[Congressional Record Volume 141, Number 147 (Wednesday, September 20, 1995)]
[House]
[Pages H9360-H9362]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    THE TRUTH ABOUT MEDICARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 
12, 1995, the gentlewoman from Texas [Ms. Jackson-Lee] is recognized 
for 20 minutes as the designee of the minority leader.
  Ms. JACKSON-LEE. Thank you, Mr. Speaker. And I appreciated the dialog 
and interchange of my colleagues who, like me, are mostly freshmen in 
this House. But I think that if we are to provide a real discussion, it 
must be clear, decisive, nonagrumentative, and as forthright as we can 
possibly be.
  And I think if there is one singular indictment of this so-called 
proposal by Republicans to help Americans with respect to Medicare, it 
is that they absolutely refuse to have full and open hearings on this 
very major change in American history.
  One day, the say. Fraudulent. Cover-up. Misrepresentation. Not many 
of us could understand a massive change in medical reform in 1 day.
  Clearly, I would simply ask the question to my colleagues, and 
certainly I enjoyed the opportunity to work with them and come to this 
podium with no beggage, I would simply as the question: How do you 
manage to reform with $270 billion in cuts of a program that is in need 
of reform and in need of a major health reform in conjunction with the 
reform of Medicare?
  The question simply becomes, How do you respond to the citizens in 
all 50 States in this Nation? The citizens in Florida that will be paid 
over $5,000 extra under the reform plan by the Republicans in the next 
7 years, or the citizens in Louisiana for $4,000, or the citizens in 
Texas for $3,000?
  Mr. HAYWORTH. Would the gentlewoman yield?
  Ms. JACKSON-LEE. I would be happy to yield in a moment, just for a 
moment. Or, in fact, the citizens in California for $4,783? Or in 
Washington State for $2,246?
  You simply do not have the facts, and the Democrats have been 
representing to the Republicans, our colleagues, that we stand ready to 
debate this issue truthfully and factually over a period where hearings 
can bring people from their distributes, I hope, from our districts, 
medical professionals, senior citizens, long-term care givers and 
actually discuss the real crux of the issue.
  Just for a moment, let me frame the question for
   you. All of us can agree that we can fix Medicare on many planes and 
many platforms, but one that we can unanimously agree on is that we can 
save $61 million if we take away fraud, abuse and waste.

  When I go to the 18th district of Texas, no one disagrees that they 
are prepared to work against and to inform and to improve Medicare from 
that perspective. But they do tell me, and the speakers that were here 
earlier indicated and did not give an answer, that they had seniors in 
their district that were making choices between prescriptions and food. 
I do too.

                              {time}  2340

  And those seniors will continue to have to make those choices or in 
fact have absolutely no health care under this plan by the Republicans.
  Let me also mention a point that is extremely important. This whole 
masquerade about choices, which I think would be relevant to 4 weeks of 
hearings, because we could understand what the choices actually mean. 
But in fact, we know in the private sector that the sickest of the 
population are not insured.
  In the present health care system that we have now in America, we do 
not have provisions for preexisting disease; we do not have 
portability, because we do not have national health reform. So how 
would that occur for senior citizens? Would there be the option for 
those who are sickest to have an opportunity to be in a solid program, 
or would you find a pool of the sickest senior citizens left by the 
wayside by the empty well not being able to drink the water?
  I would simply raise the point that in this Nation we have now the 
most healthy population of senior citizens. Thirty years ago in 1965, 
not one Republican voted for Medicare. In fact, they argued vigorously 
against it. But 30 years into the history of Medicare, now 1995, we can 
brag on the fact that our senior citizens are healthier and they are 
living longer. Shame upon us, that we come now 5 years before the 21st 
century and what we will say to those entering the 21st century is not 
for the future, but that we will return to those very damaged days when 
those who were in need of health care were lost in the wilderness of 
health care in this Nation, and were lost and never found on their 
dying beds because they were not able to receive the coverage 
necessary.
  I will yield to the gentleman for just a moment, for I have a long 
litany of things that I would like to proceed with, and I hope I can 
engage him in a discussion, and maybe he would give me an answer that 
we would in fact do well for the American public if we join together on 
4 weeks at least, minimally, to have hearings to be able to have his 
position explained, not to each other, but to the American people, and 
to make the right choice and go in the right direction in the 21st 
century and to be able to be proud about the health care that we 
provide for our senior citizens.
  Mr. Speaker, I yield to the gentleman from Arizona [Mr. Hayworth].
  Mr. HAYWORTH. I thank the gentlewoman for yielding the time so 
graciously. Certainly the gentlewoman raises many questions tonight and 
I thank her for raising them.
  First and foremost, I think it is important for us to understand as 
the gentlewoman has been doing in our district in Texas, as I have been 
doing in Arizona; in effect we have been holding our own hearings. But 
she raises a point that I think is of some interest. Of far more 
interest to me tonight is the chart purporting to talk about increase 
of out-of-pocket expenses. Could we explain the formula, the 
methodology, or the rationale that leads us to make this claim that the 
prices would rise so drastically. Because I can tell you it is 
certainly not my intent, nor did we come to the Congress with the 
notion of trying to bankrupt our seniors. Quite the contrary, we want 
to save this program.
  So I am just curious where these numbers come from, how they were 
arrived at, how we arrived at these numbers.

