[Congressional Record Volume 141, Number 161 (Wednesday, October 18, 1995)]
[House]
[Pages H10301-H10302]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      COMMONSENSE MEDICARE REFORM

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Michigan [Mr. Stupak] is recognized for 5 minutes.
  Mr. STUPAK. Mr. Speaker, what I would like to do, I am on the 
Committee on Commerce and will be on the floor most of the day tomorrow 
arguing Medicare. I can go on all night about the inequities in the 
Republican plan, but what I would like to do tonight is submit my 
statement for the Record, and yield the balance of my time to the 
gentlewoman from Florida [Mrs. Thurman].
  Mr. Speaker, I include my statement for the Record as follows:
  Mr. Speaker, a week ago, I introduced the Common Sense Medicare 
Reform. the new majority in Congress claims that it is necessary to cut 
$270 billion in order to save the Medicare Program. This is simply 
ludicrous. The Medicare trustees say that the Federal Government must 
devote $89 billion--not $270 billion. What's really going on here is 
the majority is attempting to steal $270 billion from the Medicare 
trust fund in order to keep its campaign promise by giving a $245 
billion tax cut to the wealthiest 1 percent of Americans.
  Actually, the Medicare trustees say that the Federal Government must 
devote $89 billion--not $270 billion--to save Medicare from bankruptcy. 
There must be changes and adjustments to Medicare, but it's 
irresponsible to gut a program which 37 million senior citizens depend 
on for health care coverage. My legislation takes the best ideas from 
the Republican proposal and the Democratic plan to improve the Medicare 
Program in a bipartisan manner.
  The first thing we must do to save Medicare is to aggressively fight 
waste, fraud, and abuse in the Medicare Program. Ten cents of every 
dollar spent on Medicare is consumed by fraud and waste. Some health 
care providers charge the Medicare Program many times more than what 
these goods and services would cost on the open market. For example, 
Medicare rents, you can't buy it, but rent pressure reducing mattresses 
for approximately $650.00 per month and comparable alternate pressure 
reducing mattresses can be purchased for $168.95. Foam rubber egg shell 
mattresses can be purchased for $19.95, yet Medicare pays $29.95. The 
Medicare Program pays $280 for oxygen concentrate, while the Veterans 
Administration, another Federal agency, pays only $123 for the exact 
same product. Savings from the oxygen concentrate alone could save us 
$4.2 billion over 5 years. These three examples alone demonstrate how 
billions of dollars are robbed from the Medicare trust fund.
  We can find the money we need to save Medicare. In 1994, more than $8 
billion was recovered in fraud and waste by Medicare providers, and it 
is expected that $10 billion will be recovered in 1995. We can save 
$93.5 billion over the next 7 years by actively detecting and 
prosecuting waste, fraud, and abuse, and this amount is more than 
enough to save Medicare according to the trustees' report.

  The Republican Medicare bill proposes to legalizes fraud committed by 
health care providers by making it more difficult to prove fraud and to 
recover Medicare funds. Conversely, my bill provides more and better 
tools to fight Medicare fraud by increasing the powers available to law 
enforcement. It will strengthen civil penalties for kickbacks, provide 
grand jury investigations, and increase subpoena authority. Both the 
OIG and the Justice Department endorse the fraud-fighting tools that 
are contained in my bill.
  Currently, any money saved from Medicare is returned to the U.S. 
Treasury. My legislation requires that any funds recovered through cuts 
or savings be automatically returned to the Medicare trust fund. Your 
Medicare money should not go to the U.S. Treasury to pay for tax cuts 
for the wealthiest Americans and large corporations--it should be used 
to save Medicare.
  I firmly believe that before we gut Medicare and implement radical 
and untried managed care programs, we should test the feasibility of 
these new programs on a voluntary basis. I propose that we look at 
managed care programs and health care service networks on a 5-year 
trial basis. We must make sure that such pilot programs will save 
money, provide quality care, and prolong the life of Medicare while 
giving seniors greater health care benefits and choices. Programs such 
as provider sponsor organizations [PSO's] and provider sponsor networks 
[PSN's] may be particularly useful and effective in rural areas. In 
northern Michigan, we are on the cutting edge of providing maximum 
benefit for our health dollar through cooperative efforts. I won't 
gamble with your health care. Let's make sure that the proposed changes 
improve Medicare, rather than destroy it.
  My legislation also directs that a Baby Boomer Commission be 
appointed to study alternatives for the best way to address the large 
influx of recipients who will be eligible for Medicare beginning in the 
year 2010. The Commission will work with Medicare trustees to ensure 
there will be funds available to provide health care coverage for the 
baby boomer population. In addition, the Commission will hold public 
hearings all across the country so you will have input on any proposed 
Medicare changes.
  Lastly, I advocate the use of a single-page Medicare claim form to 
increase administrative efficiency. We can simplify the Medicare system 
for beneficiaries and providers, while saving money from increased 
efficiency and cutting down on fraud.
  People should not have to pay more money to receive less coverage and 
lose their choice of doctors. The Republican majority should not raid 
the Medicare trust fund to give tax cuts to the wealthiest Americans 
and multinational corporations. Instead of stealing money from the 
Medicare System, we need to put money back into the system to keep it 
solvent for current and future recipients. Let's not gamble with the 
health of our senior citizens.
  You can see why the Republican majority refuses to make my bill in 
order because it is common sense.
  Mrs. THURMAN. Mr. Speaker, I thank the gentleman from Michigan for 
yielding.
  Mr. Speaker, I want to do this from a different standpoint of looking 
at what I think is going to happen to Florida residents. First of all, 
I want Florida residents to understand that they are looking at the $38 
billion cut between Medicaid and Medicare, and this is to pay for a tax 
cut for the very wealthy.
  Mr. Speaker, Florida stands to lose more than $38 billion in Federal 
funds under the Republican plan to cut Medicare and Medicaid to finance 
a tax cut for the wealthy.
  Now, I would like to introduce you to a wonderful couple from my 
district who worked hard all their lives and looked forward to 
retirement.
  But, like many elderly, they fell ill. While the wife struggles with 
illness herself, she has had to care for her sick husband.
  Recently, she came to me for assistance. It seems no one could help 
her secure a place in a nursing home for her husband. Thankfully, we 
were able to do that for them. But I worry about how this family will 
be impacted by the cuts in Medicare and Medicaid.
  First, under the Republican Medicare cuts, the ill wife will lose the 
security of her Medicare coverage. Yes, the Republicans are promising 
choice to my constituents.
  But the truth is, should my constituent want to stay in her current 
fee-for-service plan with her trusted doctor, she will be forced to pay 
over $1,000 a year in premiums by the year 2002.
  How can a plan promising choice produce such terrible results? It is 
because of what the Republicans are not telling seniors.

