[Congressional Record Volume 141, Number 146 (Tuesday, September 19, 1995)]
[House]
[Pages H9224-H9230]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                             MEDICARE CUTS

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 
12, 1995, the gentleman from Texas [Mr. Doggett] is recognized for 60 
minutes as the designee of the minority leader.
  Mr. DOGGETT. Mr. Speaker, I am here again tonight, as I was last 
night and this morning, to talk about the future of Medicare and 
specifically to discuss the new Republican Medicare plan, which is the 
pay-more-get-less plan. In the event that anyone has not gotten all the 
details, that is really what it boils down to. But we will spend the 
next hour discussing the details of the impact of this plan.
  Why is it that having discussed this plan to some extent already, 
that I am back again talking about it some more? Well, I can tell you 
that the reason is because on Thursday of this week, the day after 
tomorrow, just a few hours away, the Committee on Ways and Means will 
have 1 day of hearings, 1 day for all of the people in America, all of 
the experts on this subject, and let me assure you that some of the 
best experts on Medicare are the 37 million Americans who depend on 
Medicare for their health care, but 1 day in the entire year in which 
that committee will take time to hear what should the future of 
Medicare be, what should the specifics of legislation be. And in that 1 
day and that 1 day only, will they focus on what ultimately could be 
the beginning of the total destruction of Medicare as we have known it 
for the last three decades. So it is critical to take every opportunity 
to focus attention and to advise the people of America on what is about 
to happen with reference to this critical Medicare system.
  Now, I have to say to those who may have concern as to whether this 
message is getting out and whether people are hearing about it and 
really realize the impact of these drastic changes on them, that I 
believe the answer is a strong yes; that indeed the attention that we 
as Democrats have focused on the plan that the Republicans have to grab 
$270 billion out of the Medicare system in order to fund their tax 
breaks for the privileged few in this country, has already had a big 
impact.
  It was a little over a month ago that the Washington Post stated, 
``Medicare premiums would soar under new options in Republican plan.'' 
They point out that under all three versions of the Republican working 
documents that have been leaked to the press, Medicare premiums would 
go up, Medicare deductibles would go up, and Medicare copayments will 
go up.
  I can recall seeing some of those leaked documents and knowing that 
there were Republican Members actually advocating that we needed to 
discourage the seniors from having what is called Medigap insurance. 
That is to pick up the cost of what Medicare does not pay through 
private insurance. And it was part of this Republican theory that our 
seniors are simply not paying enough for their health care. Even though 
they have to pick up the costs for their prescriptions, even though we 
have no effective long-term health care plan for those seniors who 
might face the possibility of a nursing home, even with all of the 
things not covered by the Medicare system, as good as it is today, the 
Republicans say they are not having to pay enough and we need to find a 
way to actually discourage them from having this private Medigap 
insurance.
  Well, when the plan was unveiled, to the extent the veil has been 
pulled back, and it is only a partial lifting of the veil that we have 
had in the last few days, when the plan was partially unveiled, the 
Republicans began to back off from this theory and began to say well, 
we really do not want to increase deductibles, and we are not sure we 
want to increase copayments, and yes, it is OK to have Medigap 
insurance.

  So as they have heard from Americans across this country, as members 
of the Democratic Party have had the courage to stand here on the floor 
and speak out about this plan, they have begun to back off. I cannot 
help but think if we continue to speak out, even though they accord us 
only 1 day of hearings, if we continue to speak out at every possible 
opportunity, they will yet rethink the pay-more-get-less plan and 
recognize that it is not in the best interests of the American people.
  Of course, with reference to the plan that they have unveiled in 
seeking 1 day of hearings, there have been a number of people, and not 
just Democrats, who have been critical of that. As I think about 
Republican-oriented newspapers in this country, I can think of few that 
are more Republican-oriented than the lead paper in the city of Dallas, 
in my home State of Texas, the Dallas Morning News. I want to quote 
briefly from an editorial that they had on this subject of limiting the 
right of the American people to know the details of this. I say almost 
the most Republican paper in this country, because undoubtedly the most 
Republican paper is the American Civilization Newspaper. It is the 
newspaper of the Progress and Freedom Foundation, which was founded by 
our Speaker, Newt Gingrich.
  As you will recall in February of this year, the lead editorial from 
that foundation was entitled ``For freedom's sake, eliminate Social 
Security.'' In that lead editorial in February, the editorial derided 
Social Security, in addition to Medicare, and it said that ``It is time 
to slay,'' and I am quoting, ``the largest government entitlement 
program of all, Social Security.'' It said, ``Social Security must be 
abolished.''
  It is that kind of extreme ideological thinking that I think is 
behind the effort to first subvert and weaken the Medicare system with 
the pay-more-get-less system, and then to go after the weakening and 
the eventual destruction of the Social Security System, as the 
Speaker's own newspaper advocated back in February of this year.
  But returning to Texas and returning to the very Republican-oriented 
Dallas Morning News, on September 10, under a title ``Changing 
Medicare, public will need time to grasp reforms,'' the Dallas Morning 
News says,

       Remember last year when the Democrats tried to rush final 
     health plan through Congress just before the August recess? 
     At that time the Republican congressional leaders said look, 
     these reforms are too complicated. The American people need 
     time to absorb them. Let's break for August and let the 
     American people digest and debate them.

  They say, ``The Republican response was appropriate.'' Of course, you 
would 

[[Page H9225]]
expect that from a Republican-oriented newspaper. But then they go on 
to point out this. They say, ``but now their memory,'' referring to the 
Republicans, ``seems short, if not selective. One year later, 
Republican congressional leaders are trying to rush their own health 
care reforms. Here comes the hypocrisy,'' they say. Republicans want 
Congress to vote on the reforms within 10 days to 3 weeks. That is 
misguided. Congress soon must finish its plan to achieve a balanced 
Federal budget. Medicare, after all, is a lifeline for many senior 
citizens.'' They say, ``changes should not be rammed down their 
throats.''
  That is what this discussion tonight is about. I was quoting the 
Dallas Morning News that changes should not be rammed down the throats 
of our Nation's seniors.

