[Congressional Record Volume 141, Number 158 (Thursday, October 12, 1995)]
[House]
[Pages H10039-H10046]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  2100
                   THE REST OF THE STORY ON MEDICARE

  The SPEAKER pro tempore (Mr. Fox of Pennsylvania). Under the 
Speaker's announced policy of May 12, 1995, the gentleman from Kansas 
[Mr. Tiahrt] is recognized for 60 minutes as the designee of the 
majority leader.
  Mr. TIAHRT. Mr. Speaker, it is a pleasure to be here tonight. I would 
like to start by saying that as you would hear on some radio stations 
by Paul Harvey or his son, now you will hear the rest of the story.
  Very soon we will have a tripod over here, so we will be able to show 
you some of the charts we have brought along. But, basically, I wanted 
to say that, in plain English terms, the Republican Party has come up 
with a plan, a specific plan, that will preserve and protect Medicare 
for our parents and our grandparents.
  What is wonderful about this plan is that it will still balance the 
budget, which will secure a future for our children. No seniors will be 
forced from Medicare. Seniors will have the right to alternative 
choices. They will have the right to stay with their current doctor or 
hospital.
  Over the course of the next hour, we hope to talk about some of the 
specifics of this plan. We also want to address some of the real needs 
that have been created by this plan running down the wrong path for 
some time.
  I want to start out with a chart that shows what the President's 
Social Security Medicare Board of Trustees report has said. There are 
three members of this Board of Trustees that are from President 
Clinton's Cabinet, and as you can see in this chart here, it says ``The 
fund is projected to be exhausted in 2001.''
  That means by the year 2002, Medicare is going to have a very serious 
problem. What is very good about finding this out at this point in time 
is that we have time to correct the problem. We do not want to let the 
train get down the path too far, because it could result in a train 
wreck. Instead, we are able to change the system, and preserve and 
protect Medicare for our seniors.
  This chart shows part A trust fund, and it shows graphically what is 
going to happen to the trust fund. It starts over on the left side at 
approximately 1993 and goes over to 2004. Right in the center here is 
zero, which indicates the balance of the trust fund. Up here is $150 
billion, and the bottom is negative $150 billion. As you see, as the 
path progresses over time, this red line indicates that we will cross 
the zero line or, in other words, go bankrupt, by approximately the 
year 2002, again, conforming what was told to us by the President's 
Board of Trustees.

  Now, part of the plan that we have in the Republican Party, many 
people have said that there are going to be cuts that are going to be 
put in place, and that these cuts are going to fund tax breaks given by 
Republicans to their rich friends.
  Nothing could be further from the truth, for several reasons. First 
of all, I want to tell people there are not cuts to Medicare. There are 
no cuts in the Republican plan. There is limited growth.
  But if you look at this next chart, it shows that we start, today, 
1995, seniors receive $4,816. Now, that is what the average recipient 
gets per year under the current plan. Over the next 7 years, in the 
Republican plan, that grows 43 percent from $4,800 to $6,734. As the 
title across the bottom says, where is the cut?
  Now, this is going to result in a reduction in growth of about $270 
billion. That number is very specific. It was chosen for a reason. It 
was targeted for a reason. The reason is that is what it is going to 
take to preserve and protect the program.
  Now, there have been some other plans that were put forward by the 
President and by Members of the Democrat Party that were to save less 
an amount of money, which just prolonged the agony. It did not reform 
the system or preserve and protect the choices that elderly people will 
have, and it did not give them the opportunity for options, for 
alternative plans.
  We will talk a little bit more about this later, but it is a very 
comprehensive plan. It is one that has been long in the making.
  I want to give you some of the sponsors of this plan. We heard a lot 
about the American Medical Association. They are at the top of the 
list. They do support the Republican plan to preserve and protect 
Medicare. I have an ad, a copy of an ad that was run by the American 
Medical Association, and it has a quote from Lonnie Barstow, president 
of the American Medical Association. I just want to read four brief 
quotes from this.

[[Page H 10040]]

  One of the things that he says is ``This is a defining moment in 
Medicare history. No one can act without you. Your voice will be like a 
petal in a pond.'' He is talking about people, asking them to respond 
and support the Republican plan. ``It empowers patients so they can 
make their own health care choices.'' ``It recognizes the extraordinary 
value of physicians in managing and delivering health care.'' ``It 
removes the redtape and liability barriers that disrupts the patient-
physician relationship.''
  Some of the problems we have had in Medicare is we have people sit 
right here within the beltway, in the District of Columbia, not seeing 
the patients, making medical decisions. We think it is better that 
decisions remain with the patient and the physician. That is what the 
Republican plan does.
  You can see, we also have some other people that endorse preserving 
and protecting Medicare. We have the U.S. Chamber of Commerce, the 
Council for Affordable Health Insurance, the National Federation of 
Independent Business. We have the National Restaurant Association, we 
have the Citizens Against Government Waste, and we have the American 
Small Business Association.
  Many groups are concerned about their parents and their grandparents. 
Really any of us who are going to live longer than seven years need to 
be concerned about what is happening with Medicare, because it is going 
to be coming up very soon if we do not do something about it. So that 
is why we think it is very important that we get this plan in place.
  I have some quotes that came out of the Washington Post. Some people 
do not think the Washington Post is the right newspaper to quote, but 
on September 15th, this was a lead editorial. It is what the Washington 
Post has to say about the Republican Medicare plan. These are direct 
quotes.
  ``Congressional Republicans have confounded the skeptics,'' the first 
one says, meaning we have come up with a plan when they did not think 
the Republicans could come up with a plan.
  ``It is credible.'' You have heard a whole hour before where there is 
a lack of credibility for this plan. The Washington Post thinks this 
plan is credible.
  ``Its gutsy.'' We are willing to go out and change the problem, 
preserve and protect the plan.
  ``It addresses a genuine problem that is only going to get worse.'' 
Well, the time to address it is now. I have several others with me here 
today that are going to be talking with us about the Medicare program, 
preserving and protecting the Medicare program, and I would like to 
start with the gentleman from Georgia, Mr. Saxby Chambliss.
  Mr. CHAMBLISS. Mr. Speaker, why are we here doing this today? Why are 
we talking about Medicare? Why are we talking about reforming Medicare? 
The reason we are talking about reforming Medicare is because we as a 
Republican Conference are absolutely, totally and firmly committed to 
balancing the budget of this country by the year 2002.
  It no longer is a question of should we do that; it is simply a 
question of how we are going to do it, because it is absolutely 
necessary. It is necessary for our children and our grandchildren, and 
I say that with particular pride tonight. I talked during my campaign 
about my daughter and son-in-law, who are trying to live the American 
dream. They are part of what I came to Washington for, to balance the 
budget. Tonight I just found out, or late this afternoon, I am going to 
be a grandfather for the first time. That is exciting to me, to know 
that I have a more vested interest than ever before in seeing the 
budget of this country balanced.

