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is is a burning issue for America's seniors, 37 percent of whom have no prescription drug coverage at all, and a significant additional portion do not have adequate, reliable coverage.
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In the midst of all of this, the pharmaceutical industry is running a national TV campaign to try to stop any reform, to try to prevent a benefit under Medicare and to stop the kind of discount that I and others here have been urging.
This is an important issue. We need to do research. We need to figure out why prices in this country for people least able to afford it are the highest in the world. That is an appropriate area of research. Therefore, I rise to support the Tierney amendment.
Mr. GREEN of Texas. Mr. Chairman, I move to strike the requisite number of words.
Mr. Chairman, I rise in support of the Tierney amendment; but, first, I want to thank both the chairmen of our Subcommittee on Health and Environment and Committee on Commerce for the hearing today and also the commitment over the next few weeks to deal with this issue, at least through the committee process, and also the gentleman from Ohio (Mr. BROWN), the ranking member.
[Time: 16:00]
This is one of the most important issues I think that Congress is facing, is how to provide prescription drugs at an affordable price to the people who need them most, our senior citizens.
Several bills have been introduced to achieve this goal, but each has been met by critics who claim they are either inadequate, too costly, or unfair price controls. In fact, I am a cosponsor of the Allan-Turner, et al. bill that we had that my colleague from Maine talked about.
In fact, to follow up on his, I have seen the Flo advertisements on TV, and I have a little concern. I want to make sure people in our country realize who is paying for that multimillion dollar campaign on TV. It is the pharmaceutical and drug companies. Because, obviously, they do not pay for that ad on TV in Canada or Mexico, where constituents in my district may have to go, oftentimes, driving 6 hours to Mexico to get their drug prescriptions at a cost they can afford. The Tierney amendment may help provide some answers to the concerns on affordability and which method would truly meet the needs of seniors.
The fact is our Nation's health care system has dramatically evolved over the past 10 to 20 years to the point that prescription drugs are not only a major component of the health care system, but they can be critical to an individual's survival. Everyone agrees we need to find a way to make prescription drugs more affordable to seniors, who are least able to afford them but who need them the most.
Seniors are being forced to choose between buying food or their prescription medications or even postponing taking their prescription medications. Instead of taking them one a day, as prescribed, they may take them every other day just because they cannot afford them.
Because Medicare does not cover prescription drugs, so many seniors, 37 percent according to the GAO, but I think in my district it is much higher, do not have any prescription drug coverage and may incur these expenditures out-of-pocket. Worse yet, many of these beneficiaries have very limited coverage that do not even come close to meeting their medical needs.
While I am sensitive to the need for drug manufacturers to make profits on their drugs, it is unacceptable that the bulk of these profits are made on sales to people who can least afford to pay those prices. Discounts are available to HMOs, to the U.S. Government, to hospitals, and even foreign countries, but seniors are forced to pay the full price. That is just not right, and something needs to be done to correct it.
This amendment will give an important agency the opportunity to look at these issues and answer some of the questions surrounding them. Everyone knows this is a complex and difficult problem to solve. However, sitting back and doing nothing is not an acceptable option. Today, not only with this amendment, with this study, but also with what the Subcommittee on Health and Environment of the Committee on Commerce is doing, we are moving forward on it.
As new drugs are developed and approved, the access gap to these potential life-saving treatments are only widened. This amendment is reasonable and sensible, and I am glad to be a co-sponsor of not only this bill but also the Turner-Allan bill that will provide a solution to this problem. Support for this amendment is important to research and study methods and practices.
Mr. LUTHER. Mr. Chairman, I move to strike the requisite number of words.
Mr. Chairman, first of all, let me thank the gentleman from Massachusetts (Mr. TIERNEY) for bringing this amendment forward. I think he does us a great service in this body.
We have entered a remarkable period in our Nation's history. Never before have we had so many life-enhancing prescription drugs. Yet, let us face the facts. These remarkable achievements are today overshadowed by the exorbitantly high prices consumers in America are being required to pay for these prescription drugs.
This is why I rise in support of the Tierney amendment. This amendment would expressly direct this agency, an important agency, to address this issue, an issue that is perhaps the most important issue we face in health care today. It would require that agency to recommend ways to make drugs more affordable for American consumers.
Mr. Chairman, earlier this year, I requested a study on comparative drug prices in my home district in Minnesota. The report was issued in March of this year, and the results were astonishing. The report showed that the average retail prices for the five best selling drugs for older Americans in Minnesota are more than twice as high as the prices that drug companies charge their most favored customers. For one drug, Minnesotans actually paid a price 15 times higher than the price enjoyed by preferred customers. This does not just impact senior citizens, it affects all American consumers who do not have prescription drug coverage today.
