know that their hospitalization is covered. They know that if they pay a premium, I think it is about $40 a month for part B to cover their doctor bills, that they will have a guaranteed benefit and that the Federal Government will pay 80 percent of the cost of their doctor bills, and that if they are in a traditional fee-for-service plan, rather than an HMO, which most seniors are still in the traditional Medicare fee-for-service program, that they can go to any doctor, they can go to any hospital and Medicare is going to cover it. What we are saying as Democrats is we want to build on that very successful Medicare model which is very easy for seniors to understand and take advantage of and say if someone pays a premium of say 25, $30 a month for their prescription drugs, then they will be guaranteed a generous portion of that; say, maybe 80 percent or so is going to be covered by the Federal Government. And that after your first $100 deductible you can be guaranteed that your prescription drugs are going to be paid for in that way. Very simple model. It is the existing Medicare program; builds on it. Forget the ideology, just do it. That is what the Democrats are saying. Do it for every senior; everyone who is eligible for Medicare. Now, my colleague from Illinois said, well, the seniors are concerned about not wanting to have to do some complicated plan. Well, that is what the Republicans are saying. They are saying forget the Medicare model, we are going to throw some money somehow to some insurance companies and we are hoping that the insurance companies will provide some sort of benefit, but we are not guaranteeing they are going to cover all drugs or any particular kinds of drugs. We are not guaranteeing there will be any kind of particular premium structure or what the level of the Federal Government's contribution is going to be. And the seniors are supposed to shop around. These seniors, who are now 70, 80 years old, and they are supposed to shop around to see if there is some kind of insurance program that they can get. Now, I know some seniors are going to be able to do that, but I would say there are a lot that are not going to be able to, and are going to find when they are shopping that they do not find a plan that is even available. I know my Republican colleagues will say, well, they can always go to an HMO. But remember that HMOs increasingly are not available in a lot of parts of the country, and more and more HMOs are dropping seniors and do not want to offer to senior citizens. So the complication that my colleague from Illinois talks about for seniors, that complication is multiplied so much by what the Republicans seem to be proposing. And the real answer is to go back to the very simple program, the model that we have now that has worked so successfully for the last 30 years, and that is Medicare. That is all that the Democrats are asking for. And, hopefully, if this does come up in the next week or two, we can make that point about why a guaranteed Medicare plan is so superior to whatever proposal the Republican leadership is bringing up. I guess I would just conclude by saying as much as I do not like to be cynical, I believe that the Republican proposal really is nothing more than an effort to show that they are doing something and that they fully understand that their proposal is not going to go anywhere and will never be enacted into law. So that is a shame, too, to think they are being very cynical and bringing this up as we get close to the election, rather than trying to put something together on a bipartisan basis that actually can be signed into law.

Mr. PALLONE. I agree, and I am very fearful about what the gentlewoman says, which is that essentially with what the Republican leadership is doing here, they just want to bring up a bill so they can say they passed something, send it over to the other body and have it die.

Mr. PALLONE. And instead, overall, the cost of paying for the prescription drugs is actually going to save the Federal Government a lot of money. Our problem is that when we make that case, we are not necessarily able to give an exact dollar figure. That makes it more difficult to make the case. But there is no question in my mind that there are tremendous cost savings to the Federal Government if we include a prescription drug benefit.

Mr. PALLONE. Reclaiming my time, I think the gentlewoman is absolutely right. If you remember, two years ago, again, close to the election when the Republican leadership tried to bring up a bill, and that is what it basically was, that we are going to give money to insurance companies and hope that they will cover prescription drugs and you can shop around and see if they will cover you. That only passed the House and it died. But it was based at the time on a model that was used in the State of Nevada, and Nevada, which had a Republican legislature and I think a Republican governor, decided to go this route. And for 6 months after the governor signed it, they could not find any insurance company that would cover anybody. So 6 months from the day it was in effect, there was nothing out there for people to buy. And then they think what they did is they tried to get one company to cover it and even then they could not get anybody. So the whole thing is a huge mess and not working.

Mr. PALLONE. And the bottom line is, I guess being a little crass talking about the money aspect, is that the Federal Government is paying. With the way the system is set up, the Federal Government is paying for hospital care and paying for a lot of the things.

