[Congressional Record Volume 141, Number 71 (Tuesday, May 2, 1995)]
[Senate]
[Pages S5993-S5994]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                                MEDICARE

  Mr. ROCKEFELLER. Mr. President, I am here to talk about the Medicare 
Program. In the recent days, I have noticed all kinds of people 
expressing deep concern for Medicare. That is comforting, because there 
is more than enough reason to be concerned.
  Let me get right to the point. The Republican leaders in Congress, 
and the chairs of both Budget Committees in Congress, want to balance 
the budget in 7 years. If they keep their word and leave Social 
Security and defense spending completely alone, that will require cuts 
totaling $1.2 trillion.
  If they throw in the tax cuts for top income-earners that will 
require another whopping $345 billion to finance those cuts. Now here's 
the key point for anyone concerned about Medicare: as we have seen in 
papers distributed by the Senate Budget Committee itself, this drive 
for a balanced budget--and presumably some tax cuts--will require cuts 
in Medicare to the tune of $250 to $300 billion in 7 years. Medicaid 
will also have to help out with $160 to $190 billion in cuts.
  The recent talk about Medicare is not really saying this. It is all 
about the need to shore up the Medicare trust fund, because it could be 
insolvent in 7 years. It is all about the idea of restructuring 
Medicare to save the program. The argument we are hearing is that 
Medicare has to be drained of $300 billion to save the program. A 
curious argument.
  Somehow, I think we need to make sure Americans, especially the 37 
million senior citizens and disabled citizens who rely on Medicare, 
aren't being sold a bill of goods.
  The fact is that the terms set by the leadership on the other side of 
the aisle--balance the budget by 2002, leave defense alone, and throw 
in some tax cuts--may require a raid on Medicare to get the job done.
  That is why I am here.
  My basic reaction to all this talk is to urge the Republican leaders 
to simply show us precisely what you mean. I am speaking as someone who 
cast my vote, several times, for a very precise, very specific plan to 
reduce the federal deficit by $600 billion. It included savings in 
Medicare. The 1993 budget and deficit reduction plan was based on the 
simple concept of shared responsibility, and spread the burden fairly.
  Along with spending cuts to reduce the deficit, it did important 
things like expand the tax credit for working families to make sure 
work is a better choice than welfare in this country.
  But for all of the fire and brimstone heard this year about the need 
to balance the budget and now ``save'' the Medicare Program, we have 
yet to see a budget resolution, a budget plan, a single detail on just 
how everyone making the noise intends to achieve these impressive 
goals.
  Of course, the President is reacting by saying essentially ``show 
me.'' He submitted his budget on time. He offered a health care plan 
that tied Medicare savings to comprehensive health care reform. He 
rejected the idea of a constitution amendment on the Republicans' 
terms, and so of course, he is asking for some specifics.
  I cannot conceive of a budget that meets the conditions of the other 
side 
[[Page S5994]]  of the aisle--stay away from Social Security, do not 
touch defense, no new revenue, and tax cuts for corporations and the 
wealthy--without huge cuts in Medicare.
  And make no mistake about it, $250 to $300 billion of cuts in 
Medicare will mean higher deductibles and premiums for seniors, lower 
fees for hospitals and doctors, and a lot worse. If there is such a 
budget that can side-step Medicare, we are simply saying ``show us.'' 
We have put our cards on the table for the past 2\1/2\ years when it 
comes to health care, Medicare, and deficit reduction.
  While all of this talk and born-again interest in Medicare's solvency 
gets sorted out, I am here to lay out proposals that I think are 
bottom-line ways to act in the best interests of Medicare. I do this as 
someone who has tried to protect Medicare for a long time, and will 
keep fighting to do exactly that. I do this as the former chair of the 
Medicare Subcommittee on the Finance Committee, and now the ranking 
member--the majority leader is the chairman of that subcommittee now.
  I do this as someone who smells a rat when the same people who have 
talked for months about stepping up to the plate, with specifics on how 
the budget can be balanced by 2002 with tax cuts thrown in and defense 
off the table, but now suggest that the $300 million in Medicare cuts 
they are talking about is their new plan for saving Medicare. Something 
is not quite right about this picture, I suggest. I agree that Medicare 
has to be put on better financial footing. But that effort should not 
be a smokescreen for using it to finance other agendas like tax cuts 
for corporations.
  First, I am introducing legislation to create a National Commission 
on Medicare modeled after the National Commission on Social Security 
Reform that President Reagan chartered in 1981.
