Debbie Stabenow

Ms. STABENOW

Ms. STABENOW. Madam President, I ask unanimous consent that I be recognized to speak as in morning business.

Ms. STABENOW

Ms. STABENOW. Mr. President, it is a pleasure to be here again this morning speaking about one of the most important topics to touch American families, seniors, and businesses. The entire economy, right now, is struggling with the explosion of health care costs. Most of those relate to the crisis of prescription drugs. First, I thank the Senator from Georgia for his leadership, for bringing forward and fighting for Medicare and prescription drug coverage for seniors. I was pleased yesterday to join with the occupant of the chair, Senator Bob Graham from Florida, Senator Ted Kennedy from Massachusetts, Senator Harry Reid, our distinguished assistant majority leader, and many others who have come together to put forward a voluntary, comprehensive Medicare prescription drug benefit for our seniors, one we can be proud of, one that people can choose to sign up for if they need it; and if they choose not to because of other coverage, that is good as well. But it will be there for everyone. It will finally keep the promise of Medicare by truly covering the way health care is provided today. We know that is long overdue. As we all know, in 1965, when Medicare was constructed, it covered the way health care was provided. When you went in the hospital and had an operation, you might need penicillin or something else connected with your stay in the hospital. But today is different. Most people don't go to the hospital. Most people are able fortunately to receive some kind of assistance, such as medications that prevent problems. Some have high blood pressure or high cholesterol and many other things that they need to take medication to control. You also may be able to take a pill that stops open-heart surgery. A gentleman in Michigan tells me he takes one pill a month, and it stops him from having to have open-heart surgery. He said that is great, but the pill costs $400 a month. This is a gentleman who, fortunately, is a UAW retiree and is able to receive some assistance from an excellent benefit plan. But he said: What if I didn't have that? What if I was just on Medicare and didn't have that extra help that came from my job? That $400 a month that stops open-heart surgery is a wonderful benefit. We celebrate the fact that that drug was created. But too many people would either not be able to afford that, would be sitting at the kitchen table, like a lot of people today, saying: Do I eat today? Do I pay the utility bill? Am I able to pay the other things that will allow me to live independently or do I get my medicine? So I am very pleased to be a part of the effort that is building in the Senate to pass a real Medicare prescription drug benefit, which we intend to do. I thank our leader, Tom Daschle, for making a commitment that we are going to bring this issue before the Senate for a vote in a matter of a few weeks. There are those around the country who are listening today and saying, Sure, we have heard this before, but is it really going to happen? Are we really going to be able to move the ball forward? The answer is, with the help of people who are watching and listening today, we will. The reason this has been so difficult an issue is that, unfortunately, we see an industry doing very well by diverting a lot of the current rules, by getting around a lot of the rules. The current system works well for the drug industry. There are six drug company lobbyists for every Member of the Senate. So their voice is heard here every day. I was pleased yesterday to join with about 30 different health care consumer groups to launch an effort to get the people's voice into this debate. Not only are we asking people to write their Senators, their House Member, and the President and say, now is the time to act--it is past the time to act--but we are also asking people to join us in an effort called fairdrugprices.org. Fairdrugprices.org is a new action center. We are asking people to log on--maybe this is your first time on a computer; if you do not have a computer, ask a family member, ask somebody else, and if, like so many of us, you are learning all this, just type in ``fairdrugprices.org'' and go to this site. You can sign a petition to send two messages to Congress: Pass a real Medicare prescription drug benefit and lower prices for everybody. We have a plan on how to do both. If you go to fairdrugprices.org, you can sign up to be a part of this process. You can also communicate with your Member of Congress through this site, as well as directly going to their site. Also, we are asking you to share your story. If you are a small business, the senior premium for health care went up 30 percent last year, and insurance companies said most of that was the explosion in prescription drug prices. Or if you are an 85-year-old woman with breast cancer struggling to buy tamoxifen or a 65-year-old man who is struggling with high blood pressure and other ailments and struggling to get the medicine you need, sign up, share that story, and we will bring that story to the floor of the Senate. We will make the people's voice a part of this process in a very real way because when the people are engaged--and, Mr. President, you know this--the right things happen. When people are involved in telling what is real--they are not making this up; this is not a made-up problem; they are not just trying to talk the talk--they want action. They want action from Senators. They want this to be bipartisan. They want the President to embrace this. They want us to solve the problem. There are a lot of other issues we can talk about around here, but we want to get this done. This effort is beginning to really get up steam. We want to invite everybody to go to fairdrugprices.org and engage in this issue. We also ask for some help to take a serious look at other proposals that are coming forward from other places that do not do the job. There are a lot of proposals that are being called Medicare prescription drug coverage. There are those who provide coverage that is affordable. We are pleased that our plan would be a $25-per-month premium and would provide comprehensive coverage with no gaps. It would not cut home health care to do it. It would not cut our hospitals or nursing homes to do it. We have a real plan. I regret to say that our colleagues on the other side of the aisle, on the other side of the Capitol, through the Speaker and the Republicans in the House, have not yet put forward a real Medicare plan. Unfortunately, what they put forward covers very little of the prescription drug bill, and they are talking continually about including cuts to hospitals and other providers to pay for it and setting up new costs for home health care. I know in my own family and friends' families, often when you are struggling with that prescription drug bill, you also need some home health care help. Those frequently go together. Today we are very proud of the home health care industry, our visiting nurses, and our other small businesses that set up shop to help people live in dignity at home. We know it is good from a quality- of-life standpoint. We know it saves money. It is good on all accounts. Home health care makes sense. My fear is that what is being talked about by our House Republican colleagues is charging copays. One will have to pay on the front end for visits. On the one hand, while saying we want to help with prescription drug coverage, on the other, we are going to create new costs for you, we will save a little money in this pocket and take a little more out of this pocket. In the end, that will not be helpful to people. I call upon my colleagues on the other side of the aisle and the other side of the Capitol, in the House of Representatives, to join with us in a real effort. Do not add costs to home health care. Do not cut our providers who have already been cut enough. Join with us in something that is real and makes sense. One of my other concerns about what the House is talking about is that it would not be a benefit under Medicare. They are saying let private insurance cover prescription drugs with prescription-only policies. I suggest that if the insurance companies wanted to do that, they would have already done that. The reason they do not is that it is very expensive to provide a prescription-only insurance policy, outside of Medicare or outside of a standard policy. Ironically, if you go back and look at the debate prior to 1965 when Medicare came into being, it came into being because the only thing that older adults had at that time was to try to find insurance in the private sector, and about half of them could not find any or it was not affordable because it is less profitable to cover older adults or to cover the disabled or to cover people who are likely to begin to have more health ailments. So those policies were not there. Medicare came into being to make sure that everybody had access to health care; that our older citizens, our disabled citizens would be able to get the same care that other citizens received. That was a promise we made in 1965. Now, instead of making sure that promise is real by covering prescription drugs, which is the way health care is provided today, we have our colleagues on the Republican side of the aisle saying: Let's go back to what did not work before 1965. Let's go back to the system that does not work. We are saying that is not good enough. More importantly, the people of the country are