[Congressional Record Volume 142, Number 82 (Thursday, June 6, 1996)]
[Senate]
[Pages S5926-S5928]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        THE MEDICARE TRUSTEE'S REPORT AND THE REPUBLICAN BUDGET

  Mr. KENNEDY. Mr. President, today is D-day, the anniversary of the 
Normandy invasion, a climactic moment in the long struggle to liberate 
Europe in World War II. How ironic it is that on this anniversary, 
Republicans are reviving their failed campaign to deny Medicare 
benefits to the same senior citizens who fought so bravely for our 
country in that war.
  One of the most unsavory tactics in the Republican attack on Medicare 
last year was their disinformation campaign to use the 1995 Medicare 
trustee's report to justify their cuts. Their scare tactics were 
unsuccessful. Their crocodile tears for Medicare were unconvincing.
  The $89 billion--the amount which the Trustees said was needed to 
restore solvency--could not possibly justify the $270 billion in 
Medicare cuts or the higher premiums and higher deductibles proposed by 
the Republicans. Far from preserving and protecting, and strengthening 
Medicare, the Republican plan was designed to damage and destroy it by 
forcing senior citizens to give up their family doctors and join HMO's 
and other private insurance plans. President Clinton saved Medicare by 
vetoing the Republican plan--and he was right to do so.
  This year, the Republicans are returning to the scene of their crime. 
They are trotting out the same old sales campaign that didn't sell in 
1996. They are trying to use this year's trustee's report to peddle a 
retread of the irresponsible proposals the American people resoundingly 
rejected last year.
  There is nothing really new in this year's report. There has been a 
modest change in projections of outlay and income--projections that 
always fluctuate from year to year. Under this year's projections, 
Medicare solvency extends to 2001 rather than 2002. That leaves us 5 
years to make necessary corrections instead of 6 years--corrections 
that the President has already proposed and that could be adopted 
tomorrow if the Republicans were not determined to use Medicare as a 
piggy bank for new tax breaks for the wealthy.
  They are not prepared to say: All right, these are the adjustments in 
the Medicare system that are necessary to carry the Medicare solvency 
for the next 10 years. We are not going to do that. We are not going to 
agree to it because we want to be able to squeeze Medicare even more, 
to justify our tax breaks which have been estimated by Mr. Kasich in 
the House at over $178 billion. Let us just understand that, I say to 
our senior citizens.
  Mr. President, the $178 billion they want for tax breaks for wealthy 
individuals and corporations, where are they getting it? By squeezing 
the Medicare system. It is wrong. And the seniors understood that it 
was wrong last year and it is wrong this year as well.
  Just as there is nothing really new in this year's trustee's report, 
there is nothing really new in this year's Republican retread. As they 
did last year, Republicans try to justify their deep Medicare cuts by 
claiming they are needed to preserve Medicare against the insolvency of 
the hospital insurance trust fund.
  The hypocrisy of this claim is so transparent that no senior citizen 
should take it seriously. Last year, a few weeks before they proposed 
their massive Medicare cuts, House Republicans passed a tax bill that 
took almost $90 billion in revenues out of the Medicare hospital 
insurance trust fund over the next 10 years--and brought it that much 
closer to insolvency.
  Understand, Republicans took $90 billion out of that last year for 
the purposes of their tax breaks. We did not hear a word then about the 
impending bankruptcy in Medicare. The President's economic recovery 
plan in 1993 extended the solvency of the trust fund for 3 years. It 
passed without a single Republican vote.
  When we had the opportunity to provide for additional kinds of 
solvency, we were unable to get a single Republican vote. We did not 
hear a word from the Republicans then about the impending bankruptcy of 
Medicare.
  Like last year, the Republican plan proposes deep cuts in Medicare to 
fund new, undeserved tax breaks for the wealthy. Like last year, the 
Republican plan is designed to cause Medicare to ``wither on the vine'' 
in the words of Speaker Gingrich--by forcing senior citizens to give up 
their family doctor and join private insurance plans. Majority Leader 
Dole has said that enacting Medicare was a mistake from the beginning--
and he is trying to use this budget to correct that mistake.
  Last year, Republicans tried to justify their excessive Medicare cuts 
with a large array of misguided arguments. This year they are repeating 
the same arguments, as if repetition can somehow substitute for 
reality. The American people were not fooled last year--and they 
certainly will not be fooled this year.
  When Republicans took up the issue last year, they proposed to cut 
Medicare by $270 billion--three times more than the amount the Medicare 
trustees said was needed to stabilize the trust fund. This year, 
Republicans are proposing to cut $167 billion from Medicare. By 
contrast, the President's plan cuts Medicare by $116 billion--44 
percent less, but it guarantees Medicare solvency for 10 years. And it 
funds Medicare at the level necessary to assure that quality care will 
be available for senior citizens when they need it.
  Even worse, Republicans support an inflexible ceiling on Medicare 
spending. Consequently, if inflation is higher or medical needs are 
greater than anticipated, Medicare spending will not go up, and many 
senior citizens will be out of luck and out of care.
  An estimated 20 percent of all Medicare hospitalization can be 
avoided by relying on better preventive services and more timely 
primary and outpatient care.
  So, if we have interventions earlier, if we have better home care, if 
we have the investment in our seniors to avoid the more costly expenses 
when they

