WORRIED ABOUT SENIORS WHO DECIDED TO DO THEIR OWN
           SELF-REGULATION. THEY CAN'T AFFORD ALL THEIR PILLS, SO THEY'LL
           SKIP A COUPLE OF PILLS. THEY'LL TAKE THEM EVERY OTHER DAY OR
           CUT THEM IN HALF. AND OFTENTIMES HAVE BEEN PLACED IN SERIOUS
           JEOPARDY AS IT RELATES TO THEIR HEALTH BECAUSE THEY HAVE NOT
           BEEN ABLE TO AFFORD THEIR MEDICATIONS, AND THEY'VE TAKEN THEM
           INAPPROPRIATELY. THE BOTTOM LINE, MR. PRESIDENT, IS THAT
           MEDICARE SHOULD INCLUDE A DEFINED VOLUNTARY PRESCRIPTION DRUG

           BENEFIT TO HELP COVER THE COSTS OF PRESCRIPTION DRUGS FOR
           SENIORS AND THE DISABLED. AND I'M COMMITTED TO WORKING WITH MY
           COLLEAGUES ACROSS THE I'M AND THE ADMINISTRATION TO FINISH WHAT
           WE STARTED LAST YEAR AND CREATE THIS NEW COMPONENT OF MEDICARE
           THAT IS ABSOLUTELY CRITICAL. WITHOUT IT, WE ARE NOT FULFILLING
           THE PROMISE OF UNIVERSAL HEALTH CARE FOR THOSE OVER THE AGE OF
           65 OR THE DISABLED. IF WE DON'T COVER MEDICATIONS, WE ARE NOT

           PROVIDING HEALTH CARE IN THE TRUEST SENSE FOR THOSE
           INDIVIDUALS. IN FACT, ONE OF THE VERY FIRST BILLS I'VE
           COSPONSORED THIS YEAR WAS S. 10, A BILL THAT WOULD CREATE THIS
           IMPORTANT BENEFIT IN THE MEDICARE PROGRAM. AND I'M READY TO
           WORK WITH MY COLLEAGUES TO MAKE SURE THAT WE DO WHATEVER IT
           TAKES TO UPDATE MEDICARE AND CREATE A DEFINED BENEFIT THAT WILL
           MAKE SUCH AN INCREDIBLE DIFFERENCE IN THE LIVES OF SENIORS AND
           THE FAMILIES IN MY GREAT STATE OF MICHIGAN AND ALL ACROSS THE

           COUNTRY. AS WE WORK ON THIS COMPLEX ISSUE THERE ARE OTHER
           APPROACHES WHICH WE CAN TAKE IN A MORE IMMEDIATE SENSE TO CUT
           THE COSTS OF PRESCRIPTION DRUGS. LAST YEAR CONGRESS PASSED AND
           THE PRESIDENT SIGNED INTO LAW AN IMPORTANT NEW ACT THAT WOULD
           PERMIT U.S. MANUFACTURED F.D.A.-APPROVED DRUGS TO BE REIMPORTED
           BACK INTO THE UNITED STATES BY WHOLESALERS. I FIRMLY BELIEVE
           THAT IMPLEMENTING THIS ACT COULD SUBSTANTIALLY REDUCE THE COST
           OF DRUGS NOT JUST FOR SENIORS, BUT FOR EVERYONE. I'VE ORGANIZED

           SEVERAL BUS TRIPS TO CANADA WITH SENIORS OVER THE PAST TWO
           YEARS, AND AS YOU KNOW, CANADA IS JUST A SHORT TRIP ACROSS THE
           BRIDGE OR IN THE TUNNEL, FIVE MINUTES AND YOU CAN BE IN CANADA
           FOR MANY RESIDENTS OF MICHIGAN WHO I HAVE FOUND THAT AS WE'VE
           DONE THIS, I'VE DISCOVERED ON OUR TRIPS THAT THE RESULTS IN
           TERMS OF PURCHASING MEDICATIONS JUST FIVE MINUTES AWAY HAS BEEN
           QUITE UNBELIEVABLE. JUST ACROSS -- A SHORT DRIVE ACROSS THE