  One way we have got to do that is to have Medicare reform. As the 
gentleman from Kansas [Mr. Tiahrt] showed you on this chart up here, 
and I want to stick this back up for just a second, this is exactly 
what is going to happen to Medicare. That is not a Republican diagram. 
That is a diagram that was put forth by the Medicare trustees, the 
trustees that are in part appointed by President Clinton.
  We have a document signed by three Cabinet members of President 
Clinton's Cabinet that tells us if we do not reform Medicare, that next 
year, in 1996, the Federal Government will spend more money in Medicare 
expenses than we take into the Medicare Trust Fund, that in the year 
2002, the Medicare Trust Fund will be broke and the only way we are 
going to be able to pay for current Medicare benefits is out of the 
general funds of the Treasury.
  You can see what it does by the year 2004. If you want your taxes 
raised by $150 billion in the year 2004, then you ought to be opposed 
to this plan to reform Medicare. But if you want to protect and 
preserve Medicare and save it for the senior citizens of this country, 
then you need to be very aware of the changes that are being proposed 
and the fact we are going to protect and preserve it.
  Now, we have got two choices when it comes to Medicare. Number one, 
we can put our head in the sand. We can let things go on like they are. 
We can let this happen to the citizens of this country, or we can 
reform Medicare. We can make the necessary changes that will protect 
that system, not only for the folks who currently receive Medicare 
benefits, but for the senior citizens and junior citizens who will be 
receiving those benefits down the road.
  Now, I was very interested in the comments that our colleagues on the 
other side have been making for the last hour. They have alluded time 
after time to the fact that Republicans are not listening. Well, let me 
tell you, I am not listening in Washington, D.C. I will be honest with 
you. I am straightforward about that. I am not listening in Washington, 
DC. I am not holding hearings on the lawn of the Capitol in Washington, 
DC. I go home every single weekend. I was home all week last week. I 
was in places like Moultrie, Georgia, like Dolan, Georgia, like 
Sylvester, like Irwinville, like Willacoochee, like Douglas, talking to 
senior citizens about their concerns on Medicare and about what we are 
proposing to do to reform Medicare, to ensure that it is maintained.

  I have been sending out questionnaires, not to folks in Maryland and 
Virginia, but folks in my district, in middle and south Georgia. This 
is just a sample of the returns that I have gotten from folks in my 
district that I am talking to on a daily basis, not in Washington, DC, 
but in places like Macon, Georgia and Tifton, Georgia. And I want to 
just tell you some of the comments I have heard from those folks.
  I picked out just a sampling of the questionnaires. This first one is 
from Mr. and Mrs. R. J. Otten in Tifton, Georgia. We asked a question 
about do you understand the Republican plan to reform Medicare and what 
it does. This is what the Ottens had to say. ``This plan would lower 
the rate of increase for the Medicare budget from 10 percent to 6 
percent a year. When the liberal media says Republicans want to cut the 
Medicare budget, they are lying, plain and simple.''
  This next response is from Phil and Jo Martin in Lake Park, Georgia, 
down in Lowndes County. ``We will have more options to choose from to 
provide medical care and save money doing it. It needs to be done and 
soon,'' with an explanation point.
  This next one is from Dave and Judy Dresner in Macon, Georgia. ``It 
is an honest, credible effort to save a program that is helping folks.
  This next one is from Mr. A. K. Garman in Warner Robbins, Georgia. 
``I believe this problem has been put off for years, and each year of 
delay only adds to the problem. Get it under control now, or it will 
never come,'' exclamation point.
  That is the people that I have been listening to. I have been 
listening to the people in my district who receive Medicare, who are 
paying funds into the Medicare Trust Fund and who expect to receive 
those benefits down the road. We have got to do what we are doing, and 
we are moving in a positive direction.
  Now, as these responses indicate, the Republican plan offers several 
options. Let us make one thing perfectly clear. Anybody, any senior 
citizen who now is covered by Medicare, will have the right to receive 
exactly the same benefits they are receiving now under our plan. Pure 
and simple, if you like what you have got, you can keep it.
  If you would rather have something different for those folks who will 
be moving into the Medicare age over the next several years, you will 
have an option to choose from several different 

[[Page H 10041]]
plans. Those options are going to be there, and without alluding to 
them, I am going to let my fellow Georgian, Mr. Charlie Norwood, from 
the Tenth District of Georgia talk about specifics of the plan, and 
also I hope he will allude to these arrests that were referred to 
earlier by our friends on the other side.
  Mr. NORWOOD. Well, Mr. Speaker, I indeed thank my friend from 
Georgia, and I congratulate him on a new grandchild coming, the first I 
have heard of that tonight. That will be the most important thing in 
your life over the next few years. I know that for a fact. I know the 
gentleman is probably already thinking about the fact that that child 
arrives in this great country owing $187,000 just for his or her part 
of the interest on the debt. So, yes, do we need to deal with these 
problems? Of course we do.
  I am pleased to join the gentleman. I know that this is really what 
would be called a discussion rather than a debate. I hate to use any of 
my time talking about anything but the details of this new Medicare 
plan, but I feel forced or I am compelled to say a little bit about 
myself.

