[Congressional Record Volume 141, Number 156 (Tuesday, October 10, 1995)]
[House]
[Pages H9769-H9776]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                LOBBYIST INTERESTS AND CUTS IN MEDICARE

  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, this afternoon I want to discuss two of the 
most critical issues facing this Congress. They are, first, the 
question of ethics, the question of special interest influence on the 
people's House, and whether the people's interests out there across 
America are being tended to in this House or only the special 
interests' interests.
  Then there is the question of Medicare, the fact that within only a 
few days, this House will be called to vote upon the Republican 
Medicare plan; that is, the pay more, get less plan, for the Nation's 
seniors and people with disabilities.
  Indeed, not only do I want to talk about these two critical issues, 
but to discuss what appears to be an interrelationship between the 
critical matter of the future of Medicare and the $270 billion that the 
Republicans have proposed to cut from it and this question of lobbyist 
and special interest influence.
  As we look at the first question, that of ethics and of lobby reform, 
it was on day one of this Congress from this spot that many of us were 
calling to change business as usual, to call for a gift ban, to call 
for lobby reform. Since that time, we have had considerable talk of 
change. Indeed, if talk was change, I guess the Capitol dome would be 
upside down by this point, because we have had so much talk of change, 
and yet when it comes to the basic way in which this Congress operates, 
there does not appear to have been a very considerable amount of 
change.

                              {time}  1615

  We made absolutely no progress on getting a gift ban, no progress in 
getting new lobby registration laws, but we did have considerable talk 
about how much things have changed. The lobby registration laws were 
enacted the year that I was born, in 1946, and many of us think that it 
is time for there to be real change in the way that the lobby is 
regulated. There was talk of change, and finally, under considerable 
demand from Members of the Democratic Party in the U.S. Senate, that 
Senate acted this summer by a vote of 98 to 0, both Republicans and 
Democrats coming together to reform the lobby registration laws. Those 
are embodied in Senate bill 1060, and among other things this 
particular piece of legislation will close loopholes in existing lobby 
registration laws, it will cover for the first time all professional 
lobbyists, whether they are lawyers or nonlawyers, whether they are in-
house or out-house lobbyists, and they will cover those who are 
lobbying the executive branch as well as those that are lobbying this 
Congress. Furthermore, this proposal will require disclosure of who is 
paying whom, a very important matter with reference to lobbying, and it 
will also require more detailed reporting of receipts and expenditures 
with reference to lobbying.
  Mr. Speaker, this is information that the American people need to 
know and should know in order to find out whether this Congress is 
focused on their needs, on the national and the public interests, or 
focused only on the needs of a handful of Washington special interests. 
But, despite the fact that the U.S. Senate Republicans and Democrats 
finally, coming together to reform these lobby laws after 50 years, 
what has happened here in the U.S. 

[[Page H 9770]]

Congress on the House side, on this side of the Rotunda; and the answer 
is there has been a little talk, but there has been no action. There 
has been talk about change, but there has been no change. We have had 
time to consider matters this afternoon like edible oil, but we do not 
have time to consider what Members of Congress eat and drink, and dine 
and wine with members of the lobby or the way that is reported. There 
just does not seem to be time under this Republican leadership to deal 
with these matters that I think are important to the American people.
  Indeed when it comes to the question of lobbies and lobby influence 
here, the only real change that the Republican leadership appears to 
have committed itself to until this time is that of affirmative action. 
Now I know some of you are out there saying, ``Wait a minute. The 
Republicans, a lot of them are against affirmative action.'' Well, you 
are wrong about that. You have not had a chance to follow what has 
happened here in Washington. You see, there may be some Republicans 
that are against affirmative action on the basis of ethnicity, on the 
basis of gender, whether you are a woman and should have some 
affirmative action, but there is very, very strong support among this 
Republican leadership for affirmative action based on party, and they 
have spent much of this year going around to the Washington law firms 
and lobbyists checking to see if they have a sufficient quota of 
Republicans among the lobbyists that come over to this House. Some 
members of this House would not even see a lobbyist unless they are a 
Republican, so affirmative action is alive and well as long as it is on 
the basis of party, and that has been the principal lobby reform that 
this particular House leadership has provided.

  There is, of course, one second area, and that is the one to which my 
colleague, the gentleman from Colorado [Mr. Skaggs], referred to 
earlier, and that is that many in this Republican leadership have been 
extremely concerned about those very vicious lobbies: The Girl Scouts, 
Catholic Charities, the YMCA, some of the other nonprofits that come to 
the Congress from time to time not using Federal money, since there is 
a barrier to that, but who may in the course of their public service 
work receive some Federal grant for some other function, and the mere 
fact that they might want to voice their concerns to this Congress, 
there is great determination to silence them from having any say at the 
same time that at least one commentator, looking at the beginning of 
this Congress, with the New York Times, suggested that, after the 
Republicans took control of the House, the relationship between 
lobbyists and legislators moved from discreet help to open 
collaboration, and then they proceed to give a number of examples of 
the tremendous increase in influence that the paid lobby, not the 
nonprofit lobby, has had in this session of Congress.
  So, it is little wonder that this Republican leadership cannot find a 
minute this afternoon, or tonight, or tomorrow, or next week, or next 
month, to deal with the question of lobby registration and reforming 
the laws that are nearly 50 years old with reference to lobbies and the 
way they influence this Congress. They do not have time for that.
  And of course the same is true with reference to the issue of gift 
bans, with reference to the Golf Caucus of this Congress, which is not 
limited to the Democratic or Republican side, but includes both; 
whether or not Members of this Congress should be able to enjoy a 
lengthy vacation done under the name of attending a charity ski resort 
or whether they can be wined and dined every day by members of the 
lobby. That issue of gift ban finally again, after Democrats passed 
gift ban through the last session of Congress, did it a couple of times 
and saw it killed over in the Senate by the Republicans. Well, this 
year finally, under Democratic leadership, the Democrats and the 
Republicans worked together, and even though the Senate is a majority 
Republican body at present, they came together and worked out a 
reasonable balance to the gift ban issue. It does not prohibit every 
single gift, but it gets at the excesses under this whole problem of 
gifts, something this Congress has not come fully to grips with in the 
past, and that bill also passed unanimously once it got out of the 
light of day on the floor of the U.S. Senate, and it has been sitting 
over here for some time at the Speaker's desk.

