Frank Pallone

Mr. PALLONE

Mr. PALLONE. Well, Mr. Speaker, we have the perfect example in Nevada which, I believe around March or so of this year, passed a plan that is almost exactly the same as what the Republicans in the House proposed. The insurance industry told the Nevada legislature it was not going to work and there was not a single insurance company that wanted to sell a policy that would meet the specifications of what the Nevada legislature passed. So it has been a total failure in Nevada. Basically, what the House Republicans are saying is that they want to adopt a State example that has failed.

Mr. PALLONE. Certainly.

Mr. PALLONE. I certainly will.

Mr. PALLONE. Mr. Speaker, reclaiming my time, let me tell my colleagues that the gentleman's example with the dog is certainly true in New Jersey. I actually have a cat; it is actually my wife's cat that I inherited, and she had, I guess it was a thyroid problem, and in New Jersey, I guess one can get the prescription drugs at the veterinarian or one can get it from the local pharmacy. So I had to refill the prescription and I went to the local pharmacy to purchase the medicine for our cat. I was told by the pharmacist that the same drug would be twice as much if it was for a human. So there is absolutely no question that we have a huge discrepancy between a cat and a senior citizen or a dog. The other thing that is so interesting and I think so really sad is that when Governor Bush proposed his prescription drug plan and was asked by one of the reporters on the day when it was proposed, because I have the article here, The New York Times that was from September 6 of this year, he actually was critical of the Democratic plan, because of the negotiation power that the gentleman from Texas (Mr. Turner) talked about. He said it was like price control. It is just ridiculous. That is not what it is. The Democrats are not establishing price controls; they are simply saying that we want the government, it is not even the government, but in different regions of the country that a benefit provider would be set up, basically a group that would be able to go out and purchase the medication at a cheaper price because they represent so many people and they have the buying power to negotiate a better price, just like the HMOs do now or some other large employers do now. And Governor Bush, when he was asked about that, and I will just give my colleagues the quote from the New York Times here. He said that much like the drug industry, he criticized Mr. Gore's plan as a step towards price control. ``By making government agents the largest purchaser of prescription drugs in America,'' he said, ``by making Washington the Nation's pharmacist, the Gore plan puts us well on the way to price control for drugs.'' Well, why should not a regional provider be able to go out and negotiate a better price for all of these seniors? Why should they have to pay twice the price? It does not make any sense. I could not believe that he actually had the nerve to criticize the very provision in our bill that would reduce the price in a competitive way, sort of the American way, competition. You negotiate a better price.

Mr. PALLONE. Surely.

Mr. PALLONE. The reason why the prices are so much more here is exactly based on what our colleague from Texas said, and that is that since there are price controls and negotiating power for citizens in other countries, the only place left on the planet where there are not the price controls and the negotiating power is here in the United States. So the drug companies make up the difference here. They cannot make the money in these other countries, so they jack up their prices here to make up for the fact they cannot do it abroad. So that is just unfair to the average American.

Mr. PALLONE. Let me just mention another aspect of this that I think is important, and that is that what Governor Bush is now saying is, well, maybe we cannot cover all the seniors; but, if we cannot, then at least let us try to cover the low-income seniors, because the bottom line is that he does not have a Medicare plan. I mean, what he has proposed and what the Republican leadership proposed here is not Medicare. I would argue that it ultimately would lead to the destruction and dismantling of Medicare. The reason for that, and the issue I want to bring up, is the fact that now the Republicans are saying, okay, we will at least try to help the low- income people and see if we can provide them with a prescription drug benefit. Because if you look at the Bush plan, there are about 25 million seniors under Medicare that would get absolutely no help and have no option for prescription drug benefits because two-thirds of seniors have income above the 175 percent poverty level. In other words, under the Bush plan, as a single individual you would have to be making less than $14,600 a year. Otherwise, you would not get any subsidy whatsoever. The problem that I have with just targeting the low-income seniors is that it breaks the whole principle that Lyndon Johnson put forward with Medicare. When President Johnson established Medicare, the idea was you were going to get Medicare, regardless of income. It was primarily to benefit middle-income people, of course. But everyone received the Medicare benefit, regardless of income. I am very fearful of the fact if you say okay, let us just deal with the low-income and let us not deal with the average senior, that you set a very bad precedent, because you suggest that somehow Medicare perhaps should be almost like welfare, just for low-income people. If you start that precedent, you could see that for other aspects of Medicare as well. I should also hasten to point out that only a fraction of low-income seniors would get any coverage either, because basically what Governor Bush does is he says this is going to primarily be administered through the States. It would be up to the States to establish a prescription drug program for low-income seniors. We know that the record is very unclear about States. Some States have some prescription drug programs. Most do not. Those that do have it for low-income people tend to have only coverage for certain aspects.