Mr. PALLONE. Mr. Speaker, I think they have made certain changes, and I do not know what the status is now. But the one thing I was going to say is that part of this is just sort of an ideological problem that the Republican leadership has. In other words, they did not like Medicare. Most of the Republicans voted against Medicare in the 1960s or whenever it started. And it was for ideological reasons because it was a government-run program. And I think that is what you are getting. The Republican leadership just cannot accept the fact that Medicare works and we should add this benefit. They think it is too much government interference, so they are trying to send it out to the private sector from an ideological perspective. The gentlewoman was pointing out, and everybody is pointing out, let us look at this practically. Let us not say this is left wing or right wing or whatever it is. Medicare works. This is not going to work, what they are proposing. Mr. Speaker, I yield to the gentlewoman.

Mr. PALLONE. I hope so. I am eternally the optimist, as I know my colleague is, too. Let me yield to the gentleman from Illinois (Mr. Phelps).

Mr. PALLONE. Mr. Speaker, this evening I plan to spend most of the time discussing the need for a Medicare prescription drug benefit. I come to the well, to the floor this evening primarily because of my concern that the House Republican leadership is talking about, certainly presenting itself to the media, that they intend to bring up a prescription drug proposal at some point over the next couple of weeks. I am very concerned that their proposal is really nothing more than a sham and not something that is actually going to benefit any significant portion of the senior population. I thought what I would do this evening is that I would start out by sort of outlining what I believe, and what Democrats as a whole in the House of Representatives feel we should be doing about prescription drugs. First of all, I should say that the Democrats feel very strongly that the biggest problem with prescription drugs is the cost. The fact of the matter is that whether one is a senior, whether one is over 65 or whether one is under 65, it is getting to be more and more difficult to pay for one's medicine, because of the fact that the prices keep going up every year. Double-digit inflation, essentially, we have had with regard to prescription drug prices for the last 6 years. Every year, the cost goes up by a double digit percentage point. Democrats are determined to address the cost issue and to say that whatever benefit package we arrive at has to address the issue of cost and try to bring prices down. The other major issue for Democrats is that this plan, this prescription drug plan or legislative proposal has to be a Medicare proposal. In other words, right now we have a great program called Medicare that all seniors over 65 know that they are guaranteed certain benefits, whether it is a hospital stay or, if they are participating in part B of Medicare on a voluntary basis, their doctor bills are paid, and there is no question about what is covered essentially and is not covered, because there is a guaranteed benefit package for every senior, for everyone who is over 65 who is eligible for Medicare. We insist that that be the case for the prescription drug proposal as well. This has to be a benefit that is added to the Medicare program and that every senior, just like with part B when seniors pay so much a month at a very minimum premium to cover their doctor bills, that they would pay so much per month at a very low premium to cover prescription drugs, and they would know that they would be able to guarantee that prescription drugs were paid for pursuant to Medicare as part of their program. The other thing that we insist on is that this program be generous enough, in other words, that the Federal Government be paying enough of the cost of their prescription drugs so that it makes sense for one to voluntarily pay the monthly premium, like they do in part B for doctor bills. In other words, the benefit has to be significant. We have talked about as much as 80 percent of the cost. If we analogize what we have now for part B for doctor bills, what the Democrats are essentially saying is that we want a prescription drug benefit that is very similar to the Medicare structure for doctor bills, in other words, that there be a fairly low premium per month, that the deductible be as low as possible, something like what we have for part B to pay for doctor bills; that the amount that the Federal Government pays is significant, probably something like 80 percent with regard to part B to cover doctor bills; we pay a premium and when the bill comes in, the Federal Government pays 80 percent of the cost. Well, that is the kind of generous benefit that we want to provide for prescription drugs, and that there be some point, we call it a catastrophic level, at which point if one paid so much out-of-pocket over the course of the year, that the Federal Government would cover the entire cost. Now, let me contrast what I just said and what the Democrats would like to see with what we are hearing from the Republican leadership in the House. I want to stress that what we are hearing is not very good on any of these points. About a week ago, the House Republicans rolled out some general principles about what their prescription drug program might be when they finally introduce it; and they said, they are trying to give the impression that it is going to be a Medicare benefit. They are trying to give the impression that it is going to lower costs. They are trying to give the impression that we are going to have the choice of basically all drugs that would be covered and that one can go to any pharmacy and it is just going to operate in a way that provides all kinds of choice. But the reality is very different. Let me talk about some of those principles. First of all, they talk about lowering cost, but they do not have any mechanism in their proposal that addresses cost. In other words, they are not saying that the Secretary, for example, is supposed to negotiate prices, or the Secretary of Health and Human Services is supposed to negotiate prices. They are simply talking about a discount drug card. President Bush about a year ago said that he wanted the Federal Government and the Medicare program to promote the discount drug cards that some of the drug companies are now making available to seniors. Well, that is very nice. It is very nice that some of the drug companies are providing a discount drug card. I question how much savings there really are in those cards, but the reality is that that is not a Medicare program, that is not a Federal government drug benefit, to talk about someone going out and purchasing a discount card from the drug companies, when that is already available. The Republicans cannot kid everyone and suggest to the American people that somehow that is going to address the cost issue. This is already available. They need to address the cost issue in the context of their legislation. The other thing they are saying is that they are talking about this as if somehow it is going to cover everyone under Medicare, but if we look at what the Republican leadership in the House is proposing, it is not a Medicare benefit at all. In fact, what it is is giving money sort of like a voucher system to insurance companies, hoping that they will sell drug-only policies to a select group of senior citizens, probably only very low-income seniors, maybe less than 10 percent of the senior population. So the Republican leadership in the House is not talking about what I mentioned before, an addition to the Medicare program that everyone is guaranteed that if they sign up and pay their premium they are going to get a guaranteed prescription drug benefit. They are talking about something like a voucher, essentially a private program where some money would go to insurance companies and people would go around and try to find an insurance company that would cover the prescription drugs, or perhaps an HMO. Because it is clear they are continuing to push HMOs and trying to get seniors to sign up for an HMO, and they hope that the HMO, with a little more money from the Federal Government, is going to provide prescription drugs. That is not what Medicare is all about. Medicare is a guaranteed benefit. Medicare says that everyone is covered. What the Republican leadership in the House is suggesting is that this is only going to be available to very low-income seniors, those seniors who are not eligible for Medicaid but are maybe just above the Medicaid guidelines, maybe 6, 7, 8, 10 percent of the senior population that is not eligible for Medicaid and does not have any kind of drug coverage. So I just want to debunk this myth, if you will, about what the Republicans are really about. They are saying that their program is going to strengthen Medicare, but it is not going to strengthen Medicare if now essentially what we are talking about is privatizing Medicare. It is not going to strengthen Medicare if only less than 10 percent of the senior population are going to be able to take advantage of this program. I want to stop my comments now because I see some of my colleagues have joined me on the Democratic side. I would like to have them address this issue, and we will hopefully have a little debate back and forth, as well. Mr. Speaker, I yield to the gentlewoman from the Virgin Islands (Mrs. Christensen), who is part of our Health Care Task Force and is a physician, and is probably more qualified as a physician to talk about this issue than anyone else.

