[Congressional Record (Bound Edition), Volume 155 (2009), Part 18]
[Senate]
[Pages 24563-24566]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. HATCH. Madam President, I have taken a lot of votes in my Senate 
service, as I have had the proud honor of representing my fellow Utahns 
and of course all Americans across this great Nation. I deliver these 
remarks with a heavy heart because what could have been a strong 
bipartisan vote reflecting our collective and genuine desire for 
responsible reform in the Senate Finance Committee has ended as another 
largely partisan exercise as we take another step forward toward the 
flawed solution of reforming one-sixth of our economy with more 
spending, more government, and more taxes.
  Having said that, I wish to compliment the distinguished chairman of 
the committee, Max Baucus, from Montana, for having worked so long and 
hard to try to get that bill through the committee. I disagree with the 
bill, but I also recognize that type of effort, and I have great regard 
for Senator Baucus and others on the committee as well. But I have 
worked through almost 4 weeks of debate in the Health, Education, Labor 
and Pensions Committee and now through 2 weeks of strenuous debate on 
the Senate Finance Committee. I was in the original Gang of 7 trying to 
come up with a bipartisan approach, but I realized that not enough 
flexibility had been given to Senator Baucus, and I decided to

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leave that group of seven, and I am glad I did, because I predicted 
when I left exactly what this bill would turn out to be.
  It almost seems as though these hundreds of hours of debate in the 
past were for naught. It is important for Americans everywhere to 
understand that the bills we have spent hundreds of hours working on 
are not the bills that will be discussed on the Senate floor. The real 
bill that is currently being written behind closed doors in the dark 
corners of the Capitol and the White House--and we can all only hope 
that all of us, especially American families, will have ample 
opportunity, at least 72 hours, to review the full bill before we are 
asked to consider this on the floor and vote on it--is a bill that 
affects every American life and every American business. The health 
care reform bill is too big and too important to not have a full public 
review.
  I wish to spend my time today talking about why the Baucus bill fails 
President Obama's own test for responsible health care reform. This 
bill is another example of Washington once again talking from both 
sides of the mouth and using technicalities and policy nuances to evade 
the promises made to our seniors and middle-class families. First, 
President Obama in his own words has consistently stated: ``If you like 
your current plan, you will be able to keep it.'' Let me repeat that: 
``If you like your plan, you will be able to keep it.'' That was given 
on July 2, 2009, right at the White House, and we are all familiar with 
that particular commitment.
  One of the amendments I offered in the Finance Committee simply 
provided that if more than 1 million Americans would lose the coverage 
of their choice because of the implementation of this bill, then this 
legislation would not go into effect. This was a simple and 
straightforward amendment; no nuance, no double-talk. This amendment 
was defeated along party lines.
  It should come as no surprise to anyone on the Finance Committee that 
in a recent Rasmussen poll, a majority of Americans with health care 
coverage--almost 53 percent--said that the bill would force them to 
change their coverage. This bill is rife with policies that will do 
anything but allow you to keep your coverage. It cuts upward of $133 
billion out of the Medicare Advantage Program, which will adversely 
impact the availability of these plans for millions of American 
seniors, especially in rural areas. That was what it was designed for. 
It is pushing for policies at the Federal level that actuaries 
acknowledge could increase premiums significantly for millions of 
Americans, not to mention the new insurance tax which will cost 
families another $500 in higher premiums. This will make current 
coverage unaffordable for countless Americans.
  American families are very smart; they are very astute. They realize 
that there is no free lunch, especially in Washington. They are being 
promised an almost $1 trillion bill--that is really an understatement 
of what it is, and I will get into that later--that will not increase 
deficits, not raise taxes, and not cut benefits. Only Washington speak 
could try to sell a promise such as this with a straight face.
  Second: The President has consistently pledged: ``We're not going to 
mess with Medicare.'' Once again, this is another simple and 
straightforward pledge that this bill has now evaded through Washington 
double speech or doubletalk. This bill strips, as I say, $133 billion 
out of the Medicare Advantage Program that currently covers 10.6 
million seniors, or almost one out of four seniors in the Medicare 
Program. According to the Congressional Budget Office, under this bill, 
the value of so-called additional benefits such as vision care and 
dental care would decline from $135 to $42 by 2019. That is a reduction 
of more than 70 percent of benefits. You heard me right: 70 percent. I 
offered an amendment to protect these benefits for our seniors, many of 
whom are low-income Americans who reside in rural States. However, this 
amendment too was defeated in the Finance Committee. The majority chose 
to skirt the President's pledge about no reduction in Medicare benefits 
