Candidates for U.S. Senate square off on health care

This article includes part of a debate on the issue of Medicare and the new prescription drug benefits.

When the new Medicare prescription drug benefit took effect this year, Republicans praised the program for helping millions of elderly Americans cope with rising drug prices.


Candidates for U.S. Senate square off on health care

Sam Hananel
The Associated Press

When the new Medicare prescription drug benefit took effect this year, Republicans praised the program for helping millions of elderly Americans cope with rising drug prices.
Many Democrats disparaged the plan for being too complex and failing to let the government negotiate prices with pharmaceutical companies to bring drug costs down. More recently, millions of beneficiaries have complained about facing a temporary break in their Medicare drug coverage, commonly known as the "doughnut hole."

The conflict is playing out in Missouri's Senate race, where incumbent Republican Sen. Jim Talent says most voters are benefiting from the new drug program and his opponent, state Auditor Claire McCaskill, says the plan is too generous to drug companies at the expense of seniors who need help.

Here, they discuss their views on Medicare and other health care issues.

Associated Press: What is your position on the Medicare prescription drug program? If changes are needed, please specify what they are.

Talent: I am the only candidate for U.S. Senate who supported the Medicare prescription drug bill which is benefiting hundreds of thousands of Missouri seniors.

I decided when I came to the Senate that Congress needed to stop playing politics with Medicare and pass a sound, affordable prescription drug plan. Such a bill did pass the Congress, with my strong support. The bill does two things: forces prescription drug companies to discount prices and then pays part of the discounted price for our seniors. As a result, hundreds of thousands of Missouri seniors are getting drug coverage for the first time through Part D. In fact, nearly three quarters of Missouri seniors are benefiting from the new drug benefit.

In Missouri, there is no "doughnut hole," or gap in coverage for seniors. There are seven plans available which contain no gap in coverage. On average, seniors are saving $1,100 a year and the bill is costing billions less than predicted.

I've supported changes to help make the program work even better for our seniors. We've already extended the deadline and eliminated the penalty for low-income seniors, but I believe the Congress should take the extra step and eliminate the penalty for all Medicare beneficiaries. I've also co-sponsored legislation to help local pharmacists get reimbursed more quickly by the Medicare drug plans.

This is another issue where there's a big difference between me and my opponent. I strongly supported the Medicare prescription drug bill and McCaskill said she would have voted against it. There were some very close votes during the debate on this bill. If McCaskill had been in the Senate instead of me, our seniors would not have the prescription drug coverage they have now.

McCaskill: I support giving America's seniors a prescription drug benefit plan that works. The current Medicare part D was written by drug companies and goes much further in lining the pockets of pharmaceutical companies than it does helping Missouri's seniors. I supported extending the Medicare D deadline, a measure opposed by large pharmaceutical companies, and believe seniors should not be penalized if they failed to sign up in time for the program.

I support allowing Medicare to use its bulk purchasing power to negotiate with drug companies for lower prices, a practice that the current bill explicitly bans. The Veterans Administration, however, has been able to secure drug prices 80 percent lower than the average Medicare Part D plan. My opponent supported legislation that blocked Medicare from negotiating for lower prices. I think we can have a better, cheaper Medicare program that benefits more seniors and costs taxpayers less money if we are willing to put seniors first instead of profits for big drug companies.

AP: Both the Bush and Clinton administrations have so far rejected efforts in Congress to lift the ban on prescription drug imports. Should Americans be allowed to import cheaper prescription drugs from Canada or other countries?

Talent: Yes. I've always supported permitting reimportation through a process that guaranteed safety. Many of these drugs are manufactured in Third World countries, and I want to make sure our consumers are protected.

I have voted in the Senate to allow reimportation and support a provision in the Homeland Security funding bill that would allow U.S. citizens to bring a 90-day supply of prescription drugs for personal use back from Canada.

In addition, we passed the Medicare Prescription Drug bill which is providing more affordable prescription drugs to hundreds of thousands of Missouri seniors and many now have drug coverage for the first time.

McCaskill: As long as strict safety standards are met, I am in favor of allowing American seniors to buy their drugs from Canada and other countries, and this is a priority about which I have a sense of urgency. I realize how many people there are that need help with their medications.

From senior citizens to families with young children, the costs of prescription drugs are a drain on our pocketbooks that puts further stress on the family budget. I believe reimportation is one way to address the issue and Congress should stop appeasing the drug companies and implement it.

AP: Well more than 100,000 Missourians have dropped off the Medicaid rolls after the state Legislature and Gov. Matt Blunt enacted budget cuts last year to the federally and state-funded health care program for the poor. Do you support the cuts? Why or why not?