  Then they go on to point out, ``Let's not revisit the mess of last 
year. Republicans must listen to their own counsel.''
  That is what we are calling for. Do not just devote 1 day to wrecking 
a program that it has taken 30 years to get in place, a program that 
over 9 out of 10 of every Republican Member of the Congress, back when 
President Johnson signed Medicare into law, opposed. Let us focus 
attention and provide for detailed analysis.
  After all, the Republicans in this House thought that the Whitewater 
affair was deserving of 28 days of public hearings, and yet when the 
issue is a whitewash for an attempt to undermine the Medicare system, 
they seem unwilling to devote more than a day.
  Now, I see that my colleague from Texas, the gentlewoman from 
Houston, TX [Ms. Jackson-Lee], is here. I know she had the occasion to 
sit through some of those hearings and to know about these matters, and 
perhaps she has some observation about the impact of this kind of pay-
more-get-less plan and rushing it through in a single day.
  Ms. JACKSON-LEE. Mr. Speaker, I appreciate the gentleman from Texas, 
my colleague, and also appreciate the persistence that he has offered 
in this effort, and all of us have come to this issue with a certain 
bit of perplexity. I am a little bit confused, not so much because I am 
confused about what I hear from my constituents in the 18th District of 
Texas, particularly the senior citizens, about the need for Medicare 
and the need for a balanced response to some of the concerns that are 
expressed, but the gentleman from Texas is correct. We are at a posture 
where we have the answer from the GOP plan, pay more and get less, and 
yet we are finding that few of our Republican colleagues want to lay 
this out for a full-blown hearing in order to hear from our 
constituents across the Nation.
  My fourth grader is learning about the States in the United States, 
all 50 of them, and he takes great pride in pointing out the different 
States and the different distinctions. But when we look at this road 
map of the United States of America, the truth about the Republican 
Medicare cuts, we can see not one single State misses the bat, misses 
the heat, misses getting cut to the bone.
  In particular, if we look at Texas, we will find that seniors will be 
paying $3,785 more over the next 7 years of out-of-pocket increases. We 
look at Connecticut, we look at Camden, CT, and we look at up in the 
New England States, we look at New York, we look at Washington, DC, 
down in Florida, where there is a huge senior citizen population, 
$5,082.
  So the real question becomes, why the coverup? Why not a full force 
hearing on what we are doing with Medicare?
  I might raise a point with the gentleman that gives me great pause 
for concern going home to my district. There is a discussion and an 
editorial, if you will, about this concept of managed care. Might I 
just inject that we have the healthiest population of Americans, 
elderly Americans, in the 30-year history, since 1965? We can point 
today that some 99.1 percent of Americans, but particularly seniors, 
are insured because of Medicare, with health coverage. We can point to 
a healthier senior citizen population and one that has experienced this 
whole trend toward preventive health care.
  But the question becomes with this managed health care philosophy 
that is being promoted by Republicans, they will choose a managed care 
system. When you go into rural communities and some of our urban 
centers, it is already determined that what will happen is the 
healthiest of our seniors may have the opportunity to choose a managed 
care system. But what you will have remaining are the sickest of our 
seniors.

                              {time}  1830

  That then becomes an unfunded mandate of sorts on our local 
government and county government and State government. But beyond the 
dollars, what we will have will be a population that needs health care 
the most, that needs hospitalization the most, that needs the constant 
care the most, the long-term care, and they will not have it.
  And so I think that, if we are going to fix Medicare, what we need to 
do is to have hearings where hospitals and administrators and long-term 
care givers and those elderly who are most sick can explain their 
medical needs. Not that we are looking to ensure a system for fraud and 
abuse; I do not hear you talking about that.
  I think Democrats have come to the table and come to the table 
repeatedly, making the system work. But my concern is already about the 
increased cost with the recommendation by the Republicans, yet in cover 
of night, with no hearings.
  Then secondarily, what do I answer, what do I tell my seniors who are 
now sick and who may be sicker, that the only thing that they have to 
do is wait to see if managed care or an HMO will pick them up. I do not 
think that will be the answer.
  Mr. DOGGETT. As you have pointed out, when our fellow Texan signed 
Medicare into law in 1965, about half of the seniors in this country 
had no type of health insurance at all. Now we have covered about 99 
percent of those seniors, and it seems to be a plan that works for 
them.
  I do not find many of those seniors saying that they need somebody to 
manage them. The folks that I know down in Texas are a pretty 
independent lot. Managed care has its place; I am all for people being 
able to choose that alternative. But folks there do not seem to be too 
interested in being managed. They seem to be interested in having the 
kind of Medicare System that they can depend on.
  There is some concern that under the plan that is being proposed that 
we will actually end up with a two-tier system, as you point out, 
leaving the sickest people within the Medicare System and then having 
some new kind of system that takes some for those who are in a little 
healthier condition.
  I know also that in the city of Houston, as with many other parts of 
the country, as I am sure this is true in New Haven as well, that you 
have a huge medical complex there, a teaching hospital there. And there 
will be even more burden, I am confident, on the teaching hospitals, on 
the public hospitals for this kind of approach; is that your feeling?
  Ms. JACKSON-LEE. Clearly, you have made a very accurate assessment. I 
took some time in the district during the August recess to visit 
several of the facilities, including the public hospital system. They 
offered to say that there would be an enormous burden, particularly as 
it relates to the teaching aspect. Our public hospital system has been 
a very strong component of our medical education training. Those 
leaders for that community indicated this would have a dastardly, 
devastating effect on them.
  Let me leave you with one point before we yield to the gentlewoman 
from Connecticut. There is some discussion that the GOP claims that 
senior citizens will not mind paying more to save the trust fund. But 
not one penny from the increased part B beneficiary cost would help the 
Medicare trust fund. That is why we need the hearings.
  I think we need to come from underneath the cover of night that I 
have been saying. One day seems to be extremely difficult to 
understand, where you would get any facts. The facts need to be on the 
table. What are we trying to save? Where is the money coming from, and 
what will it go into? Those answers are not yet on the table. I think 
the point is well taken.