for our seniors by characterizing the benefits being lost--vision care, 
dental care, and reduced hospital deductibles--as extra benefits, not 
statutory benefits.
  Let me make this point as clearly as I can. When we promise American 
seniors that we will not reduce their benefits, let us be honest about 
that promise. Benefits are benefits, so we are either going to protect 
benefits or not. It is that simple. Under this bill, if you are a 
senior with Medicare Advantage, the unfortunate answer is no, you are 
going to lose benefits.
  Thirdly, the President has consistently stated: ``I can make a firm 
pledge. Under my plan, no family making less than $250,000 a year will 
see any form of tax increase.''
  That was when the President was a candidate in New Hampshire on 
September 12, 2008, and he has said that since.
  Let us examine the realities of this bill. As I said before, there is 
no such thing as a free lunch, especially when Washington is the one 
inviting you over. According to the Joint Committee on Taxation, there 
is more than $400 billion in new taxes under this bill to continue to 
fund Washington's insatiable appetite for spending. Here are some of 
the highlights of the $400 billion: $23 billion of new taxes on 
employers through a mandate that will disproportionately affect low-
income Americans and all at a time when our unemployment is rapidly 
approaching double digits. Some think we are already in double digits. 
There is $4 billion of new taxes on Americans who fail to buy a 
Washington-defined level of coverage; $322 billion of new taxes on 
everything from insurance premiums to prescription drugs to hearing 
devices and wheelchairs. Representatives from both the Congressional 
Budget Office, CBO, and the Joint Committee on Taxation, JCT, testified 
before the Finance Committee that these taxes will be passed on to the 
consumers.
  So even though this bill tries to hide these costs as indirect taxes, 
average Americans who purchase health plans, use prescription drugs, 
and buy medical devices--everything from hearing aids to crutches--will 
end up footing the bill. By the way, it is interesting to note here 
that although these tax increases and Medicare cuts will start as early 
as next year, subsidies to help people with their premiums which will 
skyrocket under this plan will not be available until July of 2013--
3\1/2\ years later.
  By the way, they are going to cut $400 billion out of Medicare. I 
remember a few years back in 1975 when, for that budget that year, we 
were trying to find $23 billion out of Medicare and the other side just 
about went berserk over that. Here we are cutting $400 billion out of 
Medicare that already has $38 trillion in unfunded liabilities.
  So what about the promise of no taxes on families making less than 
$250,000? Look at the evidence. According to the data from the Joint 
Committee on Taxation and former CBO director Doug Holtz-Eakin, 89 
percent of these new taxes will be paid by taxpayers making less than 
$200,000 a year. The insurance excise tax alone would cost families up 
to $500 more in premiums. That is not all. The Joint Committee on 
Taxation also found that at least 71 percent of all penalties collected 
from the individual mandate will also come from those making less than 
$250,000. As I said, there is no free lunch in this town.
  By the way, we all know when this bill is fully implemented it will 
cost significantly more. Every time Washington tells you that something 
will cost a dollar, it usually costs $10. History is prologue. Medicare 
started off as a $65 million a year program and now has a $400 billion 
annual budget. So look for these taxes to only go up in the future as 
we have just given the Federal Government a whole new checkbook.
  So based on my count, this bill already has three strikes against 
President Obama's own pledges to the American people. He said: ``You 
keep what you have.'' That is not true. ``No reduction in Medicare 
benefits for our seniors.'' That is not true. ``No tax increases on 
families making less than $250,000.'' That is not true. In fact,

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most of those taxes will go to the middle class at way below $250,000.
  Lastly, let me talk a little bit about the myth of this proposal 
actually reducing the deficit by $81 billion over 10 years. Here is the 
harsh reality. The Congressional Budget Office recently reported that 
our national deficit for fiscal year 2009 alone was a shocking $1.4 
trillion. That is the highest deficit since 1945 in real terms.
  Let me put this in perspective. This was the largest yearly deficit 
since 1945. It was more than three times our deficit from last year. I 
remember how they were complaining about George Bush and those high 
deficits. It is almost 10 percent of our entire economy. George Bush's 
deficit was less than $500 billion. I thought it was too high. We are 
now talking about $1.4 trillion in the first year of this presidency. 
Keep in mind the Democrats controlled the Congress in the last 2 years 
of the Bush presidency. This should send shivers down the spine of 
every American out there. We are literally drowning the future of this 
Nation in a sea of red ink.
  Here is the fantasy: Congress will actually follow through with these 
massive Medicare cuts that are being used to make this $829 billion 
spending bill deficit neutral. I challenge a single Member of the 
Senate to tell me when have we ever followed through on such massive 
cuts. Let me use the words of Dr. Doug Elmendorf, the Director of the 
Congressional Budget Office, on this issue:

       These projections assume that these proposals are enacted 
     and remain unchanged over the two decades which is often not 
     the case for major legislation. The long-term budgetary 
     impact will be quite different if those provisions were 
     ultimately changed or not fully implemented.

  I could not have said it better myself. We all remember the Deficit 
Reduction Act of 2005 which attempted to reduce Medicare spending by a 
mere $22 billion over 10 years. That proposal was mercilessly attacked 
by the other side of the aisle as being, among other things, 
``Orwellian'' and ``immoral.'' Now suddenly we are being asked to 
believe the Congress will follow through in almost $500 billion in cuts 
to Medicare?
  Take another example: the physician payment. This bill only contains 
a 1-year fix. After that, the doctors will face more than a 20-percent 
cut in their payments, seriously threatening access to Medicare for 
seniors. We all know that we have to fix this problem, and that we 
will. Unfortunately, the hundreds of billions of dollars needed to 
overhaul this broken system are not included in this score that is 
supposed to be balanced, and will go to further increasing our 
skyrocketing deficits.
  Let's be honest about it. The reason they can keep it down to $829 
billion was by not counting the first 4 years; not having it 
implemented until as late as 2014. In other words, that is 6 years. If 
you extrapolate it out to 10 years, we have $1.7 trillion, $1.8 
trillion that this bill is going to cost.
  One reason for that is because they know we are going to have to do 
the doctor fix rather than have doctors being paid 25 percent less by 
Medicare and even less by Medicaid, and hospitals 25 to 30 percent less 
by Medicare and even less by Medicaid.
  The biggest bait and switch on the American people about this bill's 
impact on the deficit is a simple math trick. If something is too 
expensive to do for a full 10-year period, just do it for 6 years. That 
is what they have done. Most of the major spending provisions of the 
bill do not go into effect until 2013 or even 2014, coincidentally, 
after the 2012 Presidential elections. So what we are seeing is not a 
full 10-year score but rather a 6-year score.
  According to the Senate Budget Committee, the full 10-year score of 
this plan will easily surpass $1.8 trillion, fully implemented over 10 
years, the way it is written. I believe it will be more than that in 
actuality when we add the doctor fix that we are going to have to do.
  That is on top of the $2.4 trillion we are spending right now.
  In our current fiscal environment where the government will have to 
borrow nearly 43 cents out of every dollar it spends this year, let's 
think hard about what we are doing to our country and our future 
generations. Our national debt is on a path to double. We can see the 
red lines on the chart. That is the projected national debt since this 
administration has taken over. It is on a path to double in the next 5 
years and triple in the next 10 years. There is still time for us to 
step back, press the reset button, and write a bill we can all support 
and be proud of.
  Madam President, what is their answer in the end? I guarantee you, 
the final bill is going to have some form of--it may be disguised 
semantically--a government-run plan. That scares every American.
  In 1965, when we did Medicare, the argument was that Medicare will be 
on an equal footing with the private industry. Well, it didn't take 
just a couple of years, and they found out they could not do it. So 
they had to set prices.
  Today, Medicare pays doctors 20 percent less and hospitals 25 percent 
less, and Medicaid is even worse than that. If we think the Federal 
Government can take over the whole health care system and save money, 
we haven't observed the history of Medicare. Medicare today is a $38 
trillion unfunded liability that we are saddling our kids and grandkids 
with--and even in my case, my great grandkids. I am concerned. This 
should not be a political issue.
  We ought to be working together. I guarantee, if we turn all of this 
over to the government--I heard the distinguished Senator from Ohio, 
who is very sincere and very loquacious and has an interesting 
personality. I care for him. But if we do that, everybody is going to 
suffer because the Federal Government cannot do it better. It is just 
that simple. We have all the years since 1965 to prove that.
  The fact is, if we turn this over to the almighty Federal Government 
and the bureaucrats in Washington, it will cause a furor like we cannot 
believe in this country, and rightly so. I heard the distinguished 
Senator say: Well, if the insurance premiums should increase because of 
this bill, let's turn it over to the government, and we will save all 
that money.
  What about the $38 trillion in unfunded liability in Medicare as we 
stand here today? What about Medicaid going into bankruptcy within the 
next 10 years? There is nobody who doubts that who looks at the 
financial matters in this country. The reason they are is because they 
are run by the almighty Federal Government. I would much rather see a 
system whereby we allow the States themselves, which have different 
demographics--and the Chair is from New Hampshire, which is different 
from Massachusetts, and it is also different from my State of Utah. I 
will bet that the New Hampshirites can handle their problems a lot 
better than the Federal Government in Washington. I know Utah can. We 
have a good health care system because we do all the things that are 
necessary to make it good. It is closer to the people, and the 
government is closer to the people. They have to be responsible to the 
people.
  I would like to see a system where we basically block grant these 
funds and let the States set up their own programs and have 50 State 
laboratories that literally can show us the way; where we can compare 
plans and see the good in one State and maybe adapt it to ours. If we 
turn this all over to a government plan, run by Washington, I cannot 
begin to tell you the stifling that will be to innovation and good 
ideas compared to allowing the 50 State laboratories, as federalism was 
designed to set up.
  The majority leader said: The Republicans are just the party of no; 
they have no plan. We have 40 Members here and we have six plans. We 
find that even some of our plans are off the charts in cost. Some are 
good. The fact is, we know this system needs to be reformed. Every 
Republican is for reforming the system. We are not for bankrupting the 
country. We are not for having these almighty bureaucrats in Washington 
determine what we all have to do. We are not for turning everything 
over to the government, which is already running Medicare and Medicaid 
into bankruptcy. We don't believe a central form of government should 
control everything.