saying that is not good enough. I believe people are watching and are holding us accountable. They are holding us accountable as to whether or not we are going to get past the talk and start walking the walk. Are we going to make this happen or continue to set up straw men that sound good, get people through an election, but, in the end, do not create the ability for one senior to buy one pill? That is the challenge we face, and we have an opportunity because of the leadership in the Senate by our Senate majority leader, Senator Daschle, and Senator Harry Reid, and others who have said this is so important, we are going to make this a priority now, that this summer we are going to act on this issue; we are going to bring this up. It is so important we now engage people and invite people to join us to make sure we are successful. This is not just about getting a vote or bringing up a bill, this is about fixing the problem. It is about creating a Medicare prescription drug benefit for everyone who needs it and making sure they then have the ability to get the health care they need. Frankly, I am excited about what is ahead in the next few weeks and want to invite people to join us to be a part of this effort--again, fairdrugprices.org. I want to also invite people from Michigan, if those from Michigan are listening, to visit my own Web site. We are asking people as well to come and join us and check out what is happening through my Senate Web site: Stabenow.Senate.gov. At this Web site, we are asking people to take a look at what we are doing and share the stories through our Web site as well. I also mention this morning the important efforts to cut prices for everyone. As I said in the beginning, we have two goals. We have the goal of updating Medicare so it really provides health care and meets the promise that was made in 1965, but we also know that this issue affects everyone. As I said before, if one is a business owner, a farmer trying to get health care coverage for their family, a young working family, or an older working family, right now we have a very unfortunate situation in our country. In fact, in some cases we are paying for all of the initial research on these new lifesaving drugs into the billions, over $23 billion. We have been increasing the research through the National Institutes of Health every year. As of this year, I believe, we have doubled in the last 5 years the funding for NIH, a very important thing to do. It is something we have had support for on both sides of the aisle. It is very important that we be able to move forward on this funding. That is good. We then have a situation in our country where we allow companies to take that information that you and I pay for, and begin to develop these new drugs. As they do that, as a further incentive, we allow them to take deductions on their taxes for the research. We give them a new 20-percent tax credit on new research. We also allow them to write off their advertising, marketing, and sales costs. We give them up to a 20- year patent. We say it is so expensive to create these new drugs that we are going to make sure their name brand cannot be challenged and they cannot have competition for that formula for up to 20 years. So we protect that for them through a patent. When all is said and done, after all this investment and all of this effort to support creating these new drugs, what do we have? Unfortunately, we have, as Americans, the highest prices in the world. That makes absolutely no sense. What I fear is that we are seeing more and more an industry that is less focused on new breakthrough drugs and more focused on how to create more profit by slightly changing the drug to keep the patent going, making it a purple pill instead of a red pill, changing the box, promoting it, changing the name, keeping the patent going so there is no competition, and keep raising those prices right through the roof. I was very interested in watching a program that Peter Jennings put forward on ABC a couple of weeks ago. I commend ABC and Peter Jennings for coming forward with something that was very comprehensive but, unfortunately, extremely disturbing. It indicated that about 80 percent of the new patents, the new drugs that are going on the market, the new patents approved by FDA on what is called standard drugs--that is a category that means there is very little difference between the drug that was already there and the new drug--80 percent are not drugs that have changed the formulas in a way that would improve health care. What we see happening instead is this movement of sales and marketing and advertising, and now, unfortunately, in the last 5 years--in fact, since 1996--the FDA has changed the rules so that drug consumer advertising is allowed. They have loosened the rules, and we have seen an explosion in the amount of direct consumer advertising. Anyone listening today, anyone listening in the Chamber, all we have to do is turn on our television set, and if not every ad, every other ad is a beautiful picture, a beautiful ad, for a prescription drug. That is great if they want to do that, but unfortunately we now see two and a half times more being spent on advertising than on research. The latest numbers show there was more spent on advertising Vioxx than Pepsi, Coke, or Budweiser. As I have said so many times before, someone can decide not to have a Coke today, although I am pretty addicted to Diet Coke, but if someone is a breast cancer patient, they cannot decide not to take Tamoxifen without very serious consequences. So this is not the same and should not be treated the same. So one of the bills that we put forward--and I appreciate the Presiding Officer's support and cosponsorship with me--is something called the FAIR Act, the Fair Advertising and Increased Research Act. It is a bill that would simply say we will allow the companies to write off advertising and marketing and sales from their taxes. In other words, we will subsidize that as taxpayers but only to the level we subsidize research. It makes sense to me. We will allow advertising, and certainly they can do as much as they want, but we just do not want to pay for it. So we are saying we will pay for as much or help subsidize as much on advertising as we do on research; beyond that, they are on their own. I hope we will get a vote on that bill, that we will be able to cap those excessive advertising costs, because it is overdue and we know it is part of the explosion. It is not only the advertising costs, it is that increased utilization that comes from promoting medications and the top name brand rather than one that may be exactly the same that is not advertised. That leads me to another very important issue, and that is the question of unadvertised brands. We know that at least half of the medications out today have another drug that is exactly the same or extremely close, that is just not advertised. It is called a generic. We know that if someone uses that unadvertised brand, they can cut their costs 35, 50, 75 percent. I have seen quotes of savings up to 90 percent. So there is a major effort now happening. I commend Blue Cross/Blue Shield of Michigan, which is working with our Chamber of Commerce and others, in a coalition, and I know it is happening across the country, to close the loopholes in the law. Senator John McCain and Senator Chuck Schumer have a bill, which I am pleased to be cosponsoring, that would close the loopholes which right now allow the drug companies to stop these unadvertised brands from going on the market. So we want to address that as well. We want to have the opportunity to do away with excessive advertising, use more of the unadvertised brands and drop the prices for people. We also want to open the border to Canada where right now one can buy prescriptions at half the price. The final thing on our agenda is to support those States that are creatively looking for ways and acting to lower prescription drug prices for their citizens. About 30 different States, including my home State of Michigan, are developing ways to lower prices, some very creatively. In Maine, for example, they have developed a policy where if someone is doing business and they have a Medicaid contract for prescription drugs, then they are requiring that same discounted price be provided that is provided to the State through Medicaid to those who do not have insurance but are not on Medicaid. So they are using their clout as purchasers to be able to lower prices, and they are being sued. Not surprisingly, a drug company lobby is suing all of the States that are doing that. The final bill I have introduced is called the RX Flexibility for States bill, which would make it clear that States have a right to develop innovative programs to lower prices for their citizens and to use the Medicaid purchasing power as a part of that. In conclusion, let me say we have a plan. As the Presiding Officer knows, because he is one of the key leaders on our Medicare plan, we have a Medicare plan. We have proposals to lower prices. We have a plan that will make sure our seniors and our disabled have what they need in lifesaving medicine. We will make sure small businesses can count on us to do something to lower prices for our farmers, our families. I call upon colleagues to join as quickly as possible to put this plan in action. Again, I invite all citizens listening today to join www.fairdrugprices.org. Get involved. Put the people's voice in this debate. I know we will be able to get something done. I suggest the absence of a quorum.