Mr. PALLONE. If I could use an example on the opposite side of the country in my home State of New Jersey, we have a program for certain low-income seniors to provide prescription drugs. It is financed through our casino revenue fund from Atlantic City casinos. I had numerous senior forums throughout the August recess. My district, a lot of the towns I represent, I would say they are very middle income, not necessarily poor, not necessarily rich; and I remember particularly one day being at the Neptune Senior Center, which is a town which is very diverse, poor people, wealthy people, and mostly middle-class people. There were probably 100 seniors in the room. There were maybe five or six that were covered by a prescription drug program under Medicaid, and they were complaining about how they could not get certain prescription drugs because they were not listed under Medicaid; and there were maybe another 10 or 15 out of the 100 covered under the State prescription drug program, financed with casino revenue funds, and they were fairly happy with their program. But there were collectively, between the Medicaid and the state-funded program, out of the 100 people, I doubt there were more than 20 that were receiving any coverage. The other 80 people in the room had no prescription drug coverage. This is not a problem that is faced primarily by low-income people. This is a problem that everyone faces. It is primarily middle-income people that are complaining to me now and saying, look, I cannot afford the drugs; I do not have the benefit.

Mr. PALLONE. Mr. Speaker, I would also point out, because I know that the Republicans keep talking about choice and sort of give the impression that the problem with what the Democrats are proposing is that it is one-size-fits all, in other words, it is under the rubric of Medicare and, therefore, it is going to be national and somehow it is bad because it is national and it is one-size-fits all. Nothing could be further from the truth. I would argue that the way the Democrats have set up this plan under Medicare, they have more choice, real choice than they have under the Republican plan. And I will say why. First of all, just like Medicare in general, this is voluntary. If they do not want to sign up for what would be Part D and pay the premium of so much a month the way my colleague described and the way the Democrats have put it forward, they do not have to do it. But, more importantly, if they could have the Democratic plan in effect, those who are in HMOs, those who are in employer retirement plans where they are getting a prescription drug benefit can keep those plans and the Federal Government would be helping them and helping those plans to continue to provide the prescription drug coverage. Let me explain why. Let us say that I am in an HMO and I would like to keep the HMO. Well, the reason why so many of the HMOs are now dropping seniors is because they cannot afford to cover the seniors or in many cases provide the prescription drug benefit. Well, under the Democratic plan, the HMOs will get the money to provide the prescription drug benefit, they will actually be paid by the Federal Government to provide the benefit because it is a basic benefit that everyone is entitled to under Medicare. So, if anything, there should be more choices available. I would suggest that both in New Jersey and Texas we will see more HMOs willing to provide a prescription drug benefit and cover seniors than we have now because now they will be getting reimbursed for most of the cost of the prescription drug benefit plan. So if they want to keep their HMO and they like an HMO, they are probably more likely to keep it under the Democratic proposal. The same thing with employer-based plans. Some people may not want to opt for the traditional Medicare coverage, which would include the prescription drug benefit, because maybe they, through their retirement, get prescription drugs as part of their employer-based health care plan. Well, we would reimburse that, as well, and they could keep their employer-based plan. So all we are saying is that everyone gets the benefit and the Federal Government will provide the money to pay for the benefit regardless of what program they are in, whether it is their veterans or their employer-based plan or their HMO. But there is always going to be the guarantee, the floor, that if any of those fail and they do not have the option of any of those things they can get it through their traditional Medicare plan.

Mr. PALLONE. Exactly.