  Again there is a suggestion by the majority leader, my colleague from 
Texas, Mr. Armey that this House just does not have time at the moment 
even though it has time to deal with this very critical national issue 
of edible oils to deal with the issue of gifts and the oiling of the 
political process by lobbyists through freebies to Members of Congress. 
Well, a newspaper in his district had this to say under the title 
``Wait a Minute.'' I am referring to the Forth Worth Star-Telegram of 
October 3. It said hold up the praise for the House of Representatives. 
If you are a lobbyist, take your favorite House Member to lunch, steaks 
for everyone. You would expect them there at the stockyards in Fort 
Worth to be thinking of steaks for everyone. And how about a golfing 
vacation for free? The House leadership will not get to lobby 
legislation until next year, which might mean 1997, next year being an 
election year. Thus, do the Republicans, once in power, act like the 
old Democratic leadership which the Fort Worth Star-Telegram criticized 
last year upon which these Republicans heaped descriptions like 
arrogant. The most fundamental changes have to do with reforming 
campaign finance and lobbying. Without that the conservative chant 
about taking back our Federal Government is mere loose verbiage, the 
words of a very conservative Texas editorial writer with reference to 
this willingness to talk about edible oils without talking about the 
oiling of the political process.
  In my hometown of Austin, TX, in the Daily Texan last week, a very, I 
think, thoughtful article under the title ``GOP Stalls on Congressional 
Ethics Reform,'' by Kim Bridges, a student there at the University of 
Texas. He says GOP stonewalling will not restore America's faith in 
their officials. Ethics reform, despite what Mr. Armey seems to be 
implying, is not a trifling issue. It is not a gift for the people, but 
a vital act to relieve frustrations Americans feel about the integrity 
of their Government. Well put, I would say, with reference to this 
whole issue of gift ban and of lobby reform, for when my colleague from 
Texas speaks of the fact that he thinks we have to deal with the 
national issues first and maybe get around next year or the year after 
to lobby reform and a gift ban, he has got it all backwards because you 
cannot really deal with the national issues unless you are willing to 
deal with the process that produces the judgment on that issue, and we 
are going to see, as I discussed, the whole question of Medicare, how 
that is particularly important in this debate about the Republican 
effort to cut $270 billion from Medicare.
  And, oh, yes, there is, of course least but certainly not last, the 
whole question of ethics in this House as it relates to the work of the 
House Committee on Standards of Official Conduct. I found quite 
alarming and have commented on it previously, the comments of the 
chairman of that committee, that the letter of the law is not 
compelling to me, she said. My goal is to have a process that the 
committee members feel good about, and apparently the standard in the 
House Committee on Standards of Official Conduct is the feel-good 
standard, not exactly the one that I think the American people who 
spoke out and said they wanted real change in this body had in mind. 
The only encouraging thing has not come from the leadership, but the 
fact that perhaps finally a few Members of the House are willing to act 
in a bipartisan basis, Republicans speaking up and joining Democrats to 
demand an independent counsel.
  Last week I was encouraged to read one of my new freshman Republican 
colleagues saying for the first time in print that one of the biggest 
problems we have in this place is trust. He referred to the public 
demand on Congress for gift, lobbyist, pension and PAC reform, and he 
said that for that reason this concern of the American people to have 
trust in the most basic institutions of their democracy that probably 
right now, and I am quoting probably right now, I would try to go 

[[Page H 9771]]
to an independent, to an outside, counsel were his words, and indeed an 
outside counsel, a truly independent counsel with full powers, 
unrestrained, to search in a bipartisan, or a nonpartisan way really, 
for the truth in the matter involving Speaker Gingrich is essential to 
the standard in this House and to removing the ethical cloud that has 
hung over this House from day one.
  What about the issue of Medicare, and what does all this business 
about ethics, about special interests, influence, have to do with the 
question of Medicare and the fact that Republicans think that America's 
seniors should pay more and get less, should in fact not be able to 
have the protection that Medicare was designed to provide them? Well, 
for those of you who watched the CBS Evening News last night, you begin 
to get a picture of what is involved here and how this question of 
special interest influence that some want to defer until some day 
somewhere over the rainbow, perhaps over the next election, over the 
golden rainbow, how all of that is related to this immediate question 
that will be taken up in the House on October 18, next week, on 
slashing the Medicare program by $270 billion. For in this particular 
piece my fellow Texan, Dan Rather, began the introduction of the piece, 
and he said last night on the CBS Evening News one key proposal would 
let Medicare recipients opt for something called a medical savings 
account or a MSA, a sort of medical individual retirement account. It 
is a controversial idea; some have called it radical, so you may be 
wondering how it got included in the Republican plan, and I am sure 
millions of Americans are wondering how is it that this idea of 
experimenting on us with MSA's got in this Republican plan in the first 
place. There was nothing about it in the so-called Contract on America. 
Where did they come up with this idea? In fact, indeed there was 
nothing in the Contract on America about slashing Medicare by $270 
billion.

