[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]
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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.
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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.
____________________