[Congressional Record Volume 141, Number 123 (Thursday, July 27, 1995)]
[Senate]
[Pages S10776-S10778]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     THE 30TH BIRTHDAY OF MEDICARE

  Mr. ROCKEFELLER. Mr. President, I wish I could rise only to spend 
these few moments celebrating a very important birthday of Medicare. It 
is the way 37 million Americans get their basic health protection. 
Medicare is turning 30 years old this Sunday. For three decades, 
Americans have been able to rely on health care benefits in their later 
years thanks to something called Medicare.
  Medicare was not born overnight. It had a long gestation period, ever 
since President Roosevelt shared his vision in the 1930's of a nation 
which guaranteed both financial security to its citizens and also 
health care security.
  As we all know, changing anything to do with health care does not 
happen overnight. It certainly did not happen over the last 2 years of 
nights or days. And it is hard to do. From the 1930's to 1965, which is 
a long period in this Nation's history, when President Johnson in fact 
signed the Medicare bill into law, special interests, parts of the 
medical community--sadly, large parts of the medical community--and 
plenty of politicians did everything they could to keep the dream of 
Medicare from becoming a reality.
  Today, however, we have to do more than celebrate Medicare's 
birthday. The question is whether Medicare will be there for seniors 
and their families for the next 30 years.
  Now, I do not mean to say that Medicare is going to cease to exist. 
Obviously, it is going to be there in some form. But when I look at a 
budget resolution that takes $270 billion over 7 years from Medicare 
and just happens by coincidence to give away $245 billion in tax cuts 
over that same period, unspecified tax cuts, the alarm bells tend to go 
off. Medicare was not enacted to be a piggy bank for tax cuts. Medicare 
is in fact a sacred part of America's vision and America's promise. I 
think of Geno Maynard, Sue Lemaster, and John and Betty Shumate.
  My colleagues obviously do not know who these fine West Virginians 
are but every Senator represents thousands of people like them. Geno 
Maynard is 78 years old and lives in Kenova, WV. Sue Lemaster is 83 
years old and lives in Follansbee. She is on oxygen all the time. John 
and Betty Shumate live in Beckley. That is in the coal fields of West 
Virginia. They are four of about one-third of West Virginians who 
depend on Medicare for their health.
  They all recently told me when I visited them in their homes that 
they are very worried. I did not tell them to be worried. They are 
worried. They are scared. The annual income of the average Medicare 
recipient in West Virginia is less than $11,000--$10,700, to be 
precise. That is not much money. That is their income from everything 
they get--Social Security, black lung, whatever it might be, any 
investments left over, and probably not much of that--$10,700. So they 
are very worried because cutting Medicare by $270 billion sounds 
suspiciously to them like they are going to have to pay more for less, 
and I think they may be right.
  This is a very big worry for these four West Virginians as they quite 
flatly told me because they do not have any more money to spend on 
health care.
  Yes, they could sell their house. West Virginia has high ownership of 
houses. They could sell their house. I think that is sort of an 
unreasonable thing to require to get health care in this country when 
people have worked over the course of their lives.
  And then, of course, on average, seniors already spend 21 percent of 
their incomes on health care expenses. That is three times more than 
the rest of us. They spend money on benefits that are not covered by 
Medicare, the largest of which, of course, is prescription drugs. And 
that does not include eyeglasses and hearing aids and Medigap policies 
to cover Medicare's cost-share requirements, which can be very hefty.
  Mr. President, I would love to have, quite frankly, as a member of 
the Senate Finance Committee and someone who ranks on the Medicare 
Subcommittee, I would love to have more details on exactly what the 
Republican budget will mean for these poor West Virginians. I do not 
think that is unreasonable. We are talking about a lot of money--$270 
billion. I can tell my people that a budget has passed that will cut 
$270 billion from Medicare, but what does that tell them? That simply 
gets them, naturally, scared. But where? In what form?
  I can tell them that the Republican budget will cut another $182 
billion from Medicaid, which hard-working families rely on as the last 
resort to get into a nursing home. People think of Medicaid often as 
just representing poor people. You know, not everybody gets to be born 
a Rockefeller so there are a lot of poor people. A lot of them cannot 
help it. Some of them could, but most of them cannot. And when they 
have to go into a nursing home and they do not have any family around, 
guess who pays 7 percent of the cost of that in West Virginia? 
Medicaid.
  So these cuts are potentially devastating. And as seniors think about 
them in the raw number, the aggregate number, their imaginations run 
wild. They sort of think of the worst-case scenario. I do not know 
whether there is a worst-case scenario or not, but I ought to know. I 
ought to know as a U.S. Senator on the Finance Committee. I ought to 
know that. I care about health care.
  I can tell them that the experts agree that a total of $450 billion 
in health care cuts will have to mean less benefits at a higher cost 
and lower payments to providers and, incidentally, cost-shifting right 
onto business.
  And I can show them that the same budget just happens to put $245 
billion into tax cuts. And if you did not have, let us say, all those 
tax cuts to whomever they are going to go, that would leave really a 
very small cut for Medicare or maybe a cut for Medicare and a cut for 
Medicaid, but it would be much, much smaller. And, incidentally, the 
Republican budget has increased funding for defense.
  But until we get more details on where and how these savings are 
going to be run out of Medicare, this Senator is sort of helpless as to 
how to give the people I represent any help, any sense 