                              {time}  1630

  He goes on to say, ``You can start in getting an answer to that with 
a company calling itself Golden Rule, which apparently did unto others 
with an open wallet for the politically connected.'' Then they began 
something that they do on CBS called the reality check, and turned to 
Eric Ingberg. Mr. Ingberg reported the following: ``The stampede by 
Republicans to anoint medical savings accounts as a miracle solution,'' 
and indeed, that is what it has been called, a panacea, a miracle 
solution to the needs of our seniors. He says, ``It owes much to one 
businessman's well-financed political crusade. J. Patrick Rooney, the 
head of Indiana's Golden Rule Insurance, pioneered selling the MSA type 
plans. He originated a textbook campaign to promote MSA legislation, 
which could bring rich rewards to his company. One early move, giving 
money to the National Center for Policy Analysis, the think tank that 
developed MSAs, that helped sell the idea to Newt Gingrich, who in turn 
put Rooney on his TV college lecture series,'' one of the matters 
pending there in the Ethics Committee, the particular group, the 
National Center for Policy Analysis, has itself been involved not only 
in receiving money but in debating and supporting this MSA concept.

  In one recent television presentation, not last night, on national 
television, one economist pointed out that a principal effect on MSAs 
would be to provide significant help to companies like Golden Rule 
Insurance Co. that are currently experiencing a decline in market 
share, were his words, because they have failed to innovate. They may 
have failed to innovate, I am not sure, but they certainly understand 
the legislative process, because as Mr. Ingberg reported last night, 
``Then Rooney and Golden Rule, following a time-honored political 
custom, opened their checkbooks. They gave at least $157,000 to 
GOPAC.''
  GOPAC is the group that is currently fighting a Federal lawsuit 
concerning disclosure of information about its contributors. GOPAC has 
been very resistent to the idea of even letting their contributors be 
known, and certainly to letting Federal authorities question their 
contributors about whether GOPAC was perhaps an attempt to pervert the 
democratic process and completely circumvent Federal election laws.
  GOPAC is also the same group that paid for jet trips and nights in 
resort hotels for the Speaker. They paid for him, and this was when he 
was a Member of Congress, not actually serving as Speaker, they paid 
for a trip for him to Bermuda in 1992. They paid for an 18-day stay in 
the Colorado Rockies in 1989. They reportedly funded trips to promote a 
book that he wrote in 1984. They provided a copy of their mailing list 
for his campaign, so this same GOPAC that got $157,000 from the Golden 
Rule folks has been pretty involved up here for a number of years.
  Indeed, I found considerable irony in a report of the Wall Street 
Journal on this whole matter of ethics reform, that instead of doing 
something about a gift ban and a lobby reform this fall, that Speaker 
Gingrich had advocated writing a paper.
  You would think, as many books as he has been able to write, both 
fiction and nonfiction, though sometimes when you look at them it gets 
confusing as to which is the fiction and which is the nonfiction when 
it deals with the way our government intertwines with the lives of 
ordinary Americans, but you would think that a person who had time to 
write that many books for personal profit and pleasure would have had 
time to write all the papers in the world that he needed about the gift 
ban and the lobby reform that this Congress, of which he was a Member, 
passed not once but twice last year, but which, still, as this Congress 
is beginning in September of this year, he still thinks we need to 
write a paper about. The paper, I do not know if it has been written, 
there are certainly none presented, the book sales are going on.
  Let me return to Mr. Ingberg, because he says, ``In addition to the 
$157,000 to GOPAC, the Gingrich political arm, another $45,000 went 
directly to the last two Gingrich campaigns, and in addition,'' out of 
concern for the American people and what they know about the political 
process, ``Golden Rule was golden in its rule and it sponsored the 
Gingrich cable TV show.'' He says. ``Gingrich insists himself that he 
likes MSAs because they work,'' and it appears that they have worked 
very well for him and for GOPAC.
  Indeed, continuing with the Ingberg report from last night's CBS 
news, Golden Rule would not talk to Mr. Ingberg, and he concludes his 
report by saying, ``Washington has its own Golden Rule: money talks. It 
is not exactly clear yet on the MSA issue how loud. Eric Ingberg, CBS 
news, Washington.''
  I think that it is a good example of why, when we are dealing with 
matters of public policy, we need our lobby laws reformed. We need 
gifts banned. We need to be assured before we slash $270 billion from 
Medicare that it is being done in the public interest and not in the 
self-serving interest of some insurance company someplace. Indeed, an 
insurance company that the Wall Street Journal has reported in 
September of this year, that perhaps, ``No other health insurance can 
cherry-pick,'' that is, pick the best risk out and leave perhaps the 
taxpayers, in the case of Medicare, with the balance; ``No other 
insurance company,'' the Wall Street Journal reports, ``can cherry-pick 
its way to unusually high profits as well as Golden Rule Insurance 
Company. Screening insurance applicants carefully, Golden Rule tries to 
sell policies only to the healthy, or those whose existing medical 
problems can be exempted from coverage.''
  One of the real, basic problems, whether you are talking about Golden 
Rule or any other insurance company, or no insurance company, with 
these MSAs, is that whole problem of leaving on the traditional 
Medicare system, as it sinks, those who are least healthy, and cherry-
picking off the others into these so-called MSA's, which may be more to 
the direct savings benefit of some of those who set up the plans than 
to those that might participate in those plans.
  So it is the interrelationship between the need to make a break 
between the special interest and the public interest and the 
interrelationship between this sad circumstance and the debate that 
lies ahead within the next few days on the question of Medicare and of 
Medicaid.

