[Congressional Record Volume 155, Number 156 (Monday, October 26, 2009)]
[Senate]
[Pages S10718-S10720]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
THE PUBLIC OPTION
Mr. CORNYN. Mr. President, I listened to the majority leader, Senator
Reid, talk about his melded bill, the combination of the Finance
Committee bill and the HELP Committee bill that he has now completed
merging behind closed doors. He said he is going to
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send it to the Congressional Budget Office to get a score or a cost
estimate. My hope is we will all be able to see it soon. We have not
been able to participate in the process since it has been a process
taking place between the majority leader and presumably Senators Dodd
and Baucus, the chairmen of the two committees, without Republicans
being present. So we don't know what is in it, and we don't know how
much it costs. Certainly those are two critical questions the American
people are asking and those of us who will be required to vote on this
legislation at some point would like the answers to. When will we be
able to see it? When will the American people be able to see it? How
much will the bill cost?
Today, I wish to focus on another question: Why is it that some
people in this country think another government-run health care plan is
the answer? A government-run plan goes by a lot of different names. It
is an attempt, in part, to obfuscate what people are trying to do.
Sometimes people like to call it the public option because it sounds
innocuous. Who could be against a choice, an option, if it is not
mandatory? Others say they are not for a public option unless it has a
trigger. Others talk about opting in, and we heard the majority leader
talk about a bill he intends to introduce that provides an opt out for
the States. The reality remains the same. We are talking about a
brandnew entitlement program, a brandnew government-run health care
program run out of Washington, DC, based on the fundamental and
misguided belief that one size fits all for a nation of 300 million
people.
Some of my colleagues believe a government plan is gaining momentum.
I appeared yesterday on a Sunday television show with Senator Schumer,
the distinguished Senator from New York, who said he thought Congress
was right on the cusp of a public option or government-run plan. The
more the American people find out about what is meant by the public
option, the less they like it.
Last week, we saw the Washington Post-ABC News poll that supposedly
said that support for a government-run plan was growing. In fact,
support has fallen by 5 points since June. These numbers can be
misleading. As the Presiding Officer knows, in politics and public
opinion polling, he or she who gets to ask the questions or frame the
questions, he or she who gets to decide what the sample is can have a
dramatic impact on the answers given to a poll. It is absolutely the
case that support for the so-called public option drops dramatically
when we explain to people what it would actually do.
ABC News polling director Gary Langer wrote about this dynamic in
June. He noted that while 62 percent initially favored a so-called
public option, that number dropped from 62 percent to 37 percent once
it was explained to people that it would put many private insurers out
of business because they couldn't compete with the Federal Government
and the so-called government plan.
In other words, support dropped when people realized they would not
be able to keep what they have now--which is one of the President's
promises--because many insurers would simply be driven out of business.
Thus that promise President Obama has made time and time again would
not be possible under the public option or government plan.
Today in the Washington Post, Fred Hiatt explained why a government
plan would end up breaking President Obama's promise: A government plan
would work like Medicare and Medicaid--those are two government plans--
and they would, as Medicare and Medicaid do, pay providers at low
rates.
As a matter of fact, last week we had a vote on a bill--actually, on
a cloture motion on a motion to proceed--a technical vote but one that
would have taken us to a bill to basically reverse the cuts in Medicare
reimbursement rates to Medicare providers. But it was not paid for. It
would have added $300 billion to the national debt. So 13 Democrats
joined with Republicans to defeat that. Hopefully, we will go back to
the drawing board and come up with a bill that will be paid for.
But the point is, any new government plan, as Fred Hiatt pointed out,
would work like Medicare and Medicaid and pay providers much less than
they could get under private insurers. So providers would, as they do
now, make up the difference by charging private plans more for the same
services. This is a so-called cost-shifting phenomenon. Then private
insurance premiums--if you have private coverage now--would increase
for people who have health insurance coverage now. Ultimately, some of
them would be forced to drop their private insurance because it would
be more expensive, not less, which is what I thought the object of this
exercise was about: how to bring down costs, not how to drive them up,
and the cycle would continue until all private insurers would go out of
business, and all Americans would find themselves on a single-payer,
government-run health care plan. So much for the option in the public
option.
So the fact is, the government plan would not be just a competitor;
it would, in fact, act as a predator by calling the shots. Even as it
takes the field, the government plan would undercut the private market
and create another Washington monopoly.
Some people have described the so-called public option as a Trojan
horse. I have used that phrase myself. But the person who actually
devised the public option said this--his name is Jacob Hacker, and he
is a professor at Berkeley--he put it this way last year:
Someone once said to me, ``This is a Trojan horse for
single payer,'' and I said, ``Well, it's not a Trojan horse,
right? It's just right there.''
Professor Hacker said:
I'm telling you, we're going to get there, over time,
slowly.
The truth is, we should not be creating another government plan when
the ones we have now are not working very well at all.
As Robert Samuelson wrote in today's Washington Post:
Why would a plan tied to Medicare control health [care]
spending, when Medicare hasn't?
He noted that from 1970 until 2007, Medicare spending had risen by
9.2 percent annually. Let me say that again. From 1970 to 2007,
Medicare spending had risen by 9.2 percent annually. He says this is
just one reason the so-called public option is what he called a
``mirage.''