                              {time}  2115

  I am new to this. I have been in this town 9 months. I have been in 
this body 9 months. I have never been in politics in my life. I come 
from what I think is one of the professions that may be one of the most 
respected professions in the country, and I am saddened to say that I 
have moved into one of the professions that is least respected in the 
country, but then I understand more why today than I did a year ago.
  Mr. Speaker, I think probably our first vote in this great body 
should not be for Speaker of the House. We should take an oath here to 
tell the truth. Having been on the Committee on Commerce, having been 
on the Subcommittee for Health and the Environment, I have heard more 
distortion, more mistruths in the last 2 days than I have heard, I 
believe, in my entire lifetime.
  It is unfortunate that the America people will find it so difficult 
to find the truth when we have one group, the liberal Democrats, who 
really do not want to solve the problem of Medicare. They want to make 
darn sure we do not solve it. That is not what we should be about. We 
should be working together to solve one of the great problems at the 
end of this century.
  Mr. Speaker, I was sitting in the Committee on Commerce meeting room 
yesterday morning, and we were informed that there were a group of 
citizens in the lobby that wanted to come in and be heard, wanted to 
come in and disrupt our committee meeting, the people's business, and 
would in no way consider leaving unless they were handcuffed.
  They did come into the committee, and they were very disruptive, 
there is no question about it. The lady came right up to the podium. I 
was standing right there, and she was yelling and screaming. Not 
interested in what she was saying, only interested in being disruptive 
as we tried to do the people's business.
  Our chairman was very kind, Mr. Speaker, and was very gentle with 
this lady. He tried every way he knew how to ask them to leave, because 
that was not the point in time of the government to be disrupted, 
because we were going through this bill line by line. Finally, they 
would not leave and the Capitol Police were brought in and very, very, 
very gently escorted away.
  Mr. Speaker, what is so absolutely distressful about this is there 
was only one point in that, and that was to be disruptive, to get on 
television, and show blown-up pictures like we saw in this body tonight 
in order to misrepresent actually what happened.
  This was a senior citizens coalition. This was led by a paid 
lobbyist. This lobbyist is being paid by American citizens tax dollars. 
The liberal Democrats have funded them for years. Ninety-six percent of 
their income comes from tax dollars. Their purpose for being there was 
to be disruptive, to get on television, and allow people to bring in 
big pictures here tonight to mislead the public about the facts.
  Mr. Speaker, in addition to that, I heard tonight, I do not know how 
many times, that we have had no hearings; that all we have talked about 
is to special interest groups. Well, this bill is being marked up by 
the Committee on Commerce and by the Committee on Ways and Means. We 
have had over 10 hearings in the Committee on Commerce, of the 
subcommittee. I was there. I know we had those hearings.
  It is true, not many of our liberal Democrat friends bothered to 
come, but we had the hearings and that was their opportunity to be 
heard. Ways and Means has had over 30. I think 36 hearings. A lot.
  And, by the way, Mr. Speaker, I will be delighted to be corrected 
tonight if I misspeak or have anything wrong, because I am trying to 
tell the American people the truth as best I know it. So if I misspeak 
on anything, I hope my colleagues will jump right in and correct me, 
because we need the truth to come out.
  Mr. CHAMBLISS. Mr. Speaker, if the gentleman would yield for a 
second. The gentleman is talking about these number of hearings, 10 in 
the Committee on Commerce, 36 in the Ways and Means. Is the gentleman 
talking about 30 minute hearings, or hour-long hearings?
  Mr. NORWOOD. No, Mr. Speaker, and I thank the gentleman for asking, 
many of those hearings lasted all day. What I noticed most of all was 
that the loyal opposition failed to come. We have had all summer to 
discuss this bill, and we have done that.
  I know what my other colleague from Georgia has been doing. I am from 
Georgia, too. We have been going home and talking to our senior 
citizens, having time after time town hall meetings.
  Mr. TIAHRT. Mr. Speaker, reclaiming my time, I would ask the 
gentleman, Mr. Norwood, who were some of the groups that came to the 
committee and testified in respect to the Medicare preservation plan?

  Mr. NORWOOD. We have tried very hard, Mr. Tiahrt, to hear from all 
people involved in health care. That means the patient, that means 
groups represented by AARP, that means the hospital and the hospital 
administrators. They are involved in health care. They should be 
involved. They should have some input into this great bill. It 
certainly means the providers of health care, meaning the physicians. 
They are involved. This bill affects their lives tremendously.
  We brought in people and experts to hear what they felt about it. In 
addition, we also had senior citizens, who are on Medicare, come into 
the hearings and speak to us.
  The other side talks about special interest groups. A special 
interest group is when President Clinton puts 500 people in a room who 
will do exactly what he wants to try to determine the health care of 
this Nation.
  Mr. Speaker, I think we have done this right. We have talked to as 
many people as we possibly could to have their input. The AMA? Sure. 
They have had input into this. Of course, they should have had input 
into this, just as AARP should have had input.
  We have been very fair with this. We have met with many, many people, 
and I think that we have come up with a solution to one of the most 
difficult problems we have to face in the 104th Congress.
  Mr. TIAHRT. Mr. Speaker, I hope my colleagues will stick around for a 
while. I want to involve the gentleman from Pennsylvania [Mr. 
Greenwood] in the discussion.
  Mr. GREENWOOD. Mr. Speaker, I want to thank the gentleman from 
Kansas, and each of the gentlemen for participating in this and 
organizing this special order on Medicare.
  I, with Mr. Norwood, sit on the Committee on Commerce, and together, 
before the hour is out, we will get into a lot of details, hopefully, 
about Medicare, but I really want to comment about the previous hour 
and about yesterday's activities, because I have been sitting in my 
office just boiling over what we have heard from some of the Democrats.
  Mr. Speaker, for the past hour, from I guess about eight o'clock to 
nine o'clock, we had some very entertaining theater on the part of the 
Democrats. If there were not so much at stake, I guess the American 
people might shrug this off as bad theater. But the fact is there is a 
great deal at stake, and what is at stake is something no less precious 
than the health of our country's elderly.
  Members of Congress are not elected to be entertainers. They are not 
elected to be actors. But it looks like when 