[[Page H 10302]]

  The Republicans offered concessions to doctors, at the expense of the 
seniors, by allowing the creation of provider service networks. The 
Republicans have encouraged doctors to form their own managed care 
plans.
  Knowing the benefits the doctors will get from these networks, how 
can anyone believe that there will be providers left for seniors in the 
fee-for-service plan?
  The Republicans say there will be no cut in services, but if you cap 
spending for services at below the growth in private sector health 
plans, seniors will have to pay more. To me, that is a cut.
  Make no mistake, seniors will pay more. The so-called failsafe 
provision looks back at the program to make sure spending targets are 
met. If not, payments to providers in the fee-for-service sector would 
be automatically reduced--but not in the Medicareplus plans.
  If the Medicareplus plans don't produce the savings the Republicans 
promise--and we all know they will not--then the fee-for-service sector 
will suffer.
  The promise to maintain the current Medicare option for seniors who 
want it is just a sham.
  My constituent on a limited income is now forced into a HMO, if an 
HMO thinks it is profitable to come into her region. Republicans have 
left it up to the HMO's to decide where they choose to offer services.
  There is no requirement that they serve us all. But, let us say an 
HMO comes to our region. My constituent is forced to leave her doctor 
for the plan's doctor--now that's some choice. But what if she doesn't 
like the plan's doctor or the coverage the plan offers?
  The Republicans promise her she can come back to Medicare. Even if we 
pretend that Medicare would still look like she remembered it, there is 
no guarantee--none at all--that her Medigap insurance has to take her 
back.
  This is a crucial issue that every senior in the country needs to 
understand. There is no choice. Once you enter an HMO you have 
absolutely no guarantee that you can return to the same level of 
coverage you currently enjoy in Medicare. Absolutely none.
  I have painted a picture of a woman with little choice--this is a 
portrait of Medicare under the Republicans. But, sadly, it gets worse.
  Let's talk about her husband. She finds security in knowing that he 
is well-cared for in a nursing home. But under the Republican plan, the 
Federal standards for nursing home protection will be erased. And, if 
he were dependent on Medicaid, as nearly two-thirds of nursing home 
residents are, his wife might be forced to sell their home to keep him 
there.
  The Republicans remove the restrictions on spousal impoverishment. 
They allow States to decide whether the spouse's income and home can be 
assumed for payment of nursing home care.
  Let us suppose our State does the right thing and protects the spouse 
from having her home and wages attached.
  Now our State becomes a safe haven for seniors in need of long-term 
care. By opposing 24 Governors who don't want Federal rules preventing 
spousal impoverishment, our State would stand tall.
  But in the Republicans' plan, there is always a cost for doing the 
right thing. If we do the right thing, and seniors come to our State in 
even greater numbers to benefit from our protections, we will have more 
people to serve.
  However, our block grant numbers under the new Medicaid formula will 
not increase. States who go after spouses and families and scare 
seniors away get to reap the benefits of their block grant. Floridians 
suffer.
  The picture for my constituents is not pretty. And I am saddened to 
have to deliver this message to Florida's seniors. But I won't have to 
if we work to expose the closed-door dealings of the Republican 
leadership and we bring out into the open the severity of these cuts. 
We must defeat these cuts for the health and security for our seniors.

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