[Congressional Record Volume 141, Number 124 (Friday, July 28, 1995)]
[Senate]
[Pages S10864-S10865]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                               ELDERCARE

  Mr. DOLE. Mr. President, this week marks the 30th anniversary of 
Medicare--the Health Care Program that currently serves 4 million 
disabled Americans and about 33 million elderly Americans.
  Anniversaries are normally a time for celebration. But, this 30th 
anniversary is a time of great concern.
  As we all know, the Medicare trustees, three of whom are members of 
the President's Cabinet, have warned us that, at best, Medicare has 
only seven more anniversaries left before going bankrupt.
  Mr. President, I believe one of the most important responsibilities 
of this Congress is to preserve, improve, and protect Medicare so that 
it does not go bankrupt and will continue to be there for Americans for 
the next 30 years, and the 30 years beyond that.
  Before I look to the future, however, I want to take just a minute to 
look to the past.
  When Medicare was debated in Congress in 1965, I voted against it.
  And there are those at the Democrat National Committee who seem to 
believe that vote is either proof that I am out to gut Medicare, or 
that it disqualifies me from participating in this debate.
  I only wish they would devote as much energy to the search for 
solutions to Medicare's current fiscal crisis, as they do to 
questioning the motives of others.
  My vote against Medicare was not a decision I made lightly. I knew my 
vote would lead to a round of criticism. But in the end, I voted 
against the legislation for several reasons.
  The first reason was because I had concerns that we would be 
establishing an entitlement for many Americans who truly were not in 
need of Government assistance. We all know that by their very nature, 
entitlements are designed to grow. And, as we have seen over the past 
30 years, the Medicare entitlement has done precisely that.
  In 1965, when Medicare was enacted, the House Ways and Means 
Committee predicted that the part A portion would cost $9 billion in 
1990. Needless to say, they were wrong. By 1974, we were spending $9 
billion--just 8 years after Medicare's passage. This year, Medicare 
part A will cost $158 billion--58 times the amount it cost in its first 
year.
  Second, I was concerned that this growing entitlement would be 
financed either through higher taxes or deficit spending, and that both 
of these options would compromise the futures of generations to come. 
Again, by 1974, the tax rate to finance the program was already twice 
the initial projection.
  And the third factor behind my vote was that I shared many of the 
concerns articulated by the then President of the American Medical 
Association, Dr. Leonard Larson, who said:

       The administration's medical care proposal, if enacted, 
     would certainly represent the first major, irreversible step 
     toward the complete socialization of medical care. The bill 
     does not provide insurance or prepayment of any type, but 
     compels one segment of our population to underwrite a 
     socialized program of health care for another, regardless of 
     need.

  Mr. President, the AMA at that time put forward an alternative 
proposal, called Eldercare, which I supported.
  I must say as I look back on that day in 1965 and on the weeks before 
the debate, and I have gone back to check the Congressional Record and 
some of the statements made by my colleagues, Elder Care had many more 
benefits than Medicare. We covered prescription drugs in Elder Care, 
which are still not covered today under Medicare.
 In addition, that plan would have cost less because it took into 
account the beneficiaries' ability to pay.

  Would Medicare be in better shape today had my concerns been 
addressed at its creation? I believe it would. And I also believe that 
if nothing is done and Medicare goes bankrupt, the American public will 
not look back at 1965 to decide where to fix blame--they will look back 
to 1995.
  So, where do we go from here?
  Mr. President, we cannot turn back the clock. But, we can learn from 
the past. And, that means doing what is necessary to improve Medicare 
so that it can move successfully into the 21st century.
  Despite the rhetoric coming out of the White House and the Democratic 


[[Page S 10865]]
committee, Republicans, including myself, do not support cutting 
Medicare. We recognize the need for Medicare's growth, and our historic 
budget resolution allows for an annual growth rate of 6.4 percent. 
Under this agreement, Medicare spending will top $1.6 trillion over the 
next 7 years. In addition, the trust fund's solvency will be ensured 
through the year 2005.
  Mr. President, Republicans are also interested in creating more 
choices for Medicare beneficiaries. Fee-for-service health care may be 
great for some, and they should be able to keep that if they choose. 
But, there are other options out there now that may offer more benefits 
but are unavailable to Medicare beneficiaries. I would like to see 
these
 choices extended to all Americans.

   Mr. President, the committees of jurisdiction in the House and 
Senate are currently working reconciliation legislation, that will 
include proposals to preserve, improve, and protect Medicare. As 
required by the budget resolution passed by Congress, this plan must be 
reported out of committee by September 22.
  Some on the other side of the aisle, however, have requested the 
details of this legislation be made available before the August recess.
  While we like to accommodate our colleagues as much as we can around 
here, the fact of the matter is that this is an extraordinarily 
important piece of legislation that cannot be slapped together a month 
ahead of schedule. The chairmen of the committees of jurisdiction have 
assured me that their staffs will work throughout August to give this 
bill the careful attention it deserves.
   Mr. President, we have solicited ideas from the White House since 
April, when we first received the Trustee's report. Unfortunately, we 
have had no response, which was made our job that much more 
challenging.
  But, as I said before, that does not alter our determination--I think 
it also includes many of my colleagues on the other side, I would 
hope--to preserve, improve, and protect the Medicare Program so that it 
will continue to be there for those who rely on it today and for those 
who will do so for many years in the future.


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