  Mr. DOGGETT. I yield to the gentleman from Pennsylvania for a 
question.

[[Page H9226]]

  Mr. GREENWOOD. I certainly had not intended to participate in your 
discussion tonight. I was at my desk in my office listening to the 
discussion on Medicare. It is an issue I am greatly interested in 
because, as you may know, I am one of eight Republican Members of the 
task force that has been spending the last several months writing this 
reform package.
  I came over to ask if you were interested in participating in a 
little bit more of a bipartisan discussion which I think might be more 
informative to the American people, particularly our seniors, than kind 
of a one-sided, partisan review of things?
  I offer myself here as somewhat of an expert on the package since I 
helped to draft it and would like nothing more than to help have a real 
debate and a real discussion rather than kind of a one-sided affair.
  Mr. DOGGETT. Certainly. In fact, just in response to that, I 
appreciate your presence. I have been one who had been hoping that 
Members of the Republican Party would come. Our Republican colleagues 
could use time like their special order time and use the opportunities 
we have here to speak and outline the details of the plan that you are 
advancing. More importantly, I think it is important for us to come 
together and reach a bipartisan resolution to this problem.
  There are some areas that we have common agreement on: fighting fraud 
and abuse within the Medicare System, working to improve the Medicare 
System. But I think the problem has been, and I do not say this is 
necessarily an individual problem between you and me, but the problem 
has been one of from where we start in this debate.
  This debate began back in the fall on the Committee on the Budget. 
People came and said, after a series of secret task force meetings, we 
need $270 billion out of the Medicare System. It began not with how can 
we improve and strengthen that system but where can we get the money 
from the Medicare System to do some other things that do not have 
anything else to do with Medicare?
  Mr. GREENWOOD. I will be happy, in the spirit of bipartisanship, I 
will pose it in the form of a question. Would the gentleman not agree 
that the discussion on Medicare began when the trustees report 
consisting of three members of President Clinton's Cabinet, the 
trustees issued a report, and in that report they indicated that part A 
of the Medicare program, the hospitalization fund, goes broke in 7 
years?
  This year we are taking in more money than we are spending for 
Medicare. That is good. But next year we begin to spend more money than 
we take in. There is no dispute that it goes bankrupt in 7 years unless 
we do something.
  Mr. DOGGETT. I would like to respond to that because I am so very 
pleased that you raised it. The impression that has been created over 
the last few months and certainly in the last few days is that, if we 
do not rush through what I think is fairly referred to as the pay-more-
get-less plan, that suddenly this system will go broke and no one will 
have anything. I do not think that could be any further from the truth.
  If this Congress did not act, I am not advocating that, I would like 
to see action, there is going to continue to be a strong Medicare 
System next year and for a number of years to come. There is no reason 
that this has to be rushed through with 1 day for hearings. But I do 
want to respond fully to your observation, because it is one of the 
most important.

  With reference to the Medicare trustees report, you will recall in 
the Committee on the Budget, in the early part of this year, I pointed 
out that the report we got in the spring for this year was verbatim, 
the report that we got, I think with one or two words difference, last 
year.
  Our party was concerned long before I got to Congress in addressing 
this problem. This trustees report is not anything new, nor does it 
provide a justification for raising premiums on part B. There are, as 
the gentleman well knows, an A part and a B part. And raising premiums 
in part B, as apparently is being proposed, is not going to do anything 
to strengthen this fund.
  In fact, I think one of the real problems with the approach that many 
Republicans have advocated at least quietly in the halls and the back 
rooms of this Chamber is that they want to increase premiums, 
deductibles, and the like with reference to part B. We could raise them 
1000 percent instead of just 100 percent, as has been advocated, and it 
would not make the Medicare trust fund one penny more secure than it is 
tonight.
  So this use for the Medicare trust fund report is really very 
deceptive in terms of giving and misleading the American people into 
thinking that we have a crisis that demands rushing through a bill that 
is not being done to secure the Medicare trust fund.
  Indeed, the other point that has to be made, and I think it is a very 
important one, is if there was real concern about the security of the 
Medicare trust fund, surely our Republican colleagues would not have 
come through with one of the provisions in their so-called Contract 
With America to actually take money out of the trust fund, with the 
changes that were made last year, to provide tax revenues to help 
protect and advance and secure that fund. Yet that is exactly what has 
happened.
  All that our Republican colleagues have done so far, other than this 
generally veiled plan, in the legislation this House has approved over 
my objection, is to weaken it and have less money available.
  I yield to the gentlewoman from Connecticut.
  Ms. DeLAURO. I think that this is such an important issue that it 
deserves a bipartisan discussion and debate.
  I will say, first of all, that we have tried to engage in that 
effort, and we are seeing 1 day for hearings on changing probably the 
most important piece for legislation that we have, a major, major 
change, really a reconstituting of the Medicare System in a way that we 
have not seen in the past. It is an absolute fundamental change in the 
system.
  Looking at this system, potentially turning it into a voluntary 
system, potentially privatizing, which is what the direction is going, 
and we have 1 day for hearings. So let me just say this to the 
gentleman. The fact of the matter is that you have been engaged in 
writing a plan that no one knows about. I want to go back to the last 
session of this Congress, where the whole issue of health care reform 
was not only on the table for debate in the public sector, of debate 
for almost 18 months in this body. Before the Committee on Ways and 
Means there were 14 days of debate on the health care reform bill.
  The Republican leadership has determined that we will see 24 hours 
and, quite frankly, for a plan in which in yesterday's Washington Times 
the chairman of the Committee on the Budget has expressed uneasiness, 
fear that the plan falls about a third short for what your goal is, 
which is to cut $270 billion from Medicare, and does not want to engage 
in smoke and mirrors but is fearful, if you read the same news that I 
am reading, that in fact that is what is going to occur.

