[Congressional Record (Bound Edition), Volume 155 (2009), Part 19]
[Senate]
[Pages 25307-25309]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. GREGG. Mr. President, I rise today to continue a discussion I 
have pursued on this floor a few times, and it deals with where our 
country is going and what we are passing on to our children.
  I often quote the chairman of the Budget Committee, Senator Conrad 
from North Dakota, because I have immense respect for him. He has 
said--and I agree with him and I think most Americans, when they think 
about it, agree with him--that the debt is the threat, the fact that we 
as a nation are running up this incredible debt which we are going to 
pass on to our children. To try to put it in context is very difficult 
because the numbers are so huge. I have talked about it numerous times 
here--the fact that we are running deficits at approximately $1 
trillion over the next 10 years under the President's budget; that we 
are seeing 5 to 6 percent of GDP in deficits; that the public debt goes 
from about 38 percent of GDP up to well over 80 percent of GDP under 
the most recent estimates. But these numbers are incomprehensible to 
people because they are so big. We are talking trillions and trillions 
of dollars, and the implication of these numbers is staggering to our 
next generation--to our children and our children's children--because 
it means they have to bear the burden of paying this debt that is going 
to be put on their backs.
  Last week, the deficit for this last fiscal year was pegged at about 
$1.4 trillion--an incredible amount. That is three times the largest 
debt in our history, in numeric terms. As a percentage of GDP, we 
haven't had those types of numbers since World War II. Nobody is 
arguing that deficit is not an event and something we don't like but 
that we probably have to tolerate because of the fact that we have been 
through this very difficult situation with the recession and the 
potential meltdown of our financial houses. It took a lot of money to 
try to stabilize the situation, and I am not holding that against this 
Presidency at all.
  The problem is, as we go forward we are seeing these deficits expand. 
There is no reason to maintain that type of deficit once we are past 
this recessionary period, once the financial situation has been settled 
down. For all intents and purposes, we are moving past that situation, 
so the deficits should start coming down. But they aren't coming down. 
They aren't coming down. And today we are about to see one of the 
reasons they aren't coming down because today it is being proposed that 
we add another $250 billion to the debt by doing something called the 
doctors fix and not paying for it.
  It is not an extraordinarily complicated issue. Basically, we don't 
reimburse doctors at a rate they should be reimbursed under Medicare 
because of a rule we passed back in the 1990s. It gets cut arbitrarily 
and in a way which has no relationship to what is a proper 
reimbursement rate. So every year since we passed that rule and it 
turned out it wasn't going to work right, we have corrected that. We 
have reimbursed the doctors at a reasonable rate. But every year we 
have done that, we have paid for that change, so that the cost of 
reimbursing doctors fairly did not get passed on to our children. I 
mean, if you pass that cost on to our children, when somebody goes to 
get an eye exam, someone who is in their eighties or seventies or 
sixties and who is on Medicare, when they get the bill from the doctor, 
essentially we are saying: Oh, I am sorry, the government is not going 
to pay that--the government you are a part of today. We are going to 
take that bill and give it to a child who is not even born yet, and 
they are going to have to pay that bill. But it is an expense today, 
and it should be paid today by the government.
  We are having this proposed today on this floor, by this 
administration: that we should spend $250 billion to correct this 
doctors fix problem for the next 10 years, which is about what it will 
cost, but not pay for it, just simply take it and send the bill off to 
our kids. It is actually more than $250 billion because that $250 
billion, when you put it on the debt, will generate interest 
responsibilities of about $50 billion. So it is actually a $300 billion 
item. That is not small change; that is a third of a trillion dollars. 
That is huge money. That is a tremendous burden to transfer over to our 
children.
  Do you know why this is being done? It is being done for a very 
cynical reason. The health care reform package is being discussed 
somewhere in this building behind closed doors. It is being written in 
some office over on that side of the Capitol by three or four Members 
of the Senate and a lot of staff from the Democratic side, with no 
participation by Republican Members, no participation by the American 
people, and the press is totally locked out of the room. The bill is 
being rewritten over there, but we do know that within the parameters 
of the bill is the representation that it won't cost more than $1 
trillion over a 10-year period. So all sorts of games are being played 
to try to keep it under $1 trillion.
  The most significant and most cynical and most inappropriate game--
though it is not a game, really--the most inappropriate action is this 
idea that they are going to take $250 billion to fix the doctors 
reimbursement program, which is clearly part of health care, and move 
it entirely out of the health care system reform effort. They will move 
it over here somewhere and claim they don't have to pay for it. They 
will just send the bill to the kids. Don't worry about it, it is only 
$250 billion. Just send the bill to the kids. Don't worry about it. And 
then, voila, they will have $250 billion they can spend on health care 
reform that should have been used for the doctors fix.
  But now, since they have claimed the doctors fix doesn't matter--it 
is somewhere over here, out of sight, out of mind, being taken care of 
by our children and grandchildren--voila, they can spend that $250 
billion on goodies, on initiatives within the new health care reform 
bill, which will cost the taxpayers $250 billion in order to do it. And 
I presume it will get them a few constituencies to support them because 
they have just spent $250 billion on them.
  So the true cynicism of this is that it doubles up the doctors fix 
cost. Not only does the doctors fix not get paid for, but it will then 
create $250 billion worth of new spending. So it is actually a doubling 
up of this whole exercise. It is a doubling down event here. You know, 
it is almost a Bernie Madoff--well, it is a Bernie Madoff approach to 
funding. I mean, basically, this is an entire scam. Unfortunately, in 
this instance--and obviously in the Bernie Madoff instance the people 
who invested with him were wiped out, but they made a choice to invest 
with him. Our children and grandchildren are going to get this bill 
without any rights. This $250 billion bill is going to be sent to them, 
and then the spending is going to occur, which they are also going to 
have to pay for. It is going to be added on top of the health care 
bill. It is Bernie Madoff comes to Washington and does our budgeting 
for us, and it is inexcusable that we would do this to the next 
generation.
  Some are suggesting: Well, let's do a 1-year or a 2-year fix. This 
was the original plan of Senator Baucus with regard to his bill. Let's 
just sort of ignore the fact that the doctor problem exists for the 
next 10 years even though we are doing a 10-year health care reform 
bill here. What is the effect of that? Well, yes, for at least 1 or 2 
years you pay for it. That was the proposal in the original bill that 
came out of the Finance Committee--1 year, I believe, they paid for it, 
9 years they didn't pay for it. What did that mean? One year paid for 
was $11 billion, I think. So we know the cost of the whole thing for 10 
years is $250 billion. So what they got was $239 billion to spend under 
the Baucus bill as it came out of the Finance Committee because they 
just simply ignored the concept that the

