[Congressional Record Volume 141, Number 159 (Friday, October 13, 1995)]
[House]
[Pages H10053-H10060]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         THE TRUTH ON MEDICARE

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 
12, 1995, the gentleman from Louisiana [Mr. Tauzin] is recognized for 
60 minutes as the designee of the majority leader.
  Mr. TAUZIN. Mr. Speaker, I am a member of the Committee on Commerce, 
and of all the speakers you heard this morning talking about the 
incident that occurred at the Committee on Commerce on the Medicare 
markup this week, I am the only person who was actually present for 
that incident. Let me tell you the truth about that incident; the 
facts, ma'am, just the facts, if you will.
  What occurred was a woman named Teresa McKenna, who is not some poor 
person worried about her Medicare, she is a paid lobbyist working for 
the National Council of Senior Citizens, brought a few of her members 
into the committee room as we had opened up the session to begin 
marking up the bill, and they began shouting and protesting at that 
markup hearing.
  The committees of the Congress work just like this body does. Members 
of the public are invited to attend and to sit in the galleries or sit 
in the committee rooms and to witness the process by which we mark up 
bills and debate them and process them through this House. Guests are 
always welcome, as is the press, at our committee markups.
  Had Ms. Teresa McKenna brought her members into this room, into this 
gallery, and conducted themselves the same way, began shouting and 
interrupting the process, the same thing would have occurred in this 
House as occurred in that committee room. They were asked three times 
by the officers in charge at the request of the chairman to either take 
seats or leave the room so that we could begin our business. Three 
times they refused. The officers had no choice then but to escort them 
out of the room.
  Immediately after they had been escorted under arrest outside the 
room, the chairman instructed the police officers involved not to press 
charges, but to release them to go free. In short, the committee did 
exactly what this House would do; it exercised its responsibility to 
enforce order in the process by which we debated the bill.
  Teresa McKenna represents an organization headquartered here in 
Washington. She has been representing it for some many years now. She 
is a paid lobbyist for that organization. You need to know about the 
organization. Last year it received $72 million of taxpayer funds to 
carry out their business. That is a pretty hefty sum. Can you imagine 
how much health care we could give to seniors in America if we spent 
that $72 million on some senior health care problems. But, instead, 
this group got $72 million of taxpayer moneys as grants from the 
Federal Government to do their work.

[[Page H 10054]]

  Well, what kind of work do they do? They lobby. That is what they do. 
And, guess what? That $72 million was 96 percent of the income that 
that organization derived last year. That organization is almost 
totally taxpayer funded as a lobby group. Ms. Teresa McKenna took some 
of her members and tried to disrupt the process by which our committee 
was beginning to debate this extraordinarily important issue for the 
sake of all Americans, for our mothers and fathers and grandmothers and 
grandfathers and those to come.
  Now, should she and her members have been ejected from the room when 
they refused to obey? Of course. They would have been ejected from this 
Chamber the same way. Should they have been put in jail? Of course not. 
As soon as they were taken out of the room, the charges were dropped 
and they were dismissed.

  I wanted to clear that up first of all. No Speaker of this House, 
Democrat or Republican, could put up with that kind of disorder in this 
body. No chairman of the committee, Democrat or Republican, would have 
put with that kind of disorder in the committee process.
  Did our committee have hearings on Medicare? Our committee held 10 
hearings on Medicare this year. Ten hearings. That is more than the 
previous three Congresses combined held on Medicare. We had lots of 
hearings. We have had meetings all over the country. We have had focus 
meetings all over the country. Members have had town hall meetings all 
over the country. Citizens have had many opportunities to discuss with 
us this critical and important issue of how to save the Medicare 
program.
  So when you hear Members on the other side get up and make believe 
that some poor senior citizen was arrested because she just wanted to 
be heard, understand the truth. This was a lobby group, paid for with 
Federal funds through grants, that was just trying to disrupt the 
process.
  That is what occurred the other day. What the committee did was 
exactly what the Speaker of this House is obliged to do. The committee 
gave them three warnings, and then had them removed from the room, and 
they should have done so. We processed the bill from 5 o'clock that day 
until 11 o'clock that night. We came back at 10 o'clock the next day, 
and we finished our work at approximately 12:30 midnight the next day. 
Our committee worked diligently and hard and debated amendment after 
amendment after amendment, offered mostly by Members on the other side, 
before we finally produced the Medicare bill for this House to consider 
next week.
  I will in a minute begin to discuss with you the merits of that 
Medicare bill. I want to first yield to my friend from Florida.
  Mr. WELDON of Florida. I want to thank the gentleman for yielding. I 
just want to make a point that I think is a very important one. This 
disruption of a committee hearing, this staged, theatrical disruption, 
to include photographers being present, and these photographs being 
brought here into this House, I think clearly demonstrates how 
desperate our opponents are in this Medicare debate. They have not put 
forward a credible plan to restore, protect, and preserve Medicare. 
They have not put forward a credible proposal.
  I said earlier when I was speaking that the Washington Post itself 
has come out and said our plan is credible. They have not been able to 
do that. They do not have a plan to restore Medicare, and they realize 
we are about to do something that will probably be very, very good for 
seniors in restoring the solvency of the Medicare plan, and they are 
literally desperate to do something to stop us from doing good.
  I think it is really a shame that that is what politics in this city 
has gotten down to, where these kinds of tactics have to be used. I 
think our plan is a reasonable plan. I think our plan is a well thought 
out plan. I think we have gotten a lot of input from a variety of 
different groups in open meetings.
  There have not been any secret meetings here at all. Committee on 
Commerce, as you said, had 10 hearings. I think the Committee on Ways 
and Means has had 30 meetings. We have had hearings and hearings and 
hearings and hearings on restoring the solvency to the Medicare plan, 
and we have put forward a proposal that everybody seems to be saying is 
reasonable and balanced and restores solvency to the Medicare plan. Not 
only does it do those things, but it provides our seniors more choice 
in selecting their health care plans.