           BORDER, U.S. CITIZENS CAN SUBSTANTIALLY REDUCE THE COST OF
           THEIR MEDICATIONS BY PURCHASING THEM IN CANADIAN PHARMACIES.
           THESE ARE AMERICAN-MADE, F.D.A.-APPROVED MEDICATIONS SOLD TO
           CANADIAN PHARMACIES THAT ARE THEN -- OUR PEOPLE ARE ABLE TO
           LOOK AT THOSE PRICES AND SEE SUCH A DRAMATIC DIFFERENCE. THE
           DIFFERENCE IN PRICE FOR MEDICATIONS WAS TRULY SHOCKING. A PRICE
           STUDY I CONDUCTED COMPARING THE PRICE OF SEVERAL DRUGS

           PURCHASED IN THE U.S. TO THE CANADIAN PRICES CONFIRMED WHAT WE
           SAW AS WE DID OUR BUS TRIPS. THE PRICE OF THE SAME DRUG
           PURCHASED IN CANADA IS SUBSTANTIALLY LOWER THAN THE AVERAGE
           U.S. PRICE. AND I BROUGHT A CHART TODAY TO THE FLOOR THAT SHOWS
           SOME OF THE INCREDIBLE DIFFERENCES, AND I'D LIKE TO POINT THOSE
           OUT TODAY. FOR INSTANCE, ZOCOR, A DRUG TO REDUCE CHOLESTEROL,

           COSTS $109.73 IN MICHIGAN FOR 55 MILLIGRAM TABLETS. THE SAME
           DRUG COSTS ONLY $46.17 IN CANADA. 138% DIFFERENCE. PRILOSEC, A
           DRUG TO TREAT ULCERS COSTS $115.37 IN MICHIGAN FOR 20,
           20-MILLIGRAM CAPSULES. THE EXACT SAME DRUG COSTS ONLY $55.10 IN

           CANADA. AND THIS IS 109% DIFFERENCE IN THE PRICE. PROCARDIA XL,
           A DRUG TO TREAT HEART PROBLEMS, COURTS $133.36 FOR 100 TABLETS,
           130 MILLIGRAM TABLETS IN MICHIGAN. THE SAME DRUG COSTS ONLY
           $74.25 IN CANADA, AN 80% DIFFERENCE. NORVAX, A DRUG TO TREAT
           HIGH BLOOD PRESSURE COSTS $116.95 FOR 95 MILLIGRAM TABLETS. THE
           SAME DRUG COSTS ONLY $89.91 IN CANADA. A 30% SAVINGS.

           TAMOXIFEN, A DRUG TO TREAT BREAST CANCER COSTS $136.50 IN
           MICHIGAN FOR A ONE-MONTH SUPPLY. THE EXACT SAME DRUG PURCHASED
           BY A NUMBER OF THE SENIORS THAT WERE WITH ME WAS ONLY $15.92 IN
           CANADA. 88% DIFFERENCE IN PRICE. IT'S ASTOUNDING. ZOLOF, A DRUG
           TO TREAT DEPRESSION, COSTS $220.64 FOR 150-MILLIGRAM TABLETS IN

           MICHIGAN. THE SAME DRUG COSTS $129.05 IN CANADA. A 30%
           DIFFERENCE IN PRICE. MR. PRESIDENT, THESE DRUGS ARE ALL
           AMERICAN MADE. THEY ARE ALL F.D.A. APPROVED FOR SAFETY AND
           PURITY REQUIREMENTS. AND BECAUSE THEY ARE U.S. DRUGS, THE
           COMPANIES DEVELOPING AND MANUFACTURING THEM -- AND WE ARE SO
           PROUD THAT WE HAVE THESE KINDS OF DRUGS THAT ARE BEING
           MANUFACTURED IN THE UNITED STATES AND THAT WE'RE DEFINITELY IN
           THE LEAD, IN THE CUTTING EDGE ON THE DEVELOPMENT OF THESE NEW

           DRUGS AND MANY, MANY OTHERS. BUT MY CONCERN IS THAT WHILE WE
           ARE PAYING ON AVERAGE TWICE AS MUCH, WE AS TAXPAYERS IN THE
           UNITED STATES ARE HELPING TO SUBSIDIZE THE DEVELOPMENT, THERD
           TAX CREDIT, THE FUNDING EFFORTS THROUGH THE NATIONAL INSTITUTES
           OF HEALTH IN OUR FEDERAL LABS, THE RESEARCH UNITED
           STATES-SUPPORTED UNIVERSITIES, ALL OF WHICH I THINK ARE
           APPROPRIATE. AND I HAVE LONG BEEN ONE OF THE CHAMPIONS FOR THE
           PERMANENT EXTENSION OF THE R&D TAX CREDIT AND BELIEVE THAT