[[Page S 10777]]
of a roadmap for their own personal futures.
  There is no shortage of packaging around the Republican budget. It is 
the content I am trying to get hold of. My colleagues on the other side 
of the aisle argue that they are only trying to strengthen Medicare, 
saving the program, as they put it. Give me a break.
  First of all, I watched the very same Senators vote against previous 
budget packages that included careful steps to keep Medicare strong and 
keep Medicare affordable. They voted no. Now they are saying, ``Cut.''
  Second, taking $270 billion from Medicare while handing out $245 
billion in tax cuts does not exactly sound like a way to shore up the 
Medicare trust fund. I can try on that, but I cannot get very far.
  So we have until the year 2002 before the Medicare trust fund is 
insolvent. We know that. We say that. And we ought to be doing 
something about that. We should spend our time here working out 
responsible steps that put every last dime of Medicare savings into 
that trust fund. You know, the effect of the $270 billion cut on 
Medicare--people might say, ``Well, that is going to save Medicare.'' 
Well, there is an argument, Mr. President, as to whether it extends the 
life of the Medicare trust fund by 3 years, 4 years or 5 years, but not 
6, 7, or 8. The optimists hope for 5, the pessimists for 3, but no 
more. And that is not exactly saving Medicare.
  So, the Republican budget is designed to raid, not save, the Medicare 
Program. I believe that. I firmly, fully believe that. Medicare's money 
is going to be used to finance tax cuts for the wealthy. It is that 
simple. I am not amused by that. We have been through that before. That 
is what the 1980's were all about. Our country did not prosper. In 
fact, this is not a very amusing subject in any way, shape or form. It 
has nothing to do with assuring long-term solvency of the trust fund. 
It has nothing to do with making sure the Medicare Program continues to 
provide high-quality health care for our country's senior citizens and 
the disabled. It has everything to do with a Republican contract on 
America. That is what it is called, Republican Contract With America, 
and Republican promises to balance the budget in 7 years and hand out 
tax cuts to the rich. Do you think that is political? Maybe it is. But 
it also happens to be the truth.
  Mr. President, I have introduced a bill to set up a Medicare 
commission to make recommendations on how to guarantee, in fact, the 
long-term solvency of the Medicare trust fund. Decisions on the future 
of the Medicare Program should be made outside of partisan debate on 
how to balance the budget.
  What does a 7-year, arbitrarily picked 7-year balance-the-budget 
exercise have to do with the future of the Medicare Program? Virtually 
nothing except in this case everything because they are using Medicare 
to do that. The budget resolution puts the Medicare Program into a 
financial straitjacket that does not take into account the health care 
needs of seniors or the disabled. It ignores the heavy reliance of 
rural hospitals on the Medicare Program.
  Mr. President, there is not a hospital in the State of West Virginia 
that I can think of that does not depend on Medicare and Medicaid for 
between 65 to 75 percent of its revenue stream. I cannot think of a 
single hospital at this moment in West Virginia where something other 
than Medicare and Medicaid is contributing more than 30 percent or 35 
percent or 20 percent or 25 percent to the revenues of the hospital. So 
you mess around with Medicare and Medicaid, you are messing around with 
the solvency of hospitals, and particularly rural hospitals.
  So what will happen, of course, is that small, rural hospitals will 
have to shut their doors. My hospital administrators do not speculate 
on that. They know that. And they can tell you which ones they will be. 
And it just so happens that one-half of all of the seniors in West 
Virginia live in rural areas where these hospitals are.
  Now, Mr. President, I assume that in September the Finance Committee 
will get around to submitting its reconciliation plan to the Budget 
Committee. That means in less than 60 days--in less than 60 days--the 
Finance Committee will probably have to vote on a plan to take $450 
billion from two health care programs that care for the elderly, the 
poor, poor children, many pregnant women, and the disabled, a plan we 
have not seen yet. Just read the newspapers. This is, in my judgment, a 
deliberate strategy to push each and every budget-related bill up 
against deadlines to threaten the shutdown of the Federal Government, 
to put pressure on the President and the hope that the fireworks will 
drown out what it really means to something called ``real people'' in 
West Virginia and other parts of this great country. And those real 
people include 37 million folks on Medicare.
  I just read--not that I am on the mailing list--an interesting memo 
from a Republican pollster that tells his audience that seniors are 
``PAC oriented''
 and ``susceptible to following one very dominant person's lead.''