This type of unfairness needs to be addressed, and that is exactly what this amendment does. It does not dictate policy or set up a new layer of bureaucracy, it simply directs that we look at ways to create fairness and to help American consumers afford the cost of these wonder drugs that are available today. I urge Members to support this amendment.
Mr. MCGOVERN. Mr. Chairman, I rise today in support of the amendment offered by my good friend JOHN TIERNEY instructing the Agency on Health Research and Quality to study methods of reducing the costs of prescription drugs to consumers. This is an important study in light of the focus on a Medicare prescription drug benefit, as well as the increase in pharmaceutical productions.
Prescription drugs are an important means of providing healthcare in an outpatient setting. However, the costs of these drugs are too high. Earlier this summer, I commissioned a study to specifically examine the cost of prescription drugs in the Worcester/Attleboro/Fall River, Massachusetts area. This was the first and only study of its kind examining drug prices in Central Massachusetts. The results were alarming.
On average, seniors get more than eighteen prescriptions filled each year. I was shocked to learn that uninsured seniors in my district--those without any prescription drug benefit--pay 136% more for their prescription drugs than the drug companies most favored customers. This means that if a most favored customer pays ten dollars for a prescription, the uninsured senior in my district will pay twenty-three dollars and sixty cents for that same prescription. It is unconscionable that people who can least afford to pay these high costs are being gouged by the drug companies in the name of profits and I am sickened that seniors in my district, and across the country, are forced to choose between buying groceries and medicine.
Our top priority must be a prescription drug benefit. However, this amendment is a first step in this Congress acknowledging that drug prices are too high for uninsured seniors. I support President Clinton's efforts to implement a prescription drug benefit. I also support Congressman TOM ALLEN's bill to end price discrimination by the drug companies. Together, these efforts will lower prescription drug prices and allow seniors to buy both food and medicine. We must continue to raise awareness of the need for affordable prescription drugs, at least until this Congress is able to pass a comprehensive prescription drug benefit. I urge the adoption of this important study.
Mr. BERRY. Mr. Chairman, I rise today in support of the Tierney amendment and to talk, once again, about the affordability of prescription drugs.
We have all gone back to our districts and have heard from our constituents, especially
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When I hold meetings in the 1st Congressional District of Arkansas, I hear about two issues and that's the agriculture crisis and the high cost of prescription drugs, especially for seniors.
I also get letters from Arkansas seniors who tell me everyday they can't afford to pay for all their needs, specifically, all their medicine and their food.
Seniors all over this country are not following their doctors' orders. Some of them have been given prescriptions which they cannot afford to fill. Others have filled prescriptions which they cannot afford to take as directed.
Because they cannot pay the rent, pay the electrical bills, buy food and take very expensive prescription drugs, they either stop taking them, or they take less than what is prescribed by their doctor.
They are doing things that in the long run are harmful to their health.
I find it amazing that we tell our seniors they can live longer if they take this pill and that pill, but then if they can't afford their medication that keeps them alive, we don't do anything about it.
Thousands of consumers, especially seniors have found themselves affected by the price of prescription drugs in this country.
Seniors and other Americans go to Canada and Mexico because prescription drugs in these countries cost much less than in the United States.
In my District in Arkansas, seniors paid 81% and 72% more, respectively, for the 10 prescription drugs they most commonly use than their elderly counterparts in Canada.
I have introduced legislation, with Representatives EMERSON and SANDERS, the International Prescription Drug Parity Act, that amends the Food, Drug, and Cosmetic Act to allow American distributors and pharmacists to reimport prescription drugs into the U.S. as long as the drugs meet strict safety standards.
This will allow American pharmacies and distributors to benefit by purchasing their drugs at lower prices, which they can pass along to American consumers.
Mr. Chairman, the bottom line is, consumers should not have to choose between food and medicine.
I urge all members of this body to vote for the Tierney amendment.
The CHAIRMAN pro tempore (Mr. QUINN). The question is on the amendment offered by the gentleman from Massachusetts (Mr. TIERNEY).
The amendment was agreed to.
AMENDMENT NO. 11 OFFERED BY MR. TIERNEY
Mr. TIERNEY. Mr. Chairman, I offer an amendment, amendment No. 11.
The CHAIRMAN pro tempore. The Clerk will designate the amendment.
The text of the amendment is as follows:
Amendment No. 11 offered by Mr. TIERNEY:
Page 13, after line 5, insert the following subsection:
``(d) STUDIES OF METHODS TO IMPROVE ACCESS TO HEALTH SE RVICE.--The Director shall conduct, and shall provide scientific and technical support for private and public efforts to conduct, studies of the organization, delivery, and financing of health se rvices in order to determine the cost and quality effects of various methods of substantially increasing the number of individuals in the United States who have access to health se rvices. Such studies shall include a study to determine the impact of a single payer insurance co verage program on health ex penditures in the United States during the fiscal years 2000 through 2007 compared to the projected impact of the current system on health ex penditures in the United States during such period.''
