[Congressional Record Volume 153, Number 150 (Thursday, October 4, 2007)]
[Senate]
[Pages S12696-S12698]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
VETO OF SCHIP
Mr. CORNYN. Yesterday, the President vetoed the State Children's
Health Insurance Program expansion that the Congress had sent to him,
as he said he would. I would hope all of us would get down to work on
the serious matter of trying to come up with a compromise which would
achieve the original intent of Congress when we passed the legislation
back in 1997 and when it was signed into law by President Clinton and
which has served the Nation's children so well. Instead, it appears you
can't take the politics out of politics and you can't take the politics
out of Washington.
This matter has become a political football that is going to be used
for partisan political gain. I think that is a shame. I say that not
with a sense of anger but with a sense of disappointment that we would
see something as important as providing health coverage to our Nation's
children be used in political ads and that rather than have a veto-
override vote in the House of Representatives forthwith, it has now
been postponed by Speaker Pelosi to October 18 to give the Democratic
Congressional Campaign Committee time to run ads against those who
would likely uphold the veto in their congressional districts over the
next week or so. That is a shame. I wish they would reconsider.
The problem, after all, with the bill Congress passed is that while
the State Children's Health Insurance Program was designed to take up
where Medicaid left off, this was fundamentally a welfare benefit, one
which I believe the Congress wisely decided was necessary for our
Nation's poor, low-income children, to make sure they got access to
health coverage. But what we see is this vehicle was then used, with a
140-percent increase in Federal spending, to take this program not just
from children up to 200 percent of poverty but to then say this can be
a wealth transfer from the pockets of the American taxpayers to the
middle class because under the bill the President vetoed, up to 400
percent of poverty level could be covered by this welfare benefit. That
translates to a family of four roughly making $80,000 a year. It is
simply unacceptable, from my perspective, to say that you can take
money from the pockets of the American taxpayer not for a welfare
benefit to help those in need but to help those who already have their
own health insurance, simply to provide a free benefit to those who are
already covered by their own health insurance. There is no sound basis
upon which to take what is essentially a welfare benefit and transform
that into a middle-class entitlement--unless, of course, there is
something else going on here, which I suspect there is. I will talk
about that in a moment.
In my own State, I wish we would redouble our efforts to focus our
vision on the original intent of the SCHIP legislation because in my
State, there are roughly 500,000 Medicaid-eligible children who are not
covered by Medicaid. Why? Because their parents haven't signed them up
for benefits they are entitled to under the law. There are an
additional 200,000 SCHIP-eligible children, up to 200 percent of
poverty level in Texas, who are not signed up for that benefit. So why
in the world, when there are still children in the target population we
are trying to help who remain uncovered, are we going to be diverted by
a huge expansion of this program beyond its original intent to cover
adults in 14 States? In the State of Wisconsin, more adults than
children are covered by the State Children's Health Insurance Program--
obviously, that was not part of Congress's original intent--up to 400
percent of poverty level, up to $80,000-plus for a family of four. It
is simply another example of a well-intended, perhaps as originally
intended, program that has now been expanded beyond all recognition.
If possible, I would say this was the equivalent of mission creep for
the U.S. military. It is clearly another example of trying to use a
successful Government program, a welfare benefit for low-income kids,
and to expand it beyond recognition--another example, I am afraid, of
wasteful Washington spending run amok.
The question is not whether the State Children's Health Insurance
Program will continue. Even after the President's veto, as my
colleagues know, we passed a continuing resolution which would continue
the current program through November 16. I know today that if we had an
opportunity to vote on a continuation of the current program as
targeted, it would pass unanimously in the Senate. But rather than take
care of business, rather than do our jobs, unfortunately this has
degenerated into political gamesmanship, where the House leadership,
Speaker Pelosi and others, have decided that rather than have the vote
on the override of the President's veto, which they know will be
sustained, immediately they have decided to put it off until October 18
in order for the political games to continue.
