Letter to Congressional Leaders on the "Medicine Equity and Drug Safety Act of 2000"

Dear Mr. Speaker: (Dear Mr. Leader:)

In your letter, you outlined a number of health care issues that you indicated could be resolved before Congress adjourns. I want to be equally clear about my priorities and hopes for progress this fall. As the days dwindle in this session of Congress, I am seriously concerned about the lack of movement on some of our most important issues. I am, however, encouraged to learn from your letter that the Republican leadership is now committed to providing Americans with access to prescription drugs available at lower cost from other countries.

As you know, our people are growing more and more concerned that the pharmaceutical industry often sells the same drugs for a much higher price in the United States than it does in other countries, even when those drugs are manufactured here at home. This forces some of our most vulnerable citizens, including seniors and people with disabilities, to pay the highest prices for prescription drugs in the world. This is simply unacceptable.

That is why I support the "Medicine Equity and Drug Safety Act of 2000," which the Senate passed by an overwhelming vote of 74 to 21. This important legislation would give Americans access to quality medications at the lower prices paid by citizens in other nations. The Senate bill, sponsored by Senators Jeffords, Wellstone, Dorgan and others, would allow wholesalers and pharmacists to import FDA-approved prescription drugs and would establish a new safety system intended to track these imports and test them for authenticity and degradation. Before this provision could take effect, the Secretary of Health and Human Services would be required to certify that the regulations would, first, pose no risk to the public health; and, second, significantly decrease prices paid by consumers.

With these protections in place and the $23 million necessary to implement them, this legislation would meet the test that we both believe is crucial—preserving the safety of America's drug supply.

Although your letter implies support for legislation similar to the Senate-passed bill, I am concerned by its statement that seniors would "buy lower-priced drugs in countries like Canada" [emphasis added]. Of course, few seniors live near the Canadian or Mexican borders and even fewer can afford to cross the border in search of lower-price drugs. Moreover, policies like the House's Coburn amendment would strip the FDA of all of its ability to monitor safety and prevent seniors from buying counterfeit drugs, putting their health in danger and their finances at risk.

I urge you to send me the Senate legislation—with full funding—to let wholesalers and pharmacists bring affordable prescription drugs to the neighborhoods where our seniors live. Though this initiative does not address seniors' most important need—meaningful insurance to cover the costs of expensive medications—it still has real potential to allow consumers to access prescription drug discounts.

I remain concerned that with less than one week left in this fiscal year, Congress has not passed eleven of thirteen appropriations bills; Congress has not raised the minimum wage; and Congress has not passed a strong, enforceable patients' bill of rights. And, according to your letter, the congressional leadership has given up on passing a meaningful, affordable and optional Medicare prescription-drug benefit.

I am extremely disappointed by your determination that it is impossible to pass a voluntary Medicare prescription-drug benefit this year. I simply disagree. There is indeed time to act, and I urge you to use the final weeks of this Congress to get this important work done. It is the only way we can ensure rapid, substantial and much-needed relief from prescription drug costs for all seniors and people with disabilities, including low-income beneficiaries.

On the issue of the Medicare lock-box, I have endorsed the Vice President's initiative, which has been effectively embodied in Senator Conrad's amendment that passed on the Labor-Health and Human Services appropriations bill. I am therefore encouraged by your commitment to passing this legislation; but we must still make all efforts to ensure that the Medicare payroll taxes in the lockbox are used solely for Medicare.

Similarly, I am pleased to learn of your commitment to pass a greatly-needed package of Medicare and Medicaid health care provider payment and beneficiary refinements. As you know, I proposed such refinements in my budget and in my June Mid-Session Review. This includes payment increases for hospitals, home health agencies, nursing homes and other providers as well as access to Medicaid for legal immigrants, certain uninsured women with breast cancer, and children with disabilities; extended Medicare coverage for people with disabilities; an extension of the Balanced Budget Act's diabetes provisions; and full funding for the Ricky Ray Trust Fund.

Again, I am pleased to learn of your commitment to providing Americans with access to high-quality, lower cost prescription drugs from other nations. There is no reason why we cannot work together to pass and enact such legislation immediately. As we do, we should not give up on passing both a workable, affordable and voluntary Medicare prescription-drug benefit for our nation's seniors and a meaningful patients' bill of rights for all Americans. I will do everything in my power to achieve that end, and I look forward to meeting with you on these issues as soon as possible.

Sincerely,

WILLIAM J. CLINTON