Statements on Introduced Bills and Joint Resolutions

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - July 20, 2006)

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Mr. WYDEN. Thank you, Mr. President.

Mr. WYDEN. Mr. President, I have come to the floor today to join my colleague at this time to discuss the Catastrophic Health Coverage Promotion Act that Senator Smith and I are introducing today.

Mr. President, first, I want to say how much I appreciate Senator GORDON SMITH. At a time when our citizens all across the land and in our home State of Oregon believe there needs to be more bipartisanship, Senator Smith doesn't just talk about it, he is consistently willing to meet me more than halfway on critical issues, and he does that with other colleagues in the Senate.

As we begin our time discussing this legislation, I want to let him know how much I appreciate the chance to cooperate with him once again. As he stated, we did put the issue of catastrophic health coverage at the top of our bipartisan agenda for the Senate session.

What it comes down to, Mr. President, is that Senator Smith and I believe it is a moral blot on our Nation for a country as good and rich as ours to send millions of its citizens to bed at night fearing they will be wiped out if a serious medical illness hits them. That is the reality. It is the reality for families who have no coverage at all, and it is the reality for families who have some measure of coverage, say, through an employer, but it doesn't stretch far enough.

Senator Smith and I want, in a bipartisan way, to tackle both of those kinds of concerns. That is why we have put forward the legislation we introduced today. I think now is an ideal time for bipartisanship on the catastrophic health coverage issue.

If you look back over the last few years, Senator Kerry, in the 2004 Presidential campaign, had an excellent proposal with respect to catastrophic coverage, and I said so in the course of that campaign. But I also said at the time that I thought our distinguished majority leader, Senator Frist, also had a good catastrophic coverage proposal. You could debate the various merits of the Kerry proposal and the Frist proposal--which approach involved a little more government, which approach involved the private sector--but at the end of the day, for the purposes of government work, they were pretty darn similar.

So when Senator Smith and I sat down after the 2004 election, we said let's finally get this done. Democrats and Republicans have been talking for years about how to make sure that all our citizens have a safety net under them so that they will not get wiped out from medical illness. We settled on this approach, which we thought would give us the opportunity to try some fresh, creative ideas for protecting our citizens.

Let me give an example of what happens in, for example, South Carolina, Oregon, or anywhere else in this country. If you have a small business with six people working there, and one of them gets sick, that essentially blows up the whole health premium structure for all six of the employees.

What we ought to look at is something called reinsurance. Under reinsurance, that employee who gets sick could get a bit of help for their high bills through a modest role for government, and if government steps in, in that kind of instance, you have an opportunity to hold down all of the costs for the entire six-person firm. So we should have been looking at reinsurance years ago, but because Senator Smith, who chairs the Senate Aging Committee, has been examining these questions and has worked with me, now we are going to have a chance to tackle it in a way that I think is going to give us the opportunity to get the job done.

We are also very concerned about people who have no coverage at all. So what happens if you have no coverage at all is folks walk into a hospital in Oregon or in South Carolina, usually they show up in the emergency room, and the hospital has to absorb those costs. What we would do is give that person who now has no coverage at all the possibility of actually buying some private coverage in the marketplace with a bit of a subsidy in order to be able to have coverage that would pick up at least a portion of those bills that the hospital is now absorbing.

At the end of the day, those are the two principal kinds of instances we are facing--folks who have some coverage through a private employer, but it doesn't stretch far enough, and folks who don't have any coverage at all. Under that approach, we would like to make it possible for them to get into the private insurance market, protect them from catastrophic illness. We think we can do it with a modest subsidy coming from government.

My sense is that we are now looking at health care on two tracks in our country. The first track is a track that suggests we can take steps right now in areas like catastrophic coverage to protect our citizens. There are other ideas I have advanced during this Congress. For example, Senator Snowe and I have now gotten a majority of Senators to agree with our proposal to lift the restriction so Medicare can bargain and hold down the costs. That, like the question of catastrophic coverage, is a step you can take right now. Let's protect our citizens from the catastrophic illness and let's hold down the costs of medicine. Those are practical, bipartisan approaches that can be taken today. We ought to pursue them and get them done.

