[Congressional Record Volume 141, Number 162 (Thursday, October 19, 1995)]
[House]
[Pages H10328-H10333]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   MEDICARE PRESERVATION ACT OF 1995

  The SPEAKER pro tempore. Pursuant to House Resolution 238 and rule 
XXIII, the Chair declares the House in the Committee of the Whole House 
on the State of the Union for the consideration of the bill, H.R. 2425.

                              {time}  1132


                     in the committee of the whole

  Accordingly the House resolved itself into the Committee of the Whole 
House on the State of the Union for the consideration of the bill (H.R. 
2425) to amend title XVIII of the Social Security Act to preserve and 
reform the Medicare Program, with Mr. Linder in the chair.
  The Clerk read the title of the bill.
  The CHAIRMAN. Pursuant to the rule, the bill is considered as having 
been read the first time.
  Under the rule, the gentleman from Texas [Mr. Archer] will be 
recognized for 45 minutes, the gentleman from Florida [Mr. Gibbons] 
will be recognized for 45 minutes, the gentleman from Virginia [Mr. 
Bliley] will be recognized for 45 minutes, and the gentleman from 
Michigan [Mr. Dingell] will be recognized for 45 minutes.
  The Chair recognizes the gentleman from Texas [Mr. Archer].
  Mr. ARCHER. Mr. Chairman, I yield myself such time as I may consume.
  Mr. Chairman, today marks a great and historic occasion. With the 
action we are about to take, we will perform lifesaving legislative 
surgery on our Nation's vital Medicare Program.
  In just 74 days, for the first time in the 30-year history of 
Medicare, the Government will begin a year in which it spends more 
Medicare money than it takes in. I repeat, this has never happened 
before.
  That is why the action we are taking today is so very important.
  This bill saves Medicare for seniors. It preserves Medicare for 50-
year-olds, and it tells young voters to have faith in their Government. 
We Republicans have long-term solutions, and we are determined to 
protect Medicare for them, too, without raising their taxes.
  Our bill is innovative, bold, and visionary. It is long term. When it 
comes to a program as important as Medicare, nothing else is 
acceptable.
  Under our bill, seniors will have the right to freely choose the 
Medicare plan that best suits their needs, including staying in the 
present fee for service system, and to keep their own doctor, keep 
their own hospital, and keep their own plan, if that is their 
preference. It is their choice to make, and no one in government will 
force that choice.
  For the first time, Medicare will give seniors access to the same 
kind of health care plans that are available in the private sector, 
many of which include benefits that are not currently available under 
Medicare.
  We also have to ask, why should not seniors have the same choices 
like Congressman do? Under Medicare-plus, they will. And to make 
certain our solution is long term, we protect the savings, thanks to a 
proposal of the gentleman from Pennsylvania [Mr. English], language in 
this bill guarantees that the savings cannot be used for tax cuts.
  The Democrats know that we paid for our tax cuts, more than paid for 
them, last spring, before we ever got into Medicare. This bill is about 
saving Medicare for Medicare's sake.
  Our bill powerfully and effectively cracks down on fraud and abuse. 
It rewards seniors who discover fraudulent practices. It doubles civil 
penalties and creates new criminal penalties against those who commit 
fraud.
  As I mentioned earlier, our solution is long term. It saves Medicare 
for the next generation. This contrasts with the Democrats' quick fix 
approach, a Band-Aid approach, designed to save themselves for the next 
election. 

[[Page H 10329]]

