Our guest today is Democratic Congressman from Ohio, Sherrod Brown, here to provide the Democratic perspective on the national prescription drug coverage plan currently being debated in the House. The Congressman took questions over the phone from his office in Washington, D.C., his answers were relayed by a typist. Chat producer Will Femia moderates.
MSNBC-Will Femia: Welcome Congressman Brown.
Congressman Brown: Thank you.
Question from KaptinKaos: Do the Democrats have their own plan?
Congressman Brown: The Democrat plan is specific and straight forward. It’s prescription drugs benefit inside Medicare, $25 per month premium, $100 dollar annual deductible, 20% co-pay up to $2000 drug expenses for the senior, then the government pays the rest. We also have significant cost containment price controls so that discounts are negotiated on behalf of Medicare beneficiaries by the government so that we can bring prices way down the way many other countries do. We also have brought more competition in by bringing generics into the system.
MSNBC-Will Femia: Since you mention other countries...
Question from Alan: I am forced to go to Canada to buy my wife’s RX...I am spending close to 425/month. Will the GOP plan help me?
Question from Jack Jenkins: Any prescription drug program must be better than the benefit of buying drugs via Canada. If not why bother?
Congressman Brown: The Republican plan does nothing to bring prices down, so if the GOP plan passes I’ll still be taking a bus load of seniors to Canada once every two months as I’ve done. So will you continue to go to Canada.
The Canadians and every other country in the world do something about drug prices. The Canadian government negotiates directly with the drug companies. Other countries determine price based on prices in other countries to keep the prices down. Still other countries bring in generic competition earlier.
But in every country in the world something is done to lower prices except the U.S. and as a result, our prices are 2 and 3 and 4 times higher than any other country in the world.
Question from DeFranco: Are you frustrated with all these distractions in the news that are taking attention away from your campaign against the republicans? People may get their “under god” back, but they won’t get their drugs.
Congressman Brown: The prescription drug issue is so important to 40 million seniors and millions of other Americans who don’t have full prescription drug coverage, yet the media loves writing front page stories about issues that matter but aren’t really important to people’s lives to the same degree. So when this whole “under God” court case, which members of Congress will certainly oppose almost unanimously will be dispensed with quickly but the media may put more ink into that issue on the front page than they will on an issue that’s going to affect people’s every day lives for the next 20 years. So of course it’s frustrating.
Question from Jim: The whole government is at the whim of the drug companies anyway, it’s all corrupt.
MSNBC-Will Femia: I don’t understand the drug company influence accusation. Wouldn’t the drug companies want *more* coverage because then more people would be able to buy drugs?
Congressman Brown: That’s a very good question. First, all you have to do is watch the debate here to see who’s in the drug companies’ pockets. The GOP had a major fund raiser last week. Our committee that worked on this bill adjourned early in the afternoon so that Republicans could go to this fundraiser. The CEO of Glaxo, a British drug company chaired the event and gave a quarter million dollars from his company.
If you look at the votes on issue after issue, you’ll see the Republicans sided with the drug companies and the Democrats with very, very few exceptions on our side, went against the drug companies. The drug companies have great influence here, they have total influence on the Republican party, they have some influence on the Democratic party. But most Democrats have fought for a drug benefit inside Medicare and also tried to bring prices down for seniors and others.
The reason that the drug companies don’t like the Democratic plan is that they like it when they can sell drugs individually to seniors who will pay high out of pocket costs per drug. If the Democrat plan passes, the drug companies might sell more drugs, but we would negotiate much lower prices because the government would negotiate on behalf of 40 million beneficiaries. The same way the Canadians negotiate on behalf of 30 million Canadians.
So when you’re buying in that kind of bulk, the price is 30, 40, 50, 70% lower. 80% lower as it was in the case of Cipro, because the government used its buying power of millions of citizens to bring the price down. The drug companies like it when a senior goes and pays $90 for a prescription and then another senior goes and pays another $90 at another pharmacy for a prescription, rather than getting a discount because they all negotiate prices as one.
It’s interesting you mention this because this is about the only time I can think of when a company doesn’t want to sell its products to the government or through a government plan. The defense industry, the cement makers, the road builders, the paperclip manufacturers, they all want to sell a lot of stuff to the government. The drug companies don’t because they like to pick the seniors off one by one. And the Republicans are protecting them to do that.
Question from Michael Cummings: Has there been any consideration of a tax credit for healthy people who don’t need drugs? It isn’t fair that I take care of my health but I have to pay for heart, cholesterol, and other medication for people who didn’t take care of their health.
Question from JackSmacks: Please explain why I should be enslaved to pay for the healthcare of an individual in whom I have no interest. If the cotton farmers down south find their current methods of harvesting too costly, will I be forced to pick their cotton?
MSNBC-Will Femia: Are you specifying which drugs are covered? Is this guy right about cholesterol medicine being covered?
Congressman Brown: Medicare is a universal voluntary program. It protects everyone and if you’re lucky enough to be healthy your whole life, you’ve put some money into Medicare you don’t get a lot out. But if you happen to get real sick, you get more out than you put in. That’s what insurance is, that’s what government insurance is.
We live in a civilized society where if everyone participates in Medicare as almost 99% of Americans do, then everyone is part of that universal coverage pool and it works for the whole country. It’s worked for 37 years very effectively and very humanely for the American public.
A prescription drug benefit is voluntary. Under he Democratic plan you put $25 a month in if you would like and that’s your premium. Your first $100 you pay out of pocket and then the government begins to share the cost with you. Nobody makes you do that, but if you join -or if you don’t join still - the program is universal so everyone has the potential to benefit if they choose to join. That’s the beauty of Medicare is it takes care of people.