           THESE ARE APPROPRIATE POLICIES TO ENCOURAGE RESEARCH AND
           DEVELOPMENT. BUT MY CONCERN IS THAT OUR CITIZENS IN THE UNITED
           STATES WHO HELP UNDERWRITE THE COSTS TO DEVELOP THESE
           MEDICATIONS SHOULD HAVE ACCESS TO THESE U.S.-MADE,
           F.D.A.-APPROVED DRUGS AT THE LOWEST PRICE POSSIBLE, AND THAT WE
           OUGHT NOT TO BE PAYING TWICE AS MUCH AS EVERY OTHER COUNTRY, OR

           MORE, FOR DRUGS THAT ARE MANUFACTURED HERE AND UNDER OUR
           POLICIES SUPPORTED BY TAXPAYERS' DOLLARS. WE NEED COMPETITION.
           COMPETITION IS THE KEY TO ENSURING PRICES THAT CONSUMERS WILL
           BE ABLE TO PAY IN OUR COUNTRY. WE NEED TO MAKE SURE THAT EVERY
           AMERICAN HAS THE OPPORTUNITY TO BENEFIT FROM THE NEW
           DISCOVERIES THAT ARE BEING MADE EVERY DAY AND THE NEW
           MEDICATIONS THAT ARE BEING DEVELOPED EVERY DAY IN OUR COUNTRY.
           KEEPING THE CANADIAN BORDER AS WELL AS OTHER BORDERS CLOSED IS

           AN OBSTACLE TO COMPETITION AND IS SERVING TO MAINTAIN
           ARTIFICIALLY HIGH PRICES FOR OUR CITIZENS. I BELIEVE THAT
           PERMITTING U.S. WHOLESALERS SUCH AS PHARMACIES TO BRING LOWER
           PRICE DRUGS BACK ACROSS THE BRIDGE, BACK ACROSS THE TUNNEL
           COULD REDUCE THE PRICE OF DRUGS FOR EVERY SINGLE AMERICAN. I
           BELIEVE IN COMPETITION. RIGHT NOW WE DON'T HAVE IT WHEN IT
           RELATES TO THE PRICING OF PRESCRIPTION DRUGS AROUND THE WORLD.
           AS MY COLLEAGUES KNOW, THE SECRETARY OF HEALTH AND HUMAN
           SERVICES WAS GIVEN BROAD DISCRETION IN IMPLEMENTING THE

           WHOLESALE REIMPORTATION PROVISIONS OF THE ACT THAT WAS PASSED
           LAST YEAR. THE FORMER SECRETARY EXPRESSED CONCERNS THAT THE
           PROVISIONS MAY NOT PROVIDE COST SAVINGS OR COULD POSE RISK TO
           THE PUBLIC HEALTH AND OPTED NOT TO PROMULGATE THE RULES. I
           UNDERSTAND THAT MY COLLEAGUES ARE URGING THE NEW SECRETARY TO
           RECONSIDER THIS DECISION AND TO BEGIN THE IMPLEMENTATION
           PROCESS. I'M HOPEFUL THIS WILL HAPPEN, AND I'M LOOKING FORWARD
           TO WORKING WITH MY COLLEAGUES TOWARD THAT END. BUT NONETHELESS,

           I RECOGNIZE THAT THERE ARE SOME CONCERNS WITH THE LAW ENACTED
           LAST YEAR. MY BILL ADDRESSES THOSE CONCERNS BY CORRECTING THESE
           IMPEDIMENTS THAT MAY DELAY THE SECRETARY FROM PROMULGATING
           REGULATIONS AND PERMITTING THE REIMPORTATION OF AMERICAN-MADE
           F.D.A.-APPROVED DRUGS BACK INTO OUR COUNTRY. FURTHERMORE, MY
           BIG DIRECTS THE SECRETARY TO BEGIN THE RULE-MAKING PROCESS
           WITHIN 30 DAYS OF ENACTMENT OF THE BILL. THE FIRST OF THE
           CONCERNS ABOUT WHOLESALE REIMPORTATION ADDRESSED BY MY BILL IS