  Mr. Chairman, I believe that not only will this bill be historic, so, 
too, will this Congress. We are the first group of lawmakers to 
directly challenge the convention political wisdom that it is not 
politically possible to fix America's explosive entitlement programs, 
which threaten to bankrupt our Nation and the future of our children.
  The Democrats who ran Congress for 40 years refused to confront the 
Nation's long-term problems, other than by raising taxes. Republicans 
are proving today that we can and will solve our Nation's most 
difficult problems, and I predict the American people will be thankful 
that we did.
  Mr. Chairman, long-term programs must be fair for all generations. I 
am proud to author this bill, not just as a Member of Congress, but as 
a Medicare beneficiary myself and as a parent and a grandparent. What 
we do today in historic. It is wise, it is just, and, most importantly, 
it saves, preserves, and protects Medicare.
  Mr. Chairman, I reserve the balance of my time.
  Mr. GIBBONS. Mr. Chairman, I yield myself such time as I may consume.
  Mr. Chairman, this is, I agree with the gentleman from Texas [Mr. 
Archer], truly an historic day. Unfortunately, it is another day in 
infamy for 40 million Americans who depend upon Medicare for their 
health care. These 40 million Americans will in a few years, if this 
bill becomes law, be herded into managed care, where instead of getting 
a doctor when they need help, they will get a gatekeeper, and the money 
saved by all of that will be used to pay for an unconscionable tax cut. 
That is the simple issue that we are deciding here today.
  Mr. Chairman, I yield such time as he may consume to the gentleman 
from California [Mr. Stark], the ranking member on the Subcommittee on 
Health of the Committee Ways and Means.
  Mr. STARK. Mr. Chairman, I thank the gentleman for yielding me this 
time.
  Mr. Chairman, Medicare is one of the finest achievements of the U.S. 
Government, and for 30 years, hundreds of millions of seniors have been 
provided quality health care at a reasonable cost, in an efficient 
manner, under the guidance of the Federal Government.
  Now one Republican, in a messianic grab for power, seeks to destroy 
Medicare. With reckless disregard for the seniors, these leaders on the 
Republican side bribed the American Medical Association with a $300 
million pay raise. The seniors are paying for that $300 million bribe 
to the doctors by being denied cancer treatment in mammograms and 
colorectal screening.
  The same Republicans, on the same day the bribe was given, voted to 
cut cancer screening for seniors, to repay political contributors of 
over $1 million by the Golden Rule Insurance Co. alone. Medical savings 
accounts have been delivered. They cost $3 billion. Who pays for them? 
The seniors, by having their part B premiums doubled.
  Seniors are denied the free choice under the Republican bill of 
doctors and are forced to join managed care plans run by the likes of 
Prudential Insurance Co., a company convicted of defrauding its 
customers of over $3 billion. Why should we vote to have our parents' 
health care entrusted to crooks like Prudential Insurance Co., just so 
the same rich executives who run that company can share in $245 billion 
in tax cuts? It is immoral, it is un-American.
  It is what the Republicans are doing, unknowingly, at the direction 
of one person. Not a person on that side of the aisle knows what is in 
this bill. No subcommittee ever met to consider the bill. It was 
written by one person in the bowels of this Capital to destroy 
Medicare, and that is what they are doing. This same leader destroys 
any protection from fraud and abuse and shoddy care in nursing homes, 
all in the name of less government.
  Every congressional district in this country under this Republican 
plan will see hospital payments cut by an average of $300 million. Go 
home and tell your hospital administrator that for the next 7 years 
they get $300 million less. Ask they which emergency room they are gong 
to close, which senior citizen they are going to deny care.
  Unfortunately, nothing is so likely to sway the Republicans as 
honesty and decency. But these cuts they propose will hurt, and hurt 
badly, real people. Hard-working Americans, who paid into Medicare for 
years will not get community health care centers, they will not get 
safety net systems to provide them Medicare.
  For 30 years we have working successfully to uphold the one true 
Contract with America, and that is Medicare. We have not and will not 
agree to breaking that contract in order to finance Republican tax cuts 
for the wealthiest Americans. We must do everything to defeat this 
reckless Republican plan. I urge a ``no'' vote.
  Mr. BLILEY. Mr. Chairman, I yield 2 minutes to the gentleman from 
Louisiana [Mr. Tauzin].
  Mr. TAUZIN. Mr. Chairman, I thank the gentleman for yielding me this 
time.
  Mr. Chairman, as we begin this historic debate on the Medicare 
Preservation Act, I would like to lay a few principles on the table: 
The first is that no one in this Chamber should dare suggest that they 
love their parent or grandparent any more than anybody else in this 
Chamber. As I speak today, my mother, 77 years old last week, twice a 
cancer survivor, is laying in a hospital bed in room 219 of Thibodaux 
General Hospital in my hometown. She is doing fine. My sisters are with 
her, and I speak to her every hour. She is on Medicare, one of the 
prime beneficiaries in this country of a great system. To suggest that 
anyone in this room does not love their parents enough to sustain that 
system is simply wrong. We can do better than that in this debate.