Talent: Since I was elected to the U.S. Senate, Medicaid funding has increased at the federal level by more than $44 billion. That's a 30 percent increase. Because the last two governors have proposed Medicaid reductions in Missouri, in 2003, I cast the deciding vote to provide Missouri with nearly $400 million to support its Medicaid budget. Auditor McCaskill said she opposed this legislation.

I've also sponsored legislation to lower health care costs by allowing small businesses to join together nationally through their trade associations to sponsor health insurance for themselves and their employees. In addition to lowering the cost of health care, the Congressional Budget Office said small business health plans will save the federal government $790 million in Medicaid funding and the states would save $600 million over 10 years.

I should also mention that Auditor McCaskill has aired television ads attacking me on the issue of Medicaid. Those ads have been highly criticized and called "misleading" by the Kansas City Star.

McCaskill: Republicans have a two-word plan for health care in Missouri: cut Medicaid. Medicaid is the nations health safety net and serves as a vital source of health coverage for over 53 million Americans of all ages, including over 990,000 Missourians. Unfortunately, last year, Republicans in Missouri legislature decided to kick 100,000 Missourians off Medicaid. As Medicaid is both a federal and state program, my opponent refused to even comment on the Missourians impacted by these devastating cuts, saying it was a "state issue," despite his 19 votes to cut billions to Medicaid.

Due to the shortsighted actions of the Missouri legislature, Missouri stands to lose $700 million in economic activity and hundreds of millions in federal money that will now go to Medicaid programs in other states like Iowa, Kansas, Arkansas and Illinois. I believe strongly that these outrageous cuts should be reversed. Instead of undermining Medicaid, we need to strengthen it.

Many of Missouri's families rely on the federal Children's Health Insurance Program for their children's health coverage, which in Missouri is called MC+ for Kids. MC+ for Kids provides crucial health services for over tens of thousands of children, including emergency ambulances, ambulatory surgical care and prenatal care. Before last year's budget cuts to the program, MC+ for Kids had seen great success. After Congress approved the program in 1997, the number of insured children in Missouri increased nearly 20 percent. But due to the Republican cuts, for the first time in nearly a decade, enrollment in MC+ for Kids is on the decline.

In addition to the harmful actions in Jefferson City, Missouri also now faces a $27 million gap in federal funding for our MC+ for Kids program starting on October 1. Because of the actions of Republican-led governments in Jefferson City and Washington, over 50,000 children could lose their coverage in a little over a year. I believe we should act swiftly to protect Missouri's children by reversing these harmful cuts.

AP: What is your plan for providing more affordable health care coverage for millions of Americans who cannot afford it?

Talent: I strongly support allowing small businesses to pool together to lower the cost of health care for millions of Americans. I've sponsored legislation to allow small business associations to pool their members together to purchase the same quality health insurance offered by Fortune 500 companies, labor unions and the federal government. Trade groups such as the American Farm Bureau or the National Restaurant Association could then offer these health care plans to their small business members, who could purchase health insurance for themselves, their employees and their families.

I passed Small Business Health Plans when I served in the House and I've gotten the bill further in the Senate than ever before, but it was filibustered in the Senate. Auditor McCaskill said she opposes small business health plans.

I also support greater use of information technology in health care. Electronic medical records and electronic prescriptions can save both lives and resources. I joined a bipartisan group of senators to introduce the Wired for Health Care Quality Act. This bill, which passed the Senate, will create an office to coordinate greater use and investment in health care information technology. We have seen dramatic productivity gains in almost every other sector of the American economy. The ability to link patient records and physicians electronically will save time and prevent costly medical mistakes. The technology is available to accomplish this without compromising patient privacy.

McCaskill: Missouri has suffered devastating cuts to Medicaid at the state level while Washington is adding to the problem at the federal level. More than 100,000 Missourians have lost health coverage due to these cuts. Instead of cutting Medicaid, we need to fully fund the program and expand the MC+ for Kids program.

I believe it is urgent that Congress address health insurance for small businesses. Many of our small businesses want to provide employee insurance, but cannot due to enormous costs. I support legislation for small employers modeled off the successful Federal Health Benefits Program. Small businesses could band together for lower health care prices negotiated by the Office of Personnel Management, which has a proven track record of low overhead costs. Insurance policies would have to follow any state mandates, such as breast cancer screenings or mental health coverage.

In addition, we need to re-establish and support community-based health centers for the uninsured and the underinsured. These can provide proactive and preventative health care in a much more cost-effective way than the current use of emergency rooms, which simply pass costs onto Missouri families who then pay higher health insurance premiums. These clinics can be staffed by young doctors and nurses, in return for forgiveness of some of their student loans.