  I think it is a good plan, and I think it is a sorry day in the 
annals of political history in this city when the minority party has to 
resort to these kinds of desperate tactics in this debate.
  Let us have an open debate, let us have an open debate and really 
discuss the various virtues and merits of our Medicare plan, and let us 
not resort to these kinds of tactics.
  Mr. TAUZIN. Well, if the tactics at the committee were bad, the 
tactics on the floor are worse, to pretend this was some real 
demonstration by real senior citizens, when this was an organized lobby 
group planning to disrupt the meeting. To bring pictures on the floor 
and make it look like some poor senior citizen was not heard is just 
Hollywood. That is all it is. We ought to put that behind us as quickly 
as we can and begin to debate the merits of our proposal.
  I agree, we have a good plan. We ought to debate it, and I am 
prepared to begin talking about it.
  Mr. KIM. Mr. Speaker, I agree, I think this is all politically 
motivated. I have a deep concern about all these attacks, that we are 
taking money from senior citizens and giving that to rich people. My 
golly, we are talking about a tax credit of $500 per child, and that 
was given to everybody, not just rich people. Also remember, we just 
passed an amendment which prohibits any money transfer from Medicare to 
any other general fund money.
  Mr. TAUZIN. If the gentleman will let me emphasize that point, in the 
Medicare markup we adopted the lockbox amendment, which makes sure any 
savings the new Medicare reforms produce has to stay for Medicare 
purposes. It does not go for any other purpose such as a tax cut. It is 
used within the system to keep the system solvent.
  Mr. KIM. I think the public should know that you cannot transfer 
money from the Medicare trust fund to any other account. The money has 
to stay within the Medicare trust fund. But all these scare tactics to 
frighten senior citizens, let me also point out that we should look at 
President Clinton's plan. He recognized the problem. He is the one that 
told us Medicare will be bankrupt within 7 years. His proposal is about 
saving $127 billion over 10 years.
  Mr. TAUZIN. If the gentleman will allow me, he proposed saving $127 
billion, but on the same baseline that our calculations are made, his 
number is really $192 billion. The President himself said we need to 
save at least $192 billion in spending, the bleeding that is occurring 
in the system, to save it from bankruptcy. Our number is $270 billion. 
His number is $192 billion. We are not that far apart.
  The President understands bankruptcy is about to happen in Medicare. 
We have to cut the waste, fraud, and abuse, the spending driving it 
into bankruptcy, as quickly as we can. It does not take Band-Aids, it 
takes real reform.
  Mr. KIM. That is exactly right. So the President recognizes the 
problem. As a matter of fact, the Board of Trustees are his appointees. 
They are the ones that released the report that said it is going 
bankrupt. The President's plan and our plan are not that much 
different. As you said, if we look at the same baseline, we are talking 
about the same thing.
  Let us look at the Democrat's demagoguery. They have no plan, nothing 
until about a week ago, and they come up with an idea, a gentler plan, 
which says they can save $90 billion. Let us take a look at that.
  What is going to happen with the $90 billion savings when Medicare is 
about to go bankrupt? Ninety billion dollars certainly does not go far 
enough. Their plan simply delays Medicare bankruptcy by an additional 3 
years. That is what they are doing.
  Worse than that, their plan leaves Medicare about $300 billion in 
debt, just as the first wave of baby boomers comes along. What is going 
to happen then? When the baby boomers decide to retire, then we have a 
$300 billion debt in the Medicare trust fund. Undoubtedly that is going 
to bankrupt it again.

[[Page H 10055]]

  This is just another political gesture. I am concerned about this.
  Mr. TAUZIN. The gentleman makes a great point that we need to 
emphasize. The Democratic Party finally came with some alternative. 
They finally said this week, here is what we would do. What they would 
do would be to cut the spending, the bleeding in the program, by only 
$90 billion. What that does is that just delays the bankruptcy. It is 
like putting a Band-Aid on a gaping wound and say all you have to do is 
pump.
  Mr. MORAN. Blood in the patient. The patient is going to die unless 
you close up the wound. Ninety billion dollars will only get you past 
the next election. It will not save Medicare from bankruptcy and 
protect it for the next generation. Our goal is to protect Medicare, 
not pass the next election, but for the next generation.
  Mr. KIM. That is right. Ninety billion dollars is just a political 
game without any details. You are trying to use this figure and trying 
to frighten senior citizens.
  I am concerned with what is happening right now, all the verbal 
assault and demagoguery.
  Mr. TAUZIN. Mr. Speaker, I want to start this discussion by laying 
something on the table that I think ought to be a predicate to all the 
discussions we have, a precedent. The first thing I think we ought to 
put on the table for everyone to consider is that no Democrat, no 
Republican, has a greater claim to loving their parents and their 
grandparents than anyone else in this body. No one can credibly make an 
argument that because they are a member of one party or the other, they 
love their parents or grandparents more than a member of the other 
party. This is not about parties.
  We should love our parents and grandparents enough to make sure that 
the Medicare system is not only solvent for the next 7 years but is 
solvent for as long as we can possibly see into the future. It is that 
important.
  My mother is a cancer survivor twice, survived breast cancer surgery 
in 1961, survived lung cancer surgery in 1980. She is a miracle, a 
product of the miracles of medicine. I consider her my miracle mom. She 
is still around. She is celebrating her birthday this week at the 
Senior Olympics in Baton Rouge, in her two favorite categories, shot 
put and javelin, believe it or not. She is doing great. She is one of 
the incredible success stories of our Medicare program, of our health 
care system.
  No one in this body can dare lay claim to the notion that they love 
their parents or grandparents any more than any one of us in this body, 
regardless of party. That ought to be the first principle.
  The second principle ought to be that all of us recognize what the 
President said, that he and his trustees have said, that if we do not 
do something dramatic and immediate, the Medicare system will go 
bankrupt in 7 years.
  Now, I expect my mother to be around longer than 7 years. I do not 
want that bankruptcy to occur for her, not for your mother, not for 
anybody's mother or father or grandfather.
  The second principle that we all ought to agree on, regardless of our 
disputes, is that we cannot let that happen. We cannot let this system 
that has cared for my mother and yours go into bankruptcy in 7 years.
  The third principle I want to put on the table as we begin this 
discussion is that the President himself has recognized the need for an 
immediate and dramatic action to stem the bleeding of money from this 
system, the tripling of inflationary costs in health care, to Medicare, 
the waste, the fraud, the abuse in that system--they estimate 10 
percent of the dollars we spend in Medicare is nothing but waste and 
fraud and abuse.
  The President has recognized we have to put an end to that. He has 
recommended $192 billion of reforms in that area. We have recommended 
$270 billion. The President said in 1993 that for the system to 
continue at three times the rate of inflation is intolerable. He said 
in 1993, the President, Bill Clinton said, ``I will recommend reducing 
the growth of spending in Medicare dramatically and in Medicaid. This 
will not be a cut. Don't let people tell you it is a cut. We simply 
have to reduce this incredible rate of spending to save the system.'' 
That was the President's words in 1993.