[[Page H 10042]]
some Members of Congress cannot accept reality, they figure out how to 
escape reality and create their own reality by creating their own 
theater. That is what happened yesterday and today in Washington.
  Mr. Speaker, Mr. Norwood and I went to our Committee on Commerce 
meeting scheduled to begin at 10 o'clock. The meeting finally did come 
to order, and it went until way after midnight, while we took amendment 
after amendment after amendment on the Medicare bill from the 
Democrats. But when we got there, the lawyers for the committee 
informed us that they had been informed that a group of protestors was 
planning to disrupt the meeting and that they would not leave unless 
they were handcuffed and arrested.
  They did that precisely because they wanted to create for the 
television cameras a visual image of senior citizens being arrested so 
that somehow that would reflect on the Medicaid bill.
  Mr. NORWOOD. Mr. Speaker, would the gentleman yield?
  Mr. GREENWOOD. I sure will.
  Mr. NORWOOD. Mr. Speaker, I would ask the gentleman, the lobbyists 
that organized this, did the gentleman tell me earlier that this 
lobbyist is the public relations person for the seniors coalition?
  Mr. GREENWOOD. Mr. Speaker, it is even worse than that. I will get to 
that in 1 minute, however, Mr. Norwood.
  What happened was, we then consulted with the lawyers and with the 
Capitol Police and said, well, what do we do if when this meeting comes 
to order a group comes forward and just is disruptive and refuses to 
abide by the rules of the House? We were told there is a procedure. The 
procedure is the chairman should ask the parties if they would please 
have a seat in one of the seats where the rest of the public sits, 
because this was a markup where we amend the bill.
  Then the next procedure, if they refuse to do that, is to recess the 
committee and everyone is to leave the room, including Members of 
Congress, and then the Capitol Police come in and clear the room.

  So we said, we hope this does not happen, but if it does, we will do 
that. We sat down, the chairman banged the gavel, and immediately, if 
you remember, immediately, on cue, a woman who was formerly the full-
time paid political relations director for this seniors citizens group, 
the senior citizens group, by the way, which last year received in 
excess of $70 million in Federal funds, something like 99 percent of 
all its funds were Federal funds, she got up with her script, went 
around to the front of the room, and reading her script began to scream 
at the chairman.
  Mr. Speaker, she did not want to be heard. She did not have a 
message. She did not want to listen or have a dialogue or have a 
conversation. She just wanted to scream and scream and scream.
  Mr. TIAHRT. Mr. Speaker, I have a couple of questions to ask the 
gentleman about that, because we heard earlier that these were seniors 
that came to the hearing asking to be heard in a very polite manner and 
were mistreated by the chairman of that committee. The gentleman is 
telling us that was not exactly how it happened. The gentleman was 
there?
  Mr. GREENWOOD. Unfortunately, it was anything but that. It was 
political theater. It was scripted. It was planned. It is sort of the 
latest in political guerilla warfare. You create a media event that 
works for you on television.
  Mr. TIAHRT. Excuse me for interrupting, but this is a group, the 
gentleman said, that received more than $70 million in tax dollars, 
which is in excess of 95 percent of their budget?
  Mr. GREENWOOD. That is correct.
  Mr. TIAHRT. So they are, in fact, using the tax dollars from people, 
in my case, the fourth district of Kansas, and they are trying to 
disrupt the plans to preserve and protect Medicare. So that is kind of 
like trying to push the system into bankruptcy. I am having a hard time 
understanding what motivation one would have to push Medicare into 
bankruptcy.
  Mr. GREENWOOD. The motivation is a political agenda, of course. And 
that is, as we all know, after 40 years of the Democrats controlling 
the House. Republicans were elected in the last election, and I think 
we were elected, frankly, because the country finally said a $5 
trillion deficit is serious. A Medicare program spending at inflation 
rates that are unsustainable is serious. We have to elect a team that 
is ready to go in and deal with that.
  We are dealing with it. It is a big change for the country. The party 
that is out now wants to come back in, and if it takes cheap political 
theater to do it, they will.
  Mr. Speaker, the worst of what was done was they used political 
props. The political props were people. They were little old ladies, 
many in wheelchairs, whom the young professional staff wheeled up to 
the front of the room for the TV cameras and turned them just right for 
the TV. I do not think these little old ladies knew where they were, 
some of them were that frail, and then the paid professionals left the 
room so they would not get in the camera's view.
  We all left the room, the public left the room, and six times the 
Capitol Police said to the ladies and gentlemen, ``Please, you really 
need to leave. You cannot interrupt a committee of Congress in 
session.'' They refused, because they wanted to be arrested, and, 
ultimately, they were.
  Then, act two of this very bad political theater was acted out on the 
floor of the House tonight, where Member after Member stood up and 
pretended that this was somehow a spontaneous event in which just 
average citizens came forward and wanted to be heard and could not.
  Mr. Speaker, it was political guerrilla warfare, and I hope for the 
sake of the country, and I hope for the sake of the Medicare program 
that the vast majority of Americans watching tonight and watching this 
play out can see through it, and see it for the desperate, cheap 
political theater that it is.
  Mr. TIAHRT. Mr. Speaker, let me introduce the gentleman from Florida 
[Mr. Weldon], a physician who is joining us to enter the discussion on 
Medicare.
  Mr. WELDON of Florida. Mr. Speaker, I thank my distinguished 
colleague for yielding. I did want to inquire of the gentleman from 
Pennsylvania, and he basically alluded to the reason at the tail-end of 
his comments, but I think it is something worth stressing, why would 
the Democrats do this? Why would they stage an event? Why would they 
stoop so low as to get frail, elderly senior citizens, who may not have 
even known where they were, and wheeled them into an event like this? 
Why are they doing this? And the gentleman answered that, really. They 
are really desperate.
  This is really a desperate team, Mr. Speaker. They know they are on 
the losing end here. The gentleman from Georgia [Mr. Norwood], I think 
clearly made the case, and the gentleman from Georgia [Mr. Chambliss], 
as well, that the people in our districts, the people in those 
hometowns, realize the system is broke. They realize something needs to 
be done, and they are really looking to us to make the changes, to make 
sure that Medicare is there for their parents, to make sure that 
Medicare is there for themselves. And we have a plan that makes sense 
and that is a rational plan.
  The gentleman from Kansas [Mr. Tiahrt] was correct when he alluded to 
the fact that I am a physician. I made a commitment to the voters of my 
district when I agreed to run and serve and come here, and that is that 
I would serve for 8 years, and respect Florida's 8 year limit on 
service, and then I would go back to my hometown. And my plan is to go 
back to practicing medicine.