[[Page 24566]]

  Our Founding Fathers didn't believe that. That is why they did the 
Constitution the way they did it. Anybody who believes they can do it 
better in a government-run program hasn't studied history. I have to 
admit some of our colleagues on the other side do believe a single-
payer system is better. Single-payer is socialism, pure and simple. 
They don't like to call it socialism, but that is what it is. When we 
get socialism, we get everything that goes with it, and that means 
rationing.
  We have to be reasonable about what services we can give. The States 
will do it the right way. The Federal Government will mess it up, I 
guarantee it. I don't know anybody who has been here as long as I have 
who could not acknowledge that. I don't think they should try to 
dispute that. I think they would be run out of Washington. If you want 
bureaucrats between your doctor and you, this is the way to do it--a 
government-run plan right here in Washington, with all the costs and 
expenses and the oblivious not caring about the future that we have 
seen year after year.
  That is why Republicans are up in arms. That is why we cannot support 
this bill. I wish we could work with our colleagues and get together. I 
wish we could do a bipartisan bill. I might add that one person is not 
bipartisan. You can call it that, but it really isn't. I deeply respect 
that one person, and she knows that.
  The fact is, we are a long way from having a health care bill. The 
further fact is, it will not be the bill that passed out of the 
committee today. It is going to even be worse.
  If I were sitting on the Democratic side, I would be worried to death 
about what they are finally going to come up with. They really do, for 
the most part--the majority--believe a single-payer system, run by 
Washington, DC, and the bureaucrats here is going to be better than one 
run by the States. I have to admit there are some States that would 
mess it up, no question. We can all name them too. There are generally 
States that are behind the single-payer system, but there aren't many 
of them. The vast majority of States would show us the way and help us 
to find the way and help us to do a good job on health care.
  Madam President, I am very concerned. I am one who likes to work in a 
bipartisan way, but it has to make sense. What we passed out of there 
today doesn't make sense, and it is going to get a lot worse. By the 
time they take the HELP Committee bill, which was a totally Democratic 
partisan bill, and take what they want out of that, and by the time 
they take the tricommittee bill over in the House, which is a partisan 
Democratic bill, it will get worse. When it does, the American people 
are going to be the losers.
  Madam President, I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The legislative clerk proceeded to call the roll.
  Mr. UDALL of Colorado. Madam President, I ask unanimous consent that 
the order for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  (The remarks of Mr. Udall of Colorado pertaining to the introduction 
of S. 1777 are located in today's Record under ``Statements of 
Introduced Bills and Joint Resolutions.'')
  Mr. UDALL of Colorado. Madam President, I yield the floor.
  (Mr. UDALL of Colorado assumed the Chair.)

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