  We have some agreement there. We ought to have agreement in this body 
on those same three principles. One, we all equally love our parents 
and grandparents; two, we all ought to be committed to saving Medicare 
from bankruptcy; and, three, we can agree, from this body to the Senate 
to the White House, on a plan to rescue it.
  Mr. KIM. If the gentleman will yield further, I would just like to 
point out I hope people in California are watching this debate, because 
I read the report carefully. It says that part A of the trust fund, the 
hospital insurance trust fund, which pays the hospital costs, will be 
bankrupt within 7 years, unless we do something right now.
  That is financed by payroll taxes, the FICA, which the beneficiary 
pays a half and the employer contributes the other half. If that goes 
into bankruptcy, we have two choices. One is raise taxes, which is not 
fair to younger people. Why should they pay a higher rate to subsidize 
beneficiaries, the retirees?
  The second is you have to control the costs. That is exactly what we 
are trying to do. We have shown again and again that last year alone 
the Medicare trust fund, which is mismanaged in my opinion, the cost 
has gone up 10.5 percent. The private plan in California, the costs 
have actually gone down 1.5 percent.
  If you give choices to join a private plan, just a choice, an option, 
the more joining the private plan, we can save easily 10 percent by 
avoiding this mismanagement.
  Then part B, which is, again, paying for the doctor's bill, which is 
paid by the beneficiaries, $41.22 a month, that is hardly enough. So 
what we are doing is, other taxpayers have been subsidizing two-thirds 
of this cost. The beneficiary only pays one-third. It used to be half 
and half. If we do nothing, what is going to happen at the end of 7 
years, it is going to be 90 percent subsidized by the other taxpayers, 
only 10 percent paid by the beneficiary. That is not fair.
  What we are trying to do is maintain the same situation, one-third/
two-third relationship, by doing it we have to ask the retiree to 
contribute a little more to maintain the level. We are not cutting 
anything. We are trying to maintain the same level.
  I think we should stop bickering and sending all this disinformation 
and frightening tactics, so we can work together and come up with a 
comprehensive plan. We are in a serious problem in Medicare.
  Mr. TAUZIN. I thank the gentleman for his statements. I guess maybe 
the gentleman has put his finger on it. The last thing we ought to do 
is try to scare seniors today. They have enough to worry about.
  We all ought to be trying to calm these fears. We ought to be talking 
about our debate, of course, on how to resolve it; it ought to be a 
good debate. But we ought to all talk about those three principles I 
talk about. We love you enough to try to keep Medicare solvent, and we 
will do whatever it takes in working with the White House to come up 
with an eventual solution that saves it from bankruptcy. That ought to 
be the theme.
  These fear tactics ought to be put aside. We ought to work for the 
good of this country instead of for the good of somebody's politics 
today.
  I yield to my doctor friend from Florida.
  Mr. WELDON of Florida. I just want to amplify on a point that the 
gentleman from California [Mr. Kim] just made, which I think is an 
extremely important point.
  In developing our plan, we met with a variety of different groups, 
both consumer groups and senior groups, as well as provider groups. And 
we, frankly, were shocked to discover that in many of the private 
groups that do health care, they are actually seeing their cots go 
down.
  So here we have on this one side this government-run program with all 
its bureaucracy, with all its fraud and waste, and it is increasing at 
10.5 percent. Then you go to these civilian-run, private programs, 
where they are actually reducing the premium. It is not growing at 3 
percent, it is not growing at 5 percent, it is not growing at 6 
percent. They are actually lowering the premiums to the employers, and 
that helps those employers be more competitive. It helps them to be 
more competitive on the international market, where so much of the 
competition is going on right now. 