[[Page H 9361]]

  Ms. JACKSON-LEE. Mr. Speaker, I would be happy to share with the 
gentleman that this is a basic analysis that takes into account the 
proposed $270 billion which results in a $245 billion cut in Medicare. 
But let me expand on that point so the gentleman can understand.
  The gentleman uses the term bankrupt, and I think that is an 
important term, because the recent, the earlier discussion used that 
word frequently. In fact, we find that the Republicans rely so openly 
on the trustee report, and interestingly enough, that report was given 
last year with deafening silence in 1994.
  But if I might refer to a chart that I have reviewed that shows in 
1970, which I believe was under a Republican administration, there was 
only a 2-year life in the Medicare trust fund, if you will. 
Periodically over the years, since 1970 and 1995, we have seen it go up 
to 14 years and have seen it come down lower. In fact, the trustee 
report indicated this year that it would be a 7-year life and they in 
fact thought that that was a positive, because it gave the Congress a 
larger span of time to respond to some of the very issues my colleague 
has raised.
  We agree that we need to fix Medicare. But today, 1995, rather than 
frightening seniors, if we all are to try to get forthright to 
bankruptcy, that is
 inaccurate. Bankruptcy is pending, or impending, it is tomorrow, it is 
next week, it means we have to file. There is a 7-year life on the 
Medicare trust fund of which we are responsible for trying to make sure 
there is a greater life. But we are better off today in 1995 than we 
are in 1970. These numbers are basically an analysis of how the 
breakdown in the premiums in the different States presently are and 
what would be reflected by a $270 billion tax cut that the Republicans 
want to offer that would be taken out of Medicare.

  Mr. HAYWORTH. Mr. Chairman, will the gentlewoman yield?
  Ms. JACKSON-LEE. I yield to the gentleman from Arizona.
  Mr. HAYWORTH. I thank the gentlewoman for yielding to me for a 
moment.
  I think the gentlewoman raises a compelling point, and it is this: If 
the trustees' report tells us that we have a 7-year window, then are we 
not compelled to act? In other words, is it not prudent, because both 
of us come from an environment where we were successful professionals 
in other endeavors; we are not professional politicians, we came here 
to serve our districts and we have differing philosophies. But is it 
not prudent to move now to solve the problem rather than taking our 
chances 2, 3, 4, 5 years down the road and simply hoping that we can 
correct it ourselves?
  In other words, we went back to 1970 when of course this Chamber was 
controlled by her party, regardless of who sat in the White House. We 
went back to 1994, more recently, when this Chamber again was 
controlled by a different party and nobody moved to solve the problem. 
In other words, is it prudent to wait this out?
  Ms. JACKSON-LEE. May I respectfully and vigorously disagree with the 
gentleman.
  Mr. HAYWORTH. Certainly.
  Ms. JACKSON-LEE. And the reason why I would do that is because, quite 
the contrary, in terms of your analysis, in 1970, under a Republican 
president. There were 2 years where there was a Democratic Congress. 
And over the years the Democratic Congress has maintained the viability 
of this Medicare program, both A and B. We recognize that we must fix 
this. That is something that I hope all of us embrace.
  When I go into my inner city district and I have a
   town hall meeting or I send out massive information that comes back 
to me threefold where citizens of different walks of life are 
indicating, please help us save Medicare, they are recognizing that 
over the period of time that we were, as you will, in the majority, the 
Democrats worked to save this program. And there is no doubt that we 
should not wait 7 years out to in fact try to reform Medicare.

