Bob Casey on Health Care Democratic Challenger for PA Senate

Medicare Part D program is fundamentally flawed

A: The Part D legislation currently prohibits Medicare officials from negotiating lower bulk prices with drug companies. It also continues to block the re-importation of safe, FDA-approved prescription drugs at lower prices from Canada. At the same time, the legislation lavishes extravagant taxpayer-financed incentives on the HMOs. The Medicare Part D program is fundamentally flawed and is in clear need of a complete overhaul. It provides too much benefit to the HMOs while the law's "donut holes" in coverage require many seniors to pay for all drug costs out of their own pockets.

Fill the "doughnut hole" of missing Medicare Rx costs

Fight to Expand Health Care Coverage

Opposes Cloning of Human Embryos for Experimentation

Use tobacco settlement for healthcare for unemployed

Supports suing HMOs, but opposes damage caps

A: Yes.

Q: Doctors are caught between lower reimbursements and soaring premiums. Isn't tort reform a good idea?

A: I'm not a supporter of damage caps, and I'm not a supporter of playing games with liability provisions because I don't think they lead to this wonderful malpractice reform that some think is out there. And more importantly, they adversely impact workers. I don't think that the cost of lawsuits and damages and big verdicts has anything to do with the medical-malpractice challenge the state faces. The insurance companies, the ones who have caused most of the problems, were left out and really not held accountable. It was like a huge elephant in the room and they weren't taken on. What you need is a governor who appoints an insurance commissioner who's going to be very tough in the oversight of the insurance companies.

Voted YES on adding 2 to 4 million children to SCHIP eligibility.

Proponents support voting YES because:

Rep. DINGELL: This is not a perfect bill, but it is an excellent bipartisan compromise. The bill provides health coverage for 3.9 million children who are eligible, yet remain uninsured. It meets the concerns expressed in the President's veto message [from HR976]:

1. It terminates the coverage of childless adults.
2. It targets bonus payments only to States that increase enrollments of the poorest uninsured children, and it prohibits States from covering families with incomes above $51,000.
3. It contains adequate enforcement to ensure that only US citizens are covered.

Opponents recommend voting NO because:

Rep. DEAL: This bill [fails to] fix the previous legislation that has been vetoed:

• On illegal immigration: Would the verification system prevent an illegal alien from fraudulently using another person's name to obtain SCHIP benefits? No.
• On adults in SCHIP: Up to 10% of the enrollees in SCHIP will be adults, not children, in the next 5 years, and money for poor children shouldn't go to cover adults.
• On crowd-out: The CBO still estimates there will be some 2 million people who will lose their private health insurance coverage and become enrolled in a government-run program.

Veto message from President Bush:

Like its predecessor, HR976, this bill does not put poor children first and it moves our country's health care system in the wrong direction. Ultimately, our goal should be to move children who have no health insurance to private coverage--not to move children who already have private health insurance to government coverage. As a result, I cannot sign this legislation.

Voted YES on requiring negotiated Rx prices for Medicare part D.

Proponents support voting YES because:

This legislation is an overdue step to improve part D drug benefits. The bipartisan bill is simple and straightforward. It removes the prohibition from negotiating discounts with pharmaceutical manufacturers, and requires the Secretary of Health & Human Services to negotiate. This legislation will deliver lower premiums to the seniors, lower prices at the pharmacy and savings for all taxpayers.

It is equally important to understand that this legislation does not do certain things. HR4 does not preclude private plans from getting additional discounts on medicines they offer seniors and people with disabilities. HR4 does not establish a national formulary. HR4 does not require price controls. HR4 does not hamstring research and development by pharmaceutical houses. HR4 does not require using the Department of Veterans Affairs' price schedule.

Opponents support voting NO because:

Does ideological purity trump sound public policy? It shouldn't, but, unfortunately, it appears that ideology would profoundly change the Medicare part D prescription drug program, a program that is working well, a program that has arrived on time and under budget. The changes are not being proposed because of any weakness or defect in the program, but because of ideological opposition to market-based prices. Since the inception of the part D program, America's seniors have had access to greater coverage at a lower cost than at any time under Medicare.

Under the guise of negotiation, this bill proposes to enact draconian price controls on pharmaceutical products. Competition has brought significant cost savings to the program. The current system trusts the marketplace, with some guidance, to be the most efficient arbiter of distribution.
Status: Cloture rejected Cloture vote rejected, 55-42 (3/5ths required)