[[Page H 10056]]

  So what we did is we said, how are you doing that? How have you been 
able not only to lower the rate of increase of health care costs, but 
to actually see some real dollar reductions in your costs in health 
care? And we have taken some of those principles that they have 
adopted, many of which--actually what they accomplish is they root out 
fraud and abuse. And we have adopted some of those into our Medicare 
Plus program.
  Now, our friends on the other side of the aisle would like to say 
that we do not want that, we do not want that. We cannot have that. We 
want to maintain the status quo. But the reality is the working people 
who work for these companies who have adopted many of these managed 
care type plans have to live under those managed care plans.
  The ultimate irony of all this is, if you do pause and you ask those 
working people, the people who are paying the bills for the Medicare 
plan through their payroll taxes, how do they like them, what they 
think of those plans, they say they are great. They love them. They 
think they are wonderful, and they indeed, many of them, are happy that 
it saves money for their employers so their employers can be more 
successful. And they indeed are very, very happy that it weeds out 
fraud and abuse.
  Mr. Speaker, that was such a crucial point that the gentleman from 
California [Mr. Kim] brought up. All we are doing is saying, gosh, how 
did you guys out there in the free market manage to do this? Let us see 
if we can put a little of your free market common sense into our 
Government program. That is what we have done with our Medicare Plan.
  To accuse us of some of the things that are coming from the left on 
this issue, I think is just dead wrong. It is a good plan.

                              {time}  1100

  Mr. TAUZIN. It is important I think for us to answer some of those 
accusations right up front. First, are we forcing anybody out of 
Medicare? The answer is no. Our plan says if you want to stay under the 
traditional Medicare fee-for-service, you choose your own doctor, 
choose your own hospital, you continue as my mother has under the 
Medicare program, you can continue under the current Medicare program 
as long as you want to.
  I will say it again. You can stay in Medicare as long as you want to. 
Will there be increases in the benefits over the next 7 years in our 
plan if you stay in Medicare? The answer is yes. We will increase the 
benefits per beneficiary from about $4,800 a person on average to 
$6,700 a person on average over the next 7 years.
  So if you are like my mother, you like Medicare and want to stay 
there, you can and your benefits increase over the next 7 years by 
almost $2,000. So do not believe this awful fear tactic that we are 
somehow cutting the benefits to Medicare beneficiaries. Neither are we 
forcing anybody out of the Medicare system as they knew it.
  I will tell you the other good news. What about the case if a 
Medicare beneficiary decides to choose one of these new plans and then 
does not like it? Guess what, under our plan if you choose it and do 
not like it, you can go right back into Medicare. In the first 2 years 
you can do that on a 60, 90-day turnover. You can try a plan and go 
right back to Medicare. After that you sign up for 1 year at a time.
  You will get to do what Members of Congress get to do; you get to 
choose from among plans. Do you remember when Hillary Clinton was 
presenting her national health care plan and they argued on television 
that we ought to give Americans the same option people in Congress have 
to choose different plans? Well, guess what? Under our Medicare 
proposal, seniors can stay in Medicare like it is, if they like it, or 
they can choose another plan, exactly what Hillary was recommending for 
every American.
  Third, if you do not like the plan you choose, under our plan you can 
move back into Medicare any time you want to during the first 2 years 
and every year thereafter at election date when it is time for you to 
choose.
  Guess what else? Seniors are not going to have to use vouchers and go 
buy these plans. The truth is seniors are going to have a booklet sent 
out to them in plain English, same way we get one every year, that 
explains the options to you, that tells you what you can choose and 
what you can try, and then if you do not like that you can switch back 
to the Medicare the next year or during that first 2-year period.
  That is a pretty good deal. When I went to my mother last weekend and 
she asked me what we are doing in this thing and I explained it to her, 
I said Mom would you like to have some option. She said I like Medicare 
just like it is. I said you can stay there, but would you not like to 
know you have the same options that we have in the private sector, that 
Members of Congress have under our Blue Cross plan? Would you not like 
to know you can move from one plan to another if there is a plan better 
than the one you are in and that you can go back to Medicare if you do 
not like the one you choose? She said, well, that makes a lot of sense. 
I said, yes, it really does.
  If Americans hear what is really in the plan instead of what they are 
being told about it by those who simply wanted to create fear out 
there, if they hear what is really in the plan, most senior citizens 
say, wow, somebody is finally giving us a choice, somebody is finally 
giving us a chance to choose what others in our society can choose, 
better private plans if they are better for us, and if they are not we 
can stay in basic Medicare as we know it.
  Mr. KIM. Mr. Speaker, I want to say that was very well said. I want 
to add that under the current plan, once you hit 65, you have to give 
up whatever plan you have. You must join this Government-mandated 
Medicare plan.
  Mr. TAUZIN. That is correct.
  Mr. KIM. You have no choice. That is the only plan available to you, 
which is Government run and run by bureaucrats. You have to follow 
their regulations, which is, in my opinion, socialized medicine. Just 
one plan, period.
  All we are trying to do is give those beneficiaries options to join 
other plans. Why? By joining other plans, you can save more money. This 
Medicare plan has so much abuse, so much waste and fraud, people would 
not believe. Even the report so stated that there is more than 50 
percent, which is easy to save if we eliminate the waste and fraud.
  It is unbelievable. It is out of control. That is why it has gone up 
10\1/2\ percent, while private plans are under control. Their costs 
have actually gone down 1\1/2\ percent. It is ridiculous.
  As long as a third party pays, as long as the Government pays it, who 
cares? That is the problem we have. So we are trying to eliminate that 
problem by simply offering all the beneficiaries choices to join 
private plans. We expect that at least 1 out of 4 will eventually join 
a private plan.
  Mr. TAUZIN. One out of four. Mr. Kim, you have put your finger on it 
again. Every time I go to a townhall meeting, I am always asked by 
someone in the audience the same question. Why do not you Members of 
Congress spend our money as carefully as you would spend your own? Why 
do you allow bureaucrats to waste 10 percent of the money that is 
needed for health care for the senior citizens of America? How do you 
put up with that? Why do you let it happen? Why do you not be more 
careful with our taxpayer dollars, as careful as you would be with your 
own dollars?
  The truth is it is harder when you are spending someone else's money 
to be as careful as when you are spending your own. You have to work a 
little harder. So guess what? In this bill we are putting in more 
antifraud, waste and abuse procedures; we are putting in more ability 
of Americans to help us root out the waste, fraud and abuse in this 
system than this system has ever seen.
  I want to tell people about what is in this bill that you will not 
hear from the other side. First, everybody knows about the IRS system. 
If there is somebody cheating on the IRS and you report them, you are 
entitled to a bonus. Do you know that? If someone is not paying their 
fair share so that the rest of us have to keep seeing increases in our 
taxes, any citizen can report an IRS violation and there is a bounty 
system under the IRS to reward those who report fraud and abuse in the 
IRS system.
  Well, guess what? The new bill will install the similar type system 
for every senior citizen who catches a bill coming to them, who catches 
a waste, fraud and abuse situation and reports it to HCFA. Let me be 
specific.