                              {time}  1145

  The second principle I would like to lay down is, we all agree the 
Medicare trust fund will begin running out of money next year and run 
out of money in 7 years unless we do as the trustees suggest; 
fundamentally change the system to keep it out of bankruptcy, to 
preserve it for my mother and your parents and grandparents.
  Now, we differ on how to accomplish that. We should debate those 
differences and not challenge each other's motives here. Our 
differences are simple. We believe, as President Clinton believes, and 
as he has said, ``Medicare and Medicaid are going up at three times the 
rate of inflation''. We propose to let it go up at two times the rate 
of inflation. That is not a Medicare or Medicaid cut.
  Mr. Chairman, when we hear all this business about cuts, let me 
caution Members that that is not what is going on. We are talking about 
increases in Medicare and a reduction in the rate of growth.
  We believe as the President does, that we have to substantially cut 
back the waste, the fraud, and the inefficient spending in Medicare to 
save it.
  Second, we believe seniors should have the choice to stay in 
Medicare, and our plan lets them stay. To choose Medicare, to choose 
their own doctor, choose their own hospital, or, if they want to, like 
my mother, remain in the system. Our plan allows that. We also believe 
seniors should have the same choices we Members have, other options, 
and that is what our plan provides.
  Mr. Chairman, I urge a ``yes'' vote on this good bill.
  Mr. DINGELL. Mr. Chairman, I yield myself 2 minutes.
  Thirty years ago this year I had the privilege of sitting in the 
Chair and presiding over the House when we passed Medicare into law. 
This is the gavel I used. Before that time better than half of 
Americans had no health insurance if they were senior citizens. Today, 
99\1/2\ percent of American senior citizens are covered by health 
insurance.
  What is going to happen today is that this body, under a gag rule, is 
going to vote to cut the benefits of senior citizens, to reduce their 
choice of doctors, to cut money for fraud enforcement, and to weaken 
the laws against fraud. And the Justice Department and the inspector 
general of the Department of Health and Human Services say so. It is 
going to force people into HMO's. We will close hospitals today, 
especially rural hospitals.
  Mr. Chairman, this is because the House is preparing to honor a 
Republican commitment to cut $245 billion in taxes for the rich and to 
cut Medicare $270 billion. Without that cut of $270 billion in 
Medicare, the tax cut is not possible.

[[Page H 10330]]

  This bill will reduce protection for nursing home patients. It was 
crafted by an abundance of sneaky, unreported, backroom deals. The bill 
is over 300 pages long. It has grown like fungus, and each of those 
growths represents a significant benefit to special interests. Last 
night the bill was changed after the House adjourned.

  Mr. Chairman, no one knows what is in this bill because no hearings 
have been held upon it. I urge my colleagues to reject the bill.
  Mr. Chairman, I include for the Record my full statement.
  Mr. Chairman, many years ago, a clever songwriter offered advice this 
House would do well to heed: ``Fools rush in where wise men fear to 
go.''
  The process by which we have reached this point is foolish in every 
sense. Without a single hearing devoted to the contents of this bill, 
Republicans ask America's seniors to stand like deer in the headlights, 
transfixed by the notion of fixing the Medicare program. They expect 
senior citizens to accept without question or complaint the absurd 
declaration that unless we destroy the Medicare program now, it will 
destroy itself.
  Nothing could be further from the truth. I say to my Republican 
colleagues that it's this simple: Drop your tax cut for the rich, and 
none of these Medicare cuts will be necessary.
  This debate occurs, appropriately, in October, the month of 
Halloween. This is the time for walking around in costumes and masks. 
This Medicare bill has been costumed by the Republicans in the cloak of 
Medicare preservation. But after today's trick or treat is over, after 
the mask comes off, Medicare beneficiaries will understand that the 
only reason the Republicans have to cut $270 billion from the Medicare 
program is to provide for a tax break for their rich friends who don't 
need it.
  This Republican bill will cost seniors more money. It will reduce 
their choice of doctors. It will jeopardize the quality of the health 
care system. It will compound, not correct, the problems waste, fraud, 
and abuse. And if this bill passes, my friends, the AMA's members will 
need that tax cut to shelter all their additional income from the extra 
money stuck in this bill for them in some backroom deal for which they 
sold their support.
  This is the same AMA, I remind the seniors out there, that opposed 
the creation of Medicare in the first place. Socialized medicine, they 
called it. But now that they have their snouts in the public trough, 
they just want more and more and more. For seniors, that means less and 
less and less.
  Mr. Chairman, the American people will hear more throughout the day 
about the defects in this legislation. I urge my colleagues to oppose 
this bill. It took 30 years for us to create and build the Medicare 
system; let's not take just a few hours to destroy it.
  Mr. ARCHER. Mr. Chairman, I yield myself such time as I may consume.
  Mr. Chairman, we are going to hear a lot of misinformation presented 
in this debate, and I would challenge my Democrat friends to begin to 
list the benefit cuts that are made in this package from what are 
currently available under Medicare, because there are none.
  Mr. Chairman, I yield 2 minutes to the gentleman from Kentucky [Mr.  
Bunning], a respected member of the committee.
  (Mr. BUNNING of Kentucky asked and was give permission to revise and 
extend his remarks.)
  Mr. BUNNING of Kentucky. Mr. Chairman, I rise in support of the 
Medicare Preservation Act. It's a good bill.
  It preserves Medicare--it strengthens Medicare.
  It keeps Medicare from going Bankrupt. And best of all it gives 
senior citizens more options--more choices.
  I think you will all agree that Members of the U.S. Congress have a 
good health care system.
  We get a booklet every year that lists the options available to us--
insurance plans or PPOS and HMOS. We get a wide range of choices. We 
can pick a plan that suits our needs and our family's needs. It's a 
good deal.
  I have enrolled in a PPO. I still get to see my family doctor--my 
gatekeeper. I show him this card--and my office visit only costs me 
$10. And I have this other card that I can take to the drug store and 
pick up my prescription medicine and no matter how much it costs, I 
only pay $10.
  It's a good deal.
  This Medicare reform bill that we are considering today gives the 
senior citizens of our country the same kind of options that Members of 
Congress now have. It will give them the same kind of choices we have.
  That's the beauty of this bill. We save Medicare. We strengthen 
Medicare and on top of it all, we make Medicare better.
  We are going to hear a lot of outrageous rhetoric about how we are 
slashing benefits--that's hogwash. It's political hogwash. And I, for 
one, think that this program is too important to play political games 
with.
  This bill is a good bill--it gives senior citizens the same kind of 
health care that Members of Congress enjoy now. That's a good deal.
  Mr. GIBBONS. Mr. Chairman, I yield myself such time as I may consume 
to answer the gentleman from Texas' challenge.
  I am sure the gentleman is familiar with his bill. He knows there is 
a fail-safe device in there. The impact of the fail-safe device is to 
require the Secretary of Health and Human Services to make cuts only in 
the fee-for-service program an undesignated amount of money in order to 
balance the Federal budget. There is no way that the Secretary of 
Health and Human Services can make that kind of cut and preserve fee-
for-service type service for people who elect it.
  Mr. Chairman, that is the fraud in the gentleman's bill. One of the 
many frauds in his bill. And it will drive all seniors into a 
gatekeeper operation under managed care.
  Mr. Chairman, I yield 4 minutes to the gentlewoman from Connecticut 
[Mrs. Kennelly].
  Mrs. KENNELLY. Mr. Chairman, I thank the gentleman for yielding me 
time.
  Mr. Chairman, I speak today as a woman who has served on the Ways and 
Means Committee for over a decade. During that time, I have taken a 
number of tough votes to protect Medicare's solvency--and today, I am 
again willing to vote to protect Medicare and its future. However, my 
experience tells me that a $90 billion problem does not demand a $270 
billion solution--so I know the reductions in the majority's bill are 
too deep and too damaging to Medicare.
  Let me raise two specific reasons why this legislation would hurt 
senior citizens.
  First, the bill would limit the amount Medicare pays for 
beneficiaries. The bill's hard cap on payments would not keep pace with 
medical inflation, and would therefore create a growing disparity 
between what health services cost and what Medicare would pay. This 
disparity would certainly undercut the quality of care under Medicare 
and force seniors into a terrible choice: Either pay more to make up 
the difference or settle for second-rate health care. Seniors should 
not be discriminated against in this way.

