[Congressional Record (Bound Edition), Volume 155 (2009), Part 19]
[Senate]
[Pages 25636-25638]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           THE PUBLIC OPTION

  Mr. CORNYN. Mr. President, I listened to the majority leader, Senator

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Reid, talk about his melded bill, the combination of the Finance 
Committee bill and the HELP Committee bill that he has now completed 
merging behind closed doors. He said he is going to send it to the 
Congressional Budget Office to get a score or a cost estimate. My hope 
is we will all be able to see it soon. We have not been able to 
participate in the process since it has been a process taking place 
between the majority leader and presumably Senators Dodd and Baucus, 
the chairmen of the two committees, without Republicans being present. 
So we don't know what is in it, and we don't know how much it costs. 
Certainly those are two critical questions the American people are 
asking and those of us who will be required to vote on this legislation 
at some point would like the answers to. When will we be able to see 
it? When will the American people be able to see it? How much will the 
bill cost?
  Today, I wish to focus on another question: Why is it that some 
people in this country think another government-run health care plan is 
the answer? A government-run plan goes by a lot of different names. It 
is an attempt, in part, to obfuscate what people are trying to do. 
Sometimes people like to call it the public option because it sounds 
innocuous. Who could be against a choice, an option, if it is not 
mandatory? Others say they are not for a public option unless it has a 
trigger. Others talk about opting in, and we heard the majority leader 
talk about a bill he intends to introduce that provides an opt out for 
the States. The reality remains the same. We are talking about a 
brandnew entitlement program, a brandnew government-run health care 
program run out of Washington, DC, based on the fundamental and 
misguided belief that one size fits all for a nation of 300 million 
people.
  Some of my colleagues believe a government plan is gaining momentum. 
I appeared yesterday on a Sunday television show with Senator Schumer, 
the distinguished Senator from New York, who said he thought Congress 
was right on the cusp of a public option or government-run plan. The 
more the American people find out about what is meant by the public 
option, the less they like it.
  Last week, we saw the Washington Post-ABC News poll that supposedly 
said that support for a government-run plan was growing. In fact, 
support has fallen by 5 points since June. These numbers can be 
misleading. As the Presiding Officer knows, in politics and public 
opinion polling, he or she who gets to ask the questions or frame the 
questions, he or she who gets to decide what the sample is can have a 
dramatic impact on the answers given to a poll. It is absolutely the 
case that support for the so-called public option drops dramatically 
when we explain to people what it would actually do.
  ABC News polling director Gary Langer wrote about this dynamic in 
June. He noted that while 62 percent initially favored a so-called 
public option, that number dropped from 62 percent to 37 percent once 
it was explained to people that it would put many private insurers out 
of business because they couldn't compete with the Federal Government 
and the so-called government plan.
  In other words, support dropped when people realized they would not 
be able to keep what they have now--which is one of the President's 
promises--because many insurers would simply be driven out of business. 
Thus that promise President Obama has made time and time again would 
not be possible under the public option or government plan.
  Today in the Washington Post, Fred Hiatt explained why a government 
plan would end up breaking President Obama's promise: A government plan 
would work like Medicare and Medicaid--those are two government plans--
and they would, as Medicare and Medicaid do, pay providers at low 
rates.
  As a matter of fact, last week we had a vote on a bill--actually, on 
a cloture motion on a motion to proceed--a technical vote but one that 
would have taken us to a bill to basically reverse the cuts in Medicare 
reimbursement rates to Medicare providers. But it was not paid for. It 
would have added $300 billion to the national debt. So 13 Democrats 
joined with Republicans to defeat that. Hopefully, we will go back to 
the drawing board and come up with a bill that will be paid for.
  But the point is, any new government plan, as Fred Hiatt pointed out, 
would work like Medicare and Medicaid and pay providers much less than 
they could get under private insurers. So providers would, as they do 
now, make up the difference by charging private plans more for the same 
services. This is a so-called cost-shifting phenomenon. Then private 
insurance premiums--if you have private coverage now--would increase 
for people who have health insurance coverage now. Ultimately, some of 
them would be forced to drop their private insurance because it would 
be more expensive, not less, which is what I thought the object of this 
exercise was about: how to bring down costs, not how to drive them up, 
and the cycle would continue until all private insurers would go out of 
business, and all Americans would find themselves on a single-payer, 
government-run health care plan. So much for the option in the public 
option.
  So the fact is, the government plan would not be just a competitor; 
it would, in fact, act as a predator by calling the shots. Even as it 
takes the field, the government plan would undercut the private market 
and create another Washington monopoly.
  Some people have described the so-called public option as a Trojan 
horse. I have used that phrase myself. But the person who actually 
devised the public option said this--his name is Jacob Hacker, and he 
is a professor at Berkeley--he put it this way last year:

       Someone once said to me, ``This is a Trojan horse for 
     single payer,'' and I said, ``Well, it's not a Trojan horse, 
     right? It's just right there.''

  Professor Hacker said:

       I'm telling you, we're going to get there, over time, 
     slowly.

  The truth is, we should not be creating another government plan when 
the ones we have now are not working very well at all.
  As Robert Samuelson wrote in today's Washington Post:

       Why would a plan tied to Medicare control health [care] 
     spending, when Medicare hasn't?

