[Congressional Record (Bound Edition), Volume 149 (2003), Part 4]
[Senate]
[Pages 5246-5247]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                MEDICARE

  Ms. STABENOW. Mr. President, I rise to thank my colleague from 
Illinois for his eloquence regarding the direction of our economy and 
the Federal budget and the grave concern he has that I share about the 
looming and massive long-term debt that is accumulating by the policies 
of this administration.
  When we look at where we are going and the fact that the entire 
Medicare and Social Security trust funds are currently being used to 
fund tax cuts geared to the very top, the very wealthiest 1 percent, 
and when we look at the discussions we are having in the Budget 
Committee, we begin to see a picture that is disturbing. Because when 
we ask what will happen, when we are using all of these funds for other 
purposes, and we know that in just a matter of a few years, the baby 
boomers will begin to retire en masse and they have the expectation, as 
they should, that Social Security and Medicare will be there for them, 
they have paid into the system, and we are told, when we ask, how will 
we afford that, how will we be able to keep that commitment, well, that 
assumes that Medicare and Social Security will be structured the way 
they are today. That assumes there will be no reform.
  What is becoming clear is that reform is a code word for privatizing; 
that there is a real interest, a commitment and movement to privatize 
or eliminate Medicare and Social Security, as we know it, in the long 
term.
  Today I wish to speak again very specifically about Medicare because 
I believe that is the most imminent threat because the debate that has 
occurred since 1965, when Medicare passed, in various forms is 
occurring yet again today. That is the question of whether Medicare is 
a big American success story, which I believe it is, or just a big 
Government program, which I believe this administration feels it is.
  I wish to speak specifically about special interest politics versus 
the needs of the public, the willingness to provide tax policy that 
benefits only a few, rather than the middle class, and small businesses 
that drive our economy, as well as the fact that in Medicare, we are 
seeing a willingness to move the system in a way that benefits, again, 
special interests over the needs of all of our seniors and the disabled 
in our country.
  On page A6 of the Washington Post this morning, there is a very 
disturbing article. It says: ``Bush Plan a Boon to Drug Companies.'' 
The President went before the American Medical Association yesterday 
and spoke about his plans for Medicare, again using the word 
``reform,'' which we know now is a code word for ``privatization.'' 
Reform equals privatize when we talk about this issue of Medicare. We 
now find that it also directly relates, once again, to special interest 
politics, which is very disturbing.
  The second headline is: ``Medicare Prescription Proposal Would Also 
Benefit Insurers, Analysts Say.'' Not the insured, not the seniors 
about whom we all talk, not the disabled people about whom we all talk, 
but the insurance industry.
  It begins:

       Health care economists said the drug benefit President Bush 
     proposed for Medicare yesterday would be a bonanza for the 
     pharmaceutical and managed-care industries, both of which are 
     huge donors to Republicans.

  It went on to say:

       Marilyn Moon, a health economist at the Urban Institute, 
     said Bush's plan would hand tremendous negotiating power to 
     health insurance companies.
       ``By making the private plans such a central part of the 
     future of Medicare, the government is going to have to meet 
     their demands for greater contributions to the cost of care, 
     over and above the subsidy for prescription drugs,'' Moon 
     said.
       Bush's proposal is vague on many points, including the 
     terms for insurers. Tricia Neuman, a vice president of the 
     Kaiser Family Foundation, said the plan would have to provide 
     a windfall for the companies--

  ``Would have to provide a windfall for the companies.''

     or too few would participate for the plan to work.
       The analysts said drug companies also could be expected to 
     reap huge profits under Bush's approach.

  Huge profits under Bush's approach. We have to ask ourselves: Is that 
the purpose of Medicare? Is that the purpose of health care? Is it the 
same as purchasing a pair of tennis shoes, purchasing soup, purchasing 
a new shirt so that we are talking about what profit margin we have off 
our Medicare recipients, or is the goal to make sure we have quality 
health care for every senior citizen?
  I believe it is our responsibility to make sure this is a streamline 
system with as few dollars as possible going into administration and 
that the dollars should go directly to health care for our seniors, not 
into huge profits. We welcome profits in many areas. We need profits in 
our economy. We want businesses to be successful. But when we are 
talking about Medicare, we have a different priority in what we need to 
do to help our seniors make sure they have care.
  To continue with the article:

       Bruce C. Vladeck, who was President Clinton's head of the 
     federal agency that runs Medicare, said Bush's plan ``strikes 
     me as the kind of proposal that pharmaceutical companies 
     would write if they were writing their own bill.''