Ms. STABENOW

Ms. STABENOW. If I might again say to the Senator from North Dakota, I thank him on behalf of Michigan family farmers and small family-owned businesses, as well as large family-owned businesses, for putting forward what I believe is, in fact, just the right balance. We say to our family-owned enterprises, we want you, if you have worked hard all your life, to be able to pass on that business, that farm to your family. We want to make sure you are not paying the inheritance tax. But at the same time we say to middle-class families and seniors and everybody else in the country that we are going to make sure your priorities, those that affect the majority of Americans, will be funded before we, in fact, give a tax cut again to the top half a percent of the public, the top billionaires of the country. It is the right balance. It is the right set of priorities. I thank my friend. I appreciate the opportunity to join with him in his amendment. How much time remains on my side?

Ms. STABENOW. I thank the Senator. I rise to thank my colleague for this amendment. And I join him. I am very proud to be a cosponsor of this amendment. I appreciate very much what he is doing. It seems to me, as we have looked at this issue to find the right balance, that this amendment is in fact the right balance. It says that we will say to our family farmers and family-owned businesses--of whom we have many in Michigan--that we want to make sure, after you have worked hard and your family has been able to develop a good business or family farm, that if you want to pass that along to your children, you will be able to do that and that it not be jeopardized in any way. That makes perfect sense to me. I support repeal for family-owned enterprises. I think it also says that we are going to set a limit, we are going to set priorities for the country, so when we are talking about a billionaire versus having the resources for seniors or families to be able to afford prescription drug coverage--which is also a tax, I would argue a significant tax, on our seniors and our families--or whether it is looking at the priority of educating our children, we are going to have a balance, and those who are the top billionaires in this country ought to contribute to national defense and the war on terrorism and education and health care, and so on. So I wonder. I would just ask my friend from North Dakota a question. It is my understanding that our amendment would in fact exempt 99.5 percent of all of those who might pay the estate tax. Is that correct?