Obviously, this is another reason Congress's approval rating in most
public opinion polls is well under 20 percent. The American people
wonder why is it that Washington is not hearing what they are saying
when it comes to being good stewards of the taxpayers' dollars, when it
comes to making sure the money we do spend that they earn and which is
transferred to the U.S. Treasury is spent efficiently and effectively
on important programs we all support as opposed to these programs being
used essentially as a Trojan horse for other objectives.
The final concern I have about this vast expansion of the SCHIP
program--a 140-percent increase over the current program--is it clearly
represents another step toward a Washington-controlled health care
system, something I think would be a tragedy for our country.
Eventually, it would crowd out the private sector and the choice and
the individual decisionmaking Americans can make with their own health
care provider to determine what is in their best interest, what kind of
treatment they want to have for their health care needs, as opposed to
turning that over to Government bureaucrats.
There are three things I can guarantee will happen when Washington
makes all the health care decisions. No. 1 is, it will be expensive. It
will not be free, or I should say you would be surprised at how
expensive ``free'' health care turns out to be in terms of the tax
payments that will be required to support it.
Secondly, I will tell you that a Washington-controlled health care
system will be excessively bureaucratic. It is just in the nature of
Washington. With central Government control for 300 million people,
there will be more red tape than anybody can imagine. It will make it
harder to get access to the health care that right now is readily
available for virtually all Americans. The question is, how are we
going to deliver it the most efficiently, not whether they can get
access to it. Because we all agree they should have and do have access
to health care today.
The third thing I will say is, I will guarantee once Washington makes
all health care decisions, it will be controlled by rationing. The
costs of health care delivery--when Washington makes all the
decisions--will be controlled by rationing. What is the evidence of
that? Well, if you look right now at the reimbursement rates Medicare,
Medicaid, and SCHIP provide to
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health care providers, who provide health care services under those
programs, those reimbursement rates are much lower than private health
insurance.
Where I live in Austin, TX, only 18 percent of physicians are
accepting new Medicare patients. Why? It is because the reimbursement
rates set by the Federal Government are so low that most doctors cannot
treat new Medicare patients and keep their doors open for other
business.
So if we continue down this road to a single-payer, Government-run
health care system out of Washington, DC, it will be expensive, it will
be bureaucratic, and it will result in rationing such as citizens of
Canada and the United Kingdom currently have with their single-payer
system, where the kinds of access to health care we take for granted in
this country--and we can get in a matter of hours or a matter of days,
at most--they have to wait months and years because of the rationing
resulting from a single-payer, Government-run health care system.
That is the wrong prescription for the American people. I believe
once they begin to realize this radical expansion of this program--
which has a very important target audience of 200 percent of poverty,
poor kids--has now been blown up into something that hardly anybody
would recognize, covering middle-class Americans, resulting in a vast
wealth transfer from the taxpayers to the middle class--and that it is
not just a welfare benefit, but an incremental step toward a single-
payer, Washington-controlled health care system--I think that would be
the wrong prescription for America.
Mr. President, I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Oklahoma.
Mr. COBURN. Mr. President, I want to spend a few minutes talking
about this issue of health care and children's health care, the issue
about all the politics that are involved, and the issue about the next
election and how you can make somebody look bad because they do not
agree that we ought to transfer a large segment of our health care to
the Government.
I think it is most important that the American people ought to be
asking some questions. Why is it we have a health care program that we
are putting out that the President rightly vetoed that pays $4,000 to
buy $2,300 worth of care? It is a simple question. We are going to pay
$1,700 more than we should to run it through the Government--to buy
$2,300 worth of care. That makes no sense. But whoever said Washington
makes sense?
As a matter of fact, this bill is more nonsensical than any bill we
have passed this year. It assumes that 22 million Americans now have to
start smoking to pay the taxes that will pay for this bill. Twenty-two
million? Right now we have a problem with the cost of tobacco use in
this country and long-term care.
The other situation which has not been characterized is, if you look
at the CBO scoring, for any one new child who goes on SCHIP under this
bill, one comes off of private insurance. It is one for one. That is
what the CBO says. So what we are doing is, we are asking the American
taxpayers--but, actually, we are not. We are asking the very children
whom we are supposedly going to give care to, to allow us to borrow
money now to pay for their care so they can pay a higher tax rate 25
years from now.
