[Congressional Record Volume 161, Number 3 (Thursday, January 8, 2015)]
[Senate]
[Pages S109-S110]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SENATE RESOLUTION 25--COMMEMORATING 50 YEARS SINCE THE CREATION OF THE
MEDICARE AND MEDICAID PROGRAMS
Mr. WYDEN (for himself, Ms. Baldwin, Mr. Blumenthal, Mr. Booker, Mrs.
Boxer, Mr. Brown, Ms. Cantwell, Mr. Cardin, Mr. Casey, Mr. Coons, Mr.
Donnelly, Mr. Durbin, Mrs. Feinstein, Mr. Franken, Mrs. Gillibrand, Mr.
Heinrich, Ms. Heitkamp, Ms. Hirono, Mr. Kaine, Mr. King, Ms. Klobuchar,
Mr. Leahy, Mr. Markey, Mrs. McCaskill, Mr. Menendez, Mr. Merkley, Ms.
Mikulski, Mr. Murphy, Mrs. Murray, Mr. Nelson, Mr. Peters, Mr. Reed of
Rhode Island, Mr. Reid of Nevada, Mr. Sanders, Mr. Schatz, Mr. Schumer,
Mrs. Shaheen, Ms. Stabenow, Mr. Tester, Mr. Udall, Mr. Warner, Ms.
Warren, Mr. Whitehouse, Mr. Bennet, and Mr. Manchin) submitted the
following resolution; which was referred to the Committee on Finance:
S. Res. 25
Whereas on January 7, 1965, President Lyndon B. Johnson
called on Congress to provide health insurance for the
elderly and most vulnerable;
Whereas over the past 50 years, Congress has strengthened
Medicare and Medicaid with improvements to, and expansion of,
health care benefits;
Whereas today, as a result of President Johnson's call to
action and Congress' bipartisan initiative that created the
Medicare program, 54,000,000 seniors and people with
disabilities have access to guaranteed health care benefits;
Whereas today, 68,000,000 Americans, including children,
pregnant women, individuals with disabilities, elderly who
are poor and frail, and low income adults and parents have
access to health care through Medicaid;
Whereas Medicare and Medicaid have been leaders in
improving the quality of care delivered to the Nation,
resulting in 1,300,000 fewer infections, accidents or other
adverse events and avoiding 150,000 unnecessary hospital
readmissions;
Whereas Medicare has been an innovator in developing
alternative ways to pay for health care that emphasize care
coordination across all health care providers and settings;
Whereas Medicare provides access to needed care, including
primary and specialty care, free preventative services, and
prescription drugs;
Whereas the creation of a prescription drug benefit in 2003
has ensured that nearly 90 percent of Medicare beneficiaries
have prescription drug coverage, and since 2010, over
8,200,000 seniors have saved more than $11,500,000,000 on
their prescription drugs as a result of closing the Medicare
Part D coverage gap;
Whereas in 2013, an estimated 37,200,000 people with
Medicare took advantage of at least one preventative service
with no cost sharing;
Whereas Medicaid is a critical source of comprehensive,
affordable health coverage for millions of otherwise
uninsured low-income adults and parents, including millions
of nonelderly low income adults in states that expanded their
Medicaid programs as part of health reform;
Whereas Medicaid ensures access to long-term services and
supports for vulnerable low income seniors and persons with
disabilities by covering 60 percent of nursing home
residents, picking up 40 percent of the Nation's long-term
care costs, and allowing loved ones to live with health and
dignity in their own homes and communities;
Whereas Medicaid provides early comprehensive childhood
screening, diagnosis, and treatment for 32,000,000 of the
Nation's children, including half of all low-income children;
and
Whereas Medicaid provides crucial services for pregnant
women and babies in that Medicaid covers 45 percent of births
nationwide, 53 percent of hospital stays for infants born
prematurely or with a low birth weight, and 45 percent of
hospital stays for infants with birth defects: Now,
therefore, be it
Resolved, That it is the sense of the Senate that--
(1) all efforts to improve Medicare and Medicaid must
support and build upon President Johnson's vision ``to assure
the availability of and accessibility to the best healthcare
to all Americans, regardless of age or geography or economic
status'';
(2) Medicare's guaranteed benefit is a lifeline to millions
of Americans and must remain intact for this and future
generations;
(3) Medicare should not be transformed into a voucher
program, leaving seniors and people with disabilities
vulnerable to higher out-of-pocket costs;
(4) with the strong support of the Federal Government,
Medicaid continues to serve as a safety net for vulnerable
children, pregnant women, persons with disabilities, elderly
who are poor and frail, and other low income adults; and
(5) Medicaid should not be dismantled through block grants,
per-capita caps, or by other policies that slash funding,
shift cost to states, reduce benefits, and erode the safety
net relied on by over 68,000,000 Americans.
