[Congressional Record Volume 144, Number 26 (Thursday, March 12, 1998)]
[Senate]
[Pages S1875-S1876]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 FIRST MEETING OF THE NATIONAL BIPARTISAN COMMISSION ON THE FUTURE OF 
                                MEDICARE

  Mr. BREAUX. Mr. President, last Friday, March 6, the newly appointed 
National Bipartisan Commission on the Future of Medicare held its first 
meeting. Chaired by myself and Congressman Bill Thomas, Administrative 
Chairman, the commission was established by last year's balanced budget 
agreement to thoroughly study and assess the entire program--top to 
bottom--and make specific recommendations to Congress and the 
Administration for fundamental Medicare reform. Our target deadline for 
getting these bipartisan, consensus recommendations in your hands is 
March 1, 1999.

  When I say consensus here, I mean that any recommendation we put 
forward will have received 11 votes--a super majority of the 17 
commission members. I remain optimistic that our recommendations will 
receive an even higher level of support than that required under the 
statute. Every member of the commission recognizes how very important 
it is for us to succeed in coming up with something that can be passed 
by Congress and signed into law.
  I think we got the commission's work off to a very good start. We are 
just beginning what promises to be an exciting year as we come together 
to protect and preserve a program that we all agree has served us well 
over the last 33 years. But we also have to face the reality that if 
Medicare is to be there for another 33 years and beyond,

[[Page S1876]]

we must look beyond the program's financial solvency and address issues 
like quality, equity, and efficiency as well.
  I ask unanimous consent that the text of my opening statement from 
the first commission meeting on March 6 be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

Opening Statement by Senator Breaux, Medicare Commission Meeting, March 
                                6, 1998