[[Page H 10057]]

  How many seniors have told us that when we get that bill back, the 
Medicare bill back that is being submitted to the Government, and say, 
wait a minute, I do not remember having that service, I do not remember 
that test, I do not remember this being done? How many have told us 
that? If a senior suspects they are being charged for something that 
did not happen and the taxpayers are having to foot the bill, there is 
no real incentive now to report it because somebody else paid it.
  But now the seniors will have the same incentive that every taxpayer 
has to root out fraud and abuse and report it. There will be a reward 
for seniors who help us find fraud and abuse.
  Second, the bill doubles the penalties on people who defraud this 
system. Let me say it again. We double the penalties on people who 
defraud this system. We make it mandatory that any provider under this 
system that defrauds the seniors of this country and the taxpayers of 
this country is forbidden to provide services under the Medicare system 
for a minimum of 3 years. Mandatory. That is not in current law. We 
provide a doubling of the penalties and a mandatory 3 years you are out 
of the system if you dare defraud seniors any more.
  Fourth, we put together a coordinated antifraud and abuse system like 
we never had before. We give to the Secretary the power which the 
Justice Department now has to work with people who will turn states 
evidence and help us root out other fraud, waste and abuse cases. We 
cannot afford the billions of dollars that are going into this rat hole 
of waste, fraud and abuse any longer.

  So when you hear from the other side that this bill is somehow kind 
of lax on waste, fraud and abuse, just do not believe them. You know 
what CBO said. CBO scores our work. CBO does the objective analysis 
that is done on every bill that comes before this House. It tells us 
what a bill does financially. CBO said we will pick up at least $2 
billion in extra collections from waste, fraud and abuse by some of the 
measures we put in. There is a potential to pick up a lot more. We 
think there could be as much as $50, $100 billion eventually picked up 
if we begin to root out the 10 percent of waste, fraud and abuse in 
this system.
  So we are going after it, Mr. Kim, finally. We are going after it not 
just for the taxpayers but for the seniors who want their program to be 
here after 7 years, who do not want it bankrupt and who want the 
dollars we spend, the precious dollars we spend to go to their health 
care and not to this awful system of waste, fraud, and abuse.
  Mr. WELDON of Florida. Mr. Speaker, I want to just amplify on this 
fraud and abuse issue, because it is a very, very important area. I had 
a series of townhall meetings with senior citizens in my district over 
the summer, and one of the messages I heard over and over and over 
again is we have to do something about this waste and abuse in the 
system.
  I had a lady come to me, she had a bill that was for her week in the 
hospital and it showed her staying 2 weeks in the hospital. I had 
another gentlewoman come to me with a bill that showed they billed for 
her being in the hospital and her husband being in the hospital at the 
same exact time when he was not in the hospital at all. He was at home 
and coming in to visit her every day.
  So we have some real problems in the system with that. One of the 
aspects of the Medicare Plus plan is these provider-sponsored networks. 
I want to underscore a very, very important point in that feature of 
Medicare Plus. If there is any excessive testing being done, if there 
is any excessive procedures being done, the person who picks up the tab 
for those is not the taxpayer; it is not the Federal Government, and it 
is not the senior citizen, it is the provider in that network who did 
that unnecessary test and who did those unnecessary procedures. So that 
will be a tremendous incentive in that part of our reform package, in 
Medicare Plus, that will make sure that we really do root out fraud and 
abuse.
  I think that feature, coupled with the things you were mentioning, 
increased penalties, a hot line where they can report fraud, when you 
start looking at all those things coming into effect, we will have a 
lot of savings in rooting out a lot of this fraud and abuse.
  Mr. TAUZIN. I thank the gentleman, and let me emphasize again what 
the gentleman added. The bill contains a hot line system for the first 
time. So citizens who find waste, fraud and abuse on their forms, they 
do not have to report it to somebody locally who may lose it; you can 
call directly to a hotline in D.C.
  We will also have a system whereby the Secretary puts out fraud abuse 
alerts, so if there is something going on they pick up in the 
marketplace out there, where fraudulent practice is occurring, they can 
notify seniors to watch out for this, there is something going on out 
there, help us root it out.
  In other words, we are beginning to build in this bill a partnership 
between the seniors who receive the services and who very often see the 
fraud and abuse firsthand and those who run the program and the 
taxpayers who are footing the bill. That kind of partnership means that 
we may end up with a much better, more solvent system. That is worth 
fighting for.
  Mr. KIM. The gentleman is right. As long as we have a third-party 
paying system, without somebody watching so to speak, we will continue 
to have this kind of abuse and fraud. Right now, the Government pays it 
without truly looking at it closely. That is what has happened.
  That is why I like the concept of the Republican plan to set up a 
Medisave concept. So you have a choice. Any savings you got by 
transferring your plan to a private plan without costing you a penny, 
whatever savings you can generate out of that, you can put the money 
into a tax free Medisave account and after that you can do whatever you 
want to do. It is your money to spend, which gives senior citizens 
incentives in trying to look at the cost.
  Right now nobody cares. Nobody asks how much it costs me having this 
operation. Nobody even shops around. This will give us some incentive 
to shop around so that I can get a better treatment and cheaper, so to 
speak. I think it is an incentive rather than some kind of additional 
regulation. I like the concept, and I think it is an excellent concept.
  Second, I want to point out again, going back to part B, which is 
again, as I mentioned earlier, that right now we are one-third paid by 
the beneficiary, two-thirds subsidized by the taxpayer, because $46 a 
month certainly is not enough and, therefore, all the other taxpayers 
subsidize it. Now, if we do not do anything, it will be totally out of 
control.
  So what we are trying to do is maintain the one-third, two-third 
relationship. We are trying to have it so that what we call the rich, 
wealthy senior citizens will not be subsidized, which is fair. We are 
talking about $100,000 a year or more for single, $150,000 for the 
couple immediately to stop the subsidy. Anybody making $75,000 per 
single and $125,000 per couple, we will gradually phase out the 
subsidy. Is it not fair to do it, so we can maintain this one-third, 
two-thirds relationship?
  I do not think it is right that other taxpayers subsidize 90 percent 
of it. I think right now all the media polls are saying that senior 
citizens are upset, that they are against us. I think when they find 
out the truth, I think it will be turned around.
  I do not understand why we have all the blame. Mr. Clinton's plan is 
no different than ours. How does he get away from all the criticism and 
we get all the blame?
  Mr. TAUZIN. I thank the gentleman, and you made two excellent points 
again. One is that among the various plans that we give the seniors an 
option to choose are the Medisave accounts. Medisave accounts are being 
used now. NBC showed a film the other night on New Jersey's plans in 
many corporate businesses where, instead of belonging to the Medicare 
system as you know it, you can choose instead to have the money 
deposited in a Medisave account. A catastrophic policy is purchased, 
the balance is kept in the account. If you do not use it, the money 
then becomes yours at the end of the year. If you use it, your high 
option coverage then kicks in to protect you.
  Those Medisave accounts do, in fact, allow people in the marketplace 
another option and, in fact, ought to be made available to seniors who 
want to perhaps use them, too. It does ensure 