Mr. PALLONE. The irony of it is that the insurance companies testified before your Committee on Ways and Means and before my Committee on Commerce and said that they would not sell the policies. They were not interested in it.

Mr. PALLONE. Absolutely. And the thing that disturbs me most about it, and I know that the gentleman is very knowledgeable about this, is that the fact of the matter is that every time the Republicans have come up with a proposal to deal with the prescription drug issue it has always been defensive. In the case of the House of Representatives, because the Democrats were out there with our proposal to bring prescription drugs under the rubric of Medicare and we had a proposal out there that was a very good one, and they tried to avoid it by coming up with this plan that essentially did not help anybody.

Mr. PALLONE. Mr. Speaker, I think that is what our colleague the gentleman from Texas (Mr. Turner) was pointing out, which is that even though the Republicans may argue, well, let us just do this for low- income people, what they are forgetting is that middle-income people, depending on their circumstances as such, they could be completely wiped out with the cost of these drugs. So the notion that somehow this is not something we have to do just for the average person is nonsense because they could be wiped out in a minute because of the cost of these drugs. I also say that what we are finding today is that a lot of the more expensive drugs the HMOs or some of the insurance companies characterize as not medically necessary, in other words, they will say this is experimental or this is something that is not exactly approved at this point, and it is those very things that are very expensive that end up not being covered. When we say in our Medicare prescription drug plan that they are going to have access to whatever is medically necessary, we put that language in there because we want to make clear that if their physician or the pharmacist says that this is medically necessary, it will be covered. I know that my colleague, the gentleman from Texas (Mr. Turner), has made a big point of that that one of the problems with the Republican plans is that not only is it primarily for low-income people but they never know exactly what they are going to get. And it is very easy to exclude things under the rubric of saying they are not medically necessary or they are experimental or those kinds of things, which is why it is important to establish in the plan what kind of drugs they are going to get and to make it clear.

Mr. PALLONE. It is such a cruel hoax, too, because as both of you have pointed out, this is a real problem. We are getting real people coming up to us on a regular basis saying that they are suffering. How cruel it is really for the Republican leadership in this House to say, well, we are going to solve their problem by throwing a few bucks at the insurance industry when the insurance industry is telling us that they are not going to provide the benefits, anyway. I just wondered if I could for a minute go back to this article in the New York Times that talked about what had happened in Nevada. Nevada as I said in March of this year passed a piece of legislation that was very similar to what the House Republicans had proposed in terms of providing subsidies to seniors if they could go out and buy an insurance policy that covered prescription drugs. It has been a total failure. This is a reference here in the article. This is from July 8, New York Times, of this year. It quotes Barbara Buckley, a State assemblywoman who is cochair of a task force that monitors this potential program. She says that the task force refused to authorize the release of any money until it could see the details of a drug program that met the eligibility criteria in terms of premiums, deductibles, copayment, and benefit limits. Most of those details would be decided by the successful bidder. The problem was that no insurance company wanted to offer a program that met the standards that the legislature set in terms of specifying what the premium would be, what the copayment would be, what drugs would be proposed. It says in the article, asked why insurers did not show any interest, a retired Navy captain, a Mr. Fend, who serves on this task force, said, probably because they did not think they could make any money. If they thought they could make a reasonable amount of money, they would probably buy into the program and bid on it. The bottom line is, it is just a hoax. The Republicans here have talked about a prescription drug program that will not work. It is really awful to think that they know it will not work, it has not worked in a State where it was proposed, yet they keep bringing it forth as if somehow they are trying to address the problem when they are not.

Mr. PALLONE. I yield to the gentleman from Texas.

Mr. PALLONE. Mr. Speaker, this evening, as I have so many times, I would like to talk about the need for a Medicare prescription drug program. I have to say that I will be partisan this evening. I know some of my Democratic colleagues will be joining me, because I believe very strongly that the only reason that we do not have a Medicare prescription drug plan is because of the opposition of the Republican leadership. I have to say that I have been very disturbed to see that the Republican presidential candidate, George W. Bush, Governor Bush, has now come up with a proposal to deal with the problem that seniors face with prescription drugs, but it is really no different than the same plan that we have been hearing over and over again by the Republican leadership in this House that does not provide a prescription drug benefit under Medicare but rather simply tries to provide some sort of government subsidy, primarily for low-income people, that I believe will never succeed because essentially it is not practical. It is not under the rubric of Medicare because the Republicans traditionally and now have opposed Medicare and do not want to see it expanded to include a prescription drug benefit.

