[Congressional Record Volume 149, Number 149 (Wednesday, October 22, 2003)]
[Senate]
[Pages S12992-S12993]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    MEDICARE AND PRESCRIPTION DRUGS

  Ms. STABENOW. Mr. President, I rise today to speak about the issue of 
Medicare and prescription drugs and where we are as we have been 
working to develop a prescription drug benefit for seniors and put in 
place plans that would lower prices on prescription drugs for everyone: 
Businesses, individuals, workers, families.
  We are at a crossroads. We have been working many hours in a 
bipartisan way in this body, trying to come to a positive conclusion on 
the question of Medicare and prescription drugs. There are wide 
differences in philosophy and approach, particularly with our 
colleagues on the Republican side of the aisle in the House of 
Representatives. I am deeply concerned about the direction that the 
conference committee appears to be going as it relates to the 
fundamental issue of whether we will continue to have Medicare as we 
know it in the future.
  We all know that Medicare was put into place in 1965 because at least 
half of our seniors could not find or could not afford prescription 
drug coverage and health care in the private sector. They could not 
find or afford health care in the private sector. So this Congress and 
the President at that time came together and did something I think is 
one of the most significant actions of modern age for the people of the 
country, and that is to create health care for seniors, for those over 
age 65, and for the disabled of this country, a guarantee that we would 
make a commitment together and fund a system for older Americans and 
the disabled to have access to health care in this country. It has made 
all the difference in terms of quality of life for our citizens.
  We now are at a juncture where we have seen a proposal passed as part 
of the House package that would essentially do away with Medicare as we 
know it. Instead of it being a defined benefit, meaning it does not 
matter where a person goes, whether they are going to New Jersey, Iowa, 
or Michigan, or what part of Michigan they live in, whether they live 
in the Upper Peninsula, Detroit, Benton Harbor, or Lansing, they could 
count on Medicare. They know what it will cost. Their provider knows 
what they will be paid for the service. It is a system that is 
universal, and it works.

  What we are hearing now is that there is a great desire, 
unfortunately, among, again, predominately our colleagues in the House, 
in the majority, who are saying that system should be radically 
changed. Instead of having Medicare, which is dependable, affordable, 
reliable--we know what it is; seniors can choose their own doctors; 
providers know what the payment will be--they want to change it to what 
is called premium support.
  Now, what does that mean? Essentially, it is like a voucher. They 
want Medicare to essentially say a person has X amount of dollars for 
their health care, and if it costs more than that, they pay that. If, 
in fact, they want to take that and go to an HMO or PPO, that is what 
would be encouraged. People would be pushed more and more into an HMO 
or a PPO in order to save dollars, but for most of our citizens that 
would not be available.
  The House basically wants to say that Medicare, as we know it, will 
no longer be available, and it will be privatized. Folks will be given 
a lump sum of dollars, and then they are on their own. If they are 
sicker, if they need more help, they would not be covered for that 
additional health care they need. There would only be a set amount of 
dollars or essentially the equivalent of a voucher. This completely 
undermines what we have put in place for Medicare. The idea that we 
would say to our seniors, You have health care; you can rely on it; you 
can count on it; you don't have to worry about it, that would all be 
taken away with this proposal to undermine Medicare and to essentially 
turn it back to the private sector.

  This is something I find absolutely unacceptable and I will do 
whatever I can to stop it, and I know on our side of the aisle there is 
overwhelming opposition to this notion of doing anything that would 
undermine and weaken Medicare for our seniors.
  We know, according to a study that was just done, this proposal could 
increase the costs for the majority of our seniors who are in 
traditional Medicare by as much as 25 percent or more. I should mention 
the majority of seniors, when given the choice between a private plan--
in this case Medicare+Choice--or staying in traditional Medicare, they 
have overwhelmingly chosen to stay in traditional Medicare. In fact, 89 
percent of our seniors already voted. If we just want to look at who is 
covered and who we are trying to help for the future, we should look at 
what they are saying.
  Mr. President, 89 percent of our seniors have chosen to stay in 
traditional Medicare. Only 11 percent have chosen to go into the 
private sector. Yet we are seeing an overwhelming push to force people 
to go into the private sector through a scheme that would privatize 
Medicare, even though it will cost them more money, even though it is 
not dependable.

[[Page S12993]]

  We now know, according to the Medicare actuary in Health and Human 
Services, that in fact there could be sharp differences in cost among 
individual people or individual regions, depending on the private 
sector plans and how this would work. The study that was done by the 
Medicare actuary studied the proposals calling for private plans to 
compete against one another and against Medicare's traditional 
Government-run program. It shows that those in Medicare fee-for-
service--traditional Medicare--in States such as North Carolina or 
Oregon would pay as little as $58 a month, well below the projected 
national average of $107. So they would pay $58 instead of $107. But in 
high-cost States such as New York or Florida--my good friend from New 
Jersey is here, I would guess New Jersey would fall in that category as 
well--they would be paying more like $175 a month for the same benefit. 
So on one side of the country you would have people paying $58, on the 
other side you would have people paying $175, for the same coverage, 
for the same kind of care. That is not fair. That is certainly not what 
we have now.
  They went on to indicate that we would even see parts of States where 
there would be one payment, one cost, versus other parts of the State. 
So if you live in Marquette, MI, or Ironwood, MI, in the Upper 
Peninsula, you could pay a very different price for your health care 
than if you lived in Detroit or Lansing or Grand Rapids. That is not 
fair. It does not make sense. Why in the world would we go back to that 
kind of system?
  It is for these reasons I urge my colleagues not to agree to any plan 
that changes Medicare as we know it, that privatizes Medicare, that 
takes away what overwhelmingly seniors have told us they want. They 
want prescription drug coverage--yes. But don't take away their 
Medicare. That is not a good tradeoff. We need to strengthen Medicare, 
provide a real benefit for prescription drugs, and do it right.
  The PRESIDING OFFICER. The Senator from Iowa is recognized for 9 
minutes.

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