Mr. PALLONE. Mr. Speaker, I thank the gentlewoman. I just have to remark, when she talked about how Members of Congress might have to worry about prescription drugs or the Medicare program and she said it was only herself, she did not look around at the rest of her colleagues, but we also need to be concerned about it, because it will impact us as well. I just wanted to mention one thing before I yield to the gentlewoman from Florida. I appreciate the fact that the gentlewoman from the Virgin Islands brought up the preventative aspect, because many times we forget that prescription drugs or medication is really a preventative measure and that there are huge cost savings, as with any preventative type of program. I think in general when we look at Medicare as a whole, we have paid too little attention to prevention, and whether it is home health care as opposed to having to be in a nursing home, or prescription drugs.

Mr. PALLONE. I think that is what we are headed for. Hopefully, we are wrong and maybe we are too cynical and we can be optimistic. I have the same fear my colleague does.

Mr. PALLONE. It is just so important in the course of the debate on this, if we get to it in the next week or two, that we stress that, that the preventative aspect of prescription drugs means cost savings. There will be some people who will say that the guaranteed benefit under Medicare that covers all seniors is going to be too expensive, and we need to come back and say you are going to save money.

Mr. PALLONE. Mr. Speaker, I yield to the gentlewoman from Florida (Mrs. Thurman) who is, of course, on the Committee on Ways and Means and has been a leading spokesman on the needs for prescription drugs benefit.

Mr. PALLONE. Reclaiming my time to respond, I think the gentlewoman makes a very good point. I started out this evening by saying that the Republicans are talking about bringing a bill which they have not really outlined. They have just given vague ideas of what it might be.

Mr. PALLONE. But they are not sure they want to move it or what to do with it.