Ms. STABENOW. Will my friend from North Dakota yield?

Ms. STABENOW

Ms. STABENOW. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Ms. STABENOW. Mr. President, I suggest the absence of a quorum.

Ms. STABENOW

Ms. STABENOW. Mr. President, I rise today to speak about an important part of the strategy to lower prescription drug prices for all of our citizens, particularly our seniors who are using about 18 different medications in a year. We have a strategy to focus on with the intent to do everything possible to update Medicare to cover prescription drugs with a comprehensive Medicare prescription drug benefit which is long overdue. Medicare was set up in 1965. It covers the way health care was provided in 1965. It needs to be updated to cover the primary way we provide health care today, which is outpatient prescription drug coverage. We also know there are a number of other actions we can take to lower prices for everyone. I had the opportunity yesterday with the Detroit Regional Chamber of Commerce to hear from a number of businesspeople, large and small, who are struggling with their health care insurance premiums, some choosing to no longer be able to provide health care, and others finding they are having to cut back, and hospitals and nursing homes and home health agencies, all affected by the explosion in prescription drug prices. When we look at the rising cost of health care, the majority of it is the cost of prescription drugs. A number of us have looked at what it is we can do to bring more competition, to bring prices down, and to make it more fair for Americans. Americans today are underwriting the cost of research. I am very proud that, through the National Institutes of Health, we are providing billions of dollars in basic research. We support companies then taking that research, and we allow them to write off their research costs as well as their advertising and other costs to be able to provide the necessary research and development for new prescription drugs. We give them a patent to protect their development so they can recover their cost. But at the end of that process, we find that Americans, even after we have heavily subsidized, supported, and helped pay for the research and development, are paying the highest prices in the world. One of the reasons is that there was a law passed in the late 1980s that puts a fence around the border of the United States as it relates to prescription drugs. It says that we as Americans cannot go across the border to Canada to purchase American-made, FDA-approved and safe drugs that are sold to Canada, on average, at half the price. We can't go to any other country as well. In fact, as was shown in the Wall Street Journal last Friday in a front page article, every time the European Union or Canada or some other country negotiates lower prices for their citizens, the drug companies make it up by raising American prices, even though we are the ones paying for the research that creates the new miracle drugs. To demonstrate this and to promote legislation, S. 2244, which Senator Dorgan, Senator Jeffords, myself, and many others, have introduced--it is a bipartisan bill to bring down this barrier at the border so Americans can get the very best prescription drugs at the very best prices from Canada--a number of us have been helping to sponsor bus trips to Canada to make the point. This is a picture of a number of us who were joining, from the House and Senate last week, a bus in front of the Capitol. This is a bus that the Alliance for Retired Americans has been sponsoring. In fact, we have over 14 different trips planned in the next several days into Canada. We kicked off one in Detroit yesterday where a group of citizens got on the bus to go 5 minutes across the Ambassador Bridge, in which they were able to lower their prices on average by half, just by going across the bridge. This is not about putting seniors or families on buses to go across bridges to get lower prices. This is about dropping the barrier at the border. This is protectionist legislation that does not allow us to have business relationships across the border to bring back those American-made drugs at a reduced price. We can trade with Canada on agricultural products, manufacturing products, all kinds of things. People go back and forth across the border and do business every day. But when it comes to prescription drugs, we have not been able to do that. That creates a situation where we don't see the kind of pressure on our companies to be competitive and fair to Americans. We want to get people off the bus. We want those prescriptions coming back to the United States to our neighborhood pharmacy, so a senior can walk in and get the reduced price. I will just share with you some of the price differences we have seen as we have taken the bus trips to Canada from Michigan. Zocor, for high cholesterol, if you need to purchase this in Michigan, the price will be somewhere in the range of $109. If you drive that 5-minute bus trip across the border, you can get that same Zocor for $46. If we look at Prilosec for heartburn and ulcer relief, $115 in Michigan; $55 across the border to Canada. Probably one of the most disturbing ones for me is a breast cancer treatment drug. I have taken to Canada breast cancer patients, who are in desperate need of this lifesaving treatment and medication. Tamoxifen is a well-known breast cancer treatment, $136.50 in Michigan; $15.92 across the bridge. There is something wrong with this picture. There is something wrong when Americans are supporting and funding the development and underwriting costs and subsidizing, through tax deductions and tax credits, the development of these lifesaving medications, and we are paying so much more for these lifesaving drugs. It makes no sense. I urge my colleagues to support our effort, to come on as cosponsors and support the effort to open our borders and lower prices for prescription drugs. We have a bipartisan bill, S. 2244. The time is now. We want to get the seniors off the bus, get lower priced prescriptions into the local pharmacy or the hospital or into the clinics around the State of Michigan. It is time to do that. It is past time to lower the prices for people. This isn't the same as buying a new pair of tennis shoes. It is not the same as buying a new car, although coming from Michigan, I want to see people buy a new car every year. But if they don't, it is not going to threaten their life. But if a breast cancer patient does not get her Tamoxifen, it does threaten her life. That is the difference. This is medicine. It is not optional. It is time we understand that and get serious about lowering prices, about creating the competition that will allow us to lower prices. I have never seen an issue that affects more the economy of this country. It affects every businessperson trying to provide health insurance for themselves and their employees. It affects our universities' health clinics. The president of Michigan State University came to me expressing great concern about his rising health care premiums and the requirement that he was going to have to lay off people because they couldn't keep paying these rising costs, most of it from prescription drugs, and maintain the same number of staff at the university. This is ridiculous. Most importantly, this is ridiculous because of what it means to our families and our seniors. Yesterday on the bus were a couple who are paying $1,300 a month for their prescriptions, people on a fixed income. They were getting on that bus yesterday to go to Windsor, Canada, out of desperation to lower their prices so they could live independently in their own home and not have to be hospitalized or go into a nursing home and receive the kind of medicine they need. It is wrong that we are seeing this kind of disparity. I urge my colleagues, while we are working on the important issue of Medicare prescription drug coverage, that we do something today to lower prices. We can do something right now by just simply opening the border to Canada and making sure that our citizens get the prices shown by these yellow bars on this chart, instead of paying the high prices we see they are paying right now. I thank you, Mr. President. I urge my colleagues to get engaged in one of the most important issues affecting seniors and our families today. It is time to bring the prices down.