  Let me add that reforming Medicare should be in conjunction with 
reforming this national health program that we have. And the issue is 
that over the 25 years the Democrats have been able to infuse support 
and energy into this Medicare system which has allowed it now to serve 
senior citizens for over 30 years, they have never been healthier, 
because Medicare provides partly a maintenance program. And so 30 years 
we have maintained it.
  Now is the time to come to the table. But what has happened is, 
precipitously, we have a plan that has yet not seen the light of day. 
The gentleman may have copies of it. It may be easing out now, and it 
may be in full force tomorrow. But the hearing was delayed and we are 
only having 1 day, and I do not think that we can disagree on the 
reasonableness, not of waiting 7 years, but at least 4 weeks of 
hearings to deliberate on the best way to ensure that collectively we 
have a system that does not burden the American citizens and their 
children.
  Might I add, and I happen to have seen and enjoyed meeting, I 
believe, your grandfather. And I am not pretending to speak for him or 
to suggest what his thoughts are. But I know the relationship that you 
have obviously with senior citizens. The question has to be, if we are 
both in agreement and in tandem on the idea that Medicare must be 
reformed, then I cannot see why Republicans are rebutting and refusing 
to open it up to the American public for 4 weeks of hearings in order 
to make a decided difference.
  Mr. HAYWORTH. If the gentlewoman would yield, and again, I certainly 
respect, and I think the American public, Mr. Speaker, joining us 
tonight hear a constructive debate, albeit different, and dare we say 
in some ways partisan. But that is the nature of what goes on here.
  I think it is very important to respond to several of the points that 
were raised. When we talk about improving a program, I think the 
philosophy could not be clearer in what I am hearing from the 
gentlewoman from Texas. Is it not more important to offer choices to 
Americans regardless of their age than to say, here is a one-size-fits-
all program, basically 1964 Blue Cross Blue Shield codified into law in 
1965. Is there not a way to expand choices and improve the program 
while maintaining for those seniors who want to remain on this program, 
Medicare as we know it, maintaining that program?
                              {time}  2350

  Mr. HAYWORTH. You and I disagree and indeed, I will graciously give 
the time.
  Ms. JACKSON-LEE. Let me reclaim my time, and I thank the gentleman 
for engaging in this discussion, and let me answer, and I am going to 
reclaim my time because the hour is fast closing.
  I have been in this process before and I respect the gentleman for 
acknowledging that we all come from different backgrounds and have had 
different experiences, and as a member of the city council of the city 
of Houston, we have had to now, over the years, look very seriously 
about new health packages as the costs have gone up in the private 
sector. What we find happening and what I heard most of all in my 
district and from my seniors of all various economic backgrounds is 
that they like the choice that they have now, which is the choice and 
opportunity to go to those physicians that they have developed a 
comfort level with and those hospitals that they have developed a 
comfort level with, and I would beg to differ with the gentleman.
  Reclaiming my time, what will happen is that the choices that the 
gentleman is talking about is the choice to be placed and forced into 
managed care and thereby forbidding and prohibiting seniors from those 
long-standing relationships, and what ultimately happens is that as the 
numbers begin to rise, then the choices become limited and the managed 
care becomes the only source and choice for these seniors.
  Again, I go back to the concern that I have raised with many of my 
colleagues because I come from a district that has a very strong public 
hospital system and what I say is that the burden will fall on the 
sickest of our seniors, those needing long-term care and otherwise who 
cannot participate in a managed care because they are not viable and 
will not be selected. It is a mutual selection process and a cross-
pollenization.
  I would say to the gentleman that he raises some valid points. I 
vigorously disagree, but what would be more productive is that we have 
this openly discussed through those service providers, 

[[Page H 9362]]
those seniors coming to the U.S. Congress. It does not do us as 
policymakers well for us to rely upon, as they say in the court of law, 
hearsay. It is important. Yours is hearsay, what you have heard in your 
district, and maybe what I am saying I am saying to you something that 
I heard in my district, we both know it is fact, but technically it is 
hearsay. The seniors are not here to tell either one of us.
  So it is important then that if we are serious about reforming 
Medicare, which took some, I would say, some 65 years into the 20th 
century to be formulated, now when we try to reform it in such a major 
way, do we not owe the American public and owe this issue four weeks 
for hearings to decide it in the most effective and the best way? I 
cannot agree that cutting $270 billion for a tax cut that the 
Republicans are offering would in any way assist us in reform.
  Mr. HAYWORTH. Would the gentlewoman yield?
  Ms. JACKSON-LEE. I yield to the gentleman from Arizona.
  Mr. HAYWORTH. Mr. Speaker, a couple of points need to be made and let 
me clear it up without having hearings. A misconception seemed to be 
put forth here a second ago. I am certainly not suggesting, nor do I 
think anyone in this new majority is suggesting that seniors be 
compelled to leave the doctors under whose care they find themselves 
now to somehow sacrifice that physician-patient relationship. Nothing 
could be
 further from our intent.