[[Page H 10058]]
accountability. When it is your money, you will spend it a lot more 
carefully.
  So it is one of the options that seniors will have. You do not have 
to choose it, but it is one of the options and is working quite well in 
many business settings in America for employees registered under health 
care programs with their companies.
  The gentleman also makes a second point. Under part B Medicare, that 
is the voluntary part; the part A is the part we all have to belong to 
today when we reach 65. That is the mandatory hospital coverage. But 
part B coverage is the voluntary part which most people choose when 
they have the option.
  That part B coverage covers your doctor bills primarily. That part B 
coverage is paid 68\1/2\ percent by the taxpayers of America, the young 
workers of America, and it is paid one-third, 31\1/2\ percent in fact, 
by the seniors who choose to participate in it. About one-third, two-
thirds, you were right.
  What we do in our plan is to maintain that ratio through the 7-year 
period. The recipients of the program will still pay 31\1/2\ percent, 
the taxpayers will still foot the bill for 68\1/2\ percent, but we do 
one thing that cries out for reform.
  Here is the question. How can you ask a young couple earning $20,000 
a year to continue to subsidize part B premiums for an older couple 
that is making $100,000 or $150,000 a year?
  You can understand why all of us working in the work force should 
help our seniors who are similarly situated in terms of income. But how 
do you explain to a working couple struggling to buy their own health 
care at $20,000 a year salary that they also have to subsidize the part 
B voluntary premiums of someone earning $100,000 to $150,000 a year? It 
is pretty hard to explain.
  The odd thing about it is, believe it or not, we are getting 
criticized by the other side, who should be against taxpayer subsidies 
for wealthy people. We are getting criticized for trying to make this 
change. What we are saying is that when you are in that income 
category, $100,000 to $150,000 a couple, that you should not have to 
depend upon those making $20,000 a year to pay your part B premium. 
That ought to be your responsibility if you are that well off. You 
ought not be counting on poor working Americans struggling to feed 
their families and pay their own health care.