Mr. PALLONE. What I think is happening and what we were hearing last week, they had a press conference last week and they outlined these broad principles which I pointed out earlier are all essentially a sham. They talked about that this will be a Medicare benefit, but it is not guaranteed to all Medicare beneficiaries, so how is it a Medicare benefit? But what we are hearing is they were supposed to bring it directly to markup in the two committees, the Committee on Energy and Commerce and the Committee on Ways and Means next week, and then to the floor before the Memorial Day recess. And what you are pointing out, and this is absolutely right, this is probably the most important piece of legislation to deal with in this Congress. The normal process is to have one day of hearings, usually like months of hearing, and then have a markup and allow amendments and then go to the floor. I think what you are saying is they may not do any of that, they may bring it directly to the floor. I think just a couple of days ago, I think Monday in the Congress Daily, they pointed out that the headline said ``GOP Drug Plan Faces Intra-Party Critics.'' The problem is that a lot of Republicans who are more reasonable and are really concerned about what this is going to mean have been suggesting to them that, A, that this prescription drug plan is not going to help that many seniors or that, B, the Medicare reform is really cutting back on payments for hospitals or others that have a great need.

Mr. PALLONE. The gentlewoman is right. They may not be able to muster the votes in committee and they may just take it directly to the floor, which is a huge travesty because there will be no debate other than on the floor, which is not the way it is supposed to be.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I come to the House floor this evening to express my opposition to the termination of the J-1 visa waiver program. Currently, foreign medical graduates are allowed to come to the United States on a J-1 visa for up to 3 years to train in accredited residency programs in rural underserved parts of the country. The impetus behind accepting physicians from other countries, foreign medical graduates, and training them in American residency positions is to attract physicians to provide care to the medically underserved who live in rural areas where doctors trained in the United States do not want to practice. Mr. Speaker, the law states that once a residency program is complete, the doctors are required to return to their country of origin for 2 years. However, the government has the authority to waive the requirements if it is in the United States' interest to keep the physician here. The U.S. Department of Agriculture's Rural Development Branch was thrilled by the waiver because it provided the opportunity to retain medical trainees who would continue to serve in typically medically underserved communities in rural America. But, Mr. Speaker, unfortunately, in the past few weeks, the USDA has indicated an intention to stop granting such permission under the J-1 visa waiver program. Although it is clear there is a lack of sufficient health care in rural America, and although it is clear that qualified physicians from abroad are willing to come to the U.S. to serve in these medically lacking communities, nevertheless, the government has proposed to end this program entirely. Mr. Speaker, since September 11, national security concerns have taken hold and new extensive background checks have been put in place. The USDA claims the extra money required to implement background checks on foreign medical graduates would be too burdensome and therefore the program must end. Currently, there are approximately a little more than 80 applications for the waiver that are still pending, and after these applications have been processed, the program is slated to end. Mr. Speaker, I believe that there is not justification for the cessation of the J-1 visa waiver program. Terminating this program and preventing qualified physicians from serving communities in America that lack sufficient health care does our country a great injustice. Mr. Speaker, stopping the granting of these waivers is unacceptable, and I would ask that the USDA reconsider, and that we do whatever we can, myself and my colleagues, to prevent this valuable program from ending because it is so important to rural America and to the health care of Americans in rural areas.

Mr. PALLONE

Mr. PALLONE. Madam Speaker, the biggest problem with lack of coverage today is prescription drugs. As the gentleman from Ohio mentioned, the Republican leadership is not doing anything about the cost. The biggest concern that my constituents tell me is that they cannot afford the price of drugs. What is the Republican leadership doing about it? Absolutely nothing. Their proposal to address the prescription drug issue is simply a sham. First of all, it is not under Medicare. Medicare needs to be expanded so that everyone who is eligible for Medicare gets a prescription drug benefit guaranteed, and they know what the benefit is. What the Republican leadership is saying is we are going to send some money out to private insurance companies or to the States, and we hope that Americans can take this voucher, and if they are low income, they can find some insurance company to give a drugs-only policy to cover prescription drugs. They are assuming that the only people that are going to be able to take advantage of it are very low-income people, about 6 percent of the senior population. And even those will not be able to take advantage because the insurance companies have said they will not sell these prescription drug medicine-only policies. Madam Speaker, what we need is to expand Medicare for all seniors so they all get a prescription drug benefit, and it has to be a generous benefit. It has to say if someone pays so much per month as a premium, like one does with their doctor bills, they get a guarantee from the Federal Government that it is going to bring their cost down so they can pay for their drugs. That is not what the Republicans are offering. They are doing another sham, like they did 2 years ago, where they are trying to throw some money out there and give the impression that somebody is going to get a prescription drug benefit. It is a joke on the American people. But going back to the main thing is cost. Everyone tells me they cannot afford to pay for the drugs. What the Democrats are saying is not only are we going to give a generous benefit guaranteed under Medicare, but we are going to have the Secretary make sure that the costs come down.