           THE SUNSET PROVISION. THE BILL WOULD LIFT THE FIVE-YEAR SUNSET
           IMPOSED IN THE ACT. CRITICS ARGUE THAT SUNSETTING THE
           PROVISIONS WOULD BE A DISINCENTIVE FOR DISTRIBUTORS TO DEVELOP
           WAYS TO COMPLY WITH THE REIMPORTATION REQUIREMENTS WHEN THERE
           WAS A POSSIBILITY THAT THE REIMPORTATION WOULD BE PROHIBITED
           AGAIN IN THE FUTURE. CAREFUL THOUGHT WAS PUT INTO THE
           REQUIREMENTS TO ENSURE THAT CONSUMERS WOULD BE PROTECTED. I
           BELIEVE WE IMPORTERS SHOULD BE GIVEN EVERY OPPORTUNITY TO MEET
           THESE REQUIREMENTS AND THAT REMOVING THE SUNSET WILL GIVE THESE

           DISTRIBUTORS WHAT THEY NEED. FURTHER, I BELIEVE CONSUMERS
           SHOULD ALWAYS HAVE ACCESS TO U.S.-MANUFACTURED DRUGS AS LONG AS
           THEY COMPLY WITH F.D.A. SAFETY REQUIREMENTS AND THERE IS NO
           NEED FOR A SUNSET. IF CONGRESS OR THE ADMINISTRATION IDENTIFY
           SAFETY CONCERNS IN THE FUTURE, WE SHOULD -- THEY SHOULD BE
           ADDRESSED BY REVISING THE REIMPORTATION SAFETY REQUIREMENTS,
           NOT SUNSETTING THE ENTIRE PROVISION OF THE LAW. THE ACT ALSO
           DID NOT SPECIFY THAT REIMPORTERS COULD USE THE MANUFACTURERS'

           F.D.A.-APPROVED LABELS. THESE LABELS ARE REQUIRED BY LAW IF THE
           PRODUCTS ARE TO BE SOLD IN THE UNITED STATES. MY BILL WOULD
           MAKE THOSE LABELS AVAILABLE TO THE REIMPORTERS FROM THE
           MANUFACTURERS FOR A SMALL FEE. FINALLY, WHILE THE ACT
           PROHIBITED MANUFACTURERS FROM ENTERING INTO AGREEMENTS WITH
           DISTRIBUTORS THAT WOULD INTERFERE WITH REIMPORTATION OF DRUGS,
           CRITICS ARGUED THIS PROVISION WAS NOT STRONG ENOUGH TO WORK. MY
           LEGISLATION TIGHTENS UP THIS SECTION BY PROHIBITING
           MANUFACTURERS FROM DISCRIMINATING AGAINST WHOLESALERS SIMPLY

           BECAUSE THEY INTEND TO REIMPORT THE PRODUCT. THE BILL ALSO HAS
           STRONGER LANGUAGE PROHIBITING PRICE FIXING. WHOLESALE
           REIMPORTATION OF PRESCRIPTION DRUGS IS ONLY HALF THE STORY.
           WHILE I THINK IT'S CRITICAL THAT WHOLESALERS BE PERMITTED TO
           BRING U.S.-MANUFACTURED DRUGS BACK INTO THE COUNTRY TO REDUCE
           THE PRICE FOR CONSUMERS, I ALSO BELIEVE THAT INDIVIDUALS SHOULD
           BE ABLE TO CROSS THE BORDER AND PURCHASE MEDICATIONS FOR
           THEMSELVES. THE ACT WE PASSED LAST YEAR DID NOT CHANGE THE
           CURRENT LAW WHICH PROHIBITS INDIVIDUALS FROM BRINGING

           MEDICATIONS ACROSS THE BORDER FOR THEIR OWN USE. THAT'S WHY MY
           BILL ALSO MAKES PERSONAL REIMPORTATION LEGAL. I BELIEVE
           INDIVIDUALS SHOULD BE ABLE TO CROSS THE BORDER AND PURCHASE
           PRESCRIPTION DRUGS AT A LOWER PRICE FOR THEIR OWN USE. THE
           F.D.A. CURRENTLY HAS AN ENFORCEMENT POLICY THAT PERMITS
           INDIVIDUALS WHO MEET SPECIFIC REQUIREMENTS TO BRING A 90-DAY
           SUPPLY OF MEDICATION WITH THEM INTO THE UNITED STATES FROM
           ANOTHER COUNTRY. AND MY LEGISLATION WOULD CODIFY THE CURRENT