  Mr. GREENWOOD. Mr. Speaker, the Committee on Ways and Means alone 
held 38 hearings on Medicare reform, and the Committee on Commerce on 
which I serve also held a number for hearings. I cannot enumerate them 
for you.
  But if I may finish, one of the things I think the American people 
will be interested in, that is to what extent my two colleagues from 
the other side of the aisle are truly interested in an open dialog in 
which the truth comes out. The extent to which you are willing to 
engage me this evening in discussion, if you want to have, use 99 
percent of the time to make unchallenged statements, then I think the 
American people will say: Gee, I do not think they are really 
interested in an open discussion in which both sides are presented. So, 
show the American people that you really are interested in 
bipartisanship and debate, and let us have a discussion.
  Ms. DeLAURO. I would like to also go back to say that there has been, 
first of all, we have heard about the plan. There are very few details 
about the plan.
  Mr. GREENWOOD. I have them all. I am an open book.
  Ms. DeLAURO. You may be an open book, but let me tell you about the 
Congressional Budget Office, which says the following, and this is 
quoted yesterday:


[[Page H9227]]

       The details, until the details fully emerge, the 
     Congressional Budget Office, the bipartisan Congressional 
     Budget Office, Congress's economic analyst, will not be able 
     to certify the savings, and the GOP plan will have a gaping 
     budgetary hole.

  I am not saying this. But the Congressional Budget Office is saying 
it, and more importantly, until there are details, if you are going to 
hearings this Thursday for 24 hours to debate the most significant 
change in one of the most significant pieces of legislation in this 
country, if the Congressional Budget Office cannot act on it, if no one 
else has the details of this effort, if the American public does not 
see the debate because what you want to try to do is to cover it up in 
24 hours and get this done, I do not--why are we doing this? The 
American public has a right to know. There are several questions that 
are critical.
  You asked about questions that ought to be asked. If the Republicans 
are truly interested in the solvency for Medicare, why is the solution 
to raise premiums on beneficiaries, premiums which in fact, as my 
colleague from Texas pointed out, do not go into the trust fund? That 
is the cruel hoax, because seniors are confused.

                              {time}  1845

  The cruel hoax here is that we are talking about trying to deal with 
the Medicare trust fund and making sure it is safe and secure, and 
there is $270 billion that is not going into the trust fund.
  Mr. BONIOR. Mr. Speaker, will the gentleman yield?
  Mr. DOGGETT. I yield to the gentleman from Michigan.
  Mr. BONIOR. Not only is this money not going into the Medicare trust 
fund, our Republican colleagues about 4 months ago, and we had the tax 
bill before us on the floor, took $89 billion out of the trust fund to 
pay for the tax bill. So not only are they not dealing with this in a 
fair, rational, sacrosanct way in terms of the commitment that was made 
and the contract that was made between seniors and its government with 
regard to Medicare, but they raided the fund of $89 billion 4 months 
ago in order to pay for a tax cut for the wealthiest people in our 
society.
  Mr. DOGGETT. Mr. Speaker, I want to respond to the gentleman's 
comment about the number of hearings that have been held, because we 
went through the same problem with the budget resolution, where one 
``think tank'' person after another was brought in to talk in theory 
about the budget, but no hearing was held on the specific proposal. To 
date, we have not even had the gentleman or one of his colleagues come 
down here and outline the proposal and say how much higher the premiums 
will be, how much higher the deductibles and copayments will be, and 
the other changes.
  It is hard to have a really meaningful hearing, or for that matter, a 
really meaningful bipartisan debate, in which the gentleman has said he 
wishes to engage tonight, without having the details of that plan laid 
out before us.
  Mr. GREENWOOD. Mr. Speaker, will the gentleman yield?
  Mr. DOGGETT. I yield to the gentleman from Pennsylvania.
  Mr. GREENWOOD. Mr. Speaker, I thank the gentleman for yielding to me 
for a question.
  My question is this: If in fact what the gentleman would like to do 
this evening with his time on the floor is to inform the American 
people, particularly our seniors, so they can make an evaluation about 
how they feel about this plan, will he not engage me? There are five of 
you, there is one of me. I am one of the drafters of this. I am happy 
to stand here all evening and answer questions and debate fine points 
as to what we should do, but I am going to repeat myself. The American 
people look at you and say, ``Those five Democrats are not going to let 
the Republican who is one of the drafters of the bill have very much 
time at the microphone. I guess they do not want to hear what he has to 
say. I guess they do not want to know what is in this plan.''
  Mr. DOGGETT. I would be glad to have not only one of you, but 100 or 
200 more here to debate fully and thoroughly. But I am concerned that 
what is going to happen, given the example of limiting these hearings 
to 1 day and 1 day only, that the idea will be to compress the real 
debate that occurs, once we have all the details of the plan, into the 
same limited time so people learn as much about it or as little about 
it as possible.
  Perhaps the gentleman could tell us why there is 1 day and only 1 day 
of hearings once the plan is outlined, if he is indeed interested in a 
bipartisan presentation.
  Mr. GREENWOOD. If the gentleman will continue to yield, as I said 
earlier, the committees of jurisdiction held dozens of hearings 
covering hundreds of hours on this issue.
  Mr. DOGGETT. But not on this plan.
  Mr. GREENWOOD. Number two, there will be hearings. Number three, we 
approach the end of the fiscal year, as my colleagues know. We are 
trying to deal with this issue in this fiscal year. The President of 
the United States has said that we need to reduce the growth in the 
Medicare program in the coming fiscal year by $124 billion, if we use 
the OMB budget line. If we use the CBO budget line, the budget line we 
are using and that the President encourages us to use, that is closer 
to $194 billion, so the gentleman said earlier that he wants to think 
about where we can agree.
  Where there is not disagreement among honest brokers in this issue is 
that the President of the United States and the Republican Party 
believes that at least $190 billion needs to be reduced from the growth 
of spending in this program. So if you want to start from there, we can 
have an honest discussion.
  Mr. DOGGETT. Reclaiming my time, Mr. Speaker, my question to the 
gentleman is, why is it that you are having only one day of hearings? 
And his response is, we are having hearings and it is near the end of 
the fiscal year. The hearings he is having are taking less than 1 day. 
The reason we are near the end of the fiscal year is that he has drug 
out throughout the course of this year this proposal. He still has not 
come to the floor of this House and outlined the details of the 
proposal, and proposes to rush it through on the eve of the close of 
the fiscal year, not because we have a crisis, but because I genuinely 
believe our Republican colleagues want the American people to know as 
little as possible over as short a time period as possible what this 
plan really does.