  Second, proponents of the bill claim that people on Medicare will 
have new choices while retaining their right to stay in traditional 
Medicare. I support providing additional choices, but choice for some 
should not ruin the only choice for others--traditional Medicare.
  Under the majority's bill, some seniors would pay the price for the 
choices made by others. This puts a new spin on the carrot-and-stick 
approach: Under this bill, when healthier seniors choose the carrot, 
sicker seniors get the stick.
  For example, when younger, healthier seniors leave traditional 
Medicare by selecting a medical savings account, that will leave older, 
sicker seniors behind in traditional Medicare to face rising costs. As 
a result, these higher costs would trigger the so-called failsafe cuts, 
further reducing payments to doctors and hospitals in traditional 
Medicare. The obvious consequence would be fewer and fewer quality 
providers for seniors remaining in traditional fee-for-service 
Medicare.
  Some might reply that a well-designed risk adjuster would address 
this problem of adverse selection. But the simple truth is: We do not 
currently have, nor does this bill propose, such a risk adjuster--and 
anyone who understands this issue, which is always present in insurance 
decisions, knows how hard it would be and has been to design one.
  If we are going to tell seniors they can stay in traditional 
Medicare, then we have an obligation to ensure that it is a 
real option, and not just a false promise. This bill fails that test.

  The majority often implies that seniors will barely notice the 
reductions, since so much of their bill's savings 

