Floor Statement of Michael B. Enzi
April 17, 2007
Mr. ENZI. Mr. President, I rise today to speak in opposition to the bill currently before the Senate.
First Mr. President, I would like to briefly review the status of the new Medicare law that Congress passed in November of 2003.
That landmark legislation enacted the first major benefit expansion of the program since 1965 and placed increased emphasis on the private sector to deliver and manage benefits. It created a new voluntary outpatient prescription drug benefit to be administered by private entities. The legislation also expanded covered preventive services and created a specific process for overall program review if general revenue spending exceeded a specified threshold.
I am pleased to be able to report that this new program is working. All across the country, seniors are expressing their approval of the new benefit. In my State of Wyoming, the new Part D prescription drug benefit has been a huge success. Last year, I traveled around Wyoming and visited with seniors in Cheyenne, Douglas, Sheridan, Casper, Powell, and Rock Springs. I talked to folks all over the state and told them about the new program as I encouraged them to sign up for it. I also talked to a few of the pharmacists in Wyoming that worked so hard to make this program a success. I believe I can speak on behalf of many of my colleagues in saying thank you to the thousands of pharmacists throughout the country that did so much to implement this great program.
Today, about 89 percent of Wyoming seniors are receiving prescription drug coverage, an increase of 16 percent from last year. They remember what it used to be like when they tried to get their prescription medications and they don’t want to go back. I have received hundreds of calls and letters from Wyoming seniors who like the way things are and don’t want Congress interfering with their prescription drug plan because it is working for them. Five separate surveys show that more than 75 percent of all beneficiaries are satisfied with the way the program works.
Not only are about 90 percent of seniors now receiving prescription drugs, the program is costing LESS than originally expected. When is the last time a government program cost less than was estimated? I came to Washington in 1997, ten years ago, and I don’t know that I have ever seen a government program that spent less money than we expected. Private competition is working better than we envisioned and it is saving seniors and the government more and more money every day. Why should we change that?
Mr. President for some reason my colleagues on the other side of the aisle have decided they need to "fix" a program that isn’t broken. We have implemented a plan that is working and before we change it, we need to be sure about what we are doing and the effect it will have on the program and the impact it will ultimately have on seniors from coast to coast.
The bill now before the Senate would strike the non-interference clause from the Medicare law. The "non-interference" language in the Medicare law prevents the federal government from fixing prices on Medicare drugs or placing nationwide limits on the drugs that will be available to seniors and the disabled. I support this language 100 percent. Decisions on what drugs should be available should be made by seniors and their doctors, not by some central committee in Washington.
Under the Medicare Part D law, each prescription drug plan has its own list of preferred drugs. Each plan’s list is different – some are broader, some are narrower. Each list, however, has at least two drugs from each therapeutic class of medications and everyone can find a plan that is advantageous to them.
Mr. President, the "non-interference" bill before us is not only unnecessary, but it could also prove to be harmful to the health of our nation’s seniors. The "non-interference" language protects seniors and the disabled from having the government decide which drugs their doctors can prescribe. It maintains the sacred relationships that seniors have with their doctors, who know best about what particular drugs are right for their patients. Patients support this language, and they want us to maintain it.
Mr. President, I would like to repeat, we have already implemented a plan that is working. Yet, the majority party wants to "fix" the Medicare drug benefit. It’s ironic to me that they use the word "fix"—fix is exactly what this bill will lead to, the government "fixing" prices on drugs. It’s not a bill about negotiating prices; it’s a bill about fixing prices. As most Americans know, the government doesn’t negotiate in the Medicare program. It sets the prices that the government will pay doctors and hospitals for serving seniors.
Setting the price is the same as price controls. And we saw what happened in the 1970s when we tried to control the price of gasoline. Do you remember the long lines at the gas pumps? Trying to control the price of gasoline was a complete disaster. Let’s not experiment with giving government the ability to control the prices of prescription drugs.
Despite what some folks are reporting, the non-partisan Congressional Budget Office has said over and over again that removing this language would not save the government or seniors any money. It wouldn’t save money because the Medicare prescription drug plans will have strong incentives to negotiate drug price discounts that would be as low – or lower – than anything the government could negotiate. Additionally, many plans represent more people than Medicare, Medicaid, or the Veterans Administration, so the plans have greater purchasing power than the government. To effectively negotiate, you need to competing products, or you have to be willing to do without one of the products on which you are negotiating.
How many times does the Congressional Budget Office have to say that this bill will not save the government any money before it starts to sink in? When will my friends on the other side of the aisle acknowledge that this bill will not save any money?
We do, however, know of something that will save the Federal government and seniors money – competition among private plans. What has been proven to reduce costs -- especially for seniors with low incomes -- is the new Medicare drug benefit that we passed in 2003.
The competition among private plans is driving the cost of the program down. The average monthly premium has dropped by 42 percent, from an estimated $38 to $22 – and there is a plan available in every state for less than $20 a month. So let me suggest letting competition work to drive the prices even lower instead of instituting government price controls that have failed in the past.
Also, because the program has choice, if the price of one plan goes up, beneficiaries can switch plans. It’s important to remember that sometimes the prices will go up, because medical costs will go up as long as new technologies are invented that allow people to live longer, healthier lives.
Democrats want to change Part D to resemble the drug benefit program of the Veterans Administration. In the VA system, the government sets a price on a drug it can get at the cheapest rate and limits or restricts access to those it can not get at cheap rates. As a result, the VA benefit excludes three out of four drugs available through Part D. Changing the Medicare program to be as restrictive as the VA system is completely illogical!
Another thing about the VA system is that it can take a long time for new drugs to be included on the formulary—sometimes as long as three years. Let me repeat that. It can take as long as three years for new, life-saving drugs to be included on the VA formulary.
Lastly, the VA owns the whole system, so you have to order your drugs from them or you have to fill your prescriptions at one of 350 government-run facilities nationwide. In contrast, seniors signing up for a Medicare prescription drug plan can choose their plan based on the pharmacy they want to use to fill their prescriptions. As a result of all of these things, more than one million retired veterans have signed up for Medicare in the last year. I talked to many Veterans in Wyoming and they all told me that they signed up for Medicare Part D so they could finally get the drugs they needed that they couldn’t get from the VA.
Unfortunately, my colleagues on the other side of the aisle want to make the Medicare program more like the VA program. They want to take away a senior’s ability to choose. The real thing we should be talking about is how we can change the VA program to be more like Medicare Part D.
The mark also contains a few other provisions relating to the comparative effectiveness of prescription drugs—a study that determines whether drug A is better than drug B at treating a disease. The mark also contains a provision authorizing consideration of comparative clinical effectiveness studies in developing and reviewing formularies under the Medicare prescription drug program. No surprise here, but the Congressional Budget Office stated no savings will result because of this section.
This is the first step of a dance the democrats want to do called "cutting in on the relationship between doctors and patients". Decisions about what drugs patients should take should be made by doctors and patients. I think we should keep the government out of the exam room.
To close, I would just like to remind folks of a few key points:
The Medicare program is working. More seniors are getting the drugs they need at lower costs.
The bill before the Senate tries to "fix" something that isn’t broken.
This bill will take away the choices seniors have about the drugs they use.
The Congressional Budget Office has stated several times that this bill will not produce any savings.
The bill tries to make the Medicare program more like the Veterans program, but the Veterans program has fewer choices than the Medicare program—that’s why over one million veterans have signed up for the Medicare program.
We don’t need meddling for the sake of meddling or a new system conjured up for political convenience. Let’s stop wasting the time of this important body and move to a bill that can actually do some good for the American people.
Thank you Mr. President.
I yield the floor.