My mother has had pretty low expenses from 65 to her present age of 81. Medicare has made money on her but at some point probably Medicare will spend more money on her than she’s presently paying in. That’s what insurance is all about. That’s what a government health program should be about. That’s what equity and fairness and community values are all about.
Essentially the Democratic plan covers all prescriptions that the doctor orders. If there is a cheaper version in some cases, the Medicare will pay only for the less expensive version. The Republican plan will have a significantly more limited list of drugs that the patient can receive.
The Republicans’ way of cutting cost is to take the choice away from the patient. The Democrats way of cutting cost is to have the Secretary of HHS negotiate discounts with the drug manufacturer and push the price of individual drugs down.
Question from Gus Fowler: What is the policy going to be on pre-existing conditions? I read that what they’re talking about now isn’t worth it for people who pay less than $700 a year for drugs, and that’s me. If my doctor suddenly says I need some new medicine, can I then sign up for the program or is it too late?
Congressman Brown: You can sign up for the program at any time.
With the Republican plan, if your drug expenses are anywhere between 2000 and 5000, it makes no sense to join. It might make sense to join if your drug costs are between 1000 and 2000 dollars. Beyond that it doesn’t. Less than a thousand probably doesn’t make sense.
The Democratic plan probably doesn’t make sense if you spend less than about $500 but beyond that the Democratic plan will pay off for any senior.
Question from Zeke: I know the Dems have a problem with the “hole” in the Republican plan, buy why don’t they just accept this plan and try to fill in the hole later? Instead we’re going to end up with nothing and it’ll be the American people who have t
Question from Mike Gorski: Please, Please, Please pass a national prescription drug coverage bill. I’m 55 & very concerned about being able to pay for my medication when I retire & have no insurance. My wife and I pay over $400.00 per month in co-pays now.
Congressman Brown: We have tried to fill the hole repeatedly in amendments in committee. The Republicans won’t even allow an amendment on the House floor do to that. I don’t think it’s responsible for Congress to pass a bill that provides almost no benefits, as the Republican plan does, that does nothing about drug prices, and that will be the first major step in privatizing Medicare. That is why we are going to continue to fight until we can get a drug plan that is better than the Republican plan.
The Republican plan is really worse that no plan at all because it privatizes Medicare. It gives absolutely minimal benefit because it subsidizes insurance companies who then may or may not write decent benefit plans that provide decent benefits to seniors.
Question from GodlovesAmerica: Why do the dems have a problem with this republican proposal? It covers the poorest people and the people with the biggest drug costs. That sounds like it was WRITTEN by democrats! What’s your problem? Do you have to obstruct everything the republicans propose?
Question from Bumpkin: Will there be a financial “means” test to ensure that wealthier seniors pay a bit more than those with low incomes?
Congressman Brown: The Republicans talks about their plan helping the poor, but the gap, or the big “donut hole” of out of pocket expenses for the poor still exists, so the poor get very little benefit out of this. They would get minor amounts of help with their premium and their co-pay, but the gap would mean thousands of dollars in out of pocket expenses for seniors whether they’re poor or not.
The Democrats want a universal plan modeled after Medicare because Medicare works. I don’t want to see the market segmented where we have this program for the poor and we have these benefit for middle income people and separate but lesser benefits for wealthier people.
Medicare works because everybody’s eligible. There’s no cream skimming or slicing off of individual groups. It’s universal so it is politically attractive to the entire population. That’s why we’ve seen Medicare over the years withstand the assaults of conservatives who want to eliminate a plan they never liked. There was a Republican leader today in rules committee who said Medicare is a Soviet style program. The hostility toward Medicare among leading Republicans in this city is unbelievable. They didn’t vote for itin 1965, it ended in the Gingrich years, and they still talk in very derisive terms about what I think is the best government program perhaps ever invented. And if the Republican voters knew how Republican leaders talked about Medicare and what they thought about Medicare, they would just be absolutely incredulous.
Question from RPh: How will the new plan protect retail pharmacies - how will we stay in business?
Congressman Brown: Very good question, very big issue. The reason this bill has not yet been scheduled today is because lots of Republicans are getting lots of calls from their pharmacists, small town, community pharmacists and chain drug stores, to ask them to vote against the bill. Because this Republican bill will over time force seniors through private insurance (as if we need another insurance carrier in all this, with Medigap and HMOs and all this) they’ll have to buy a plan and that private insurance plan will in many cases bypass local drug stores so that under the Republican plan seniors will have to either go mail order for their prescriptions or perhaps to a big chain drug store. The community pharmacists are very upset with this, as are seniors who understand what the plan does to their relationship between the pharmacist and the patient.
The chain drug stores are concerned it will go to all mail order, but I think it will go mostly mail order but to some large chain drug stores. But either way, the patient is hurt because the patient’s relationship with the pharmacist will be jeopardized.
MSNBC-Will Femia: Thank you very much for taking this time with us Congressman. Can you give us some closing comments before we have to let you go?
Congressman Brown: It’s important to compare the two plans.
The Democratic plan is inside Medicare with major efforts to reign in prices.
The Republican plan is a subsidy by the government to the insurance companies which will ultimately lead to much lower benefit with much higher out of pocket costs with no constraint at all on the outrageous prices drug companies are charging.
The Republican plan was written by the drug companies and for the drug companies because the drug companies are very, very happy with their plan. The Democratic plan assures that every senior will have the opportunity to get a prescription drug benefit as good as any member of Congress has through the Federal Employee Health Benefit Plan.
MSNBC-Will Femia: Thank you very much for your time Congressman.
Congressman Brown: Appreciate it. Enjoyed it. Thanks.