[[Page H 10331]]
would be achieved by cutting fraud and by providing seniors more health 
care options. But the truth is that almost all of the bill's savings 
come from cutting payments to providers and increasing beneficiaries' 
premiums. In fact, the Congressional Budget Office [CBO] has said that 
only 1 percent of the bill's savings come from reducing fraud, and that 
only 2 or 3 percent of the bill's savings come from providing seniors 
new choices. More than 95 percent of the savings will come in ways that 
will be all too evident to America's seniors. The Medicare they know 
will be no more.
  Mr. Chairman, the American people want to keep Medicare solvent. I do 
too. That is why I am voting for $90 billion to save Medicare. But $270 
billion in Medicare reductions is ludicrous. It should not happen, and 
it will wreck Medicare as we know it.
  Mr. ARCHER. Mr. Chairman, I yield 30 seconds to the gentlewoman from 
Connecticut [Mrs. Johnson].
  Mrs. JOHNSON of Connecticut. Mr. Chairman, I want to point out for 
the Record that no speaker has pointed to any benefit cuts. In fact, 
our bill guarantees all Medicare benefits, for future retirees as well 
as for current retirees, an increase of spending per retiree of $2,000 
over the 7 years, which is just as much as we increased spending over 
the last 7 years. Thus, absolutely guaranteeing the benefits will be 
there for America's seniors.
  Mr. GREENWOOD. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman 
from North Carolina [Mr. Burr], a fine new freshman Member of the House 
who has contributed significantly to the bill.
  (Mr. BURR asked and was given permission to revise and extend his 
remarks.)
  Mr. BURR. Mr. Chairman, I came to Congress because I believed that 
there were many things in this country that just did not work like they 
were designed. Medicare is one of them. For once, it is time for us to 
stand up to the Federal Government bureaucrats who believe that they 
can do no wrong.
  In my opinion, Medicare is a perfect example of good intentions 
choked by a bureaucracy unable to address the changing needs of a vital 
program. It is long past time that we inject the wisdom of the private 
sector, which has created products that work, into a health care 
blueprint for seniors in America.
  It is time to offer choice to Medicare beneficiaries which allow and 
encourage them to spend their health-care dollars in a way that best 
fits their health needs.
  It is time we allow our parents the ability to choose their coverage 
while maintaining the security of the current system for those who need 
it.
  Call me crazy, Mr. Chairman, but for decades we have delayed, 
ignored, and tinkered with Medicare while my parents and 36 million 
other Americans have seen their health care costs rise and consume 21 
percent of their disposable income.
  Mr. Chairman, when I joined with Members of the 104th Congress in a 
genuine effort to reform Medicare and preserve it for the next 
generation, I made a deal with myself. I pledged that I would not 
support a plan that I could not sit down with my parents and explain.

                              {time}  1200

  Well, I have explained it, and, Mr. Chairman, I am here today to say 
that we owe it to the American seniors to pass this preservation act.
  Mr. DINGELL. Mr. Chairman, I yield 15 seconds to the gentleman from 
Michigan [Mr. Stupak].
  Mr. STUPAK. Mr. Chairman, the gentlewoman from Connecticut said there 
are no cuts in this bill. I would direct the attention of the 
gentlewoman to page 275 in PPS hospitals, which shows that for 1996, 
which started 18 days ago, fiscal year 1996, there is a 15-percent cut 
for hospitals. That 15 percent will not only affect seniors, but the 
whole population that is served by those hospitals.
  Mr. DINGELL. Mr. Chairman, I yield 2 minutes to the distinguished 
gentleman from California [Mr. Waxman].
  (Mr. WAXMAN asked and was given permission to revise and extend his 
remarks.)
  Mr. WAXMAN. Mr. Chairman, what we are going to do today, if the 
Republicans get their way, is a travesty, it is irresponsible, and it 
is wrong. Thirty-seven million Americans depend on Medicare. They want 
a program that let them see their own doctor and protects them from 
financial ruin when they get sick.
  Mr. Chairman, they do not want us to gamble with Medicare. They do 
not want us to go along with what some health-care theorist thinks 
might make them more cost-conscious consumers. They already watch their 
dollars. They pay enough in premiums and coinsurance, and most Medicare 
recipients live on less than $25,000 a year.
  Most of all, they do not want us to balance the budget on the backs 
of Medicare recipients. They do not want us to cut Medicare so we can 
cut taxes.
  The supporters of this bill are not telling us some facts. First of 
all, not only will Medicare beneficiaries pay higher premiums to hold 
on to part B, but the bill will allow doctors and hospitals to charge 
the patients more money directly over and above what they get now paid 
from the Medicare fund. That is something they cannot do at the present 
time.
  Second, this will take away the choice of doctors and will herd 
people into managed care plans. That is not a bad choice if you want an 
HMO, but that should not be your only choice.
  Third, this bill is going to jeopardize the quality of care for 
everyone, when hospitals and emergency rooms are forced to close, when 
medical research hospitals are starved of funding.
  Mr. Chairman, this is a bad bill. It has not been thought through and 
we ought not take a chance with a program that is so important to so 
many Americans.
  Mr. ARCHER. Mr. Chairman, I yield 30 seconds to the gentleman from 
California [Mr. Thomas] chairman of the Health Subcommittee of the 
Committee on Ways and Means, a gentleman who has contributed so much in 
the development of this plan.
  Mr. THOMAS. Mr. Chairman, we are going to respond every time someone 
makes a misstatement, and the misstatement was that we are cutting the 
hospital updates. We are not cutting; we are slowing the growth.
  Mr. Chairman, the gentleman from Louisiana talked about ``slowing the 
growth'' in a statement from the President. Here are the updates 
according to the CBO numbers. As any Member can see, every year the 
hospital reimbursement goes up. That is slowing the growth. That is not 
a cut.
  Mr. ARCHER. Mr. Chairman, I yield 2 minutes to the gentleman from 
Georgia [Mr. Collins], a member of the Committee on Ways and Means.
  Mr. COLLINS of Georgia. Mr. Chairman, there is an old saying: 
Temptation will beat your door down, but opportunity will knock only 
once.
  Today the Democrats offer temptation: To extend Medicare until 2006. 
But the Republicans offer an opportunity to extend Medicare to 2012 and 
beyond.
  The real difference between temptation and opportunity is that the 
Democrat temptation sets the stage for another tax increase by the year 
2006. Their plan will leave the Medicare trust fund underfunded by $309 
billion--just when those Medicare funds will be needed by the World War 
II generation.
  But Mr. Chairman, this is nothing new--this has been the pattern of 
Congress over the last 31 years, since Medicare was created.
  Congress has either increased the rate or changed the income base 23 
times in 31 years in order to keep the Medicare program running.
  The temptation the Democrats offer today continues that history and 
ensures that taxes will again have to be raised in order to continue 
Medicare.
  Mr. Chairman, what happens when payroll taxes are increased?
  Seniors know. Seniors know their children and grandchildren will have 
less income for their families; the cost of consumer goods and services 
will increase; and we are less competitive in the world market.
  Mr. Chairman, when our Medicare seniors, who are on a fixed income, 
go to the doctor, the grocery store, or pay utilities, the cost of each 
of these services will reflect the increase in payroll taxes.
  The Democrat temptation to Medicare reform repeats the mistakes of 
the past.
  The Medicare Preservation Act is the best of the two options.

