[Congressional Record Volume 156, Number 44 (Monday, March 22, 2010)]
[Senate]
[Pages S1785-S1786]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              HEALTH CARE

  Mr. ALEXANDER. Mr. President, I have been in and out of public life a 
long time, and I have never had anything affect me in a personal way 
like the health care debate. I got up this morning in West Millers Cove 
in Blount County and drove to the Knoxville airport, and almost every 
single person with whom I talked on the way into the airplane had 
something to say to me about the health care debate. When I get on the 
plane, here comes another fellow right down the aisle, hands me a note, 
and says: Thanks for all your hard work. None of them are for the 
health care bill passed last night. They are all deeply concerned and 
deeply worried about it, and they see it as I see it. They see it as a 
historic mistake.
  Unlike the Social Security bill, the Medicare bill, the Medicaid 
bill, the civil rights bills of 1957 and 1964 and 1968 and later, all 
those bills passed with significant bipartisan support. But the bill 
last night was a completely partisan act. The only thing bipartisan 
about it is the opposition to it. I think it is important that we 
continue to say why that is true.
  The fundamental mistake is that the bill basically expands a health 
care delivery system that we all know is too expensive at a time of 
enormous concern about the national debt. In the middle of a great 
recession, we are expanding a health care delivery system that we know 
is too expensive; instead of focusing our attention and working 
together to set as a goal of reducing the cost of the health care 
delivery system so more Americans can afford to buy insurance. That is 
the basic difference of opinion.
  The Democrats believe we should expand the system we have now. Of 
course, they make some changes, but basically it is an expansion of a 
system that is too expensive, and they make it more expensive. We 
believe what we should do, instead, is to reduce the cost of the 
American health care delivery system, and by doing so make it possible 
for more Americans to be able to afford health insurance.
  Here is what the bill does now, as we see it. It imposes even larger 
taxes on job creators in the middle of a recession. It will mean 
Medicare cuts and premium increases for millions of Americans. The 
Medicare cuts, it is said, are alright because there is some fraud and 
abuse in Medicare. We agree with that. But what we are saying is that 
Medicare, according to its trustees, is going broke by 2010, and every 
penny of savings in Medicare ought to go to Medicare to help make it 
stronger. This bill spends almost all the money on a new entitlement, 
and the bill last night cuts Medicare even more deeply.
  Some say: Well, it only hurts providers and hospitals. Well, those 
hospitals are the ones that may announce, as some are announcing, that 
we are not going to accept Medicare patients anymore because we are 
already being reimbursed so little. But it also cuts Medicare 
beneficiaries' benefits. The Congressional Budget Office says that 
fully half of those who have Medicare Advantage--and that is one out 
four Medicare beneficiaries in the country--will see their benefits 
cut. That is what this bill does.
  As far as premium increases go, the President and I had a little 
friendly discussion about that at the health care summit. I said: For 
millions of Americans, individual premiums would go up. He said: No, 
they won't. I said: With respect, Mr. President, the Congressional 
Budget Office says yes, they will, by 10 to 13 percent, on the average. 
He said: Oh, no, oh, no, they will be getting a better policy. But that 
is like saying: If the government requires you to buy a better car and 
it is more expensive, it may be better but it is still more expensive. 
For a variety of reasons individual premiums are going to go up, and 
one is the government requirement that you buy a better policy.
  Senator Collins, who was the insurance commissioner in Maine, has 
surveyed her State, and her conclusion is that 87 percent of the 
individual policies there will be more expensive under this bill. It is 
true that maybe half of those persons would get subsidies--paid for by 
taxpayers--but that still leaves maybe 40 percent of the individual 
policies in Maine where individual premiums will go up. They will go up 
because we are dumping more people into Medicaid--the State program for 
low-income Americans--and we don't reimburse physicians and hospitals 
adequately for those patients.
  Today, one-half of doctors won't see new Medicaid patients. So what 
do hospitals and the doctors do when they do see a Medicaid patient? 
They transfer part of the cost of seeing that patient--that Medicaid 
patient--on to someone who has private insurance. So that forces 
premiums to go up.
  When you have a provision in the bill, as this bill does, which says 
that my policy can't go up much when compared with my son's policy, 
well, that might keep my policy from going up so much, but my son is 
going to be paying a lot more. So younger Americans are going to be 
very surprised as the cost of their policies goes up. Then the 
provision in the bill with the requirement to buy policies was 
weakened, and because it is weak, a lot of young people especially may 
not join the policy. When they do not, that will leave sicker and older 
people within the system, and that will help drive premium costs up as 
well. So for all those reasons, for millions of Americans, it is 
accurate to say that premiums will go up.
  I was at the University of Tennessee this morning--a tremendous 
university. Dr. Chu, the President's Energy Secretary, is visiting 
there today and tomorrow. I wish I could be with him to talk about the 
work they are doing, between the Oak Ridge National Laboratory and the 
university and its science program. Senator Bingaman has visited there 
before. But one of the undercurrent stories in America today is the 
condition of America's public higher education. State funding for 
public higher education has been flat for the last 10 years.
  Why is that? Because Medicaid costs continue to rise. Governors can't 
control those budgets or control those costs, and the reason they can't 
is because we write the program up here and then send them about a 
third to 40 percent of the bill. They cannot afford it, so what do they 
do? They cut the amount of money that goes to the University of 
Virginia or the University of Tennessee or the University of New Mexico 
or the University of Wyoming and then what happens? Either quality goes 
down, fewer students are served, fewer faculty are attracted or tuition 
goes up, which is why the students are protesting in California about 
the 34-percent increase in tuition at the University of California. 
They probably didn't even imagine the reason for that

[[Page S1786]]

is the Federal Government is causing Medicaid costs to continue to rise 
and Governors, therefore, make cuts and tuition goes up. This bill will 
make that worse.

  Then, on top of that, you have the last-minute takeover of the 
Federal student loan program. Suddenly, 19 million students--well, 15 
million of those 19 million will go to the Federal Government to get 
their loan, beginning in July, instead of to 2,000 lenders across the 
country. The Government is saying we are going to save money. That may 
be true. But guess what the Government is going to do with its money. 
They are not going to say: Because the Government can borrow the money 
at 2.8 percent it is going to cost us less to operate the program, 
therefore, we are going to give students the savings. They are going to 
spend the savings. So they are going to borrow it at 2.8 percent and 
loan it to the students at 6.8 percent. That is overcharging America's 
students to help pay for the health care program.
  These students are not Wall Street financiers. They are working 
people, some of them pretty grown up, in their thirties and forties, 
going back to Walter State Community College. They often have a job. 
They are not going to be very happy when they find out they are paying 
higher interest. The estimate that we have made in our office is it 
might be $1,500-$1,700 dollars over 10 years in more interest. That is 
the amount the Governor is going to be overcharging them to pay for 
other government programs, including health care.
  The action that is being taken may be historic. But we believe that 
it is a historic mistake and that throughout the rest of this year the 
debate will not end about health care; but it will change. It will be 
larger than just health care.
  As the President himself said last year, the health care debate is a 
proxy for a larger debate about the role of government in America's 
life. We believe that is a debate our country should have, and we 
believe the country will soundly reject a policy of more taxes, more 
spending, more debt, and more Washington takeover.
  I yield the floor.
  Mr. BINGAMAN. Mr. President, I heard my colleague's comments about 
health care. I will plan to return to the Senate floor to discuss 
health care in some detail in the next couple days.
  The ACTING PRESIDENT pro tempore. The Senator from New Mexico.

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