                              {time}  2130

  Fully 50 percent of my patients were senior citizens. I had a 
substantial Medicare practice and, indeed, I have to say, this issue of 
the importance of Medicare hit home for me in a very personal way about 
4 weeks ago, when my father, 75-year-old combat war veteran from World 
War II, a retired postal worker, had a stroke. Now, fortunately, thank 
God, it was a small stroke, and he is looking at making a good 
recovery. But I am very happy that he has a good health insurance plan 
in the Medicare system and that will be there for him to provide him 
the coverage that he needs for physicians and for hospital care to see 
him through this event so that he can get 

[[Page H 10043]]
back to home and return to independent living, as he had before.
  And this reform plan, this proposal that we have, I think is an 
outstanding proposal. I am very happy that both of you gentlemen from 
the Committee on Commerce that have worked so hard on this program are 
here to talk about it because it is a good plan.
  It allows senior citizens the option to stay in standard Medicare. It 
allows senior citizens who are already in HMOs that they are happy with 
to stay in that HMO. It allows physicians and communities to set up 
provider-sponsored networks so that they can form managed care networks 
if they want. It also has an option in there for medical savings 
accounts so that seniors who want to set up a medical savings account 
time option will be able to do that. There is also an option in there 
for those people who are approaching retirement and they have much like 
the insurance plan that they currently have with their employer, if 
that insurance company offers a product for senior citizens, that they 
can select that option and stay with that plan and stay with those 
providers in that plan.
  So we have a host of options in this. It has been scored by the 
Congressional Budget Office as realizing the savings necessary to keep 
the program solvent and it has been declared by the Clinton 
administration that the program is going to go insolvent. I think this 
is an excellent plan.
  My hat is off to those members of Ways and Means and Commerce, such 
as the distinguished gentlemen from Georgia and from Pennsylvania, who 
have worked very hard, very diligently, I believe, on this. And I think 
when all is said and done and the American public sees the plan, they 
are going to like the plan. And they are also going to realize how 
desperate our opposition really was to resort to the kind of cheap 
tricks like they did yesterday in the Committee on Commerce.

  I think it was a sorry day in the annals of Democrat political 
history that they had to stoop that low, and I think we have got a good 
plan. I think the plan is going to pass. I think we are going to have 
Democrats voting for our plan in the end because they know it is a good 
plan. I think the public is going to support it.
  I very much want to compliment you, Mr. Tiahrt, for putting together 
this discussion to talk about this very important thing, because this 
is a very important issue. We need to take the time to make sure that 
this is properly spelled out to the public and they understand it.
  Mr. CHAMBLISS. Very briefly, you make an excellent point. The point 
being that the folks on the other side that are opposing this plan have 
stooped to an all time low level.
  I happened to be in the chair a little bit earlier in the evening 
when Jim Greenwood came down, after sitting in the office and, as you 
said, boiling for a while, you came down to the floor. You could have 
sat up there and just turned your TV off, but you did not do that. You 
wanted the American people to know the truth.
  You came to the floor of the House to engage the folks on the other 
side of the aisle who were not telling the truth about what happened 
and how it happened. I would like for you to comment on what reaction 
you got from the folks when you offered to come down here and engage in 
debate tonight.
  Mr. GREENWOOD. I appreciate the gentleman for commenting about that. 
I was sitting in my office listening to this absurd, sort of UFO show 
about what happened yesterday. And I said, I have got to go down to the 
House and straighten this out. They are telling the Americans things 
that are just not so.
  So I took the microphone. I said, we are going to have an hour 
between 9 and 10. And how about if instead of Democrats doing an hour 
and have things their way and then the Republicans do an hour and have 
things our way, why do we not share time and we can have a dialogue 
back and forth and maybe the American people who are paying for this 
might actually learn something instead of getting the propaganda 
approach. I asked for some time and they refused. They yielded me 15 
seconds, which was enough to make the request, and then they said they 
would not do it.

  The issue is, why are they so desperate. And the fact, if you look 
back just a few weeks, after we had 38 hearings in the Committee on 
Ways and Means on Medicare, another 10 hearings in the Committee on 
Commerce, 48 hearings on Medicare, countless hours of hearings, we then 
said, now it is time. We heard from all the senior citizens groups, all 
the professionals, all the experts, it is time to do the hard work of 
drafting the bill.
  While we were doing that, day after day, sometimes until 2 o'clock in 
the morning, crafting the bill, the same folks we just heard from were 
coming down here and telling you, I will tell you what the Republican 
bill is going to do. It is going to raise the cost of Medicare 
thousands of dollars for senior citizens. And then they are going to 
raise their co-pays. Then they are going to raise the deductibles. Then 
they are going to push them into managed care. Then they are going to 
lower the quality of care and take benefits away from them. And we 
would have press conference after press conference. And the Democrats 
would say, wait until you see this horrendous plan.
  We quietly, carefully went to work putting together a plan that, as 
has been said, does not raise the cost of Medicare for anyone. Co-
payments are the same; deductibles are the same, still pay 31 percent 
of the premium in part D. Taxpayers pick up the rest. Benefits package 
is exactly the same. If you want to stay where you are, you can stay 
where you are. New opportunities in managed care and Medisave accounts.
  So we got the bill all put together very carefully and introduced it, 
and the Democratic staff took it and looked at it. And I could just see 
the Democrats huddling around and saying, OK, all that bad stuff is in 
here, right? All those horrible things we said they are going to do to 
seniors, tell us what to say. And the analysts must have said, well, 
they did not do that. They did not do those terrible things. So now 
what are we going to do?
  The Democrats say, what are we going to do? We have to destroy their 
plan because if we do not destroy their plan, they will succeed and 
they will save Medicare and they might get reelected or something and 
we will not take the House back. So what do they have left? Cheap 
political desperate theatrics. If Americans fall for that, if Americans 
cannot see through that kind of ridiculous, childish, adolescent 
behavior, this country is in trouble. But I do not think it is.

  Mr. NORWOOD. Mr. Speaker, we need to talk a little bit about the 
specifics. I think that, if there is anything good that has come out of 
the Committee on Commerce markup over the last 2 days, at least we have 
the Democrats admitting that part A of the trust fund is in fact going 
bankrupt in 7 years. That is the best we can get out of them.
  They will admit that the hospital part of the fund, that paid for by 
payroll taxes, is doing broke in the year 2002. They say to us, 
however: Well, you do not need to save $270 billion because part B, 
which is the part paid basically for physician services, is just great. 
It is fine. It is doing super.
  Well, patients today pay 31.5 percent of their part of the premium in 
part B. Guess who pays the 68.5 percent? The Treasury, the American 
people. That is subsidized. We are glad to do that as long as we can. 
We want to help people as much as the other side does. But, my 
colleagues, I will have to tell you, the part that comes out of the 
Federal Treasury, that 68.5 percent, is growing unbelievably out of 
control.
  And think of this: That Treasury that they never considered that this 
country can ever run out of money, that is the Treasury that owes $5 
trillion. This is the Treasury that borrows a trillion dollars every 4 
years, if we do not change what they are doing.
  We are going to be borrowing a trillion dollars every 3 years when we 
hit the 21st century. The price of medicine is going to continue to go 
up as long as we do not go into this program and we rework it, as we 
have.
  So it is not fair to say that the part B part of the trust fund does 
not have just as serious a problem as the part A part of the trust 
fund.
  Now, I think if I could only have one message go out of here tonight, 
it would be this: We are going to offer senior citizens many choices 
and we want to hit all those choices. But the think I would like for my 
mother-in-