We know there are current entitlement programs that have major
unfunded liabilities. Medicare has a $38 trillion unfunded liability
and will effectively go bankrupt in 2017. Yet this bill, at least the
Finance Committee bill--I presume the bill coming out of Senator Reid's
office will do the same--takes $500 billion from Medicare to create a
new entitlement plan, a new government-run health care plan, when
Medicare itself has $38 trillion in unfunded liabilities. It just does
not seem to make any sense.
Medicaid, which, of course, primarily helps pay health care costs for
the poor, reduces access to health care in many communities because
reimbursement rates are so low that many providers simply cannot take
new patients. As ``60 Minutes'' reported just last night, fraud and
abuse in government health care programs cost taxpayers about $90
billion a year. Does this sound like a model we want to hold out--a new
government-run plan--when the ones we have now are broken and need
fixing?
On the Medicare fraud and abuse, according to FBI special agent Brian
Waterman, Medicare fraud is a bigger problem in South Florida than the
drug trade. He said:
There are entire groups and entire organizations of people
that are dedicated to nothing but committing fraud, finding a
better way to steal from Medicare.
One former Federal judge looked at his Medicare statement and found
that someone had billed the government for two artificial limbs on his
behalf even though he still has the ones God gave him. In other words,
he did not need any artificial limbs, but somebody charged them to
Medicare on his bill without his knowledge.
I agree with our colleague, Senator Landrieu from Louisiana, that a
government plan would just replicate the same kinds of problems we have
seen in Medicare and Medicaid. As she said:
Why don't we fix the two public options we have now instead
of creating a [new] one?
Well, supporters of a government plan say we need to have more
competition and give consumers more choice. I could not agree more. But
this
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is not--this is not--the way to do it. Competition occurs when we have
more private insurance companies competing in marketplaces, which would
happen under some proposals made by our side of the aisle--if we would
simply create a system where individuals could buy health insurance in
any State across the Nation and were not just confined to buying health
insurance in their own State. Competition increases when we get more
insurance carriers to enter the market, not by creating a government
plan that will drive them out of it.
We have proposed ways, as I have said, to increase the number of
private insurance options in every State. We think if that is the goal,
certainly we ought to be able to come together in a bipartisan way to
accomplish that goal. But I do not know why in the world we would
settle for a health care proposal that would ultimately drive people to
a single-payer, government-run health care plan, would raise taxes on
the middle class, raise premiums on those who have insurance now and
depress the wages of those who have that health insurance now, and
would cut, as I mentioned a moment ago, $500 billion from a Medicare
Program that is scheduled to go bankrupt in 2017. Why would we settle
for something that would make things worse instead of better for more
than 100 million Americans? Why would we vote to spend $1 trillion or
more on a new entitlement program without fixing the ones we have now?
Well, it is not just me saying that this so-called public option with
the opt-out the majority leader has now proposed--which he admits does
not have 60 votes, and the one Republican, Senator Snowe, who said she
would vote for the bill said she would not vote for a bill with a
public option. So I am not sure why, with one Republican supporting the
Finance Committee bill, they have now apparently rejected Senator
Snowe's support and opted for a strictly partisan proposal coming out
of Senator Reid's conference room.
But I also checked, and another health care expert whom I respect
shares some of my views about the dangers of the so-called public
option.
Secretary Mike Leavitt, who is the former Secretary of the Department
of Health and Human Services, said:
Advocates for a public health-care plan continue to look
for a way to give political cover to moderates while
advancing their goal of implementing a government-run health-
care system.
He said:
[Ultimately,] it is designed to undercut private insurance.
He said it is ``dangerous for three reasons.'' He said:
One, it would be cheaper for employers to stop offering
private [coverage to their employees and to] funnel their
employees into the government-run plan. Employers, not
employees, would get to make that choice.
Secondly, he said:
[A] government-run plan would use the coercive force of
government to dictate the prices that [are going to be]
charged by others--by doctors, nurses, and hospitals--in a
way that private entities cannot.
Third, he said this proposal is dangerous because a ``government-run
plan would be subsidized by American taxpayers, while private plans are
not.'' In other words, he says, if, in fact, States will be given a
chance to opt out of the so-called public option, they would not have a
chance to opt out of the tax dollars their taxpayers would spend in
order to subsidize the so-called public plan.
As he concludes, he says:
The state ``opt-in'' is a transparently false choice. It is
just another gimmick to try to find votes for an unwise
policy that would increase the federal government's control
over health care.
We can do better. We must do better. I urge my colleagues not to take
the bait on this so-called public option, whether it has an opt-out or
not, because it is just another disguised way to try to end up with a
single-payer, government-run health care system out of Washington, DC.
Mr. President, I yield the floor.
The ACTING PRESIDENT pro tempore. The Senator from Oklahoma.
Mr. INHOFE. Mr. President, first of all, let me say to my friend from
Texas, the wake-up call is out there. People are fully aware of what is
going on right now--the fact that you have a government option; you
have a form of socialized medicine; you have something that has proven
not to work in areas such as Canada and Great Britain and elsewhere. It
is kind of interesting to me that we see those countries trying to
emulate something we are doing at the same time we are edging over in
their direction. I do not think that is going to work.
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