[Congressional Record Volume 146, Number 149 (Wednesday, December 6, 2000)]
[Senate]
[Page S11621]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. WELLSTONE. Mr. President, I will speak on the bankruptcy bill in 
a moment. But in the time I have in morning business, I will speak on 
another matter. I do not have any statistics with me, but maybe that is 
better; I can talk about it in more personal or human terms.
  In 1997, we passed the Balanced Budget Act with much acclaim. To be 
very bipartisan about this, President Clinton was very much for it. I 
think many Democrats and Republicans voted for it. But what has 
happened is--with the benefit of some time for observation and, 
hopefully, reflection--the cuts in Medicare have been draconian and 
have had a very harsh effect on health care, the quality of health care 
in our States, for Minnesota, Rhode Island, and all across the country.
  It does not do any good to look back and affix blame. The point is, 
last year we said we were going to fix this problem. I think Senators--
Democrats and Republicans alike--have heard from people back in their 
States.
  In my State of Minnesota, here is the effect of this. First of all, 
in our rural communities, in what we call greater Minnesota outside the 
metro area, in the absence of getting some decent Medicare 
reimbursement, where you have a disproportionate number of elderly 
people living who are dependent on health care, the cost of providing 
that health care runs ahead of the reimbursement. The hospitals are 
losing money.
  Here is the problem. This is not the case of greedy hospitals or 
greedy doctors. As a matter of fact, they have a very low profit 
margin. In fact, many hospitals have gone under over the last several 
years. When the hospital is no longer there, that is the beginning of 
the death of a community because people do not raise their children in 
communities unless there are good schools and good hospitals and good 
health care.
  So we are in a real crisis, which should be spelled in capital 
letters, in the State of Minnesota, where many of our rural health care 
providers will go under unless we fix this problem, which is a problem 
we created. The same thing can be said for nursing homes, where there 
is inadequate reimbursement. The same thing can be said for home health 
care providers. The same thing can be said for medical education, which 
is financed, believe it or not, in part out of Medicare. The cuts in 
the reimbursement have led to a very serious situation in all of our 
States--certainly in Minnesota.
  Then there are those hospitals--Hennepin County Medical Center is a 
perfect example; it is a very good public hospital; there are not a lot 
of them left--that, in fact, provide medical care to a disproportionate 
number of poor people in America. These hospitals are really having a 
difficult time making it. They are not going to continue to be 
financially solvent because we have so cut the reimbursement that they 
do not have the financial stability.
  We never should have done this, but we did.
  Then last year, we passed a piece of legislation. I feel kind of 
guilty about this. I didn't think it 100-percent fixed the problem, but 
I thought it did more than it did. So I went back to meet with people. 
We all go back to our States. We should. We meet with people in 
communities. We want to do well for people.
  I said: Listen, I think this is going to really help. To the best of 
my ability, I talked about what this package was. But as it turns out, 
it, at best, I think, dealt with about 10 percent of the cuts, 
somewhere in that neighborhood.
  We should not leave here--I want to go home, believe me. I want to go 
home. I would love to be back home. I would love not to be here right 
now, although I am always happy to be in the Senate. It is an honor. 
But you know what I am saying.
  Mr. President, I ask unanimous consent that I have 2 more minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. WELLSTONE. If we just put everything off and have a continuing 
resolution until next year and we do not fix this problem, it will be 
irresponsible.
  There is one proposal--that tends to be the Republican proposal, as I 
understand it--that gives a lot more of the money over the next 5 years 
to managed care plans without any requirement that they be accountable 
and that they serve senior citizens and serve people who live in rural 
communities, which they do not do now. Too many managed care plans have 
cut loose people they are supposed to be helping, and that is not the 
answer.

  We have a package--I believe it is a Democratic package; it can be 
Democratic, Republican, anybody's package for all I care; I just want 
to get it done--which is $40 billion over the next 5 years, which does 
put the emphasis on getting the resources back to our rural health care 
providers and home health care providers and nursing homes and public 
hospitals and medical education, all of which is essential to whether 
or not we are going to be able to provide people with humane, 
dignified, and quality health care.
  This is an important family issue. This is an important people issue. 
This is an important Minnesota issue. This is an important national 
security issue. We ought to get the job done before we leave.
  Mr. President, it is my understanding that we now have concluded with 
morning business.
  The PRESIDING OFFICER (Mr. Hutchinson). The Senator's time has 
expired.

                          ____________________