  So our plan changes that and phases out that subsidy for the well-to-
do in America who do not need a subsidy from those who are working in 
the poor and middle class families struggling to pay their own health 
care.
  Mr. WELDON of Florida. Mr. Speaker, I was a practicing physician 
before I came to the U.S. Congress, and, actually, the truth is a lot 
of those working families on limited incomes, families where maybe the 
husband has a $15,000, $20,000 a year job, and the wife may have a 
part-time job while the kids are in school making $6,000 or $7,000 a 
year, many of those families have no health insurance, they have zero 
health insurance. I have seen that in my practice, where they do not 
have the money to pay me, and you have to set up a schedule of payments 
or you have to just write that off, because you know they cannot afford 
it. So you end up seeing them for free.
  We have been taxing those people to subsidize the part B premium for 
many very, very wealthy senior citizens. This is just another example, 
I believe, of how our plan is a well thought out plan, a balanced plan. 
What we are asking is those wealthy seniors, who have the money to pay 
for their part B premium, that they pick it up themselves. So we have 
some provisions in there that will make sure that those affluent 
wealthy senior citizens are paying, indeed, their fair share of what 
their health care costs are and that we are not excessively burdening 
working families, many of whom have no health insurance.
  I think that is a very, very good balanced feature of our Medicare 
reform proposal and our Medicare Plus plan.
  Mr. TAUZIN. Again, you have put it so well. Here we are talking about 
a family that cannot even afford to buy their own health care they are 
at such a low income, struggling. Yet our law now requires them to 
subsidize, through their taxes, the health care premiums of the wealthy 
in America. That does not make sense when you talk about part B 
voluntary programs.
  You can make an argument, as we have all made the argument, that when 
it comes to part A, all of us who work in America owe our part A 
contributions to make sure that part A is solvent. That is maintained 
in this plan. But to say that working Americans, who cannot afford 
medical care insurance for their own doctors for their children, and 
who do not even have coverage for their family, who have to go, if you 
will, to Hill Burton coverage, or the good graces and charity of their 
physician for health care, to say to them we are going to ask you to 
pick up the part B premium for people earning $150,000 or more for next 
year is a little unfair.
  If ever there was an unfairness in a system, I think we have found 
it. We correct that unfairness in this bill. One of many features of 
this bill that I think Americans should look at instead of reading the 
fear tactics put out by the other side.
  Mr. KIM. Mr. Speaker, I read a month ago a report that simply says 
that we live longer, which is good news, and that each beneficiary 
actually spends $170,000 more than he or she has contributed in a 
lifetime. Of course, some people live longer and some people die 
earlier, but, on average, each senior citizen actually spends $170,000 
more than they have contributed in their lifetime. We have to make this 
up somehow.
  Part A we know is a payroll tax, 2.9 percent, half and half, employee 
and employer. Is it fair to raise that? No, I do not think it is right 
to raise it because why should they pay it? So we have tried to 
maintain the same tax rate. Part B, one-third, two-third relationship, 
that must be maintained. That is not fair asking young people to pay 
more.
  So we have tried to maintain the same rate. What else can we do, 
except avoiding all the waste and fraud? We have all the innovative 
ideas of giving choices to private plans.
  What really bothers me is our colleagues, the Democrats, come up with 
this silly $80 billion savings. Come on, that is certainly not enough. 
They know it. It is clearly stated in the report. That is not going to 
do anything. It is just a political motivator. Who are we trying to 
kid?
  As I said earlier, at the end of 7th year, when the baby boomers 
decide to retire, how will we do it? By then we will be $300 billion in 
debt using the 80 plan they are suggesting, which they never had a plan 
until a couple of weeks ago. Last minute, without any details. It is 
just a joke. It is another politically motivated tactic that they are 
trying to use to say we have a gentler plan, that the Republicans are 
cutting too deep, too fast.
  I have just had it with this rhetoric and painting us like we are 
mean-spirited people. Come on, we care about people, just as they do. 
We should stop the bickering, and they should join us. If they have a 
problem, let us work this out together and come up with a comprehensive 
plan so they can save Medicare from bankruptcy.
  Mr. TAUZIN. I thank the gentleman. I think I know where the problem 
is. The problem is that, No. 1, the Democrats who do not like our plan 
would prefer to call us mean spirited and create all these fear 
tactics, and Republicans who are upset with the Democrats for not 
coming up with a plan would like to believe that the Democrats do not 
want to save Medicare.
  I do not think either of those arguments are true. I really do not. I 
think Medicare is sacred to all of us here. I think the other side 
should be given credit that they do not want Medicare to go bankrupt, 
but their solution will not sell anymore. Their solution is either 
raise taxes some more or borrow some more money. Do not try to control 
the cost or the waste, fraud, and abuse, just raise taxes some more or 
borrow some more money.

  I want to end, before I yield back to my friend from California on 
that note. I was raised to believe that it was the job of parents in 
America to try to leave some patrimony to their children, to try to 
leave them a base, a foundation upon which to build their future. I was 
raised to believe that. I think most of us in this country were raised 
to believe that.
  But the most awful crime occurring in our country today, if all the 
other 