[[Page H 10044]]
law to hear and remember more than anything else is that, if you like 
Medicare as it is today, part A, part B, Medigap, messing with HCFA, 
if you like all of that, you can stay with it. You do not have to do 
one thing to change that. Is the co-payment going up? No. Is the 
deductible going up? No. It is going to be exactly next year like it 
was last year, if you make that choice.

  Now, I believe many seniors will look at the different great options 
that we are going to give them, and some are going to take different 
choices. But any senior citizen who wants to stay on Medicare precisely 
as it is today can do so without any increase in cost.
  Let me conclude one thought about that. I think that it is wrong for 
us to stand here and not say to senior citizens, that 31 percent that 
you pay for your premium in part B, it is going up. It is going to 
increase.
  It has doubled over the last 7 years under the present Medicare plan. 
It has gone from around 20 bucks up to 46 bucks a month. I will stay 
here right now and tell anybody who wants to know, it is probably going 
to go up in the neighborhood of about $90 a month by the year 2002. But 
that has nothing to do with our reforms. That increase in the part B 
premium is going to occur whether we reform Medicare or whether we 
leave it exactly as it is today.
  So in general, and I know it is someone else's time, but in general, 
anybody who wants to keep Medicare as they have it today with no 
increased cost in part A and an increase in your premium cost in part B 
because of inflation, then you can stay right there.
  Mr. WELDON of Florida. Mr. Speaker, I just want to clarify a couple 
of the points that the gentleman made. The deductible right now, that 
stands at $100 per year per beneficiary.
  Mr. NORWOOD. Yes.
  Mr. WELDON of Florida. That is going to stay the same.
  Mr. NORWOOD. That is correct. It is not going to increase.
  Mr. WELDON of Florida. Now, the co-pay, that is the 20 percent that 
Medicare does not cover. So Medicare is going to continue to cover the 
80 percent, and it is not going to decrease at all; correct?
  Mr. NORWOOD. Exactly as we do it today.
  Mr. WELDON of Florida. Now, the premium that we are talking about for 
the average senior right now I think that is at $46.
  Mr. NORWOOD. Per month.
  Mr. WELDON of Florida. Okay. The Clinton administration was talking 
about letting that increase to about $75 per month over the next 5, 6 
years, as I understand it, and his attempt to balance Medicare. And 
what will the Republican proposal be doing?
  Mr. NORWOOD. Our proposal increases that $7 a month.
  Mr. WELDON of Florida. Only $7 more a month.
  Mr. NORWOOD. Seven dollars per month.
  Mr. WELDON of Florida. That is as I understand it. I think that is an 
important point worth stressing here, that we are not going to be 
raising co-pays, and we are not going to be raising deductibles. 
Actually what we are planning on doing with the Medicare premium 
basically is the same thing that our Democrat President over in the 
White House is proposing doing. That is to let it increase gradually 
with the cost of inflation.
  This is one of the reasons why I think this reform proposal is really 
an excellent proposal because for those seniors on a limited budget who 
are very dependent on making sure that they have good quality medical 
care because they have heart disease, they have arthritis, they have 
diabetes and they have to make sure they get in to see the doctor every 
month or every 2 months or every 3 months, they are trying to get by on 
the Social Security check.
  We are not going to be putting increased burdens on those seniors. We 
are going to be making sure that the resources are available for them 
so that they can continue to see their physician. We are also going to 
be giving them that continued freedom of choice so that if they are 
happy with their practitioner that they will be able to continue to go 
see the doctor that they have been comfortable with for many years. I 
think that is extremely important.
  I know that in my practice, when I took care of seniors, I knew that 
it was important to them to be able to know that, if they got sick and 
they were in the emergency room, that their doctor was going to be 
there for them and that they were going to have their Medicare to pick 
up the tab. They were not going to be bankrupted by an excessively 
large medical bill that they could not afford to pay. Our proposal, the 
Republican proposal that we are putting forward, preserves that for 
senior citizens.

                              {time}  2145

  I think it is a good plan. I think it is a well-balanced plan. I 
think it was a real sorry state of affairs to see how desperate our 
opponents were in trying to score political points to do what they have 
done with this cheap political shot.
  I think the gentleman from Pennsylvania [Mr. Greenwood] really 
revealed something when he came down here to the floor and said, ``Let 
us have an open debate and let us really debate the issues,'' and I 
would put forward to members of the minority party who may be watching 
these proceedings that I would be delighted to appear on the floor of 
this House with the Members gathered here today and debate those people 
openly and fairly. Let us have an open hour where we can really 
exchange issues and really talk about this plan because this is a good 
plan. This is a plan that I think meets the needs of our seniors. It is 
a well-balanced plan.
  We did take input, as the gentleman from Georgia [Mr. Norwood] said. 
We did take input from the seniors' groups. I know I went back to my 
district and I met with AARP people three times, and I showed them our 
product. They were afraid of change. I have to say there was some 
concern in the room. But they understand that something has to be done 
to preserve this program, that it is going to be insolvent and that it 
is starting to go insolvent next year.
  So they know some changes need to be made, and they believe that this 
is a good proposal and it is something they can live with and that will 
help to make sure Medicare is there for all seniors in the future.
  Mr. GREENWOOD. That is the thing that has been so astonishing is the 
comment that somehow we have not been listening to the seniors on this. 
I know I have had meeting after meeting after meeting with seniors in 
all the senior centers. I have had big town meetings for the whole 
county to come. I have had a senior citizen advisory committee, and 
despite the fact there is this constant barrage of scare tactics coming 
out of Washington, we call it ``Mediscare,'' the Democratic Party had a 
great leader who said, ``We have nothing to fear but fear itself.'' Now 
we are seeing that they have nothing to offer but fear itself. That is 
a pretty sad state of affairs.
  Despite all the fear-mongering that is going on, everytime I have 
been able to take our bill and sit down with senior citizens one at a 
time, five at a time, 200 at a time and walk through what we are 
offering, they all go, ``Oh, that sounds great. You mean I can stay 
where I am, and you guys are not going to cut Medicare?'' They keep 
saying, ``You are going to cut Medicare.'' The chart shows we are not 
going to cut Medicare. We are going to increase the expenditures for 
the average citizen from over $4,800 a year where it is now over the 7 
years to $6,700 a year plus for a senior citizen. That is a lot of 
money. That will buy a lot of health care. That is a 40-percent 
increase.
  What we are not going to do is we are not going to continue to waste 
money in the program, so the inflation rate is 10 percent a year. If we 
can hold the inflation rate to 5 percent a year, every senior citizen 
in the country knows what 5 percent a year, they would like to get that 
on the CD's back home after all these years. Five percent is a pretty 
good inflation rate. That is plenty of money.
  The theory the other folks keep putting out, you know, if I find a 
television for sale for $500 and it is in one store, I go to another 
store, it is $400, I guess I ought to spend $500 for the same TV; 
otherwise, I am getting cheated out of $100. I think seniors are better 
shoppers than that.