  Mr. HEFNER. Mr. Speaker, will the gentleman yield?
  Mr. DOGGETT. I yield to the gentleman from North Carolina.
  Mr. HEFNER. I would just like to make a couple of observations. The 
gentleman said we are not sincere about doing something about Medicare, 
looking after senior citizens. I would just urge the gentleman to look 
at the track record.
  Mr. GREENWOOD. I did not make those comments.
  Mr. HEFNER. That was the inference I drew. Let me make one thing 
perfectly clear. If it is your purpose to cut $270 billion over 5 
years, and then the Committee on the Budget chairman said today in a 
seminar that he came and spoke at, our seminar, that we have paid for 
the tax cut, it is bad enough that you frighten senior citizens, and 
the Speaker of this House, that says that Democrats have demagogued and 
terrified senior citizens, I am a senior citizen, and the last thing in 
the world we need, senior citizens, to be frightened about is health 
care.
  If you spend very much time in your district office, you have these 
precious souls that come into your office, and their biggest concern is 
to make a decision whether they are going to be able to pay their rent, 
their water, or their lights, or have their prescriptions filled. Then 
when you talk about the changes in Medicare, even minimum, just a few 
dollars a month, to us a few dollars a month is not much, but for that 
senior citizen that is living on a fixed income that increase in 
premium is tremendous, $7 or $8 or $10 a month.
  Then you are going to have a look-back provision that says, ``Hey, if 
these things are not coming up, we are going to have to look back,'' 
and you are going to look back to the same people that you are going to 
come to again. The last thing in the world that the senior citizens 
need in this country is another hassle as they get into their declining 
and sunset years.
  If you want to look at the track record, there is not a living Member 
of this House or the Senate that was here when Medicare passed that 
supported it. The tax cut is going to be $240 billion. It is not paid 
for. It is bad enough 

