[Congressional Record (Bound Edition), Volume 149 (2003), Part 11]
[House]
[Pages 14419-14420]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            MEDICARE PROBLEM

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Indiana (Mr. Buyer) is recognized for 5 minutes.
  Mr. BUYER. Mr. Speaker, I come to the House currently to discuss the 
Medicare issue, and this is a tough issue that is facing us. It is one 
whereby Members can choose a political route, or they can choose a 
route of policy.
  The numbers that are presently in front of us cannot lie. These 
numbers are cold. They will not go away, and that is that we have this: 
the demographics, the baby boomers when they become seniors, there is a 
smaller population behind them, and the present Medicare model as we 
know it cannot exist unless we go to a 20 percent payroll tax.
  There is a desire here within Congress to deliver a prescription drug 
benefit to Medicare. Well, if we just add prescription drugs to 
Medicare without addressing the long-term solvency, we have only 
exasperated the insolvency of Medicare as we know it.

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                              {time}  1715

  Therein lies our challenge. So I believe if we just added a 
prescription drug benefit to Medicare without making this long-term 
solution to the solvency of Medicare, that is a very faulty approach.
  Right now within the Republican Caucus there is a discussion about 
two approaches on how to do this. These are two completely different 
approaches.
  The country has had an opportunity to see the approach sponsored by 
the gentleman from California (Mr. Thomas) as chairman of the Committee 
on Ways and Means, because Congress has passed this measure two other 
times, and that is an insurance-based product, a defined benefit. We 
provide a cash assistance to beneficiaries to help them manage their 
drug bill and to make that assistance then targeted to those who need 
it.
  We create this insurance pool for the purchase of drugs-only 
insurance which the Federal Government would then underwrite. These are 
two different approaches.
  The first approach that I mentioned, really, is there are five of us 
that have come together and have drafted this approach. This insurance-
based approach, though, really begins to concern us. It concerns us 
because there are not any willing carriers out there who are going to 
step forward and say, well, we believe that there is insurable risk 
here and we will offer this product. Really? They will offer the 
product if the government becomes the guarantor, and then the real 
question is, well, then does the government have to become the 
guarantor in order for them to make a profit and deliver it?
  We have a great concern about the viability of an insurance-based 
product, and that is the reason five Members of Congress have come 
together and we have drafted a completely different approach.
  What I would like to do is share the principles of our approach. Our 
Medicare prescription drug package proposes, number one, a generous 
assistance to low-income seniors and the disabled, a defined 
contribution. We have a specifically defined assistance to all seniors 
that rely on income. We also have family-friendly participation through 
a tax benefit. We also encourage participation by employers through a 
tax benefit, and we also have a stop-loss coverage for high-risk drugs 
to all seniors. We also provide a bridge to comprehensive reform for 
long-term solvency that we call enhanced Medicare, and what we are 
trying to do is provide choices for seniors with lower prices in a 
private sector approach.
  What does all this mean? All this means is that what we hope to 
accomplish is that we turn to those in the private sector to have what 
we call a value card, and these different groups, companies could be 
approved by CMS, and they then, by virtue of their membership and their 
purchasing power, they provide discounts. An individual would have a 
discount card. They are automatically enrolled. They can opt out, but 
they are automatically in. It costs $30, and then government, based on 
their income, adds dollars to their card, and then they are able to 
take this card and they can swipe it down at the drugstore and they 
keep track of the drugs for which they purchase.
  Where we want to be family friendly is often we say, parents, get 
active in the lives of your children. Well, I also want to turn and 
say, children, get active in the lives of your parents. So if you have 
an elderly parent who also needs assistance to buy drugs, I do not know 
why children are not getting more involved in the lives of their 
parents. What they can do is they can get a $4,000 tax deduction, and 
they can add $4,000 then to their parents' drug card. We think this is 
being very family friendly.
  We also have a catastrophic coverage and we think that is important. 
And tomorrow, hopefully, there will be a Republican conference to cover 
both these proposals.

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