Mr. WYDEN. Mr. President, I rise to highlight a Presidential message
that was delivered to Congress 50 years ago today.
But before I reiterate the importance of Medicare and Medicaid--facts
that I think my colleagues and I can all agree to I would like to look
back at where we have been, to recall what life was like for so many
people who were poor and disabled, uninsured or unlucky before these
vital safety net programs were here.
Those were the days of the ``poor farm'' and the ``almshouse,''
places the poor and uninsured would go for care. It wasn't a happy
choice and more often than not, it was the only choice.
[[Page S110]]
These places provided care, often rudimentary, and often carried a
stigma. Accommodations were sparse at best. In return for health care
and housing, residents were expected to work in the adjoining farm or
do housework or other menial labor to offset the cost of their stay.
This was the primary option for someone whose extended family
couldn't provide help or didn't want to--right here in the USA. Few
Americans today remember those days.
When President Johnson submitted his message to Congress 50 years ago
today, fewer than half of America's elderly even had health insurance.
In that era, and it wasn't that long ago, it wasn't uncommon for the
sick elderly to be treated like second class citizens, and as a result,
many aging Americans without family to care for them ended up
destitute, without necessary health care, or on the street.
It was a time no one wants to revisit, a time that one sociologist
said was ``another America'' where ``40 to 50 million citizens were
poor, who lacked adequate medical care, and who were `socially
invisible' to the majority of the population.''
It is worth remembering how far we have come. Today, I ask my
colleagues to use this anniversary as a vivid reminder of the
difference Medicare and Medicaid make in the daily lives of Americans,
and also the health care advances that have occurred as a result.
A couple facts to highlight for my colleagues:
Today, with rock-solid essential health services, 54 million
Americans--nearly every senior and person with disabilities--has access
to Medicare's guarantee.
Meanwhile, Medicaid has made a critical difference for 68 million of
the Nation's most vulnerable, including more than 32 million children,
6 million seniors, and 10 million persons with disabilities. Because
Medicare and Medicaid made health care possible for millions of people,
they have also been the catalyst for innovations in treatment that
benefit people of all ages. Here's one example:
In the first 30 years of Medicare alone, deaths from heart disease
dropped by a third for people over age 65. By providing coverage and
access for millions, these programs became catalysts for changes in how
medicine is practiced and paid for, while finding the root causes of
disease and perfecting better therapies to treat them.
As time has marched on, these programs evolved and improved, and the
rest of the health care system followed.
In 1967, Early and Periodic Screening, Diagnosis, and Treatment,
EPSD, comprehensive health services benefit for all Medicaid children
under age 21 was created--helping improve the health of our Nation's
kids.
In 1981, home and community-based waivers were established so that
states could provide services in a community setting, allowing
individuals to remain in their home for as long as possible. Every
state now uses this option to facilitate better care and services to
their Medicaid population.
In 1983, Medicare took one of many legs away from fee-for-service
with the advent of the hospital prospective payment system, a system
that pays hospitals based on a patient's illness, and how serious it
was, not based solely on how much it cost to treat them. This change,
once considered drastic, has become common place and accepted.
In 2003, the prescription drug coverage was added to Medicare's
benefit, providing access to necessary medications for those most
likely to need them. As a result of greater access to prescription
drugs, beneficiaries' health have dramatically improved.
In 2010, as a result of health reform, preventive services became
free to patients, prescription drugs became cheaper for those
beneficiaries who fell in the donut hole, Medicare began to move away
from purely volume-driven care, and onto paying for quality and value,
and the life of the Medicare trust fund was extended.
Finally, in 2012, the Centers for Medicare and Medicaid began
releasing loads of claims data for the public to use. Access to this
information has been game-changing in understanding the cost of care
and variations in the way medicine is practiced across the country.
Today, any of these examples are easy to forget because they are
commonplace. But that makes them no less remarkable.
I will close by noting something else, just as striking about
Medicare and Medicaid: It was a bipartisan effort. The enactment of
these programs shows that Congress can craft bipartisan solutions to
very complex and politically difficult problems. That's what happened
in 1965 when the Senate passed the legislation creating Medicare and
Medicaid by a 68-32 vote after the House approved it three months
earlier on a robust 313-115.
As the 114th Congress gets underway, my colleagues and I could all
take a page from President Johnson's playbook: Congress shouldn't use
partisan tactics when the solutions can be bipartisan.
And there's the lesson; that despite sharp differences and
partisanship, the Congress of Johnson's day was able to rise above that
culture and those challenges to find agreement and make America a much
better place. As this new Congress begins, I hope we can use that 50-
year-old spirit to strengthen, protect and improve Medicare and
Medicaid to keep the guarantee strong and ensure health care to those
who need it most.
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