[[Page H 9772]]

  October 18, a day, 1 day in American history, the only day in 
American history that this same Republican leadership that has been so 
closely tied with Golden Rule is going to rule that the American people 
and their Representatives here in Congress will have that 1 day to mark 
up on the floor of the House and decide the fate of the Medicare 
system, whether the Medicare system will follow the approach of the 
majority leader, the gentleman from Texas [Mr. Armey], who said there 
in Texas earlier this summer that Medicare is an imposition on his 
freedom, he would have never set it up in the first place, whether we 
follow the approach of eventually seeing Medicare abolished as an 
imposition on someone's freedom, or we take the approach that those of 
us from Texas and elsewhere who supported the Medicare creation in the 
first place, that having the security, the health security in one's 
retirement years, affords a certain freedom of itself.
  There is closely linked, of course, to the Medicare issue in this 
Congress, as it relates to seniors, as it relates to people with 
disabilities, the question of Medicaid. Some people think of Medicaid 
only as a program for poor people. It is true that the people who 
participate in the Medicare program are poor, but in my State of Texas, 
three of every four residents of nursing homes are on Medicaid. That is 
the principal financing system, since a deficiency of Medicare, which 
we should be out here today debating how to improve and strengthen it 
instead of how to bleed it dry, but a deficiency with reference to 
Medicare is that it does not adequately cover long-term health care or 
prescriptions. The Medicaid program is therefore turned to.
  What is the solution that is being offered to those three of four 
Texans who rely on Medicaid to help them in nursing homes, being there, 
I am sure, since I have yet to find anyone in this country, much less 
my home community of Austin, TX, who had as their ambition to go into 
their nursing homes. There are many fine nursing homes, but most of the 
people, if not every single one of them that are in nursing homes, are 
in there because they cannot take care of themselves. So those most 
vulnerable people in our society, three out of four Texans in nursing 
homes, they are depending on Medicaid.
  What does this same Republican leadership that could not find time to 
deal with lobby reform or ethics reform, could not find them to 
complete an ethics investigation, how is it that they propose to deal 
with Medicaid, the safety net for those three out of four Texans and 
many, many people across this United States? They proposed to abolish 
Medicaid, to eliminate it. They say that they will replace it with 
certain block grants to the States, and then they will just transfer 
the program along to the States. Of course, they will not transfer 
enough money for the States to do it adequately, but maybe the States 
can make up for it and take care of it in some way.
  In the course of transferring the Medicaid problem to someone else, 
instead of assuming responsibility where it belongs, as a national 
problem, as a national issue of providing a safety net to the most 
vulnerable people in our society, our seniors who cannot take care of 
themselves and are in nursing homes, our people with disabilities who 
are in nursing homes today, this Republican leadership has added to the 
taking away adequate money. They have also taken away adequate health 
and safety standards.
  Yes, it was with considerable effort, and after one scandal after 
another that States were not adequately policing. In fact, I know from 
my service in the Texas legislature as a Texas State Senator that we 
uncovered with one agency there in Texas a pile of about 600 complaints 
that had never even been looked at with respect to some of these 
administrators in some of these homes.
  Yet, after one problem after another, it finally produced Federal 
standards to ensure the safety and health, sometimes not adequate 
standards, but certainly better than what we would have otherwise 
across this country for those who are in nursing homes. What does this 
Republican leadership do about those safety and health standards? It 
repeals them. It repeals not just one that someone might find debatable 
or questionable or not productive in assuring health and safety. We 
need to review all these regulations to see if they serve their 
purpose. However, the Republican leadership has a better idea. Instead 
of looking to fine-tune the regulations and assure the health and 
safety of the millions of Americans who are in nursing homes, they 
repeal all the regulations, so that we will have the least common 
denominator with reference to health and safety in nursing homes.

  I suppose, at a time when funds are going to be cut back to those 
nursing homes, one could hardly expect that even the most concerned 
nursing home would not be out there trying to figure a way to cut some 
corners in order to make a go of it. Yet, at the same time the money is 
going down, the regulations are being totally repealed. We leave the 
health and the safety of millions of America's most vulnerable seniors 
and individuals with disabilities to no Federal protection whatsoever. 
As I visited at Austin this weekend, people there were amazed, were in 
a state of disbelief that a leadership could be so callous as to repeal 
every one of those health and safety regulations.
  There is another aspect of it. That is the fact that we will also no 
longer have any limitation with reference to compelling a spouse who 
has the misfortune of no longer being able to attend to the needs at 
home of their loved one, their husband or their wife, and have to place 
their husband and wife, perhaps with Alzheimer's or with some other 
exceedingly difficult and troubling disability, which takes an immense 
emotional toll on a spouse in any event, but now, in addition to that, 
they could be forced to sell their home, to sell their car, in order to 
finance the spouse being in a nursing home, under the way this plan is 
going to be revised.
  Some may think that that is just, you know, a possibility that might 
not be achieved, but I had occasion this weekend in Austin, TX, to talk 
with someone who faced a very similar situation. I stood for a couple 
of hours out at a grocery store in north Austin, and held office hours 
there so people could come up and discuss with me their individual 
problems, or discuss this great concern that so many of them have about 
Medicare and Medicaid.
  Carlene Willy came up, a University of Texas employee, and told me 
about the plight of her mother, about the fact that when her mother had 
to go into a nursing home, that she was forced to sell her house as a 
part of going into that nursing home, in order to get approved for 
Medicaid; how she is struggling as an individual, and does not really 
know if Medicare costs go up considerably, and we end up with this pay 
more, get less Republican plan, and if at the same time the Medicaid 
that provides financing for nursing homes, that is block-granted in a 
truly block-granted hinted approach, that if that happens, she is going 
to be faced with a personal crisis; because, you see, it is not only a 
question of how Medicare affects our Nation's seniors and our Nation's 
millions with disabilities, but it is a question of how it impacts the 
ordinary middle-class family, or in her case, a single individual; how 
they are going to face the problems of making ends meet themselves, in 
some cases taking care of their children and at the same time meeting a 
medical emergency or a need for long-term health care of a parent or a 
loved one of advanced years.
  Mr. Speaker, my problem, as I listened to these stories at home of 
people concerned that we are about to junk one of the most effective 
programs this Congress has ever set up, Medicare, supplemented by 
Medicaid, when we hear then in Washington how the Members of the 
Republican leadership think they can fix up and doctor up Medicare, 
that the kind of doctoring they have in mind is the kind of doctoring 
done by Dr. Kevorkian.
  It just does not it seems to me that Medicare or Medicaid need any 
kind of mercy killing. I think it needs to be strengthened and improved 
on a bipartisan basis, not bled to death. I guess that is, perhaps, 
another analogy. There was a time in medical history a couple of 
centuries ago when doctors thought many elements could be treated by 
bleeding.