I also think there is another track to health care. I noticed that Senator Hatch was on the Senate floor. He and I were the authors of the legislation creating the Citizens' Health Care Working Group that is going to look at opportunities to make sure that all Americans have decent, affordable coverage. We have only been on that issue for more than 60 years--going back to the 81st Congress, in 1945, and Harry Truman. I have said let's also work on that second track that involves getting all Americans under the tent for essential and affordable health care coverage.

That obviously isn't going to get done in the next 15 minutes. But if the Senate, on a bipartisan basis, as Senator Smith and I have sought to do on the catastrophic issue, and as Senator Hatch and I have sought to do on a broader approach to look at health care that works for all Americans--if we team up and look at health care on those two tracks, I think we can make a great contribution for our country.

There are no costs going up in the United States like medical bills. We spent $1.7 trillion last year on health care. There are 290 million Americans--I guess we are approaching 300 million. When you divide $1.7 trillion by 290 million Americans, it comes to something like $25,000 that could be sent to every family of four in America with the amount of money now being spent on health care.

So while we are spending enough money, my sense is that we are not spending it in the right places. Once again, Senator Smith has given us an opportunity to think creatively about better ways to approach the use of the health care dollars. I was pleased when Senator Smith suggested in our legislation that we also make it possible to include a focus on health care prevention. We are not doing enough with health care prevention in this country. The Medicare Program shows that pretty well. Medicare Part A, for example, will pay huge checks for senior citizens' hospital bills, but Medicare Part B pays virtually nothing for prevention to keep people well. That makes no sense. We need a sharper focus on health care prevention, and one of the things that I think is attractive about Senator Smith's leadership on this issue is that he has said even in the context of looking at catastrophic health care, let's put a sharper focus on prevention. We are going to make it possible in this legislation to do that.

I note we have other colleagues on the floor. I have secured time to focus on the Voting Rights Act legislation later in the afternoon, but I am very pleased to have the opportunity to talk for a few minutes about the Catastrophic Health Coverage Promotion Act Senator Smith and I are introducing today. We have focused on a number of issues in a bipartisan fashion over our years in the Senate, but this has the potential to be the biggest as it relates to the needs of our citizens at home.

We want to make sure when folks go to bed at night, they don't have to fear they are going to be wiped out financially by a serious medical illness. This legislation moves us one step closer toward the goal. We hope many colleagues on both sides of the aisle will want to support the legislation.

Mr. WYDEN. Mr. President, Senator SNOWE and I today are introducing the Medicare Prescription Drug Lifeline Act. This legislation provides a solution for those seniors falling into the coverage gap, also known as the doughnut hole of the Medicare prescription drug benefit. The doughnut hole occurs when the spending for a senior's drug expenses reaches $2,250: at the point, the senior is on their own until their spending for prescription drugs reaches a total of $5,100, where the benefit picks up again. The Kaiser Family Foundation estimated that nearly 7 million seniors will fall into the coverage gap this year.

Seniors who enter this ``no man's land'' of spending face the same problems seniors faced before the drug benefit even began: they skip doses, they don't take all their medicine to make it stretch, and they are forced to choose between their food and fuel costs and their prescription drug costs.

This legislation would take three steps to deal with this problem: First, the Secretary of HHS would be required to let seniors know they are approaching the coverage gap. Second, it would allow seniors, when they are notified that they are reaching the coverage gap, to switch plans to avoid the gap. Finally, the legislation requires the Government Accountability Office to examine ways in which the benefit could be redesigned to eliminate the gap without increasing Federal spending. Together, these provisions will give seniors a lifeline to coverage.

Senator SNOWE and I both voted for the legislation that created the Medicare prescription drug benefit. When we did so, we pledged that we would continue to work to improve the benefit. Senator SNOWE and I have teamed up together on many occasions to try to reduce the cost of the prescription drug program by giving the Secretary the same power other Government officials have to bargain for better prices. Our legislation has won a majority of votes in the Senate, and we intend to continue to press for that power.

The latest effort is aimed at another shortcoming in the law: finding a way to help seniors avoid falling into the coverage gap. Senator SNOWE and I believe that our legislation will help seniors a straightforward way to avoid the gap.

Congress needs to address both these issues and we will continue our strong commitment to seniors by working to improve the drug benefit.

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