       I am very pleased to bring to order the first meeting of 
     the National Bipartisan Commission on the Future of Medicare. 
     I am honored to be chairing a group of such knowledgeable and 
     well-respected people for the important task of making 
     recommendations to preserve and improve the Medicare program. 
     That doesn't mean looking at the program only in economic 
     terms or in terms of solvency. It also means looking at the 
     fundamental question of what we want Medicare to do and what 
     kind of health care system we want for our elderly while 
     addressing issues such as quality, equity, and efficiency.
       I was appointed chairman of this commission 7 weeks ago 
     today and in that time I have worked closely with Congressman 
     Bill Thomas to establish an operational framework for the 
     commission. I am pleased to be working with Congressman 
     Thomas and I think that our working together testifies to the 
     bipartisan nature of this commission. Let me say from the 
     outset that I am firmly committed to having this whole group 
     work together in a bipartisan, inclusive fashion. That is the 
     only way we are going to have an end-product that enjoys 
     widespread support in the Congress, in the Administration and 
     across this nation.
       I am also very pleased that one of the first orders of 
     business was asking Bobby Jindal to serve as our Executive 
     Director. He was an asset to Louisiana as Secretary of the 
     Department of Health and Hospitals and I know he will be an 
     asset to this Commission. Congressman Thomas will be 
     introducing Bobby shortly.
       I have said before that everything will be on the table. We 
     shouldn't begin our work by excluding or endorsing any 
     options. Every member of this commission should know that his 
     or her views are going to be considered. The statute creating 
     the commission requires 11 of 17 votes in order to issue a 
     report so this is not going to be a report that is supported 
     only by Democrats or Republicans. In fact, I don't think we 
     will be truly successful unless we have agreement among an 
     overwhelming majority of the commission members. As President 
     Clinton said to the commission members yesterday, if there is 
     not a consensus--don't let it be your fault.
       The process we are suggesting for the work of the 
     commission is designed to be inclusive and to build the 
     consensus we need to be successful. The suggested task forces 
     are designed to help gather information and develop a range 
     of options for consideration by the full commission. 
     Congressman Thomas and I sent out a survey to the membership 
     about how to structure this process, including the task 
     forces, and many of the comments and suggestions we received 
     are reflected in the documents you have in front of you. You 
     should look at these documents as a conceptual outline of the 
     Commission's goals throughout the year. As we have stated--
     the timeline we have presented to you is designed to be a 
     tool, not a work plan or a final product, to help focus the 
     Commission's decision-making and to measure its progress. We 
     may find that it is necessary to change the agenda and have 
     more meetings as we go through the year. We may also expand 
     or delete topics depending on the Commission's interest.
       No one would dispute that we have a very difficult task 
     ahead of us. We have been charged by the Congress and the 
     Administration with making recommendations on ways to 
     preserve and improve the Medicare program. In order to do 
     that, we must first come to an agreement on the scope of the 
     problem facing Medicare. There will be some disagreement on 
     this issue as there probably will be on most issues presented 
     to the commission. But I am convinced that if we work 
     together in a bipartisan way and lay all the facts and 
     suggestions on the table, we can have a constructive debate 
     on this issue.
       We can't afford to let these issues be politicized any 
     longer. There is just too much at stake for the health 
     security of our senior citizens and the fiscal well-being 
     of this country. We must put aside the old ways of dealing 
     with Medicare--do away with ``Medagoguery''--do away with 
     the blame game where everyone scrambles to pin the blame 
     for failure on the other party--do away with the 
     shortsighted SOS approach which is woefully inadequate 
     when you look at the demographic realities facing this 
     program.
       I believe that there is no greater challenge facing this 
     country right now than how to preserve Medicare for future 
     generations. While we added a few years to the life of the 
     trust fund in last year's balanced budget agreement, we did 
     nothing to prepare for the 77 million baby boomers who will 
     depend upon Medicare for their health care beginning in 2010.
       In the context of overall entitlement reform, how to go 
     about fixing Medicare is very complex. Unlike Social 
     Security, which promises specific levels of income, Medicare 
     promises specific health benefits which are susceptible to 
     volatile increases in medical inflation and the high cost of 
     advances in medical technology. Part of the problem with 
     getting a handle on the scope of the problem is the 
     unpredictability in estimates regarding such things as health 
     spending and economic growth. But the demographic realities 
     will not change.
       We all know how politically sensitive the issue of Medicare 
     is. That is why the Congress and the Administration created 
     this Commission--to make the tough recommendations for fixing 
     the program and to make it easier for elected officials to 
     take the tough political step of enacting these 
     recommendations into law.
       For most of the things we do in Congress, the most 
     important objective is to craft legislation that can pass. 
     There are some people who would rather stand for what they 
     believe is the ideal solution and never compromise, even if 
     that means nothing gets done. The primary objective of this 
     Commission should be to come up with the best proposal 
     possible and then worry about how we're going to get it 
     passed by the Congress and signed into law by the President.
       Let me assure my fellow commission members that my previous 
     positions and efforts on Medicare are not going to dictate 
     this Commission's agenda. I hope you all make the same 
     commitment.
       I know there has been a lot of attention given recently to 
     the issue of expanding Medicare and allowing certain groups 
     to ``buy in'' early. First, let me reiterate that this 
     commission has been specifically charged by statute with 
     making ``recommendations on modifying age-based eligibility 
     to correspond to changes in age-based eligibility under the 
     OASDI (Social Security) program and on the feasibility of 
     allowing individuals between the age of 62 and the Medicare 
     eligibility age to buy into the Medicare program.'' This 
     language is explicit and this Commission will be thoroughly 
     exploring this idea. As I've said several times in the past 
     few months, I think that Congress will let the Commission do 
     its work and study the impact of this policy on the Medicare 
     program before moving ahead in Congress. However, having said 
     that, I certainly wouldn't oppose legislation if it is 
     offered and if it is the will of this Congress to move 
     forward with legislation of this nature. There are an 
     estimated 41 million uninsured people in this country and 
     that is a serious problem that affects everyone--not just 
     those who don't have insurance. Any efforts to decrease the 
     number of uninsured people in this country (such as the 
     children's health bill last year) should be given careful 
     consideration.
       We have a huge challenge of trying to help educate the 
     American people about the seriousness of the problems facing 
     Medicare but we must realize that nothing is going to pass 
     the Congress and signed into law that doesn't enjoy their 
     support.
       I am hopeful that the Congress and the Administration will 
     act on whatever recommendations this commission puts forward. 
     We as elected officials have a responsibility to future 
     generations to fix this program so that our children and 
     grandchildren can enjoy the same guarantee of health 
     insurance that their parents did. I don't want the report of 
     this Commission to simply gather dust on a library shelf.
       Let me close by saying that I am optimistic. I know there 
     are a lot of people ``inside the Beltway'' who think that 
     this issue is too politically sensitive to inspire meaningful 
     debate. That it is unrealistic to think that such a diverse 
     group of people representing such a wide range of opinion can 
     reach a consensus. But I believe that this Commission faces a 
     unique and critical opportunity that cannot be squandered. 
     Medicare has been a success for 33 years and is a vital part 
     of our national fabric. We have an obligation to ensure that 
     the success of this program continues for the next 33 years 
     and beyond. Our parents and grandparents have reaped the 
     benefits of health security afforded by Medicare since 1965--
     our children and grandchildren deserve no less. If we make 
     this a truly bipartisan process, hear from everyone who has a 
     stake in preserving this program for future generations, and 
     focus on our similarities and not our differences, we will 
     succeed.

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