[[Page S5927]]

must come into the hospital, that can save billions and billions of 
dollars. We ought to be thinking about that, without reducing the 
services for our elderly and actually improve the quality of health 
care for our seniors.
  As much as 10 percent of all Medicare expenditures may be due to 
fraud, and can be reduced or eliminated by better oversight.
  The work Senator Harkin has been involved in, in reviewing Medicaid 
and Medicare fraud, is absolutely powerful and absolutely convincing 
about the tens of billions of dollars that can be saved. You go to any 
hall in this country and ask our senior citizens where there can be 
savings. Any senior citizen can give you chapter and verse about how 
there can be savings in the Medicare system. Many of them can tell you 
about the fraud that is being perpetrated upon them at the present 
time. We ought to address that kind of issue before we are talking 
about reductions in essential services.
  Medicare could save $20 billion annually if senior citizens have 
assistance in monitoring their medications more carefully in order to 
avoid adverse drug reactions.
  We spend billions and billions of dollars a year from adverse drug 
reactions where the senior will go to a doctor and receive various 
medications, receive other medications from another doctor, and find 
there is an inconsistency in terms of taking both medications and then 
find they have an illness. There are ways to remedy that problem, to 
save billions and billions of dollars--again, to improve the quality of 
health. We do not hear that issue raised or discussed or debated.
  We do not have to destroy Medicare in order to save it. Congress will 
never allow the Medicare trust fund to become bankrupt. I know that, 
and the American people know it. It is time for the Republicans to stop 
raiding Medicare, and join in sensible steps to improve and strengthen 
it for the future.
  Another false Republican argument in defense of their Medicare cuts 
is that the reductions are not really cuts, because the total amount of 
Medicare spending will continue to grow. But every household in America 
knows that if the cost of your rent, the cost of your utilities, and 
the cost of your food go up--and your income stays the same or goes up 
more slowly--you have taken a real cut in your living standard.
  Republicans speak of a cut in defense, even though defense spending 
has remained stable. Apparently, the same Republican logic does not 
apply to spending on Medicare that applies to spending on guns and 
tanks. A cut is a cut is a cut--whether it is in Medicare or Social 
Security or national defense.
  Republicans also claim that deep cuts in Medicare are necessary to 
balance the budget. But that argument only proves that Republican 
priorities are wrong. Democrats favor a balanced budget, and President 
Clinton has proposed a balanced budget--balanced fairly, not balanced 
on the backs of senior citizens, or children, or workers. There is a 
right way to balance the budget, and a right-wing way. And 
unfortunately, the Republicans continue to pick the right-wing way.
  Republicans deny that their Medicare cuts will fund tax cuts for the 
wealthy. This time, the leopard claims that it really has changed its 
spots. But their budget clearly envisions $60 billion in revenue 
increases from tax extenders and closing of selected corporate 
loopholes in order to fund $60 billion in new tax breaks for the 
undeserving rich. Without those new tax breaks, they wouldn't need to 
cut Medicare by $167 billion.
  The Democratic amendment eliminates these new tax breaks for the 
wealthy and uses them to protect Medicare. The Medicare trust fund 
should not be a slush fund for Republican tax breaks for the rich.
  Republicans can run as hard as they want in this election year, but 
they can not hide from these facts.
  Even more damaging than the loss of the billions of dollars that 
Republicans would slash from Medicare is their attempt to turn Medicare 
over to the private insurance industry. The Republican budget contains 
a number of changes to force senior citizens to give up their own 
doctors and join private insurance plans.
  Once they are forced into these plans, senior citizens will be 
stripped of many of the protections they enjoy today--protection 
against overcharges by doctors and other health care providers, 
protection against premium-gouging and profiteering by insurance 
companies, protection of their right to keep their own family doctor 
and go to the specialist of their choice.
  Republicans claim they only want to offer senior citizens a choice, 
but this is a choice no senior citizen should be forced to make.
  The harsh cuts in Medicare contained in the Republican budget are 
also a repudiation of our historic commitment to Social Security, 
because the distinction between Medicare and Social Security is a false 
one. Medicare is part of the same compact between the Government and 
the people as Social Security. That compact says contribute during your 
working years, and we will guarantee basic income and health security 
in your retirement years.
  Any senior citizen who has been hospitalized or who suffers from a 
serious chronic illness knows that there is no retirement security 
without health security. The cost of illness is too high. A few days in 
an intensive care unit can cost more than the total yearly income of 
many senior citizens.
  The low and moderate-income elderly will suffer most from these 
Medicare cuts. Eighty-three percent of all Medicare spending is for 
older Americans with annual incomes below $25,000. Two-thirds is for 
those with incomes below $15,000.
  No budget plan that purports to be part of a Contract With America 
should break America's contract with the elderly. It is bad enough to 
propose these deep cuts in Medicare at all. It is even worse to make 
these cuts in order to pay for an undeserved and unneeded tax break for 
the wealthiest Americans.
  Everyone knows that the real vote on Medicare is not on the floor of 
the Senate or the floor of the House of Representatives. The real vote 
will be cast in November by the American people, and they know that the 
future of Medicare is too important to be decided by a Republican 
Congress or a Republican President.
  Mr. ROCKEFELLER. Will the Senator yield for a question?
  Mr. KENNEDY. I ask unanimous consent to proceed for 2 more minutes to 
respond to questions.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. ROCKEFELLER. I simply ask the Senator from Massachusetts, when he 
was referring to the 1993 Budget Reconciliation Act--where I think we 
reduced Medicare expenditures because that had to be done, but we did 
it consistent with beneficiary purposes--the Senator brought up the 
point that we did not get a single Republican vote. It was a stunning 
moment. I will never forget it. I was sitting right over there. We had 
to get every single Democrat to let that effort to improve Medicare 
survive.
  I do not understand that. I do not understand the inconsistency of 
that. If they are for trying to do something about Medicare now, why, 3 
years ago, was there a total lack of interest, with no mention of 
Medicare trust fund health at that time?
  Mr. KENNEDY. The Senator is entirely correct, and there is no Member 
of the Senate who knows more about those negotiations than the Senator 
from West Virginia, since he was really the leader in those 
negotiations, which were enormously complex and difficult.
  Even with the reductions that were worked out, we were sensitive to 
any reduction in benefits for recipients and looked for other ways to 
find the savings that were achieved in that program but, nonetheless, 
extended the solvency for a period of 3 years.
  As the Senator knows, even after that period of time, we found out at 
the start of this Congress that our Republican friends wanted to take 
some $80 to $90 billion out of the trust fund to designate it for tax 
breaks for the wealthy. Not only were they unresponsive to the calls 
and challenges at the time the Senator has mentioned, but even 
following that, they were willing to raid the trust funds for tax 
breaks for the wealthy.
  It is enormously troublesome, I think, for all of us to see, again, 
the effort to raid the Medicare trust funds to use for additional tax 
breaks today.
  I am wondering, as the Senator from West Virginia, who is a real 
expert on