This bill lacks integrity in terms of the way it pays for itself.
Everybody knows that. It is another little wink and nod from
Washington: Yes, we have a pay-go rule. Yes, we are going to pay for
it. But, oh, by the way, it costs $121 billion, but we are only going
to tell you it costs $35 billion. And, by the way, we don't have the
tax revenues to pay for it, so we are going to lie about the tax
revenues on it.
It is important that Washington start getting what America has
already got; that is, how about some plain words that have to do with
our health care situation? If we want to move to national health care,
let's have a debate about national health care. Let's talk about the
fact that in England the average length of time waiting for treatment
for a cancer after it is diagnosed--they are trying to move from 10
months to 3 months. In this country it is 4 weeks. It is 4 weeks. The
cure rates for cancers in this country are 50 percent to 100 percent
better than anywhere else that has a nationalized health care system.
Why is that? Why is it that 80 percent of all the innovation in health
care in terms of new medical products, new techniques, new devices, new
diagnostics come out of this country's private sector?
Let's have a real debate about national health care. But let's quit
lying to the American people that in the name of children we are going
to spend their future money to create a segue to national health care.
In the State of New Jersey, well over half the money for children's
health care is spent on adults. In the State of Florida, 750,000 kids
under 200 percent of the poverty level are not on SCHIP right now. In
the State of Texas, 700,000 are not. Yet we are going to create a
system to raise--it is important the American people know what 200
percent of the poverty level is. It is $42,000 a year.
What we are saying under the present SCHIP bill--the one that has
been extended with the CR--is if you as a family make less than that,
we are going to help you out with your kids. But if you make more than
that, you ought to be contributing.
This body does not care about kids because it voted against a premium
support amendment to allow kids in these higher income families a way
to buy health insurance. What we have said is no, we cannot do that.
But we can certainly be dishonest about what our intentions are in the
rest of the bill.
So as the American public hears all the criticism of those who say:
We don't want more Government; we want less; we want the Government we
have to be more efficient, more transparent, and more accountable--as
they criticize us for those positions, they are going to say we don't
care about children.
Do you care about children if you are going to steal their future by
undermining their ability to have a future by not paying for and
growing the Government and borrowing more and more money? It cannot
happen. We cannot give our children a future if we continue to be
dishonest with ourselves and dishonest with the American public.
I think President Bush is right on this issue. No. I don't think so.
I know he is. One of the reasons we are having difficulty at this time
in our country with health care is because 52 percent of the health
care now is run by the Government. Why is it a large percentage of
people who are now coming on to Medicare--and in 3 years the baby
boomers start coming on to Medicare--why is it the vast majority of
them cannot find a Medicare physician? Why is that? Could it be that we
have promised something we are not going to pay for, so we are going to
reimburse at a lower level?
The next thing to come out of this body will be: If you are a
physician in this country, you have to take Medicare, just as in
Massachusetts you have to take Medicaid. Our health care system ought
to be about freedom and choice and personal responsibility, and, yes,
it ought to be about helping those who need our help. But, quite
frankly, if you are making $80,000 a year in this country, we ought to
be about paying off debt rather than paying for your child's health
insurance. That is what this bill does. That is what this bill allows.
So we are going to have a debate. We are going to see the political
games played out. This bill will not be overridden in the House, and
then we are going to have to come back and address it. My hope is when
we address it, we will add premium support for those who are on the
edge so we can help those who are in private insurance stay in private
insurance, we will be honest on how we pay for it. The most
disappointing thing about this bill is the lack of integrity and
honesty and character in terms of the way it is paid for. It shows the
depths of which we fool ourselves and play the game of politics rather
than play the game of statesmanship. It is a disappointing aspect, and
I would say our approval rating is well earned just on the basis of
this bill.
I yield the floor.
I suggest the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The legislative clerk proceeded to call the roll.
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Mr. WHITEHOUSE. Mr. President, I ask unanimous consent that the order
for the quorum call be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
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