  Moreover, with reference to $270 billion and somehow a tax cut for 
the rich, the gentlewoman from Texas certainly realizes that the Budget 
Committee, under the stewardship of the gentleman from Ohio [Mr. 
Kasich], worked very hard to make sure that those tax cuts were fully 
provided for in the budget plan and the road map and the glide path to 
a 7-year balanced budget. Moreover, even if the budget were balanced 
today, we would still have this threat of the Medicare Trust Fund.
  Ms. JACKSON-LEE. Reclaiming my time, and I thank the gentleman for 
his insight on this, but let me respectfully share with the American 
people that the $270 billion tax cut has always been associated with 
the money that was going to be cut out of Medicare, plain and simple. 
Let me say to you that even those Republicans who no longer serve in 
government, Arthur Fleming, the health secretary, Health and Human 
Services Secretary under President Eisenhower, still going strong, has 
indicted the Republican Party and said he cannot believe that you would 
offer these proposals without allowing the American people, seniors in 
particular, to participate.
  Mr. Speaker, what we are facing, and what I hope that we will 
engender, are calls from across this land, all of the States that are 
impacted by these draconian cuts. I hope that you all will get calls, 
and likewise in my office, demanding, if nothing else, a reasoned 
debate among the American people on this issue.
  Might I say that we all will have to live with these cuts no matter 
what party we are in. We will have to live with them not so much 
because the Democrats were involved in cutting. That is not our 
posture. Our posture is to lay down before the bulldozer, but because 
our constituents will be harmed and hurt and it is probably going to be 
irreparable injury, and in a court of law, there are grand damages for 
that.
  I would simply say to the gentleman what we will be facing in this 
Congress, without having proposed a national health reform program, we 
will not jointly be able to go to the American people and say that we 
in good conscience cut this for them 7 years, over $4,000 in some 
instances, people having to make the choices between food and 
prescription drugs, and in joint support of that, the cuts in Medicaid, 
$182 billion, and those indigent seniors who cannot get long-term care.
  Mr. Speaker, I am reclaiming my time and I thank the gentleman for 
his interest, but the key is that those who are in long-term care 
needing Medicaid will likewise not have the right and not have the 
ability to have health care.
  Let me just say one other point as we move toward closure. Can the 
gentleman not, or my colleagues that I have just heard my fellow 
freshmen that are Republicans, can they not deny that the population, 
the aging population is getting stronger, is living longer, and in 
fact, if you would analyze the trust fund and find out the real reason 
why there is a life span that is shortened each year is because people 
are living longer? We should be applauding that. We should be very, 
very enthusiastic that the gentleman from Arizona has a grandfather and 
many of us have our parents, my parents, alive and well because of 
Medicare.
  Thirty years of Medicare, the healthiest population of Americans, and 
yet we are forced in this majority Congress of Republicans to stand up 
and tell the American senior citizens and those citizens who
 have to support senior citizens that we are going to cut them off at 
the knees and tell them that what is more important is the partisan 
debate, you are right, between Republicans and Democrats, rather than a 
reasoned set of hearings that would allow us to put forth programs to 
eliminate waste, fraud and abuse, to be able to work with the physician 
population, the hospital population, both private and public sector, 
the prescription or pharmaceutical industry and begin to analyze for 
real what we are doing or what we need to do to improve the delivery of 
services at a more efficient price, and not leave, and not leave that 
broken and bent body on the road we travel, unhealthy senior, left 
alone on the roadside seeking a simple drink of water. What are we 
going to give them?

  Mr. HAYWORTH. Will the gentlewoman yield?
  Ms. JACKSON-LEE. I think my time is up and I am going to continue to 
reclaim it because I think this is an important point I want to make.
  The sickest of our seniors, the sickest of our seniors will be left 
without care, without attention, and as the gentleman is willing to 
debate me now, when I ask him or can I ask him, as he goes and leaves 
the floor and dialogues with his colleagues tomorrow the simple 
question, would it not be better for America if we had these hearings 
to present your presentation, to allow the debate on what I am offering 
to say, but most of all, to listen to the multitude of those who will 
be most impacted by these draconian cuts?
  Mr. HAYWORTH. The gentlewoman asked a question. Would she yield for 
an answer?
  Ms. JACKSON-LEE. I will yield for just a moment because I want to 
conclude.
  Mr. HAYWORTH. Simple point. If the gentlewoman can explain to me how 
an increase over seven years in benefits per beneficiary of $2,000 can 
be a cut, going from $4,800 this year to $6,700 in 2002, where is the 
mathematical rationale to show me that that is the draconian cut that 
the gentlewoman has talked about so often this evening?
  Ms. JACKSON-LEE. I would be happy to show you what the draconian cut 
results in because it is very clear, and the reason why it is very 
clear is because it is evident that you are dealing with provisions A 
and B, and obviously that masquerading of those particular sections are 
where the Republicans are suggesting to the American people that they 
are benefiting the beneficiaries.
  These numbers clearly suggest that those citizens will be engaged in 
higher premiums, clearly will be paying higher premiums because of the 
large cuts that the Republicans are proposing. Where are the hearings? 
Where are the voices of the senior citizens? Let us resolve this on 
behalf of those citizens to make a whole colloquy for all Americans.


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