Ms. STABENOW

Ms. STABENOW. Mr. President, will my colleague from New Jersey yield?

Ms. STABENOW. I appreciate my colleague stepping in the Chair so I might come down for a moment before my good friend from New Jersey leaves. I wanted to indicate my personal thanks to him--as well as my colleagues whom I know share this gratitude--for his willingness to come to the floor and articulate in such a precise way and an understandable way what the challenge is to this whole question of Social Security and privatization of Social Security; and the fact the Senator has been willing to put the time in to really make it clear what is at stake for people, I am very grateful. I thank him on behalf of the people of Michigan for doing that. I wanted to ask one question before the Senator left. I know one of the things we talked about before is that Social Security is not just retirement. It is also a disability policy. If you are a worker and become disabled, your family is able to receive assistance, as a disability policy. If you, unfortunately, lose your life on the job, it is a life insurance policy. Isn't it also true that we really have three parts to that system? I know the Senator from New Jersey spoke to that as well. This is not only a question of retirement, but it is a question of a security system--disability, life insurance, and retirement. That is why it is so critical that it remain in place. I would appreciate it if the Senator might speak to that for a moment.

Ms. STABENOW

Ms. STABENOW. I commend the Senator from North Dakota for his ongoing leadership on the Budget Committee. These are challenging times. He has forecast for over a year great concerns about an evaporating surplus and what could happen with a downturn and other pressures on the budget. He has continued to advocate fiscal discipline. I join the Senator in that and in setting the right priorities for the country, the right priorities for our families. assistance for israel

Ms. STABENOW. Will the Senator yield?

Ms. STABENOW. I ask the Senator, who is the chair of our Budget Committee, about issues that are in that budget which I think are so critical for all of us, and I share with the Senator his frustration about the lack of willingness or ability to move ahead in order to pass this supplemental and to be able to pass the budget. One of the important provisions that we have worked on together relates to the question of prescription drugs and putting forward a comprehensive Medicare prescription drug benefit that I know the Presiding Officer has been deeply involved in leading and advocating as well. Would the Senator not agree that it is critically important that we be able to move ahead with this budget so we can address the issue of Medicare prescription drugs and be able to address the spiraling costs of medications, affecting every part of our economy and that our budget resolution, in fact, puts in place the ability to do that?