[[Page H9228]]
that you do this to Medicare and to senior citizens. At least you could 
have the decency to apply it to the budget deficit. It goes directly 
from Medicare, and it goes directly to a tax cut for Members of 
Congress, for some of the wealthiest people in this country. I am a 
senior citizen. I would a lot rather have the comfort of having my 
Medicare than to have a few dollars tax cut.
  Let us just look at the track record of the Republicans on Social 
Security and Medicare. The first budget that Ronald Reagan's budget 
director brought to this House, David Stockman brought a budget to this 
House, and it called for a $125 a month cut in the minimum Social 
Security for our oldest, sickest senior citizens, $125. It was going to 
completely erase that from the Social Security payment. It caused such 
a ruckus and uproar that it was quickly withdrawn.
  The record is not good. You have not supported Medicare. You were not 
here, and I will give you the credit for that, but no Republican 
supported Medicare. This is not something that has paid for a tax cut. 
You are using Medicare cuts, and why not be honest about it and say, 
``This is our philosophy. We want to make these cuts and we want to use 
these cuts to pay for tax cuts for our agenda.'' At least have the 
decency to say that. In road shows all over this country, the Speaker 
has gone all over this country in road shows talking about ``We have 
paid for the tax cut, and we are going to give the senior citizens more 
choice. We are going to allow you to be sick up to $4,800 a year. After 
that we have to make some adjustments.''
  Mr. GREENWOOD. The gentleman is misinforming the House. I would be 
happy to correct him.
  The SPEAKER pro tempore (Mr. Gutknecht). If the gentleman would 
suspend, I would remind the participants that the gentleman from Texas 
[Mr. Doggett] controls the time.
  Mr. DOGGETT. I have yielded for a comment to the gentleman from North 
Carolina [Mr. Hefner], and I will continue to yield to all of those 
here for questions and observations, but I would ask that you have the 
opportunity to finish, and that the rules of the House be enforced, and 
that we have regular order, if the gentleman would proceed.
  Mr. HEFNER. The matter of fact is, and it is so evident if you listen 
to the arguments and listen to the numbers, $270 billion in Medicare 
cuts, $240 billion in tax cuts that go basically to the most privileged 
people in this country. if that is your philosophy, be proud of it. But 
it is not paid for. If it was paid for, it was paid for out of student 
lunch programs and from Medicare, and it came from the most vulnerable 
people in this country.
  If that is your philosophy, be proud of it, but do not disguise it 
and say we have paid for the tax cut and senior citizens are going to 
get more choice. I can imagine me going to a carrier and saying, ``I 
want to buy some insurance.'' You are going to give me a voucher. I go 
to an insurance carrier and say, ``I have had heart disease. I have had 
open heart surgery.'' They are going to laugh me out of the office. The 
voucher is going to be no good for me.
  We are not frightening senior citizens across this country, as the 
Speaker and everybody has said, we are telling the truth. It scares the 
devil out of them, and it should. We should tell the seniors the truth 
and let them know what they are in for, at least tell them the truth, 
because at least maybe they can prepare for the worst to come, and it 
is going to be some bad times for senior citizens in this country if 
this Medicare package passes.
  Mr. DOGGETT. Mr. Speaker, we use tonight as an opportunity to share 
with colleagues across this House, because we are being denied an 
opportunity to have a full and fair debate in committee this week, so I 
yield to my colleague the gentleman from Michigan [Mr. Bonior] for any 
questions or observations.
  Mr. BONIOR. I thank the gentleman for yielding. I just want to follow 
up on what my colleague, the gentleman from North Carolina [Mr. 
Hefner], said when he talked about the question of scaring our senior 
citizens today.
  What is going on here is just an outrage with respect to the scare 
that has been put into these people by these proposals that have been 
offered by my friends on the other side of the aisle. I will tell the 
Members what is scary, Mr. Speaker. Scary is a 76-year-old woman who 
lives basically off of Social Security. Maybe she has a few pennies 
more than that. She has to pay for her heat, she has to pay for her 
rent, she is going to have a few pennies left over for her other odds 
and ends. Then she gets up, reads in the paper, hears on the radio or 
watches on TV, that her premium is going to be doubled from $46 a month 
to $90 a month.
  Then she hears from the Senate Republicans that her deductible is 
going to be increased from $100 a month to maybe $150 to $250 a month. 
Then she hears and reads and sees on her TV that the House Democrats 
want to cut Medicaid by $82 billion. Sixty percent of Medicaid goes to 
older people in this country in the way of nursing home care.
  Mr. DOGGETT. That the House Republicans want to pass.
  Mr. BONIOR. The House Republicans. No wonder she is frightened. No 
wonder they are frightened and scared out there. They ought to be, 
because we are talking about huge amounts of money out of their pocket 
for basic health care, out of their Social Security check that is going 
to shrink every month. They ought to be scared and outraged because of 
the formula that is being devised here to shift that money to the 
wealthiest people in our society in the way of a tax cut.
  Mr. Speaker, one might say that this is not a trend, it is something 
that the Republicans are just bent on doing. But today in the Committee 
on Ways and Means the Republican majority is talking about doing the 
same thing to middle-income people. They want to put a $1,000 tax 
increase on middle-income people, people making up to $27,000 a year, 
just today, the so-called earned income tax credit for middle-income 
folks. So it is not just happening to seniors, it is happening to 
middle-income people. They are after your pensions, they are after your 
health care.
  What we are finding is this gap that is growing in this country 
between the wealthy in our society and the rest. The chasm is growing 
deeper and it is growing wider. It is time that people stood up and 
said, ``Enough of this extremism, enough of this move to the far end of 
the political spectrum with respect to the economics of people.'' 
Medicare is too important of a sacred trust, a sacred trust that was 
made between the government and its people back in 1965, when we had 
tremendous percentages of poverty among our seniors. We have reduced 
that poverty tremendously as a result of Medicare. Now we are going to 
find ourselves in a situation in which our seniors and their children, 
who will be required or are obligated or duty-bound to pick up this tab 
for their parents or grandparents, are going to be pressed as well 
economically. I thank my colleague for his comments.
  Mr. DOGGETT. I have just one response to the gentleman's observation, 
because I think it is an important one. That is that there may be some 
younger people that are watching and observing the debate going on 
across our Nation over Medicare, feeling that they do not have a stake 
in this. As you pointed out, many of those young people at the 
beginning of their earning power, working people in this country, the 
folks out there working for an hourly wage, are about to get hit with a 
tax increase by the Committee on Ways and Means under the Republican 
leadership.

                              {time}  1900

  But they also stand in the course of this Medicare debate to suffer 
as well. One recent study that was done by Lewin VHI has pointed to the 
danger of cost shifting as a result of this Medicare plan and has 
suggested, and I quote, that lost wages in increased premium 
contributions would equal about $1,000 per covered worker over the 
1996-2002 period.
  So those same workers that we are talking about, that are about to 
get a Republican tax increase with the changes being made in the 
Committee on Ways and Means, are also people that stand to lose about 
$1,000 from cost shifting under one study because of a Medicare plan 
that is being done in isolation from the rest of the health care 
problems of this country. That may simply cause hard-pressed hospitals 
and health care providers to shift more cost to those who are under 

[[Page H9229]]
65 to try to recoup some of the losses that will occur to them if this 
plan goes into effect.
  I know my colleague from New Jersey has arrived and that he has a 
number of questions and has spoken out eloquently on this subject. I 
yield to him.
  Mr. PALLONE. Mr. Speaker, I just wanted to thank the gentleman from 
Texas again for doing this special order tonight. I really will say 
once again that that chart that he has up there that says ``the GOP 
Medicare plan, pay more and get less,'' really says it all.
  This is what the seniors are increasingly telling me in my district 
and throughout the State of New Jersey. They understand that this is 
nothing more than a tax increase and a reduction in services.
  You cannot take the amount of money that we are talking about here, a 
$270 billion cut in Medicare--and I also notice that the rest of my 
colleagues talked about the cuts which are, I think, $180 billion in 
Medicaid as well--you cannot take that level of cuts in these programs 
without either reducing the quality of service or charging senior 
citizens more for what they are getting for health care.
  The reality is that what the Republicans are talking about 
essentially are doing both, because they have already told us. I know 
my friend, the gentleman from Michigan [Mr. Bonior], mentioned some of 
these things before. We have already heard about at least three 
possible implementations of this Medicare cut that would increase costs 
to seniors and in effect amount to a tax increase.
  One is on the Senate side, the increased co-payment, I believe, for 
Part A for hospital care from $100 to $150. We have heard about the 
Gingrich proposal with regard to Part B that pays for physician 
services, that in essence doubles you premium for Part B over the next 
5 to 7 years; and we have also talked about means testing.
  I know that there has not been a lot of discussion in general about 
means testing, but this idea that we are going to charge wealthier 
people more for their Medicare premiums, for their Part B premiums, to 
the point where at some point they would not have any subsidy, would 
have to pay the whole cost of their Medicare premiums, well, right now 
the Republican leadership is talking about a $75,000 threshold for 
that. In other words, you would have to be making at least $75,000 
before they start charging you that tax.
  But the bottom line is, I know from my own experience and I have seen 
it in the State legislature and here in Congress, those thresholds 
start to go down very quickly when the Republican leadership of the 
Congress is looking for extra money. So do not be surprised, New Jersey 
residents or Americans, if next year it is 65 and the following year it 
is 50 and then it drifts down to 40. I have heard some of my colleagues 
already talking about a $35,000 threshold.