  He noted that from 1970 until 2007, Medicare spending had risen by 
9.2 percent annually. Let me say that again. From 1970 to 2007, 
Medicare spending had risen by 9.2 percent annually. He says this is 
just one reason the so-called public option is what he called a 
``mirage.''
  We know there are current entitlement programs that have major 
unfunded liabilities. Medicare has a $38 trillion unfunded liability 
and will effectively go bankrupt in 2017. Yet this bill, at least the 
Finance Committee bill--I presume the bill coming out of Senator Reid's 
office will do the same--takes $500 billion from Medicare to create a 
new entitlement plan, a new government-run health care plan, when 
Medicare itself has $38 trillion in unfunded liabilities. It just does 
not seem to make any sense.
  Medicaid, which, of course, primarily helps pay health care costs for 
the poor, reduces access to health care in many communities because 
reimbursement rates are so low that many providers simply cannot take 
new patients. As ``60 Minutes'' reported just last night, fraud and 
abuse in government health care programs cost taxpayers about $90 
billion a year. Does this sound like a model we want to hold out--a new 
government-run plan--when the ones we have now are broken and need 
fixing?
  On the Medicare fraud and abuse, according to FBI special agent Brian 
Waterman, Medicare fraud is a bigger problem in South Florida than the 
drug trade. He said:

       There are entire groups and entire organizations of people 
     that are dedicated to nothing but committing fraud, finding a 
     better way to steal from Medicare.

  One former Federal judge looked at his Medicare statement and found 
that someone had billed the government for two artificial limbs on his 
behalf even though he still has the ones God gave him. In other words, 
he did not need any artificial limbs, but somebody

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charged them to Medicare on his bill without his knowledge.
  I agree with our colleague, Senator Landrieu from Louisiana, that a 
government plan would just replicate the same kinds of problems we have 
seen in Medicare and Medicaid. As she said:

       Why don't we fix the two public options we have now instead 
     of creating a [new] one?

  Well, supporters of a government plan say we need to have more 
competition and give consumers more choice. I could not agree more. But 
this is not--this is not--the way to do it. Competition occurs when we 
have more private insurance companies competing in marketplaces, which 
would happen under some proposals made by our side of the aisle--if we 
would simply create a system where individuals could buy health 
insurance in any State across the Nation and were not just confined to 
buying health insurance in their own State. Competition increases when 
we get more insurance carriers to enter the market, not by creating a 
government plan that will drive them out of it.
  We have proposed ways, as I have said, to increase the number of 
private insurance options in every State. We think if that is the goal, 
certainly we ought to be able to come together in a bipartisan way to 
accomplish that goal. But I do not know why in the world we would 
settle for a health care proposal that would ultimately drive people to 
a single-payer, government-run health care plan, would raise taxes on 
the middle class, raise premiums on those who have insurance now and 
depress the wages of those who have that health insurance now, and 
would cut, as I mentioned a moment ago, $500 billion from a Medicare 
Program that is scheduled to go bankrupt in 2017. Why would we settle 
for something that would make things worse instead of better for more 
than 100 million Americans? Why would we vote to spend $1 trillion or 
more on a new entitlement program without fixing the ones we have now?
  Well, it is not just me saying that this so-called public option with 
the opt-out the majority leader has now proposed--which he admits does 
not have 60 votes, and the one Republican, Senator Snowe, who said she 
would vote for the bill said she would not vote for a bill with a 
public option. So I am not sure why, with one Republican supporting the 
Finance Committee bill, they have now apparently rejected Senator 
Snowe's support and opted for a strictly partisan proposal coming out 
of Senator Reid's conference room.
  But I also checked, and another health care expert whom I respect 
shares some of my views about the dangers of the so-called public 
option.
  Secretary Mike Leavitt, who is the former Secretary of the Department 
of Health and Human Services, said:

       Advocates for a public health-care plan continue to look 
     for a way to give political cover to moderates while 
     advancing their goal of implementing a government-run health-
     care system.

  He said:

       [Ultimately,] it is designed to undercut private insurance.

  He said it is ``dangerous for three reasons.'' He said:

       One, it would be cheaper for employers to stop offering 
     private [coverage to their employees and to] funnel their 
     employees into the government-run plan. Employers, not 
     employees, would get to make that choice.

  Secondly, he said:

       [A] government-run plan would use the coercive force of 
     government to dictate the prices that [are going to be] 
     charged by others--by doctors, nurses, and hospitals--in a 
     way that private entities cannot.

  Third, he said this proposal is dangerous because a ``government-run 
plan would be subsidized by American taxpayers, while private plans are 
not.'' In other words, he says, if, in fact, States will be given a 
chance to opt out of the so-called public option, they would not have a 
chance to opt out of the tax dollars their taxpayers would spend in 
order to subsidize the so-called public plan.
  As he concludes, he says:

       The state ``opt-in'' is a transparently false choice. It is 
     just another gimmick to try to find votes for an unwise 
     policy that would increase the federal government's control 
     over health care.

  We can do better. We must do better. I urge my colleagues not to take 
the bait on this so-called public option, whether it has an opt-out or 
not, because it is just another disguised way to try to end up with a 
single-payer, government-run health care system out of Washington, DC.
  Mr. President, I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Oklahoma.
  Mr. INHOFE. Mr. President, first of all, let me say to my friend from 
Texas, the wake-up call is out there. People are fully aware of what is 
going on right now--the fact that you have a government option; you 
have a form of socialized medicine; you have something that has proven 
not to work in areas such as Canada and Great Britain and elsewhere. It 
is kind of interesting to me that we see those countries trying to 
emulate something we are doing at the same time we are edging over in 
their direction. I do not think that is going to work.

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