[Congressional Record Volume 141, Number 156 (Tuesday, October 10, 1995)]
[House]
[Pages H9747-H9748]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




  CALLING FOR TIME FOR CONSIDERATION AND PUBLIC SCRUTINY ON PROPOSED 
                            MEDICARE REFORMS

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 

[[Page H 9748]]
  12, 1995, the gentleman from New Jersey [Mr. Pallone] is recognized 
during morning business for 5 minutes.
  Mr. PALLONE. I am very concerned, Mr. Speaker, that the Speaker, the 
gentleman from Georgia, Newt Gingrich, and the Republican leadership 
are basically moving forward with this Medicare plan that they have 
proposed much too fast and without any real opportunity for public 
scrutiny. I am a member of the Committee on Commerce, and not yesterday 
but the Monday previous, on October 2, we received a copy for the first 
time of the 421-page House Medicare restructuring legislation proposed 
by the Republican leadership. Later that same day, on Monday, October 
2, our Committee on Commerce was expected to mark up the bill, without 
any opportunity for a hearing, without any opportunity, really, to even 
have looked at the legislation.
  At the time, I proposed an amendment to postpone voting until 
hearings were held to review the impact of the legislation on senior 
citizens and the health care industry. All but one Republican voted 
against the measure, voted against the effort to postpone until we had 
hearings, and, of course, the amendment failed. Because of that, many 
members, the Democratic members of the Committee on Commerce, including 
myself, felt we really were just witnessing a railroad job, and there 
was no point in staying at the markup anymore.
  Instead, on the next day, Tuesday, October 3, a week ago, the 
Democratic members of the Committee on Commerce called our own hearing 
to begin discussing the ramifications of this bill. I learned a number 
of things in the course of those hearings on the Republican Medicare 
proposal. First, I learned that of the $270 billion proposed for 
reductions in Medicare, nearly half would not even go to shoring up the 
Medicare Hospital Trust Fund, known as Medicare part A, which the 
Republicans, and I believe falsely, are suggesting faces insolvency.
  Instead, the seniors would be asked to pay more for physicians' and 
outpatient services under what is known as Medicare part B, and 
premiums would double from $46.10 per month over the next 7 years to 
over $90 a month. I make this distinction between part A and part B 
again because the Republicans keep talking about the insolvency, which 
is not really true, of part A, which is the hospital trust fund. 
Medicare part B, though, the fund which pays for physicians' care, and 
where the seniors are being asked now to pay twice as much for their 
premiums, that Medicare part B comes out of the same fund as would $245 
billion in tax cuts proposed by the Republican leadership.
  I would maintain that since any changes to Medicare part B do not 
really impact part A, they are separate funds, it is highly likely that 
the part B cuts would be used for tax cuts, and most of those, of 
course, much of that to the wealthiest of Americans. Do not let the 
Republican leadership fool you. Most of the money that they are talking 
about cutting is, in effect, going to be used for a tax cut. The amount 
of the cut in Medicare is almost equivalent to the $245 billion tax cut 
they are proposing.
  The other thing that I learned about this Medicare plan is that it 
essentially seeks to lure seniors into HMO's and other managed care 
programs with no choice of doctors. This is the main way that the 
Republican leadership proposes to save a lot of money, if seniors do 
not move into managed care plans. There are budgetary gimmicks in this 
legislation that would kick in and take even more money out of the 
Medicare system.

  Previous to having received this Medicare legislation, I had talked 
on the House floor about the Republican proposals for a voucher system, 
where they would simply give a senior a voucher or a coupon for a 
certain amount of money and say, that is all we can afford. That is all 
we are going to give you for your Medicare. Of course, the Republican 
leadership said that is not what they had proposed as part of their 
Medicare program, but if you look at the details of the Medicare 
program, you can see that is exactly what it is. It is a voucher 
system, because essentially what they are doing is giving the HMO and 
the managed care system a certain set amount of money, and if a senior 
wants a better system, or if the HMO or managed care system wants to 
charge seniors more for a better quality health care system, then the 
senior has to pay for it. That is another thing that are not brought 
out, but if you look at the legislation, it is exactly true.
  Then, beyond that, if over the next 7 years or over the next 5 years 
we find out that not enough money is saved because not enough seniors 
are going into the voucher system or into the HMO or the managed care 
system, then all the cutbacks, the so-called failsafe, where if they do 
not save enough money they are going to cut back more on the 
reimbursement to doctors, hospitals, and health care providers, all 
those cuts come in the fee-for-service system, the current system where 
seniors choose their own doctor or their own hospital.
  What is effect you are going here with this Medicare legislation is 
saying, you either go into a voucher system, or if you do not, we are 
going to force you into one, because the cuts are going to come on the 
fee-for-service side. Mr. Speaker, I would like to talk about this 
more. Maybe there will be more of an opportunity later this afternoon.

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