Ms. STABENOW

Ms. STABENOW. Mr. President, I rise to ask our colleagues to move beyond the obstructionist position, to work together to get the supplemental passed so we can move on to other critical issues that affect our families. This is one. It is important. There are important pieces in this bill that deal with our issues of homeland security and certainly, representing the great State of Michigan, issues of border security are critical. We are very concerned about making sure we have the resources in place. There are other important resources in this supplemental bill. However, I am equally concerned about the ability to move beyond this, to get this completed on a bipartisan basis and move beyond this to the rest of the agenda that has to happen. The Presiding Officer has spoken eloquently about the sense of urgency families feel about medicine and the inability to afford critical lifesaving medicine, whether you have cancer, a heart condition, high blood pressure, or a disabled child and you need to be able to provide that child with medicine that is needed. We have the ability and, within our budget resolution, the capacity to pass a Medicare prescription drug benefit that will update Medicare and make sure there is a voluntary universal plan in place for those who need it, to be able to afford their prescription drugs. We also have the ability to lower prices across the board. Our side of the aisle has put forward a strategy to provide a way to lower prices for our business community, large and small. I have seen the business communities come forward, small businesses that are losing the ability to provide health care for their employees because premiums are going up 30 and 40 percent this year. The big three automakers shared some statistics with me. I came from a weekend-long event on Mackinaw Island, which I invite the Presiding Officer and my colleagues to come and enjoy during the beautiful summer months. There is a wonderful gathering of business and political leaders and university educators who come together once a year to discuss challenges facing the economy in southeastern Michigan and across Michigan and the business concerns. High on their list, if not at the very top, was the rising costs of health care, predominantly due to the explosion of the prices on prescription drugs. We heard a presentation from DaimlerChrysler that indicated on a SUV today priced at $18,600 the cost of employee health care is $1,300, and that the fastest growing part of that is prescription drug costs. We not only need to be providing Medicare prescription drug coverage for seniors and for the disabled, but we need to close the loopholes which allow the companies to stop compensation through generics that go on to market or are supposed to go on to market once the patents run out where the formula is available to other countries to use and to produce prescription drugs at a lower cost. We also need to open our borders to Canada. Two weeks ago, we passed fast-track trade authority, but the only thing we could not trade between the United States and Canada is prescription drugs, which makes absolutely no sense. We know, and we will be demonstrating next week in bus trips from a number of States across to Canada, that you can lower your prices at least in half. I am pleased to have joined with Senator Dorgan from North Dakota, Senator Jeffords from Vermont, Senator Wellstone from Minnesota, and many others, in an effort to open the border so we can have that competition, and our pharmacists, our hospitals, our businesses can have business relationships with the Canadians, bringing back American made drugs sold to them at lower prices. We have that bill. If we had the opportunity, we could complete the supplemental and bring up that bill and lower prices immediately. We have been able to put forward a bill that caps the amount the taxpayers subsidize in excessive advertising costs. The drug companies are spending 2.5 times more to advertise a drug than to create a new lifesaving drug, and we have a bill--and the Presiding Officer has joined in the effort--to cap the amount that can be written off on advertising and marketing costs to the same level that research costs are rip-offs on taxes, so taxpayers are subsidizing no more for advertising and marketing sales than we do for research. That would cut costs immediately. We also have a bill to allow more flexibility for States using innovative techniques as in Maine and Vermont, where they are being sued by the drug companies for coming up with creative ways to lower prices. We have an agenda to lower prices. We have an agenda that includes a comprehensive, voluntary, Medicare prescription drug benefit. If we can get beyond the current stalemate, we will have the time and opportunity to bring forward these issues that directly affect every single American--every business, every farmer, every worker, every family, every senior. It is an issue whose time has come. People in our States are saying it is time to act. It is past time to act. We have been talking about this. You would think, given all the time we spent talking about it, on both sides of the aisle, we could have funded a prescription drug benefit. The reality is we need to act. We need to do it now. I am deeply concerned that we are seeing, day after day, stalemate on moving forward on critical issues such as the supplemental that are so important to us and that are blocking us.

Ms. STABENOW. I am happy to yield to the distinguished Senator.

Ms. STABENOW. I thank the Senator very much for those comments. I could not agree more. When Medicare came into being, as the Senator from Nevada knows, it provided coverage for the way health care was provided at the time. You went into the hospital, you had an operation, and it covered the medications in the hospital. But we all know that health care has dramatically changed, and we are proud of that. We are proud that we have these new lifesaving drugs that stop someone from having to have the operation. We know most health care now involves prescriptions. The problem we have is that this great American success story called Medicare that was put into place does not cover prescriptions. So effectively, now, we are not providing the health care that we promised our seniors and the disabled. So for me and I know for the Presiding Officer and for our leader from Nevada, it is common sense. It is past time to update Medicare. I know we are urgently trying to make that happen. I thank my friend for raising that. I know we have a tremendous amount of support all across this country for getting this done. I often think, in the debate on health care and this debate on prescription drugs, if we only had the same sense of urgency on this issue from a policy standpoint that we have when someone in our family gets sick or we get sick. When you find you are diagnosed with cancer and you have to have cancer medication, you can't say, ``This is too tough. We will do it next year. You can have your medicine next year.'' Or when your child gets sick, you can't say, ``You can't get sick this year. You can get sick next year.'' Yet we put off this issue year after year after year. We need this kind of urgency that our families feel. I know our leader from Nevada feels that. Certainly the majority leader of the Senate and the Presiding Officer from Georgia have eloquently stated this. We are going to keep coming to the floor, day after day after day, creating this sense of urgency, urging people to get involved with us to create the sense of urgency that we need to get this done.

Ms. STABENOW. I would be honored, yes.

Ms. STABENOW. I could not agree more. I was thinking as the Senator was speaking, we have seniors who got up this morning and literally sat at the kitchen table and said: Do I eat today or do I get my medicine? Do I pay my utility bill or do I get my medicine? They didn't check to see if their registration card was Democrat or Republican. That is not what this is about. This is about real people's concerns. People expect us to work together. They expect us to rise above those kinds of partisan efforts and work together to get things done for them in a meaningful way. So I share the same concern. Every day this week that we are not able to address this is another day where thousands, probably millions of people across this country, are trying to decide how to put their pennies together to be able to afford the medicine that they or their family need. I would say enough is enough. It is time to get on with it. I yield the floor.

Ms. STABENOW

Ms. STABENOW. Absolutely.