  These are the kind of comments we heard last year when we were 
debating prescription drug coverage and were told--in fact, we heard 
comments coming from staff in the House quoted in the paper as to how 
they were running their proposals by the pharmaceutical industry to 
make sure they were OK. It is clear this one is OK, and we should all 
be very concerned about who we are trying to help.
  Continuing to quote:

       ``A slew of private health plans would have nowhere near 
     the negotiating power that Medicare would have if there was 
     national drugs benefit,'' said Vladeck, now a health policy 
     professor at Mount Sinai School of Medicine in New York City.
       If Bush's proposal were enacted, it could provide a high-
     profile benefit for industries that are reliable donors to 
     Republican candidates and committees. The Center for 
     Responsive Politics said that for the past two elections 
     combined, pharmaceutical manufacturers gave $30 million to 
     Republicans and $8 million to Democrats.
       Health service companies and HMOs, a leading form of 
     managed care, donated $10 million to Republicans and $5 
     million to Democrats over the past two elections, according 
     to the center's figures.

  This should be a deep concern of every American, as well as my 
colleagues on both sides of the aisle and on the other side of this 
building about how this issue is being framed because of the realities 
it points out what is really going on with this issue.
  I will make one more point. The article continues, quoting President 
Bush yesterday:

       Bush, promising to bring more free enterprise to medicine, 
     denounced ``government-run health care ideas.''

  I have been saying for a long time that those who want to privatize 
Medicare believe that Medicare is a big Government-run program, and 
there is a major philosophical difference that has

[[Page 5247]]

gone on since 1965 when only 12 colleagues from the other side of the 
aisle joined in passing Medicare. There is a huge chasm of difference 
as to whether we ought to even have Medicare.
  Fundamentally, that is what this debate is about. It is not about 
what the premiums should be, what the copay should be. It is about who 
runs the system as to whether there should be a guarantee so that every 
person who turns 65 and gets that Medicare card knows they can choose 
their doctor, that they can get the medicine they need, that they know 
what the copay is, what the premium is, regardless of where they live 
in the country.
  In a State such as Michigan, where we have the major metropolitan 
area of Detroit all the way up to Ironwood, MI, in the western part of 
the UP, people today know that under Medicare they can get the health 
care they need. That was a promise made by the United States of America 
in 1965, and now under a lot of different pretty words, a lot of 
different connotations of reform, we see an effort clearly outlined--
and even in the President's own words--to put more free enterprise into 
the health care system. That is privatizing the health care system. 
That is privatizing Medicare.
  In general, I do believe there is an important partnership between 
the public and the private sector. We have an employer model of health 
care in this country that has worked for workers and their families. I 
appreciate there is a benefit in having partnerships.
  We have said as a country that once an American citizen reaches the 
age of 65 or they are disabled, we think it is important that whether 
one has private plans in their community, whether they can find them 
and/or whether they can afford them, they should be able to have health 
care. The reason Medicare came into being was that over half the 
seniors could not find or afford private insurance. That is why 
Medicare was created.
  I, for one, will not quietly stand by to see a promise of some 38 
years eroded by this administration or in this Congress. I know there 
are colleagues of mine on both sides of the aisle who have concerns. I 
am hopeful we can come together under Medicare.
  What is very clear is--and in this article the outside analysts, 
independent voices, are saying--the fight is about how we administer 
the prescription drug benefit. The companies want to keep it disbursed 
in the private sector because they know if the some 40 million 
beneficiaries of Medicare today are in one insurance plan, they will be 
able to negotiate a group discount for the first time. They will not be 
paying retail. They will not be paying the highest prices in the world 
in order to get their medicine. They will be able to get a group 
discount.
  The fight is on to make sure that seniors in this country do not have 
the collective power to be able to get that discount through Medicare. 
That is what this is about. It is one of the most fundamental fights we 
will have in this Congress and on the floor of the Senate, and I hope 
my colleagues on both sides of the aisle will come together and be 
willing to stand up and say Medicare works, Medicare is a great 
American success story, and we continue to promise that the Medicare 
plan will be there for every single senior and the disabled in our 
country.
  This is a fundamental fight, and I hope my colleagues will join me in 
making sure this plan that is passed is not a boon for the drug 
companies or for the HMOs but is a boon for the seniors of America.

                          ____________________