Mr. PALLONE. I want to thank the gentleman. I think we are running out of time. The last point the gentleman made is so important. I really believe that one of the reasons why Governor Bush has proposed this scaled-down prescription drug plan that really only addresses some of the problems for low-income people is because he has proposed using so much of the surplus for this grandiose tax cut plan, which primarily benefits the wealthy and corporate interests, and so he does not have enough money left to pay for a Medicare prescription drug program the way the Democrats have proposed. And so that has actually forced him in some ways to propose this more scaled-down version that will only help some low-income people. That is unfortunate, because if we have a surplus, and you and I both I know are worried about these estimates and whether the level of surplus that is being talked about will ever materialize, but there is certainly enough that we could provide the prescription drug program along the lines of what the Democrats have proposed. I would hate to see that not happen just because of Governor Bush's tax proposals and the tax proposals that the Republicans have put forward, which I think really do not help in any significant way the average American. I just want to say we were here again tonight as Democrats because we believe strongly that this is a major issue that should be addressed in this Congress, that is, providing a prescription drug program under Medicare. We are going to continue to be here every week until this Congress adjourns demanding that this issue be addressed.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, the year 2000 has been a great year for those of us actively involved in building and promoting relations between the United States and India. This week, I am proud to welcome Indian Prime Minister Atal Bihari Vajpayee to Washington. The Prime Minister's visit comes months after President Clinton made a similar visit to India. I was fortunate to join the President on that historic visit. While here in Washington, the Prime Minister will focus on economic relations between the two countries, as well as the role of the Indian- American community as a bridge between the two democracies. Since the early 1990's, I have been advocating for the U.S. to build a long-term and enduring relationship with India. This relationship makes sense since both countries share common democratic traditions. Portions of India's constitution were modeled after the U.S. constitution, and both countries share the same views of freedom of expression, protection of individual rights and a vitality of the political process. India and the U.S. have forged close economic and commercial links. India represents enormous opportunities for U.S. firms to make new investments and enter new markets. Good relations with India can only increase the economic ties we currently have. A strong economy in India is a basis for lifting people out of poverty and for creating a strong democratic base. The two countries also have become linked as centers of scientific and technological innovation. In the fast-changing world of high technology, the U.S. and India have already begun sharing process of information, of skills and of people who provide great benefits for consumers in both countries. India has a highly trained corps of software engineers whose talents are being utilized here and in India. Both countries, victims of terrorism in the past, have teamed up to establish a Joint Working Group on Counterterrorism, which should enhance the effectiveness of both nations' efforts to combat terrorism worldwide. As the region's only democracy, India will play a major role in security issues throughout Asia for years to come. I have believed for some time that India should receive a permanent seat on the United Nation's Security Council and am anxious to hear from the Prime Minister if there were any new developments while he was in New York last week. Providing this seat to India will help make the world a safer place. While I was in India with the President earlier this year, I was fortunate to attend the signing ceremony in Agra of an historic agreement to promote cooperation in the areas of clean energy and the environment between our two countries. This agreement marks a major step toward promoting clean energy in India and protecting India's and our global environment. As part of this agreement, joint trade and investment efforts will promote clean energy technologies in India. India and the U.S. also are conducting joint public-private partnerships in the energy sector. In fact, one New Jersey utility, PSEG, is on the verge of signing an agreement with the Indian government to carry out just such a partnership. This utility also is exploring creative methods for improving the electric supply and system reliability with partners in Karnataka. These types of efforts will promote clean energy technologies and help India avoid the pollution we experienced with our industrial development. India does not need to sacrifice its economic growth because its local businesses will conserve energy and improve their ``bottom lines''. I look forward to working with the Prime Minister during this week's visit to further these efforts between India and the U.S. to conserve resources, improve energy supply, and protect our environment. As the founder and past Chairman of the Congressional Caucus on India and Indian-Americans, as well as the Representative for one of the largest Indian-American communities in the country, I am excited by the developments of the past year between our two countries. It is my hope that Prime Minister Vajpayee's visit will strengthen relations between the world's two greatest democracies.