                              {time}  1645

  That seems to be the approach that our Republican colleagues have 
taken 

[[Page H 9773]]
to Medicare. They say it has some problems, and it does, and it needs 
attention, though it is not a crisis situation. But their solution is 
not to improve and strengthen Medicare; their approach is the approach 
used by the medical profession 200 years ago: Bleed the patient. Keep 
bleeding it.
  In this case, they want to bleed it to the tune of $270 billion in 
order to fund a tax break for the wealthiest people in this country, 
$245 billion over the next few years, eventually $600-something billion 
in total tax breaks that are going to come out as a result of cuts or 
with the benefit of cuts from the Medicare System, with the slashing of 
the Medicaid Program, to fund those tax cuts. Treat that patient by 
bleeding it and bleeding it, and if bleeding does not work, start 
amputating things, which is what they are doing with reference to both 
Medicare and Medicaid.
  Mr. Speaker, I believe that as we look at this Republican Medicare 
plan, and little looking has occurred because we have had the Committee 
on Ways and Means only this week beginning to have a chance to mark up 
or chop up the bill. That is going on perhaps this afternoon. The 
Medicare Program is getting its first markup now, and then in little 
more than a week it will be here on the floor of Congress with only a 
day to debate it, and then the American people will hear some 
discussion of the pay-more-get-less plan. But it will be perhaps only 
after a conference committee resolves the differences that we will know 
the full burden of that plan and what it will ultimately mean to the 
people of America.
  Before going into that, I do need, as a Texan, to point out one other 
thing about this Medicaid debate, and it is a particularly critical one 
for my State, not just my State, and that is the question of the 
formulas, for as the State comptroller of Texas has so ably pointed out 
throughout this debate, this particular Medicaid formula being advanced 
here in the House is going to provide the State of Texas next year with 
46 cents on the dollar, 46 percent of the Medicaid spending of New York 
State; $298 per capita in Texas, $654 in New York. By the year 2000, a 
Texan will be worth 54 percent of what a person in New York is worth.
  Now, I am confident that there are very significant needs in New York 
State with reference to the health of disadvantaged young people. About 
1 in 4 children in this country are on Medicaid for their health care 
needs, for disadvantaged seniors. But why is it that a Texan is only 
worth half as much as a person in New York? I think all of these people 
are important and in need of health services. But the formula that this 
House is being asked to approve gives us 50 cents on the dollar, not 
even that next year in the State of Texas, and yet some of the Texans 
that are in this Republican leadership have blessed that plan which 
denies to Texas and denies to many other States a recognition of the 
growing levels of people that come on to our Medicaid Program.
  Again, when you shortchange Texas, as this plan does, as our State 
comptroller has pointed out, you again put the squeeze on nursing 
homes. At the same time you take off the regulations, you assure 
shortcuts, you assure poor-quality care, and assure danger, until 
another scandal comes along and someone says, wait a minute, that 
Republican Congress that was so zealous, so extremist in 1994, has to 
repeal every single health and safety standard as to giving Texas 50 
cents on the dollar--with reference to its individuals with 
disabilities and seniors in nursing homes--of what New York got. We 
have to go back, because we have had one scandal after another of 
people being found dead and diseased in nursing homes across this 
country. We ought not to let that happen.