[[Page 25308]]

doctors fix had to be done too. That also is a pretty cynical act--not 
as cynical as the idea you are going to pass the full $250 billion fix 
and not pay for it, any of it, which is what we will be voting on later 
today, but still pretty cynical in that they would basically be 
spending $239 billion which they know we don't have.
  The PRESIDING OFFICER. The Senator's time has expired.
  Mr. GREGG. I ask unanimous consent to speak for an additional 30 
seconds.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GREGG. So they know we don't have the $239 billion, but at least 
they admit it is there and they don't try to pass the whole bill off to 
our children.
  So as we go forward in this health care debate, let's have no more 
sanctimonious claims that we are being fiscally responsible and 
producing bills that are in balance and that don't add to the deficit, 
not when we put a $250 billion IOU on our children's backs. It is 
totally inappropriate.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER. The Senator from Mississippi.
  Mr. WICKER. Mr. President, I understand I am recognized for 10 
minutes.
  The PRESIDING OFFICER. The Senator is correct.
  Mr. WICKER. Mr. President, in 10 minutes Senator LeMieux will make 
his maiden speech to the Senate, and I know Members are anxious to hear 
that speech, but in the meantime I would like to talk further about 
health care reform.
  Earlier this month, the Senate Finance Committee voted to approve a 
deeply flawed bill that would raise taxes, cut Medicare, increase 
government spending, increase health care premiums, and actually drive 
the cost of health care up, not down. We know the Finance Committee's 
bill will not be the final product voted on by the Senate.
  Three or four Members of one party, and one party only, without the 
press there, without the public looking in, without other Members of 
the Senate there, are meeting now behind closed doors to merge the 
Finance Committee bill with the HELP Committee's version. The secret 
nature of these meetings is all the more reason for the final version 
of the bill to be made available to the public prior to a final vote.
  We have all heard the outcry from our constituents asking us to read 
the bills before we vote on them. I think we should go one step further 
than reading this health care bill ourselves: we should allow the 
public to read the bill themselves.
  Just recently, eight of my friends on the other side of the aisle 
sent a letter to the majority leader demanding--rightly--that this 
health care legislation be made available for 72 hours before the 
Senate proceeds with this bill. The letter from these eight 
conscientious Democrats says, among other things:

       Without a doubt, reforming health care in America is one of 
     the most monumental and far-reaching undertakings considered 
     by this body in decades.