Ms. STABENOW. I thank our Senate majority leader. If we did not have his leadership, we would not have the opportunity to be talking about specific proposals for a comprehensive Medicare prescription drug benefit or opening the doors to Canada or in other ways lowering prices for families, seniors, businesses, workers. The entire economy is affected by this issue, and we would not be in a position to do that without the leadership of Senator Daschle. I thank him for that and also say that this week, as we are celebrating the leadership of another colleague, it would not be possible without Senator Jim Jeffords. I commend him. As our majority leader talked about going to Canada, Senator Jeffords has been at the forefront of breaking down those barriers so we could open the border. I find it ironic we are debating an open trade bill, fast track, so we can have more trade and yet the only thing we cannot trade with Canada is prescription drugs made in the United States and subsidized by American taxpayers. Yet if they go to Canada and the prices are dropped in half, we cannot benefit from that. Senator Jim Jeffords has been a leader. I am very proud to be joining with him on a bill with Senator Dorgan and many others. I once again commend Senator Jeffords for his courage in so many ways in stepping forward on matters that directly affect people every day. It is no less true on this question of prescription drugs. It is true, as our Senate majority leader said, people are choosing every day between food and medicine, paying the light bill, and being able to pay the rent. I have been inviting people from Michigan to come to my Web site and be a part of something we are calling the Prescription Drug People's Lobby. People have said to me, Why do you call it that? Well, it is very simple. We looked up the numbers, and today there are six drug company lobbyists for every one Member of the Senate. Their voice is heard, and they spend every day doing everything to, unfortunately, stop us from lowering prices. They do wonderful work. We celebrate American-made ingenuity that creates these new drugs from which we can benefit, but if they are not affordable, then they are not available. It is as simple as that. We have to address the question of prices and updating Medicare to cover prescription drugs. So I have formed something called the Prescription Drug People's Lobby in Michigan. I have colleagues doing the same. I know Senator Jean Carnahan is doing this. Senator Durbin and others are joining in this whole effort to invite people to share their stories to make their voices heard. I am very pleased today to share one of those stories from Mrs. Malissa Askin. I share a story that reflects exactly what our Democratic leader, our majority leader, was indicating. Mrs. Malissa Askin, from Romulus, MI, e-mailed me 2 days ago and asked that I share her story. I appreciate that she is allowing me to do this. She starts out by saying: I guess my story is no different from the many Americans, when it comes to deciding if I can afford food to live, or medications. It boils down to a choice these days (what can I afford to keep myself alive?), once I pay my bills. Then she goes on to say: I am 68 years old. My husband is deceased and I have no family. I have had a heart bypass, both arteries in my neck cleaned out and now in April I was operated on for cancer, not to mention other surgeries. I am supposed to be on nine medications. However, at the price of these meds, I can only afford three. I do not know what will happen with me by not being able to be on the meds I cannot afford, but it makes me wonder what I am living for. I feel like nobody cares. Well, Mrs. Askin, people do care. We care. I care. Our Senate majority leader cares.

Ms. STABENOW. I am deeply grateful for the comments of the Senate majority leader. His leadership, truly, on so many issues, particularly this issue, touches the lives of so many people every day. I am very grateful to the majority leader for that leadership. We are focusing on bringing bills to the floor so we can solve the problems addressing what Mrs. Askin from Romulus, MI, has written about. We cannot say: We will wait another year: Mrs. Askin, why don't you wait on medications that you need, wait until next year or the year after or the year after? This is not like buying a new car or a new pair of tennis shoes or are you going to wait on buying a piece of clothing. This is lifesaving medicine. There has to be a sense of urgency. Health care has changed. Most of the time we are not admitted into the hospital. Thankfully, medication will allow people to avoid open- heart surgery or allow them to live with dignity at home or allow parents to care for children who are chronically ill or disabled, that allow them to live longer. We welcome these new innovations. It is wonderful. I am proud that in this country we are in a partnership with investments from all taxpayers to the National Institutes of Health, utilizing the American ingenuity of the companies that go to work. It is wonderful. Unfortunately, the end result is not wonderful. At the end of this process, the very people who help invest in the process cannot afford these lifesaving medications. Something is wrong. When we get to the end of the process and the health care system we have set up for older Americans who use the majority of medications, or those who are disabled who use the majority of medications, does not recognize these new lifesaving drugs incorporated in part of the health care system called Medicare, there is something wrong. When we are creating these medications and they are sold to every other country in the world at half the price they are sold to us, there is something wrong. When we see today these lifesaving medications are treated like any other product and twice as much or 2\1/2\ times more is spent on advertising than the research, and we, as taxpayers, pay for that through tax writeoffs, something is wrong. More was spent on Vioxx last year for advertisement than spent by Budweiser on beer, Coca-Cola on Coke, Pepsi-Cola on Pepsi. There is something wrong. It is fine to advertise and promote, but when the companies drive the prices beyond our ability to be able to afford the medications, when this advertising and promotion and sales going on in doctors' offices all over the country each day create a situation where a small business has to drop their insurance for their employees because they cannot afford the premium, it has gone too far. When manufacturers have to stop providing health care for retirees or lay off people because of rising health care costs, most of which is the cost of their prescription drugs, it has gone too far. I could go on and on with examples of what has been happening. Right now one of the largest costs, one of the costs driving every part of our economy, is the explosion in the pricing of prescription drugs. We can do better than that. We can open the border to competition for Canada. We can limit the amount we are willing to subsidize in those explosive advertising costs. We can support States in innovative ways. They are looking for ways to bring down prices for their own citizens such as in the State of Maine and the innovations they have incorporated, making sure when patents run out and it is time for the generic, the same formula can be sold without the brand name at pennies on a dollar. Those generic laws work, and we are, in fact, doing that. We have a plan that works. It is now time to put it into action. In closing, I say to Mrs. Askin that people do care. We are working very hard to get it right. We are working hard so citizens will not have to decide every morning what bill to pay, what food they can afford, or whether or not they can afford their medicine. It is time to get it right. I will work very hard until we get it right so you can know that you can benefit from the wonderful new medications that have been placed on the market to save lives, to extend life, so you can also enjoy all the other wonderful parts of your life without worrying about whether you can afford your medicine. I yield the floor.