[[Page H 10332]]

  It addresses concerns about excessive charges for health care, 
addresses waste, fraud, and abuse of precious Medicare dollars, and 
ensures that Medicare will be solvent until 2012 and beyond.
  The Medicare Preservation Act requires that we look ahead and 
anticipate the World War II generation; and we will study the changes 
to make sure it is working like it's supposed to.
  It does all this by changing the Medicare process, without a tax 
increase.
  Mr. BLILEY. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman 
from Texas [Mr. Barton].
  (Mr. BARTON of Texas asked and was given permission to revise and 
extend his remarks.)
  Mr. BARTON of Texas. Mr. Chairman, Medicare is going to lose $18 
billion this year from waste, fraud, and abuse. That is $50 million a 
day, $2 million an hour, $3,000 dollars a minute. Since the debate 
began at 9 o'clock this morning, Medicare has lost $6 million due to 
waste, fraud, and abuse.
  Mr. Chairman, the bill before us has the toughest penalties ever 
presented to the Congress on waste, fraud, and abuse. For the first 
time we have a definition of Federal health care fraud.
  Mr. Chairman, I want to read that very quickly:

       Whoever, having devised or intending to devise a scheme or 
     artifice, commits or attempts to commit an act in furtherance 
     of or for the purpose of executing such scheme or artifice to 
     defraud any health care benefit program; or to obtain, by 
     means of fault or fraudulent pretenses, representations, or 
     promises, any of the money or property owned by, or under the 
     custody or control of, any health care benefit program.