  I guess this is the kind of advice that leads to all kinds of delays 
in the budget process and the packaging around Medicare that we are 
most definitely seeing.
  So I have joined with all the Democrats on the Senate Finance 
Committee and all the Democrats on the Senate Budget Committee in a 
letter to the majority leader asking for a copy of the Republican 
secret plan to cut Medicare by $270 billion, and to have this before 
the August recess. Is that an extraordinary or somehow terribly unfair 
request? That will give us at least a few weeks to discuss the biggest 
cuts in Medicare's history with something called our constituents, 
about whom we presume to care.
  We need to know what seniors and their families, who count on 
Medicare to pay their medical care bills, think about these changes and 
how they will be affected. We have to know that. We have an obligation 
to know that. It would be a travesty for this contract to enact major 
massive changes to the Medicare program and not to be able to share any 
details with seniors, with their families, before the Senate is asked 
to vote on it.
  Then, if all this comes to a reconciliation bill, it is my 
understanding, and the Parliamentarian can correct me if I am wrong, 
that we will have a total of 20 hours of debate on the floor of the 
Senate--20 hours, no more--to discuss thousands of things in the 
reconciliation bill. I think that is what some people on the other side 
of the aisle want.
  Mr. President, the solvency of the Medicare trust funds is too 
important to be left to politics as usual.
  The Republican suggestion that the Democrats are uninterested in 
doing what is necessary to put Medicare on sound financial footing does 
not ring true to me. Going back to the days of President Roosevelt, it 
was Republicans in Congress who voted against its creation, and it is 
now Republicans in this country who pose a real threat to Medicare's 
future. They will keep on saying they are saving Medicare, but raiding 
Medicare is what they are doing, and that is no way to rescue Medicare.
  There is nothing partisan about the West Virginians who turn to 
Medicare when they retire. I have no idea of the politics of the four 
people that I mentioned. I have no idea if they are Republicans or 
Democrats or Independents or unregistered. It makes no difference. I 
represent them for whatever and whoever they are. In this case, they 
are older, they are scared and they are human beings. My job is to 
represent them in the Senate, the only place I can, and that means 
preserving the meaning and promise of Medicare.
  I think, generally speaking, although sometimes some of my colleagues 
from the other side will tease me, I do not consider myself a 
particularly partisan Senator. But on this matter, the $450 billion of 
cuts in Medicare and Medicaid, with $245 billion of tax cuts available 
for who knows who, I am partisan and I am mad, and I am mad on behalf 
of my people from West Virginia, which is not the richest State in the 
country. Nobody in West Virginia gets anything without working hard. 
Everybody has to fight, and the least they deserve is some truth and 
some leveling from their Congress.
  So I close by saying I hope in this week that Medicare turns 30 that 
we will be reminded what Medicare's future means to something called 
the dignity, something called the peace of 

[[Page S 10778]]
mind and something called the quality of life for many millions of 
older Americans.
  I thank the President and yield the floor.
  Mr. McCONNELL addressed the Chair.
  The PRESIDING OFFICER (Mr. Gregg). The Senator from Kentucky.

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