           ENFORCEMENT POLICY INTO LAW. IT REQUIRES ESSENTIALLY THE SAME
           SAFETY PRECAUTIONS CURRENTLY EXPECTED OF INDIVIDUALS WHO BRING
           MEDICATION OVER THE BORDER UNDER THE F.D.A.'S ENFORCEMENT
           POLICY. WE ALSO RECOGNIZE THAT -- I WOULD ASK UNANIMOUS CONSENT
           FOR FIVE ADDITIONAL MINUTES.
           

           THE PRESIDING OFFICER: IS THERE OBJECTION?
           WITHOUT OBJECTION.
           

           MRS. STABENOW: THANK YOU VERY MUCH. THE BILL ALSO RECOGNIZES
           THAT SOME INDIVIDUALS MAY BE TOO ILL TO CROSS THE BORDER
           THEMSELVES AND PERMITS THEM TO DESIGNATE A PROXY TO BRING THE
           MEDICATION BACK FOR THEM AS LONG AS THEY PROVIDE A LETTER FROM
           THEIR DOCTOR INDICATING THAT THE TRIP TO ANOTHER COUNTRY WOULD
           ENDANGER THEIR HEALTH. THE BILL ALSO PROVIDES OPPORTUNITIES FOR
           INDIVIDUALS TO ORDER MEDICATIONS OVER THE INTERNET. THERE ARE A
           NUMBER OF NEW SITES THAT ARE BEING DEVELOPED DEVELOPED, AND
           THROUGH OTHER
           
           MEANS: HOT LINES, ET CETERA, IN ORDER TO HAVE PRESCRIPTION

           DRUGS DELIVERED ALSO BY MAIL. MR. PRESIDENT, I'M COMMITTED TO
           THIS ISSUE AND TO MAKING PRESCRIPTION DRUGS MORE AFFORDABLE FOR
           EVERYONE. THIS IS A MATTER OF FAIRNESS. THIS BILL IS A MATTER
           OF FAIRNESS TO AMERICANS YOUNG AND OLD WHO NEED TO BE ABLE TO
           HAVE ACCESS TO AFFORDABLE PRESCRIPTION DRUGS. WE AS AMERICANS
           OUGHT NOT TO BE UNDERWRITING THE RESEARCH AND AT THE SAME TIME
           AFTER THE MEDICATIONS, AS GREAT AS THEY ARE, ARE DEVELOPED AND

           MANUFACTURED AND SOLD, TO HAVE AMERICANS PAYING ON AVERAGE
           TWICE AS MUCH AS THOSE IN OTHER COUNTRIES. THAT MAKES NO SENSE
           TO ME. I'M COMMITTED TO WORKING WITH MY COLLEAGUES ON BOTH
           SIDES OF THE AISLE. I APPRECIATE THE TIME THAT I HAVE BEEN
           GIVEN TODAY. THIS IS A CRITICAL ISSUE. I CANNOT THINK OF A MORE
           SERIOUS ISSUE AFFECTING PARTICULARLY OLDER PEOPLE TODAY THAN
           THE ISSUE OF ACCESS TO MEDICATIONS. AND I THINK IT'S SHAMEFUL

           THAT WE HAVE EVEN ONE SENIOR THAT IS HAVING TO CHOOSE TODAY,
           TOMORROW, NEXT WEEK BETWEEN EATING AND TAKING THEIR MEDICINE.
           WE CAN FIX THAT. ONE WAY IS TO START WITH THIS LEGISLATION
           WHICH OPENS OUR BORDERS AND ALLOWS REAL COMPETITION FOR THE
           BEST PRICE FOR AMERICAN CITIZENS. THANK YOU VERY MUCH, MR.
           PRESIDENT. I WOULD YIELD BACK THE TIME.
{END: 2001/01/30 TIME: 16-30 , Tue.  107TH SENATE, FIRST SESSION}