  That is the definition. They can be fined and imprisoned for up to 10 
years. If the fraud results in bodily harm, they can be imprisoned for 
up to 20 years. If the fraud results in death, they can be imprisoned 
for life.
  Mr. Chairman, that is tough. If they make a false statement, they can 
be imprisoned for 5 years. That is currently a misdemeanor. If they try 
to embezzle or steal money, they can be in prison for up to 10 years. 
If they try to bribe or engage in graft, they can be in prison for up 
to 15 years.
  Mr. Chairman, I could go on and on, but this bill has the toughest 
waste, fraud, and abuse penalties ever presented to this Congress. I 
urge my colleagues to vote for it.
  Mr. DINGELL. Mr. Chairman, I yield 90 seconds to the gentleman from 
Michigan [Mr. Stupak].
  Mr. STUPAK. Mr. Chairman, the last gentleman spoke about fraud in 
this bill. I agree with the gentleman. It is a fraud to have this bill.
  Mr. Chairman, if you take a look at it, this GOP bill, what the 
Republicans have done, they have legalized fraud in this bill. They 
have raised the legal standard that is required of law enforcement to 
crack down on fraud, waste, and abuse. They have raised the legal 
standard in which HCFA and OIG can recover proceeds, money stolen from 
the trust fund.
  Mr. Chairman, the GOP bill makes it harder to detect fraud; makes it 
harder to prosecute fraud; makes it harder to recover. Even CBO, that 
the gentleman from California [Mr. Thomas] has quoted from, says the 
fraud provisions will only get us $2 billion over 7 years.
  Mr. Chairman, they do not even find any fraud in this bill until 
1998. They cannot find any. I can tell my colleagues that with oxygen 
concentrates, we can recover $4.2 billion in 5 years just by using the 
same formula the Veterans Administration uses. But my colleagues on the 
other side do not accept those things.
  Mr. Chairman, there is no fraud-fighting elements in this bill. The 
Department of Justice is against it. The Office of Inspector General is 
against it. They have all come out against these so-called fraud and 
abuse sections. Take the charts from CBO and take the time line that 
has been created. Mr. Chairman, $2 billion is all they recover.
  Mr. ARCHER. Mr. Chairman, I yield 1 minute to the gentleman from 
California [Mr. Thomas], chairman of the Subcommittee on Health.
  Mr. THOMAS. Mr. Chairman, we are talking about fraud and abuse. What 
my colleagues should do is look at the bill.
  Mr. Chairman, this bill, as the gentleman from Texas [Mr. Barton] 
correctly pointed out, does more than any other provision ever in the 
history of Medicare.
  Fraud: We find it. We utilize 37 million Americans with not only a 
toll-free number, but a whistleblower reward structure by the 
Secretary. We require, it is not required now, an explanation of what 
goes on, so recipients will know what has been done to them.
  Mr. Chairman, we have a Medicare Integrity Program. We utilize the 
newest technology to go after fraud. We have a corporate whistleblower 
program. We double the civil penalties. We have criminal penalties. We 
have expulsion from all Federal programs if providers are found to be 
violators.
  Mr. Chairman, we increase the enforcement with bucks put in by the 
Shaw-Gibbons amendment for more enforcement officials. Lastly, and most 
importantly, we define in a way so that people will know what they can 
or cannot do. It is clear. It is responsible. Fraud: we find it, we 
fight it, and we fix it.
  Mr. GIBBONS. Mr. Chairman, I yield 1 minute to the gentleman from 
Michigan [Mr. Levin].
  Mr. LEVIN. Mr. Chairman, clearly the issue of fraud and abuse is a 
sensitive nerve on the majority side, and it should be.
  Mr. Chairman, the Inspector General and the Justice Department have 
said my colleagues on the other side are going to cripple efforts under 
Medicare, and they are.
  The Republican side called these efforts to weaken the fraud statute 
salacious. It is. What they inserted last night was a provision that 
does not touch their weakening of the fraud and abuse provisions. They 
have weakened them, and they have told Members maybe they will fix them 
later.
  Why did they do this? And nothing they did last night can cover it 
up. What they did last night may be a small step forward in some areas, 
but it is five steps backward in terms of fighting fraud and abuse 
against Medicare. That is what they have done and it is shameful.
  Mr. BLILEY. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman 
from Wisconsin [Mr. Klug].
  Mr. KLUG. Mr. Chairman, this is quite simply a choice about two 
different headlines.
  January 1, 2002. ``Medicare Bankrupt. Seniors Devastated. Hospitals 
to close. Safety net Destroyed.''
  Or October 20, 1995. ``Medicare Saved. Federal government delivers on 
its promise to seniors.''
  Which headlines would you prefer to see. Now which headline do you 
think I want my mom to see who's now living in Wisconsin who's 78 years 
old?
  If we do not save Medicare today the President's own Medicare 
trustees say the Medicare trust fund will be tapped out in 7 years. 
There will be nothing left. Zero. Zippo.
  Oh sure there is another way to fix it. To raise taxes. To pump more 
into a bureaucratic, Washington system whose losses are twice the 
private sector. The President admitted the other day he made a mistake 
raising taxes last year. No fooling.
  What kind of tax increases will it take to save Medicare--how about 
another 1.3 percent payroll tax--$585 a year for someone making $45,000 
a year. Now that is just in the next few years.
  But as the shortfall gets worse we would have to raise the taxes 
again--nearly double the current rate--meaning an increase of $1,584 a 
year for that worker making $45,000.
  The impact on small businesses is absolutely devastating--the Chamber 
of Commerce says a small business with 25 workers--mail in another 
$13,000 in tax payments. How do most businesses react to tax increases, 
they cut jobs, raise prices--and that means 3 million jobs vanish.
  Fix Medicare today--give seniors options, live up to the promise. 
Listen to the President's own death bed conversation about raising 
taxes. Which headline do you prefer? Medicare thrives, or Medicare 
dies. Not too tough a choice is it?
  Mr. Chairman, the choice is easy. One headline or the other: 
``Medicare Thrives'' or ``Medicare Dies''.