Mr. TIERNEY. Mr. Chairman, this particular amendment is going to request that the director conduct and provide scientific and technical support for the private and public efforts to conduct studies of the organization, delivery and financing of health se rvices in order to determine the cost and quality effects of various methods of substantially increasing the number of individuals in the United States who have access to health se rvices.
Mr. Chairman, those studies should include a study to determine the impact of a single-payer insurance co verage program on health ex penditures in this country during the fiscal years 2000 to 2007 compared to the projected impact of the current system on health ex penditures in the United States during that period.
Mr. Chairman, simply put, I bring this amendment forward for the gentleman from Washington (Mr. MCDERMOTT), the gentleman from Vermont (Mr. SANDERS), the gentlewoman from Wisconsin (Ms. BALDWIN), as well as myself. What we seek to do is to make more explicit one of the duties that the agency is already charged with, and that is the duty to study ways of increasing access to health se rvices.
We have a situation in this country where there are estimates of 43 million Americans without health in surance co verage. Of those numbers, 11 million are said to be children. The balance of those people are adults, the majority of whom are working adults. This is simply a situation that is intolerable, Mr. Chairman, and it is about time that we started to look at the reasons why that is so and what we can do about changing that dynamic and making sure that all Americans have access to affordable health ca re.
As a former small business president of the Chamber of Commerce and someone who deals often with small businesses, I can tell my colleagues that there has been a change of mind amongst many people in the small business industry. They, at one time, were listening to the larger national organizations and international organizations about how terrible it would be if we had universal health ca re. Now they are seeing the alternative of what happens under the current system. They see the number of people that are uncovered, and they realize that the premiums they are paying to cover their employees and their own families are increased by virtue of the fact that those premiums are also covering the 43 million Americans who have no coverage.
That has to be paid for somewhere. Those people do get health ca re. They unfortunately get it when it is later on in their situation, when the situation is more critical, when treatment is more expensive, and now we need to know why that is so. Now we need to know why we cannot cover everybody.
I think it has come around to providers, whether they be doctors or nurses or others. It has come around to hospitals, to CEOs who I have talked to, as well as business people and consumer groups. We need to look at a more effective health ca re system in this country.
It is more than enough to say that we have a problem. It is time to do something. And when we talk about some of the immediate solutions, and my colleagues have heard as well as I have that we need to put more money back into community hospitals, particularly teaching hospitals because of the cuts in the 1997 Balanced Budget Act, and that is so.
The estimates were that we were going to cut $112 billion and that we were then going to be able to take care of fraud and abuse and get preventive services, and that was going to help it be more affordable. The fact of the matter is, that estimate was overshot. Some $200 billion is estimated to have been squeezed, and those hospitals and home care providers and others do need some money to be put back in. But to just put money back in would be a temporary fix. The system is broken. It is not working. We are not covering everybody. And if we do not cover everybody, we cannot control the cost and cannot make sure that we provide good quality services to everyone.
What this bill will do, Mr. Chairman, is to get this agency to do a study and to compare it to what we have now. What will improve the cost situation. More importantly, what will improve the accessibility and the affordability issues.
Now, among those things we asked to be studied is the single-payer system. That is one option. In no way does my amendment say that that is all we should study or that we should predetermine that is exactly where we have to go. It is a proposal that I think has considerable merit. The Massachusetts Medical Association had two independent studies done, and not to the surprise of many, it came back saying the single-payer system would have been a better system if applied in Massachusetts over the next 8 years. It would save money, it would cover more people in that State, it would provide them better services.
We should find out if that is so for all the States in this country. We should find out if we should have a single-payer system or some other form of universal health ca re. We should balance and measure those systems against each other and how they will do. And then we should measure it against the current system to find out what would be best.
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MODIFICATION TO AMENDMENT NO. 11 OFFERED BY MR. TIERNEY
Mr. TIERNEY. Mr. Chairman, some people are concerned about the language because they thought my amendment was simply saying that we would study only single-payer, but, in fact, we have looked at some language and I am more than happy to ask for unanimous consent that my amendment be modified in accordance with the modification that has been sent to the desk which says that the study shall include an examination of the financial impacts of a range of health ca re reform proposals to include, but not be limited to, a single-payer insurance pr ogram compared to the current system across an 8-year period beginning in fiscal year 2000.
The CHAIRMAN pro tempore. The Clerk will report the modification.
The Clerk read as follows:
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