[[Page H 10059]]
crimes were lumped together, they are misdemeanors compared to this 
great felony. The greatest felony in America today is the fact we in 
America today, our generation, is now not simply living on our income, 
we are now living on the income of our children and our children's 
children yet to be born. We are living at such a deficit rate that our 
grandchildren and children will have to endure an 80 percent real tax 
rate on their earnings to pay for our debt.
  We are not leaving our kids any inheritance anymore; we are leaving 
them mortgages and we should be ashamed. If there is one felony we 
ought to end in this Congress, in this country, it is the notion that 
we can live off our children's income forever, that it does not come 
due one day, that somebody does not have to pay that bill one day.
  What we are trying to do this year is to say beginning through this 
year into the next 7 years we will put Medicare in solvency again, we 
will put the budget in balance, we will quit living off our children's 
income and we will do it in a way that protects our seniors and gives 
respect and due credit to the workers of America who are trying to fund 
this system and make it work.
  What a great challenge. What a great challenge. Is it worth some 
political heat? You bet you. You bet you. Is it worth getting a little 
political stain on you because you get hit and accused and abused 
through the process? Of course. Do I care whether or not anybody's 
politics is helped or hurt by this? Not a bit. What I care about and I 
hope you care about is at the end of this process we cure Medicare for 
America, we make it solvent again, we balance this budget in 7 years 
and we end this awful felony of living off our children and our 
grandchildren's income.
  Shame on us for letting that continue for one more year. Blessings 
upon us if we can do it in this 7-year period. It will take at least 
that long, but we ought to be about that business today. We ought to be 
about it as Americans, not as Democrats or Republicans. We should be 
about it as parents who love our kids enough to leave them something 
better than a great debt they cannot pay.
  Mr. WELDON of Florida. That will be hard to follow on. As always, he 
spoke very, very well on this issue.
  I want to close by pointing out that the Washington Post itself, a 
publication that has a long-standing reputation of opposing Republican 
initiatives and supporting Democratic initiatives, and I raise that not 
to criticize the Washington Post but just to emphasize that this is 
basically a statement from a group who has been traditionally our 
critics, they say that the Republican's Medicare plan has confounded 
the skeptics, it is credible, it is gutsy, and it addresses a genuine 
problem that is only going to get worse.
  This is what they had to say about our opponents. They called their 
proposal crummy stuff. They called it demagoguery big time, scare talk, 
expostulation, and they called it irresponsible.
  What you were just talking about, you were talking about being 
responsible when you talked about leaving our children not a debt but 
leaving them a good posterity at this, that is called being 
responsible. That is called being a responsible parent when you do 
that. That is what this is about. It is a responsible proposal that we 
are putting forward and what our opponents are doing is irresponsible, 
and I thoroughly support the Republican Medicare reform plan, the 
Medicare Plus plan. I think it is a good plan. It will preserve and 
protect Medicare for our seniors. I think it is good for seniors, it is 
good for working people who are getting near retirement age, and it is 
good for those young people who will be saddled with all those taxes if 
we do not straighten the problems out.
  I thank this gentleman from Louisiana for planning this 1-hour 
special session to talk about this. I think this has been very, very 
good. The gentleman from California [Mr. Kim] has made some very, very 
good comments. I think this is a very, very complicated issue, but we 
covered a lot of the high points on what our plan offers.

                              {time}  1130

  Mr. KIM. Mr. Speaker, I was coming down to the office when I heard 
this radio talk show, and it concerned me because they were 
interviewing an opponent that said that now Republicans are trying to 
tax the students. I was absolutely shocked.
  As a matter of fact, we added more money for Pell grants. We are not 
cutting any student programs. All we are doing is we are asking 
students when they borrow the money, they should pay back all the 
interest. Right now they do not have to pay anything until they 
graudate or 6 months later.
  Is it fair for the other young people who are not fortunate enough to 
go to college to subsidize a medical student with free interest? Of 
course, not. So we are asking them to pay back interest after they 
graduate, which is about 60 cents a day on average. This kind of 
demagoguery, this kind of scare tactics, frightening now senior 
citizens, now young students, I do not appreciate this.
  This is my second term, but this is politics and I am very 
disappointed. We should send a clear, true message to the American 
people, not twisted, not demagoguery, not scare tactics.
  A lot of senior citizens from my district are frightened. I have to 
go explain to them the factual information. I was an engineer all my 
life. I do not know any other way except presenting facts. Now they are 
satisfied. But it is really not necessary doing all this. They should 
tell the truth, exactly what it is.
  I thank again the gentleman from Louisiana [Mr. Tauzin] who has done 
an outstanding job hosting today's debate.
  Mr. TAUZIN. I thank my friends from California and Florida for what I 
think is a very useful hour.
  Let me say it again: The Washington Post, what most people consider a 
very liberal editorial page, said it very clearly. But I want to 
caution, if you want to get educated on the Medicare proposal before 
the Congress, do not count on the newspapers or anybody else to educate 
yourself. Try to educate yourselves and be in touch with us. Write to 
us, call us, ask for information, as you always do, come to town hall 
meetings. We will continue to share that information here on the floor 
as freely as we can.
  Let me say again, our plan mandates no one to leave Medicare. They 
can stay in it if they like, and it will grow from $4,800 per recipient 
to $6,700 over 7 years. It is good reform that saves Medicare for a 
whole generation, not just for the next election, and that is 
important.
  It is a plan I think we ought to be debating, as the gentleman from 
California says, in a way that does not pit the White House against the 
Congress, or Democrats against Republicans, in this awful kind of 
political warfare. It is one where we all ought to recognize we all 
love our parents and grandparents, we love them enough to behave 
ourselves around here, instead of acting like children, and to come to 
some mature decisions about how to save this program and make it endure 
for the good of the seniors of America, while respecting the legitimate 
interests of taxpayers that want to make sure the wasteful spending in 
this system is curtailed as rapidly as possible.
  This is a great challenge for the country this year. I hope we are up 
to it. I hope seniors are calm and cool and deliberative as they look 
at these programs. If there is something wrong in what we are 
proposing, I hope they suggest changes that make sense that we can 
incorporate into it.
  The last thing we need is demonstrations and disruptions like we saw 
in the Committee on Commerce organized by lobbyists paid exclusively by 
Federal funds. The last thing we need are scare tactics. What we need 
is honest, truthful debate of the facts, and then coming to terms as 
Americans, not as party members, but as Americans, to save this 
incredibly important system for those we love so dearly, and who 
created the path upon which all of us have walked.

  I want to remind you of something. All of us owe so much to the 
seniors who came before us. All of us owe so much. They did not leave 
us with a big debt, they gave us a lot. We ought to not leave our 
children with a great debt, and we ought to honor and love our mothers 
and fathers enough to take care of them in their senior years 

[[Page H 10060]]
with a program that does not go bankrupt because we did not have the 
political courage to debate it as mature adults.
  I again want to thank the gentleman from California [Mr. Kim] and the 
gentleman from Florida [Mr. Weldon].

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