  We know that there is a huge gaping hole here. On the one hand they 
have these various tax increases which I just mentioned. On the other 
hand they have cuts in providers' fees, cuts in the amount of 
reimbursement that is going to go to hospitals or other health care 
facilities.
  Those things are going to result in less quality care. The hospitals 
in New Jersey, we have already identified through the New Jersey 
Hospital Association 76 hospitals that are on the critical list, that 
if they have any significant, and I am not talking about the level of 
cuts that we are talking about here but any significant cuts in 
Medicare or Medicaid, some of them are going to close and a lot them 
are going to significantly reduce their services.
  But beyond that, beyond paying more for those taxes, as the gentleman 
from Texas said, beyond getting less because of the quality of care and 
because hospitals and other providers are going to reduce the services 
that are available, we still have this gaping hole which we know that 
the Republicans are saying, ``Well, if all this doesn't squeeze enough 
money out of this system, then in a few years if we find out that we 
haven't saved enough, then we're just going to have to go back to the 
drawing board and come up with either more tax increases or more cuts 
in services.''
  What is that going to mean? Again, it is going to be more tax 
increases. You will see those premiums for part B going up even more. 
You will see that means-test threshold going down. You will see those 
co-payments or deductibles increasing, and at the same time you will 
see less and less money going to the hospitals and going to those who 
are providing the services.
  There is no way to provide this level of cuts, to make this level of 
cuts in Medicare and also Medicaid, without having to pay more and get 
less, just as the gentleman says. I think that the Republicans and the 
leadership should fess up and say, look, this is a major tax increase, 
this is a tax increase on seniors that is going to pay for a tax cut 
for a lot of well-to-do Americans.
  They might as well admit it because every day we see, as this 
unfolds, and it has not unfolded completely, there are still a lot of 
details that we have not gotten, but as it unfolds we see more and more 
that that is the bottom line and that is what we are getting.
  I just wanted to congratulate again the gentleman from Texas and the 
gentlewoman from Connecticut for putting this together, because we have 
got to bring that point home.
  Mr. DOGGETT. Mr. Speaker, I yield for a question to the gentleman 
from Pennsylvania.
  Mr. GREENWOOD. That is very kind of the gentleman, and I appreciate 
it.
  Mr. Speaker, with all due respect the amount of disinformation that 
has been brought forth this evening by my colleagues on the other side 
is breathtaking. Let me just correct a series of them very quickly.
  There will be no increase in deductibles. There will be zero increase 
in deductibles. There will be zero increase in copays. The part B 
premium, which is at 31.5 percent for senior citizens today, will 
remain at 31.5 percent for senior citizens into the foreseeable future. 
That slight increase which seniors have received each year will be more 
than overcome by the COLA in their Social Security. They will be paying 
what they are paying today.

  Second, with regard to the part of your poster there that says get 
less under our plan, every single senior citizen in America will be 
able to, next year and the year after that and for the next 7 years, be 
able to retain precisely the fee-for-service Medicare plan that they 
have today with every single benefit that they have today. There will 
be no change whatsoever. They will continue to pay 31.5 percent of the 
part B premium, and their friends and neighbors and children will pay 
the balance for them. In addition to that, they will have more choices.
  Mr. DOGGETT. Reclaiming my time, I am so pleased to hear those 
comments from the gentleman tonight, because everything you have 
assured us that this plan will not do is what as you know one newspaper 
after another has reported was the plan of the Republican task force 
before last week. Thank heavens we are having some impact in educating 
the American people about the dangers of this Republican plan. 
Apparently there are at least some members of the Republican Party that 
are backing away from raising deductibles, not in the U.S. Senate where 
they propose to double them under the Republican Senate plan. There are 
some who may be backing off copayments.
  The problem is, as the gentlewoman from Connecticut has pointed out 
with yesterday's Washington Times, hardly a mouthpiece of the 
Democratic Party, that you have a giant gap in your plan. That giant 
gap is proposed to be filled by what you call a look-back provision.
  That means that at the end of the year, if you do not get the savings 
necessary to get the tax break for the privileged few, you are going to 
have some bureaucrat in Washington reach back and cut in the program. 
When that cut occurs, it is going to be even more difficult for people 
to find a health care provider that will provide them Medicare.
  I know from my own community that there are many citizens right now 
that have difficulty finding a provider that will take Medicare. 
Fortunately you did provide some detail last week, and I am referring 
to the House Republican leadership packet, the so-called information 
packet, which is a bit of a contradiction because there is not much 
information in it, but in that packet you said that it was a myth that 
you would chase doctors out of Medicare.

[[Page H9230]]

  Your answer, though, was that doctors today are turning away Medicare 
patients, which is true, and that doctors under your plan could choose 
to participate in what you call Medicare Plus. But Medicare Plus is not 
the Medicare system that people have relied on for the last 30 years, 
and which you say you would continue to give them the right to 
participate in. I do not think the Republican Party, tonight or in 
their so-called information packet or at any other time, has provided 
any genuine assurance to the American people that they are not going to 
be forced out of a Medicare system, and whether they are going to have 
providers who will provide them Medicare in the traditional way.
  I yield to the gentleman from North Carolina.
  Mr. HEFNER. I would just like to make a point. I know the gentleman's 
intentions are good. You can give us these numbers, but you do not know 
where the money is coming from. You do not even have the total numbers 
on all where this money is coming from or how you are going to pay for 
it, as late as today. You can give these assurances, but delivering 
them is another thing.
  Where is the money going to come from? All these assurances that you 
have given to us here tonight, if you can give us these assurances and 
put our mind at ease, why do we not have an extensive debate, something 
at least as long as the Waco hearings or the Oklahoma hearings or what 
have you, and let the American people, the senior citizens, sit before 
the television and assure them? We will see who they believe and see 
whose record speaks for itself over the years. Let our backgrounds, let 
the history speak for itself. But the assurances that you give us, you 
cannot guarantee that. And your party cannot guarantee that.