  The charge given to the Social Security Commission was to propose 
``realistic, long-term reforms to put Social Security back on a sound 
financial footing; and to forge a working bipartisan consensus so that 
the necessary reforms can be passed into law.''
  We need this kind of bipartisan process to shore up Medicare. We need 
to jump off the current rhetorical, budget-driven track to one where we 
can resolve the real question: how best to keep Medicare dependable for 
seniors over the next generations.
  If Medicare is cut by unprecedented amounts of money to pay for 
anything but Medicare, the consequences will be disastrous for health 
care providers and beneficiaries. Rural hospitals will close in droves. 
Doctors will be forced to turn away the elderly. Medicare will no 
longer be reliable insurance for seniors in West Virginia.
  As my second proposal, I will offer an amendment to the budget 
resolution when it comes to the Senate floor that will put Medicare in 
a lock-box to protect it from looting.
  This isn't the blueprint we need to get Medicare back on solid ground 
for the long term, but it will buy a few more years of solvency and 
ensure it will not be used for anything but the promises made to senior 
citizens. Medicare is not a slush fund to finance tax cuts or other 
Government programs.
  I will tell you why I am concerned about Medicare. I am worried its 
true purpose is getting lost.
  It is a promise, a pledge, to the American people that they will be 
able to live their lives in dignity and security past their working 
years. Instead of treating Medicare like a checking account in this 
budget process, we need to remember it is an investment.
  The Medicare trustees sounded the alarm about the short-term 
insolvency of the Medicare Program more than 3 years ago.
  In fact, the Medicare trustees urged action on comprehensive health 
care reform to address the country's systemic problem of rising health 
care costs that are draining the Medicare hospital trust fund and the 
pockets of American families and businesses.
  But comprehensive reform was rejected by the Congress last year. I 
should note that up until very recently, the Medicare Program 
outperformed the private sector in holding down its costs. Over the 
past 2 years, Medicare costs have been slightly higher than the private 
sector costs.
  But, and this is a big ``but,'' the private sector is insuring fewer 
and fewer people, while Medicare's enrollment is increasing; and 
Medicare pays for home care services and skilled nursing home care, 
types of services that are not normally covered by private insurance 
policies.
  Mr. President, I have heard lots of talk about needing to move the 
Medicare Program into the 21st century by ``restructuring'' it so it 
looks more like insurance in the private sector.
  So far, I just cannot share in the enthusiasm for copying something 
that is leaving out so many hard-working people and families from any 
kind of health care security. In fact, Medicare was first established 
because the private insurance industry had failed so miserably to 
provide affordable insurance to senior citizens. While many of my 
colleagues like to talk about the ``miracles of the marketplace,'' I 
still see cherry-picking and redlining, medical underwriting and policy 
cancellations, job-lock, and families paying more and more money for 
fewer and fewer health benefits.
  Just think about sending 37 million people with pre-existing medical 
conditions to the private insurance market with vouchers called choice-
clerk and medi-check. High administrative costs in the private sector 
will eat up the value of Medicare benefits right off the bat. Will the 
senior citizens living in small towns across West Virginia end up 
paying more of their own money for their health care or be forced to 
join an HMO--if one is even available in the area?
  To ``save'' Medicare we need comprehensive proposals to address these 
issues, not just blind cutting of Medicare. Last year, we offered 
proposals to fix these myriad problems. Republicans disagreed with our 
approach, and celebrated the defeat of our proposals. Our opponents' 
television ads stated again and again that there's ``a better way.'' 
Slashing $250 to $300 billion out of Medicare is not a better way.
  Mr. President, cutting $250 billion out of Medicare over 7 years is 
not the way to guarantee the long-term solvency of the Medicare 
Hospital Trust Fund. It might add a few more years of solvency--5 to 8 
tops, CBO thinks--to the trust fund. We need to rise to the challenge 
met when Medicare was created and Social Security was rescued, and 
chart a long-term prescription for Medicare's health over the next 25 
years of more.
  I make my two suggestions as a way to get started.
  Protect Medicare from raids to pay for anything, especially tax cuts, 
but what its intended for--the promise of health care security for the 
seniors of West Virginia and the country. And while we know Medicare is 
safe, let us replicate the approach used to save Social Security and 
really prepared Medicare for the challenges of the next century.
  I thank the Presiding Officer and yield the floor. I suggest the 
absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. GORTON. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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