  Mr. TIAHRT. I would like to explore some of the details, and I yield 
to the 

[[Page H 10045]]
gentleman from Georgia to cover some of the details in the Medicare 
plan that we have to preserve and protect cover Medicare.
  Mr. CHAMBLISS. You have been one of the leaders in devising this 
plan. I sort of know the highlights of it. I would appreciate it if you 
and the gentleman from Georgia [Mr. Norwood] who serve on the 
committee, would pitch in. As I understand it, what we are going to do, 
No. 1, we are going to offer every senior citizen the same Medicare 
program they have got right now. We have mentioned that a couple of 
times. That is an absolute.
  Secondly, we are going to provide what is called a provider service 
network, where hospitals and physicians will be able to get together 
and form a group, and they will be able to offer certain services to 
individuals. They will be able to sell those services to any group out 
there.
  Mr. GREENWOOD. If I may, what will happen, the Medicare program would 
pay a figure, let us say $5,000, for each senior citizen in that 
community right to the hospital and doctor network. That would be, we 
would basically be paying the insurance premium for that. In exchange 
for that, the hospitals and doctors and surgeons and specialist say, 
``We will meet all the health care needs of the seniors who sign up in 
our program.'' It is a great idea. It is innovative.
  You know, the hospitals and doctors like it because they leave the 
insurance companies out of the deal and save some money that way for 
them. The insurance companies are not wild about it, but it makes it 
competitive.
  Mr. NORWOOD. The networks may be just a group of physicians who are 
offering part B. It may be a group just of hospitals that are offering 
part A. Or it may be a combination of physicians and hospitals who get 
together and achieve the efficiencies that medicine could have done for 
years had it not been for the Justice Department up here. It is going 
to be a great move in the right direction, cut the middle man, lower 
the costs, and let people be involved in their health care with their 
doctor, not with HCFA.
  Mr. CHAMBLISS. Is that going to cost senior citizens any more money 
than what they are paying today?
  Mr. GREENWOOD. No. it is probably going to save them money. My mom 
and dad have chosen in our area, where we have managed care programs 
already, they have chosen to obtain their Medicare benefits through the 
managed care program. You know what happened to them, they are saving a 
thousand dollars each a year because they do not have to buy the 
Medigap policy anymore. They have got a prescription drug program now 
which seniors know in regular Medicare you do not get, and they have no 
copays and no deductibles; it is a great deal for them. They like it. 
They are happy there, and there is going to be an opportunity for 
seniors, and the other great thing is that we are setting this thing up 
so the seniors can get into the kind of plan, try it out, if they are 
happy and love it and their doctors are the best doctors in the 
community, great. If they decide they do not like it, in any given 
month----
  Mr. NORWOOD. Every 30 days.
  Mr. GREENWOOD. They can just walk out and go back to Medicare.
  Mr. NORWOOD. Go back to what they have got right now.

  Mr. CHAMBLISS. If they like it or try it and do not like it, they can 
go back. You alluded to HMO's, health maintenance organizations as 
being in effect right now in your area. Is that another option that we 
are going to broaden under our plan?
  Mr. GREENWOOD. Yes. What we are doing, we are increasing between 5 
and 10 percent the financial incentives for the managed care companies 
to go and aggressively market their product. So what they will be doing 
is going to the senior centers, advertising on television, saying, ``If 
you come to our plan, get your Medicare through us, we will get you a 
prescription drug program with maybe a $2 copay. If you come to ours, 
we will give a membership in the gym.'' It will be very competitive.
  Mr. NORWOOD. The marketplace comes into this. The marketplace is 
going to bring these costs down.
  Mr. WELDON of Florida. What about the issue of fraud and abuse? I 
know that is a very, very important one for the seniors in my district, 
many of whom have complained very bitterly about seeing tremendous 
amounts of that going on, people being billed for hospital stay when 
they were not in the hospital, people going in for lab tests and being 
charged twice for that lab test. Do we have some provisions in our bill 
that will deal with that problem once and for all and get some real, or 
get a real handle on the fraud and abuse issue?
  Mr. NORWOOD. I do not know if once and for all is correct. A crook is 
a crook and is going to continue to be a crook. But in general, we are 
tightening that up tremendously.
  It was very interesting to me in the markup yesterday that we were 
talking about that in the Medicare program, 10 percent of that goes to 
waste, fraud and abuse, and the number is debatable about how much 
money is lost every year, but is between $18 billion and $20 billion a 
year, and to me it appears that the operators of HCFA are incompetent. 
It just set the other side on fire for us to say how dare we call them 
incompetent.
  They have for years let waste, fraud and abuse go ahead at about a 10 
percent level. And when asking the director of HCFA, ``Well, when are 
you going to solve this problem,'' he said, ``Well, maybe in another 
year to two we will come up with a plan.'' Well, we have come up with a 
pretty darn good plan now. The gentleman and I will do this together, 
but we have got a task force being set up that is basically funded by 
those who abuse the system, and the penalties go back into the system 
to fund this task force.