[[Page S5928]]

Medicare, Medicaid and health policy generally, if he does not find 
that to be one of the most repulsive aspects of the proposal that has 
been advanced by our Republican friends?
  Mr. ROCKEFELLER. I say to the Senator from Massachusetts, I do, and I 
am also confounded, frankly, by the sense of its stupidity. It is not 
just obscene, it is stupid. The American people have rejected the idea 
of tax cuts for the wealthy. That was rejected, and then they come 
right back again for the same thing. Maybe there has been more emphasis 
in the House than here, but nevertheless, there is this tremendous 
desire for tax cuts for the wealthy. They have to have those tax cuts, 
and the Medicare beneficiaries just take second place.
  I was stunned when I heard the Senator say, ``this is the anniversary 
of the invasion of Normandy and for those people, let them fall where 
they might.''
  Mr. KENNEDY. They are the ones who fought in the wars and pulled the 
country out of the Depression and are the ones who paid into this fund 
over a period of time. This is not a piggy bank. The Medicare trust 
fund is not a piggy bank for Republicans to dip into to grant tax 
breaks for wealthy individuals. That is really the fundamental issue. 
It will continue to be debated here and across the country in the 
course of the campaign.
  I thank the Senator from West Virginia.
  Mr. ROCKEFELLER addressed the Chair.
  The PRESIDING OFFICER. The Senator from West Virginia.
  Mr. ROCKEFELLER. I thank the Presiding Officer. I want to continue 
some of the thoughts of the distinguished Senator from Massachusetts, 
who has incredible knowledge of this history, over 30 years in the 
development and nondevelopment of health care policy.
  Might I ask the Presiding Officer how much time I have in order to 
speak?

  The PRESIDING OFFICER. Ten minutes.

                          ____________________