  Mr. GREENWOOD. If the gentleman will yield to me, I can.
  Mr. DOGGETT. I yield to the gentlewoman from Connecticut.
  Ms. DeLAURO. I have a lot of respect for my colleague. We have worked 
together on a number of issues. I would like to believe and I think the 
American public would like to believe what you say.
  Again, just yesterday in the Washington Times, it says that--

       The Congressional Budget Office will not be able to certify 
     the necessary savings and the GOP plan will have a gaping 
     budgetary hole. Senior GOP aides said an even larger problem 
     is that a preliminary CBO analysis has revealed Republicans 
     will glean little more than $30 billion from one of their 
     most highly touted reforms, allowing seniors to enroll in 
     health maintenance organizations instead of staying in 
     Medicare's traditional fee-for-service program. Republican 
     aides also said they foresee little savings from the 
     malpractice reforms. The CBO also questions savings from 
     reforms aimed at curbing waste, fraud and abuse. That leaves 
     Republicans in a difficult position. They had been counting 
     on saving as much as $80 billion from such reforms. A 
     shortfall of that magnitude would reduce payments to doctors 
     and hospitals each year by about $18 billion.

  The look-back provision is buying a pig in a poke. You do not know if 
you take a look and your savings are not realized, you are going to go 
back after people again. We had this debate and discussion last night.
  Mr. GREENWOOD. I would love for you to yield because I could give you 
wonderful answers to your questions if you are really interested in the 
truth.
  Ms. DeLAURO. Let me just say to you that when you cut back in the 
same way that you did in the Medicare Program, and we know that there 
are lower fees on reimbursements to doctors and hospitals, that you are 
doing the same thing in the Medicare system where it is not going to be 
just cuts to the providers.
  We all agree that there can be cuts to the providers. I could not 
stand here and say that we could not do that. On the other hand, what 
you will see, you will see a cut in services. You will see a cut in the 
quality of care that is being delivered to our seniors.
  Let me make one other point. There are some members of the other 
party that are trying to move away from their leadership. They are 
being quoted all over this country.
  In Fresno, CA, one of my colleagues was heard saying, and this is a 
quote, one of my Republican colleagues: ``We are concerned about saving 
Medicare at least for the next 15 years.'' Beyond that, he says he 
cannot commit to continued support from the Congress. Make no mistake 
about it. The plan is to end Medicare as we know it.
  One of our colleagues in Maryland, when he went out in terms of his 
road show this weekend, one of his constituents asked, ``Why are you 
offering tax cuts, while you're increasing the cost of Medicare?'' The 
Congressman's response was, ``Wouldn't you rather sing My Wild Irish 
Rose?'' I am not making this up. This is his quote. When you cannot 
defend your position, you change the subject.
  There are a lot of questions that are unanswered. I would ask the 
Republican leadership the following questions: If you are willing to 
have hearings, will you support the Dingell resolution that calls for 4 
weeks of hearings in this body? If you are so interested in saving 
Medicare, are you willing to take the tax package off the table? Those 
are the questions that have to be answered.

                              {time}  1915

  Mr. DOGGETT. I appreciate your questions, and I have only about a 
minute left, but I would yield for observation briefly to my colleague 
from Texas.
  Ms. JACKSON-LEE. First of all, I am gratified that we attempted to 
have a bipartisan discussion, and I think it is important that we 
evidenced by this discussion that we need 4 weeks.
  Lastly, the sickest of our seniors will be left without any coverage 
or at least without a sense of being able to have the best coverage. 
The system is not bankrupt. There is a life of 7 years, and there has 
always been a life on the Medicare system. That is the reality that we 
should teach the American public to get to national health reform.
  I thank the gentleman from Texas.
  Mr. DOGGETT. Mr. Speaker, I thank all of my colleagues for 
participating tonight, and particularly my Republican colleague from 
Pennsylvania, Mr. Greenwood. Under the procedures of this House, he and 
his party now have a full hour in which to present their plan, and I 
hope they lay it out line by line so that the American people can see 
what is in this plan.
  They have yet to lay it out, perhaps, to some of their own Members 
who do not understand the details, and as the morning's papers seem to 
indicate, do not know, themselves, how they are going to fill the great 
void that is there in their plan, and how it is they are going to 
provide a $270 billion cut in Medicare, without demanding that 
America's seniors pay more and get less.
  We need a full and thorough debate; not just in their forum tonight, 
but with a series of hearings and a full open rule when this matter 
comes before the House. I hope the presence of my Republican colleague 
here tonight is an indication that the Republican leadership is going 
to change its ways, just as he says they have changed their ways on 
some of the increases that they were originally contemplating in taking 
out of the pockets of our senior citizens, that they will change their 
ways and that they will not fade the heat any further from the American 
people, but will instead give us a full, fair and open debate in 
committee and on the floor of this Congress.
  If we do that, if we have the kind of bipartisan exchange, then the 
American people will know what is about to happen to them. They can 
understand the full consequences of having to take from seniors in 
order to afford a tax break to the most privileged few in our society.
  Mr. Speaker, I hope that we will see that happen and hope that our 
Republican colleagues in the hour that they now have, will indicate to 
the American people that we will have that kind of full, fair and open 
debate, unrestricted in terms of time, unrestricted in terms of 
amendments, so we can really get about the job of improving and 
strengthening the Medicare system instead of taking away from it.

                          ____________________