  I think probably most of all, we are going to involve the patient 
with their bill. We do not even do that very well. A lot of times they 
may be charged for that second lab test, but the poor patient does not 
know it. They do not receive the bill. We are going to insist that HCFA 
and that crowd send patients a copy of their bill as they pay them.
  Can you imagine? I cannot understand why in the world we would never 
have done that before.
  Mr. CHAMBLISS. You do not mean the Federal Government is going to 
have to respond to the patient?
  Mr. NORWOOD. I think they are going to have to tell people what they 
are spending money for so the patient can have some input into areas 
that are wrong. Maybe they are honest errors. It does not matter. It is 
still part of that $20 billion. We have got to root that right out of 
this system.
  Mr. GREENWOOD. The bill raises significantly the penalties for any 
health care producer that is guilty of fraud. We are going to involve 
the patients, as the gentleman from Georgia [Mr. Norwood] said, because 
what the Medicare beneficiary gets to do is look at the bill and the 
Secretary of Health and Human Services is directed to set up a system 
whereby if the senior finds out that there has been fraud or abuse in 
the bill, gets to share in it and proves it, and there is a rebate, 
gets to share in the profits or in the differences.
  But what is more important really here is you cannot depend on the 
Federal bureaucracy to weed out, to look at every single doctor bill 
for 37 million Americans. As Americans seniors move into these managed 
care companies, then all of a sudden the managed care companies have a 
real financial incentive to find the waste, fraud and abuse. If they do 
not, it is out of their pocket, not Uncle Sam's pocket.
  Mr. TIAHRT. One question I would like to approach the group with, I 
heard the charge earlier in the previous hour the savings we are going 
to get from the provisions we have to preserve and protect Medicare are 
going to go toward tax cuts for the wealthy. Have we put provisions in 
there to prevent the savings from Medicare to go to pay for tax cuts 
for the wealthy? I do not think that it is true. Could we respond to 
that?
  Mr. NORWOOD. I would very much like to respond to that. Earlier this 
spring, we had a tax reform tax bill.
  In my view, what that was, it was a tax rebate. The 103d Congress 
raised the largest amount of taxes ever raised in the history of the 
United States, $260 billion.
  What we have said, as the 104th Congress, because the people at home 
said it to us, ``We do not like that tax increase. We think you should 
cut spending to manage your affairs up there, 

[[Page H 10046]]
not keeping taxing us.'' Our tax reform bill puts $245 billion back 
into the hands of families for them to keep. None of this discussion 
yet has anything to do with Medicare. What we are basically saying is 
that young families who have an income of $25,000 and they have a 
couple of children at home, their tax liability goes to zero.

                              {time}  2200

  We are saying to families that have an income of $30,000 a year, a 
couple of children at home their tax liability is cut by 50 percent. 
Now I am not sure when I am going to get to the rich, you stop me when 
I get to the rich, but I do not believe I have gotten to the rich yet.
  The whole tax reform thing is giving people back their money from the 
tax increase from the 103rd Congress. This money that we are saving, 
particularly from Part B, is going back into a lockbox. It is going 
back into the Federal Treasury. That is where the money came from to 
start with. We are putting it back into the Treasury.
  Mr. GREENWOOD. Mr. Speaker, a very important point has to be made 
here. If we recall in the first 100 days of this Congress, the first 
three months-plus, we paid for those tax reductions. The way we did it 
is we reduced by $180 billion over the next seven years the 
discretionary spending for all of the Federal bureaucracies. That was 
hard. We made the tough choices, and that is how we funded the tax 
reduction for the families and so forth.
  Then, on top of that, we reduced the cost to the Federal Government 
of the welfare program in our welfare reform bill. Putting people back 
to work and making them less dependent, we saved another $80 billion. 
We saved every penny which we planned to offer back to the American 
people in tax reductions.
  Mr. WELDON of Florida. Let us suppose we did not have our tax cut for 
families with children. Would the Medicare plan be solvent then?
  Mr. GREENWOOD. Absolutely not. The Medicare Part A, the 
hospitalization, the bigger piece of the pie, is already paid for by 
wages, a tax paid by employers and employees. Well, today we are in 
okay shape, because we are going to spend less money today, in October 
of 1995, than we are going to take in. But beginning next year, we 
start to spend more than that tax takes in. In seven years, we are out 
of money. So if we do nothing, even if we do not have the tax break, 
that does not solve the problem.
  Mr. WELDON of Florida. You are saying if we did not give families 
with children, the most heavily taxed group over the past 40 years in 
this country, an issue that is contributing to the breakdown in the 
family in the United States, the heavy tax burden on those young 
families with kids, if we took that tax break away from them, the 
Medicare plan would still be insolvent and we would still have to have 
this bill to try to protect and preserve Medicare?

  Mr. GREENWOOD. That is absolutely correct. I think most of those 
young families want that tax reduction and need it.
  This will be the final thing I will say tonight. There are some 
Americans out there who say ``I am not taxed enough. You ought to tax 
me more, Congress.'' My answer to them is write a check, put it in an 
envelope, make it out to the United States Treasury, and send it in. If 
you do not feel you are paying enough, send some more in. A lot of 
families are struggling and need help.
  Mr. CHAMBLISS. The tax you are referring to, the Medicare tax that 
currently is in existence, goes into a trust fund. It is a fund that is 
set aside to solely pay for Medicare benefits and nothing else. That is 
why there is no relationship between tax reform and Medicare, there is 
simply no relationship. That is trust money.
  Mr. TIAHRT. If we can wrap this up this evening, I would like to say 
in plain English, we finally have a specific plan that will preserve 
and protect Medicare for our parents and our grandparents. It is a 
realistic plan, it is up front, there is no fine print. It allows the 
right to select alternative options, the right to stay with your 
current doctor, your current hospital. It attacks waste, fraud and 
abuse. There is real accountability for physicians. It is a long-term 
solution, and Medicare is guaranteed to survive. This is not just 
politics as usual. This is a real plan that is going to work.
  I want to thank those who participated tonight, the gentleman from 
Florida, Mr. Weldon, the two gentlemen from Georgia, Mr. Norwood and 
Mr. Chambliss, and also the gentleman from Pennsylvania, Mr. Greenwood.
  I think this has been very enlightening for the American public as we 
have come to a conclusion here, refuting all the arguments that you 
heard in the first hour. We have a good plan, and we are going forward 
with it. I thank the American public for the time.

                          ____________________