  If we would address this formula and in fact address whether it is 
really in the interests of this country to shift the Medicaid problem 
to the Nation's States instead of dealing with it here as a part of our 
responsibility to assure that every American would have the level of 
health care coverage that a Member of Congress would have, then I think 
we would be doing a better job than getting mixed up in the formula 
debate in the first place.
  But let us look now, as a part of this Republican pay-more-get-less 
plan, at some of the things that are done with reference to differences 
between the Senate and the House plans, because I think ultimately we 
are going to get a little bit of both.
  The Republican plan, as analyzed, would appear to mean premium 
increases per month of about $18 over what we would otherwise have. 
That does not seem like much to a lot of people, but to the person who 
came along to see me out at the grocery store in North Austin this 
weekend and had a sack of prescriptions--not one of which was paid by 
Medicare since Medicare does not cover prescriptions--another $18 a 
month is a mighty big chunk to have to take care of.
  Also, the deductibles would be increased. Both the House and the 
Senate plans increase premiums, and the Senate plan also cuts benefits 
and doubles deductibles from $100 a year to $210 a year. Now I 
understand that to someone making well over $100,000 here in the 
Congress, that does not seem like very much. But if you are one of the 
women in this country, the millions of women in this country, who have 
nothing more than a Social Security check, and a small one at that, to 
pay for your health care and for your rent and for your prescriptions 
and your food, getting that deductible increased so that you do not 
have Medicare after you pay the first $100, you have to pay the first 
$200 or $210 before you have Medicare, I think what is going to happen 
is what people told me about yesterday when I was over at the Conley 
Guerrero Senior Activity Center there in Austin, is that when they face 
that choice of whether to get health care many of those seniors are 
going to say well, I believe I can wait. I believe I can tough out the 
pain. I do not believe that I can afford to eat and pay my rent and go 
get that additional care, because I have to come up with $18 more a 
month in premiums. I have to come up with $210 before it even does me 
any good, and I believe I can put it off.
  In many cases, putting it off is going to do serious damage to the 
health of that senior, who is not an expert in health care. I think we 
need to be encouraging access to health care, accessibility of that 
health care, rather than erecting new barriers for those seniors.
  I also found in my visits in Austin considerable concern about the 
question of whether or not one would be able to continue to see their 
own physician. Many of these seniors have complex health care problems. 
It is important once a physician-patient relationship is established. 
There are things that cannot be recorded in that funny handwriting you 
sometimes see the doctor makes on the chart. There is a human 
connection between the health care provider, between the physician and 
the patient. Seniors particularly have concern about having that 
relationship broken, about having that relationship ruptured by what 
they call managed health care. They are concerned about the quality and 
the contact with the health care individual. I think that is a 
legitimate concern and one that is not being adequately addressed by 
this Republican plan.
  Then the Senate plan, as you may know, is a plan that would also, 
instead of bringing down the age and covering more of those in our 
society who do not have health insurance, the Senate plan goes the 
other way. It says, well, let us eventually not cover people who are 65 
years old at all with Medicare, deny them all Medicare coverage, just 
as we are going to repeal all of those health and safety standards for 
the nursing homes. Deny it for those who are 65, deny it for those who 
are 66 entirely, and raise the age to 67. I think that is the wrong 
direction in which to go.
  These changes that are being proposed to be implemented this year, 
through, as bad as they are, as far-reaching as they are, when they 
come up in this House on October 18, next week, are not nearly so 
severe as where we are headed with reference to Medicare.
  You see, the basic premise that these great reformers have with 
reference to Medicare is the basic premise that Medicare is an 
imposition on their freedoms, that it was a mistake. That is why over 
90 percent of the Republicans who are in Congress in 1965 voted against 
it in the first place. If you go back and you look at the debate 30 
years ago, you can just about read it today, because they are saying 
the 

[[Page H 9774]]
same thing today that those who opposed Medicare were saying three 
decades ago.

  I see the gentlewoman from Colorado [Mrs. Schroeder], who has spoken 
so eloquently on these matters, entering. I have been discussing, of 
course, the interrelationship between the failure of this Congress to 
deal with ethics, continuing to postpone this investigation of the 
Speaker, continuing to defer action on lobby reform, on gift reform, 
and now the fact that we are about to get 1 day on the whole question 
of gutting and cutting Medicare by $270 billion, which may actually 
have, as a principal benefit, apply the golden rule to golden rule 
insurance companies, providing significant savings to those who may 
prosper as private companies on this disintegration of the Medicare 
System, but may do nothing but cause great pain and harm and fear to 
the Nation's seniors and individuals with disabilities.
  Mrs. SCHROEDER. Mr. Speaker, would the gentleman yield?
  Mr. DOGGETT. I yield to the gentlewoman from Colorado.
  Mrs. SCHROEDER. Mr. Speaker, I thank the gentleman from Texas. I was 
working in my office when I saw you take the floor and I thought you 
were making some very eloquent points that I am really pleased you have 
the courage to come over here and continually make.
  I do think there is an interconnection. This morning when I arrived, 
I gave a 5-minute dissertation of what was going on in Medicare and 
Medicaid and talked about the fact that what they are talking about 
doing is taking away the spousal impoverishment, so that if a family, 
if a couple, suddenly one has to go into a nursing home, guess what? 
They have to spend everything they have before they can qualify for 
Medicaid. They undid the spousal impoverishment that we worked so hard 
on.
  They also said that now, if you go to a nursing home, there is not 
going to be any standards that we worked so hard to get, standards to 
treat people with dignity. We remember those horror stories, and on and 
on and on.
  I want the gentleman from Texas to know that a Member from the other 
side took the floor, would not yield back to let me answer him, and 
started saying that I was doing mediscare again and this was just 
terrible and what was really wrong with America was Federal estate 
taxes were too high. Now, Federal estate taxes were too high? That just 
tells you, it kind of brings the gift ban, it brings the campaign 
finance reform, it brings the fat cats together. In other words you are 
a middle-class couple and somebody gets really ill, you have to deplete 
all of your resources. They can then go after your children's 
resources. They are undoing all of the laws that we put in to protect 
and divide those. And the answer was, I am trying to scare people 
because they did that. I did not do that, they did it. They scared 
people. And what is really wrong with America is the Federal estate tax 
is too high.
  Now, none of these people are worried about the estate tax, because 
they are not going to have any estate at all. What they are worried 
about is where do they go now that poor houses have been absolved in 
most of the country.
  So I think the gentleman is doing a very good job, and I think that 
is why we are seeing this connection, this synergy come together, of 
just writing off the average American.
  Mr. DOGGETT. I actually was noting that I visited with Carlene Wiley 
in Austin, TX on Saturday morning at a grocery store in North Austin, 
and she is one of those people who is just too concerned about estate 
taxes for her mother, because the only way she could get her mother 
into a Texas nursing home when he was unable to care for her any more 
was to sell her mother's house, so that her mother has no estate left 
other than whatever little personal belongings she may have there in 
the nursing home.
  I think that may be the type of person. We are talking about real, 
live human beings that are out there today facing these problems, 
whether we take that system in place today and extend it so that if you 
have a couple out there and one of them becomes so ill with say 
Alzheimer's that they can no longer be cared for at home, with the 
tremendous emotional toll that that would take on a husband or wife, 
that they find themselves in addition to that awful emotional loss 
faced with selling their house or selling their car, selling their 
estate in order to just get a basic level of health care without any 
longer even a Federal safety net there as far as assuring that when 
they get into the nursing home after they have sold their house and 
car, they will have any quality care.