Ms. STABENOW. I suggest the absence of a quorum.

Ms. STABENOW. I could not agree more. In 1965, we set up the promise of health care for those over age 65 and those who are disabled through Medicare, a wonderful American success story. Yet because it has not been updated to cover prescriptions, it no longer covers the way health care is provided today. My mother as well, my aunt, my uncle, my other relatives who have had health care coverage when working, now find themselves in a situation where they cannot really get what they need because most of what they need is outpatient prescription drug coverage. I know that is why we are working so hard in the Senate to bring the sense of urgency that Mrs. Askin feels to pass a comprehensive prescription drug benefit, not one like, unfortunately, our colleagues on the other side in the House have been proposing, which for most people would give less than 20 percent coverage and cut our hospitals and create more costs for home health care in the process. That plan is not good enough. What we are talking about is something that would allow us to provide comprehensive prescription drug coverage without adding costs for home health or cutting our hospitals that have already been cut but looking at something comprehensively. When we look at Mrs. Askin, the bottom line for her is if she were to do what she needs to do to remain healthy, it would be a monthly bill of $938. How can someone do that? How can someone do that and live?

Ms. STABENOW. I would be happy to comment on that situation. From Michigan, it is a simple 5-minute drive across the bridge from the tunnel from Detroit to Canada; or from Port Huron, or Sault Sainte Marie, a simple 5-minute drive to Canada. We have worked together, on a number of occasions, with the Canadian Medical Society and pharmacists in Canada. I find it most outrageous that these are American made drugs, the exact same drugs. We took a group of breast cancer patients using tamoxifen, at $136 a month in Michigan, 5 minutes across the border for the same drug sold for $15. I am told the companies make a modest profit on the $15. There is something wrong, something desperately wrong. I support underwriting basic research. I support the ability to create patents so companies do not have to have competition for their name brands for 15 or 20 years, so they can recover their costs and all the other things we do to help create these wonderful lifesaving drugs. What do we get for it? The highest prices in the world. It is simply not good enough.

Ms. STABENOW

Ms. STABENOW. Mr. President, I rise today to express my strong concerns about the trade difficulties suffered by our Nation's asparagus growers, and to discuss an important amendment I attempted to offer to the trade bill. Unfortunately, my amendment was blocked by some of my colleagues on the other side of the aisle. I know that in many respects global trade holds great promise for agriculture by opening new markets and building new demand for the bountiful, nutritious food and fiber that is grown in America. But, some commodities have been harmed by past trade agreements. That is an important fact that should have been acknowledged and addressed during the Senate's debate on trade agreements. Under preferential treatment provided through the Andean Trade Preferences Act (ATPA), Andean countries, like Peru, have been shipping duty-free asparagus to the United States since 1992. The asparagus market is extremely sensitive to these imports. Many of the growers in my state forecast an end to domestic asparagus production if something is not done soon to help. Last year alone, growers in Michigan lost $2.9 million due to competing duty free asparagus imported from Peru. I support the goal of the ATPA B to encourage economic growth in Andean nations as an alternative to the production and export of illegal, narcotic drugs to the United States B but not at the expense of the entire domestic asparagus industry. Since enactment of ATPA, shipments of fresh asparagus from one Andean nation, Peru, have increased from 14.5 percent of total imports to 41.3 percent. Since 1992, shipments of frozen asparagus from Peru have increased from 3 percent of total imports to 71.4 percent. I authored an amendment that would have helped to resolve this trade situation and that would have provided some relief to domestic asparagus growers. My amendment was cosponsored by Senators Levin, Murray, Cantwell, Boxer, and Feinstein. The amendment would have allowed preferential treatment of Andean asparagus up to a certain point and then established a safeguard for domestic growers. In sum, my amendment allowed Andean imports of duty free asparagus up to 30 percent of the total imports of asparagus into the U.S. per year. Once the 30 percent threshold was met, duty free treatment would be suspended for the remainder of the calendar year. This was a reasonable solution that would have helped both our nation's asparagus growers and would have allowed imported Andean asparagus to compete on a level playing field. It is unfortunate that this amendment was not included in the trade bill. I intend to continue to work on this issue and consider other programs, such as market loss payments, that may provide some relief to the asparagus growers in my state and across the nation.