  The letter goes on to ask four things of the majority leader: that 
the legislative text and complete budget scores from CBO on health care 
legislation to be considered on the Senate floor be made available 72 
hours in advance; secondly, the letter asks that the legislative text 
and complete CBO score on health care legislation as amended be made 
available; and they make the same request as far as amendments to be 
filed and offered on the floor and the final conference report which 
might come from the House and Senate.
  I congratulate these Members of the other party for making this 
request. I think the question on the minds of people around Washington, 
DC, and around the country watching this issue is, Will this request be 
ignored? Will these eight Members of the Democratic caucus be 
steamrolled by their leadership? Will this conscientious request be 
cast aside by the majority leader?
  The people deserve to see the final product of the majority party. 
And we know the American people want to see it because as more 
Americans learn about the product, the less they like it. A survey 
released Monday found that a majority of Americans opposed the plans 
backed by the President and Democrats in Congress. This skepticism 
persists despite the best public relations ever of my Democratic 
colleagues and our President.
  The bill approved by the Finance Committee essentially is still a 
partisan one. Numerous studies and estimates have highlighted how the 
bill's new mandates would actually raise insurance premiums for 
Americans, not lower them. A recent Pricewaterhouse-
Coopers analysis of the bill found that by 2019, the average cost of a 
family's insurance policy would increase by $4,000, more than it would 
if Congress simply does nothing at all. Of course, no one is suggesting 
Congress do nothing at all. The status quo is clearly inadequate, and 
there are many things we can do on a step-by-step basis to improve the 
health of Americans.
  But back to this $4,000 in extra costs for insurance, the driving 
factor behind that is the staggering tax hikes necessary to pay for 
this $1 trillion new entitlement program. The Finance Committee's 
proposal raises taxes by hundreds of billions of dollars--on insurance 
plans, on medical device producers, on pharmaceuticals. We all know 
taxes will not lower the cost of these services. In fact, we can expect 
the opposite--these taxes will be paid by average Americans.
  Former CBO Director Douglas Holtz-Eakin recently said: ``These costs 
will be passed on to consumers by either directly raising insurance 
premiums or by fueling higher health care costs that inevitably lead to 
higher premiums.''
  He went on to say the plan ``would not only fail to reduce the cost 
burden on middle-class families, it would make that burden 
significantly worse.''
  In addition to failing to reduce the price of health care, the 
Finance plan carries a number of other serious flaws, particularly as 
it relates to Medicare and health care options for our seniors. The 
bill cuts Medicare by $500 billion. Let me repeat that. The bill cuts 
$500 billion from Medicare, despite the fact that the Medicare program 
is already insolvent and on the path to bankruptcy in the year 2017, 
unless we take action.
  Billions of Medicare dollars would be cut from hospitals, from 
nursing homes, from hospice care under this Finance Committee proposal. 
It would also slash $120 billion from Medicare Advantage, denying 11 
million seniors the health care choices and options regular Medicare 
does not offer.
  If these provisions were not bad enough, the bill's negative impact 
on State budgets is even more disturbing. Medicaid would be expanded to 
a level that threatens funding of essential State services such as 
education, such as law enforcement. In my State of Mississippi, 
Medicaid payments already make up 12 percent of our State's overall 
budget, and Governor Barbour has joined a growing chorus of Governors, 
both Republican and Democratic, in warning of the consequences of 
Congress forcing States to shoulder more of the Medicaid burden. In 
fact, if the finance bill is enacted, Medicaid's expansion would result 
in fully 25 percent of Americans being on this government-run health 
care system. We know it is now run so poorly that many physicians will 
not accept Medicaid patients. The bill proposes we put one-quarter of 
Americans on this very poorly run program.
  After weeks of talk, we get a bill that is worse than the status quo. 
I fear this bill is only going to get worse when the majority leader 
emerges from his secret negotiations and tries to pass his version of a 
Federal health care takeover. I think we can do better. Raising taxes, 
increasing costs, and eliminating choice is hardly the type of health 
care reform the American people want, particularly during a time when 
unemployment levels are at a 25-year high. There are many commonsense 
reforms that could pass Congress quickly and with bipartisan support. 
This is not a choice between a Federal takeover and the status quo. A 
step-by-step approach can inject competition,

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increase choices, and use market principles to bring down prices. By 
allowing people to purchase health insurance across State lines, by 
implementing medical malpractice reform and allowing small businesses 
to join in association health plans, we can lower the cost of health 
care and increase choice without raising taxes or increasing government 
spending or increasing the size and scope of government.
  That is the kind of health care reform the American people deserve, 
and it is the direction the health care debate should take.
  I yield the floor.
  The PRESIDING OFFICER. Under the previous order, the Senator from 
Florida is recognized for 20 minutes.

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