[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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