                              {time}  1700

  Mrs. SCHROEDER. The gentleman is right. I know the gentleman's 
family, and he knows mine. I cannot think of anything worse than my 
husband and I later on, one or the other of us becoming very, very ill 
and having to go to a nursing home. Obviously we would feel terrible 
about that.
  But the fact is that now, after what the Committee on Commerce did, 
we took away the spousal impoverishment thing. It would not just be the 
mother and her home, it is everything that couple owns must be sold 
before they can go onto Medicaid. Everything they own.
  The remaining spouse, who is still healthy, ends up with a big goose 
egg. How are they going to live the rest of their life? Suppose they 
are 80 at this point, and their home has now been sold and their car 
has now been sold?
  That is why the Women's Caucus worked so hard in 1988 to say, no, no, 
no, divide the couple's assets and make sure both of them do not have 
to be impoverished to get one of them the kind of care they need, 
because what happens to the one that is left, the survivor?
  Now, of course, they can also go after adult children. They are 
repealing that, so they could also come after this woman's home that 
was in the grocery store. It would not just be her mother's home she 
had to cash out. They could now put a lien on her home to help pay, 
because of what they did in the Committee on Commerce.
  But to have the response be, well, we really should lower estate 
taxes on people, that is ridiculous. I believe the Federal estate tax 
does not even kick in until they have a Federal estate of over 
$600,000. That is not an issue for the average American person. But who 
is giving these big campaign contributions? Who is giving the gifts, 
who is taking people to play golf, who is doing all that? Those are the 
things that we are complaining about.
  Mr. DOGGETT. I was wondering in that regard if the gentlewoman had 
the opportunity last night to see the reality check. She is aware of 
the need that this Republican leadership has to do a reality check, 
because sometimes we wonder where they came from when they talk about 
conditions in America that do not seem to bear any relationship to the 
way real life is out there for ordinary hardworking Americans. But did 
the gentlewoman see the reality check last night about the role of 
Golden Rule Insurance Company and the medical savings accounts with 
reference to this whole Medicare struggle?
  Mrs. SCHROEDER. I thought the gentleman was doing a very good job of 
explaining that, and I think they ought to explain it again, because I 
also saw this weekend that the other side of the aisle is talking about 
even doig away with all the Federal health insurance for all Federal 
employees and Federal retirees and giving them this same medical health 
account that they talk about, that this insurance company apparently is 
feeling that they could make a lot of money on.
  Mr. DOGGETT. In other words, if they pick out the healthiest seniors 
and leave traditional Medicare with those that are the weakest and the 
sickest and lack good health, that need the most care, they cherry pick 
those, as the term is used in the industry, then the next step, just 
like probably the next step after wrecking Medicare is to wreck Social 
Security and slay that dragon, as Speaker Gingrich's Peace and Freedom 
Coalition called for in February this year, that the next step would be 
to go to Federal workers and to let same golden rule apply there.
  Mrs. SCHROEDER. Golden Rule is going to own all the gold if this 
works the way the gentleman from Texas is explaining. That is exactly 
what I understand. They are going to say to people, if I am right, they 
have this option to have this medical savings account. However, anybody 
who has more than a couple thousand dollars of expenses a 

[[Page H 9775]]
year certainly would not take that option, would the gentleman not 
guess?
  Mr. DOGGETT. I would think that would be the case. The gentlewoman is 
aware that at the same time that Golden Rule developed this zealous 
interest for reforming, in its own self-interest, the Medicare system 
which has served America so well, that it contributed $157,000 to 
GOPAC. Is the gentlewoman familiar with GOPAC?
  Mrs. SCHROEDER. The gentleman from Texas is absolutely right. GOPAC 
is something I am very familiar with. I think one of the other items 
that I also read this weekend was the New Yorker article about GOPAC 
and about its connection to the Speaker and bringing this new 
leadership in, how it funded the tapes and the training and all of 
those types of things that we now see happening.