Mr. PALLONE

Mr. PALLONE. Mr. Speaker, I want to thank my colleague from Texas because he really lays out the differences between the Bush Republican plan and the Gore Democratic plan, but there were two things I just wanted to comment on because I thought they were so important. First, the gentleman pointed out that when he talked about these private insurance-only policies that the Bush Republican plan is relying on, they are assuming that there is going to be a voucher of some sort that seniors are going to be able to take with them and go to buy this private insurance policy for prescription drugs. It is illusory. It is not going to happen. The reason is very simple, which is that insurance companies do not provide benefits, they insure against risk. We know that almost every senior is going to have to use prescription drugs, so it makes sense to put it as a benefit under the existing Medicare program rather than look at it as some sort of risk. Insurance companies are not going to provide coverage when they know that every senior would actually benefit and take advantage of the plan. That is why these insurance policies were not sold in Nevada and why they will never be sold anywhere else. The second thing is that the Bush Republican plan is sort of a cruel hoax. The gentleman laid out that during the month or so that we were back in our districts and Congress was not in session that he talked to real people, as did I, and they are suffering. They are making choices; dividing pills, having to make choices between food and prescription drugs. When the gentleman went to a lot of the towns in his district, he knew this was a real problem. I feel that what Governor Bush has proposed is just something that is illusory and is there to give the impression that somehow he wants to address the problems that these real people have. And he has really only come up with it in the last few weeks because Al Gore has been out there talking about the Democratic machine and it has gotten a positive response. So all of a sudden Governor Bush had to come up with something, knowing full well that it is not going to work. And I think that is a real cruel hoax on these people that we have been seeing every day for the last month that are crying out for some relief. I want to yield to my colleague, the gentleman from Maine (Mr. Allen). Again, I know that he has been out there talking about the problem of price discrimination because so many seniors now that do not have coverage and have to buy prescription drugs at the local pharmacy out of pocket pay significantly higher prices than those who are in HMOs or some kind of an employer plan that is able to buy the prescription drugs in bulk and negotiate a good price. The thing that really bothered me was the fact that, in laying out his plan today, Governor Bush actually criticized the Democratic plan, the Gore plan, because it tried to address the issue of price discrimination that somehow even making this attempt was a bad thing, and yet that is the biggest problem that seniors face right now and everyone faces because of that price discrimination. Mr. Speaker, I yield to the gentleman from Maine (Mr. Allen).

Mr. PALLONE. Mr. Speaker, I yield to the gentlewoman from Florida (Mrs. Thurman).

Mr. PALLONE. Mr. Speaker, reclaiming my time, what I said before in response to what the gentlewoman said, we had the example in Nevada that implemented the Republican plan almost exactly what Mr. Bush and the Republicans in the House have proposed 6 months ago, and not one insurance company has offered to sell that kind of a policy. So we do not even have to take the word of Mr. Kahn. We have an example in a State where there is no policy offered.

Mr. PALLONE. Mr. Speaker, reclaiming my time, I yield now to my colleague, the gentleman from Arkansas (Mr. Berry), who again has been one of the main proponents of increasing health care access and addressing the problem of prescription drugs and has been working on these health care issues for some time.

Mr. PALLONE. I want to thank the gentleman. Certainly he speaks the truth about what we are facing and how the Bush Republican plan does not address the problems that we were hearing about during the August recess. I yield to the gentleman from Maine.

Mr. PALLONE. Mr. Speaker, I want to thank everyone for participating in this tonight and make the point that this is our first day back in session, but we are going to keep at this. We are going to keep demanding that the Republicans take action and that the Republican leadership allow the Democratic proposal to be considered and that we pass a prescription drug program under Medicare that really is meaningful because that is what the people need. It has to be addressed. It should be addressed between now and when we adjourn, not next year.

Mr. PALLONE

Mr. PALLONE. Would the gentleman yield?