                              {time}  1215

  Mr. DINGELL. Mr. Chairman, I yield 2 minutes to the distinguished 
gentleman from New Jersey [Mr. Pallone], chairman of the Democratic 
Health Care Task Force.
  Mr. PALLONE. Mr. Chairman, I want to make a plea to my colleagues on 
the 

[[Page H 10333]]
other side of the aisle to oppose this ill-conceived Medicare plan. The 
Republican leadership proposal, as we know, will cut $270 billion out 
of Medicare to pay for $245 billion in tax cuts mostly for the wealthy.
  It is not necessary to make these cuts in order to keep Medicare 
solvent. The Medicare trustees have told us that Speaker Gingrich's 
cuts had three times any estimate of what is needed to make Medicare 
solvent. Mr. Chairman, seniors are going to be forced to pay more to 
get less under the Gingrich proposal. Part B premiums will double 
without a penny of that increase going back into the part A Medicare 
hospital trust fund.
  Seniors will ultimately be forced into HMO's and have to give up 
their own doctors because the Republican proposal puts money into HMO's 
at the expense of the traditional Medicare system.
  My colleagues, the Republican plan will destroy America's high 
quality health care system because hospitals and other health care 
providers will be so squeezed for Medicare dollars that they will be 
forced to close or significantly cut back on their services.
  None of this would be necessary if Speaker Gingrich were not 
insisting on a big tax break for the wealthy. I know that at least half 
of my Republican colleagues from the State of New Jersey have already 
indicated that they are voting no on this terrible bill. I would ask 
all of my colleagues on the other side to heed the words of three 
Republican State legislators from the Jersey Shore who wrote to my New 
Jersey colleagues in the House this week and urged support for the 
Gibbons-Dingell substitute.
  They said, and I quote:

       Alternative proposals have been offered that would maintain 
     the solvency of the part A and part B trust funds until the 
     year 2006. This $90 billion compromise package would provide 
     a decade for Congress and the White House to achieve a well-
     planned and balanced proposal to resolve Medicare's financial 
     problems.
       We feel very strongly that a rush to judgment on this issue 
     is bad public policy. America should not turn its back on our 
     parents and grandparents.

  Mr. Chairman, I include for the Record this letter from my fellow 
Republican State legislators in New Jersey urging opposition to this.

                                              State of New Jersey,


                             9th District Legislative Offices,

                               Forked River, NJ, October 13, 1995.
     Re Medicare.

     To: Hon. Christopher H. Smith, Hon. Robert E. Andrews, Hon. 
         Marge Roukema, Hon. Robert D. Franks, Hon. Robert G. 
         Torricelli, Hon. Rodney P. Frelinghuysen, Hon. Robert 
         Menendez, Hon. H. James Saxton, Hon. Frank A. LoBiondo, 
         Hon. Frank Pallone, Jr., Hon. William J. Martini, Hon. 
         Donald M. Payne, and Hon. Richard A. Zimmer.
       Dear House Members: It is our understanding the House Ways 
     and Means Committee has voted 22-14 to send the Medicare 
     reform package to the House floor next week.
       Our 9th District Delegation, which represents the largest 
     Senior Citizen population in New Jersey in Ocean, Burlington 
     and Atlantic counties, issued a letter on September 22, 1995 
     to House Speaker Newt Gingrich and Senate Majority Leader Bob 
     Dole, urging them to scrap this plan.
       Copies of our correspondence to Speaker Gingrich and 
     Senator Dole were conveyed to New Jersey's Congressional 
     Delegation. For your convenience, a second copy of this 
     appeal is enclosed.
       Please allow our Delegation this opportunity to reiterate 
     our profound concerns about these cuts in Medicare services 
     for our elderly.
       As you are aware, alternative proposals have been offered 
     that would maintain the solvency of the Part A and Part B 
     trust funds until 2006. This $90 billion compromise package 
     would provide a decade for Congress and the While House to 
     achieve a well-planned and balanced proposal to resolve 
     Medicare's financial problems. This compromise would also 
     provide the opportunity for a bipartisan consensus.
       Our Delegation is genuinely sensitive to the difficult 
     decision you face and have had our own feet roasted by the 
     hot coals of Leadership. We feel very strongly that a rush to 
     judgment on this issue is bad public policy. America must 
     never turn its back on our parents and grandparents.
       We, respectfully, urge New Jersey's House Members to oppose 
     this $270 billion Medicare cut. Your leadership, in targeting 
     Medicare fraud, the staggering costs of health care and in 
     building a bridge to the future with the alternative 
     proposals set forth by Reps Sam Gibbons that will provide the 
     chance for Congress to seek a consensus solution to preserve 
     Medicare for our parents and grandparents.
       Thank you for your thoughtful attention to this appeal on 
     behalf of the Senior Citizens of Ocean, Burlington and 
     Atlantic counties.
           Sincerely,
     Leonard T. Connors, Jr.,
                                            Senator--9th District.
     Jeffrey W. Moran,
                                        Assemblyman--9th District.
     Christopher J. Connors,
     Assemblyman--9th District.

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