  It sounds very convoluted, and when we start talking about it, I am 
sure people's eyes glaze over, but I think it is terribly important to 
understand how this Government is working. I think when they understand 
that, they will understand that there is so much cynicism, that if 
really big bucks goes into something that then allows you to become so 
terribly powerful, guess what, you are very apt to use your power to 
make those big bucks even more bucks.
  It is a good investment, right? It appears that this insurance 
company that made this investment in GOPAC made a very good investment. 
They are now going to get paid back many times over by having 
legislation that helps them.
  Mr. DOGGETT. So Golden Rule contributed to this farm team program 
called GOPAC to train and tutor people, and these were the same people 
that were going around, regardless of what office they were running 
for, and telling the American people that they could come to Washington 
and they could eliminate waste and fraud and eliminate bureaucrats and 
they would solve all the problems in the world.
  Now what they are doing, instead of eliminating waste and fraud, is 
eliminating the basic standard of care that our seniors have relied on, 
whether they are in nursing homes or whether they are in Medicare. In 
fact, the anti-fraud provisions in this bill, which you would expect 
all of us would have gotten together on, they have actually provided 
less funding to fight fraud with reference to Medicare and Medicaid in 
the appropriations bill than was done in the last Congress in which the 
gentlewoman served. Is that not correct?
  Mrs. SCHROEDER. The gentleman from Texas again, I am sorry to say, is 
very correct. We should not look at people's words, we should look at 
the bill. Here all they want to do is throw words. We have not even 
seen the real bill, I guess, on Medicare.
  We got a printed one, I hear, on Friday. Then on Monday there was a 
new chairman's mark that was something entirely different, and I guess 
they spent yesterday discussing it, but again it was all verbal. It is 
all fuzz. It is a bag of smoke. It is a real bag of smoke, but in that 
bag of smoke I think there are some chunks of gold for a few people who 
invested early, invested early in the new group in power.
  What it really means is they are toasting the average American's 
Medicare card, that the Medicare things that you thought you owned and 
you thought were represented by your Medicare card are being really 
brokered away in all of this and diminished.
  For all of this Mediscare that I think they are the ones projecting, 
I think it is interesting that they do not ask the trustees did they do 
the right thing. They have not taken their bill to the trustees. They 
are not having hearings.
  I have been saying, look, they have had more hearings on the Chinese 
prison system than we have had on Medicare, and I think it is because 
they do not want all these connections of the Golden Rule and GOPAC and 
Medicare proposals all coming together, because then maybe more people 
would see it than just the several television shows that have been 
talking about it or the New Yorker article that is talking about it.
  Mr. DOGGETT. I always thought when they talked about Mediscare, they 
were talking about the Republicans who were mediscared to come out here 
on the floor and explain these cuts that they are making, and they 
still have not as of today. We have yet, through this very afternoon, 
now that we are well into October, we have yet to have a Republican 
Member come on the floor and explain the way seniors are going to be 
cut.
  They are saving all that for this surprise package that I suppose 
will be presented to us next week. At least we have a date for that. We 
have no date for a report on the ethics problems involving Speaker 
Gingrich. We have no date for dealing with the problem of lobbyists 
giving gifts to Members of this Congress. We have no date with 
reference to reforming the 50-year-old lobby registration laws. But 
they have given us 1 day next week for the surprise package to cut $270 
billion from Medicare, have they not?
  Mrs. SCHROEDER. Absolutely. If the gentleman would yield again, we 
also have no date for when we are going to take up campaign finance 
reform, which was the grand handshake up in New Hampshire. We have not 
seen that, either.
  But the really interesting thing is, in all my life in politics, 
whenever there has been an election year we have always talked about 
the October surprise. The October surprise was always what the 
candidate was going to pull at the last moment.
  I suddenly think we have a new word that ``October surprise'' is 
going to mean, and it is going to be the surprise for America's older 
citizens and what this Medicare package might mean that we have not 
seen yet. This October surprise is going to have a whole new message 
this fall. Beware the October surprise.
  But I think if you really know about it, which is what the gentleman 
is trying to tell everybody, you would not be surprised, because if you 
make the connection between GOPAC and you make the connection between 
campaign finance reform and gifts and lobbying and all the things that 
concern people, then you would not be surprised the way it is going to 
come out, I think.
  But for those who have listened to the rhetoric and not demanded the 
details, they are going to be surprised. I think the time has come to 
demand the details. If this is so harmless, let us see it. If this is 
so wonderful, maybe they have come up with something no one ever 
thought of before.
  Mr. DOGGETT. Maybe Golden Rule has come up with something.
  Mrs. SCHROEDER. Maybe Golden Rule has come up with something.
  Mr. DOGGETT. I believe the gentlewoman was a supporter of a proposal 
by a colleague of ours, the gentleman from California [Mr. Miller], to 
actually suggest as a part of lobby reform that we identify the 
lobbyists that come up with these great ideas that suddenly become 
amendments and laws binding all of us in America.
  If we had that on this Medicare plan, then we would be able to see 
with lobby reform what role Golden Rule had, and whether there is any 
relationship between the well over $1 million that put it, according to 
one of those political commentators on CBS last night, in the first 
tier of power here in Washington.
  Mrs. SCHROEDER. Absolutely. I think another thing we need is, 
unfortunately, because we are seeing so many lobbyists now really just 
moving in and supposedly writing the bills, they ought to put their 
name on the bill. Let them know which lobbyist coauthored these bills.
  Then I think we would not be so surprised, if you saw who the real 
authors of some of these bills are. Then I think you are not going to 
be surprised about what the results are, and it becomes really 
essential that the American people see this. Jefferson must be just 
cringing as he hears this discussion, if he hears this discussion.
  Mr. DOGGETT. In other words, instead of letting all the ego of names 
stay right here in the Congress, so that it is the Joan Smith Act, this 
could be known as the Golden Rule-Gingrich Act to Cut Medicare or 
whatever one might want to call it.
  Mrs. SCHROEDER. Absolutely. If we had that kind of disclosure, I 
think we would have much less in the line of October surprises when 
this passes because we will know exactly how it is going to look. It is 
going to look like something they favor. If they paid the fiddler, they 
are calling the tune.
  And apparently they paid the fiddler, and apparently they are calling 
the tune, so let us get the facts out. I think 

[[Page H 9776]]
the gentleman from Texas once again has done an eloquent job.
  Mr. DOGGETT. I thank the gentlewoman, also. I believe this issue of 
ethics and special interest domination of this body and the Medicare 
cuts of $270 billion are closely interrelated. We must deal with both. 
We have a date for dealing with one of these next week. It is time to 
get a date for dealing with the gift ban and the lobby reform.

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